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Parks AK, Hayman LL. Unveiling the Strong Black Woman Schema-Evolution and Impact: A Systematic Review. Clin Nurs Res 2024:10547738241234425. [PMID: 38439544 DOI: 10.1177/10547738241234425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2024]
Abstract
The Strong Black Woman (SBW) schema is described as a statue of unrelenting strength, resilience, and self-sufficiency, serving as a shield of protection and cultural adaptation to suppress and control manifestations of racial and gender oppression. Stemming from superwoman syndrome, a conceptual model exploring the multifactorial roles women hold and their impact, the SBW extends beyond gender roles to the sociopolitical context of the Black woman's lived experience. Endorsement of the SBW posits risk for health disparities including stress, anxiety, depression, and obesity. This review was conducted to explore the SBW schema and experiences of Black women who endorse it, to delineate how Black women describe themselves in relation to the SBW persona, and to inform further inquiry, nursing practice, and clinical approaches to improving health outcomes of this population. A systematic review of qualitative studies was conducted with a literature search from CINAHL, APA PsycINFO, MEDLINE, PubMed, and SocINDEX databases yielding seven relevant papers for this analysis. Studies using the superwoman schema and the SBW schema with participants who identified as Black women were included in the review. Consistent with the SBW phenomenon, many participants described examples and consequences of being an SBW. While most women identified with SBW, not all endorsed the persona entirely, challenging its ideal and reinforcing positive self-care. Themes include (a) Strength by nature, not choice, (b) Suppressed emotion, (c) Success over everything, and (d) Prioritizing others over self. Additional emerging themes are also included. Black women increasingly recognize the negative impacts of the SBW schema, pinpointing how their internal feelings manifest in their external world. The conceptual framework itself is an anomaly, incongruently impacting both the mental and physical health of Black women, further contributing to the long-term health and sociopolitical disparities that Black women experience. Simply acknowledging and understanding these experiences by healthcare practitioners are not enough to prevent or eliminate the risks involved with the endorsement of the SBW schema but rather intentionally addressing these as a contributing social determinant of health that predisposes them to long-term chronic conditions.
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Song M, Bessette HC, Musil CM, Lyons KS, Winters-Stone KM, Hayman LL. Assessing Life's Essential 8 and Adverse Childhood Experiences in Grandparent-Grandchild Co-residing Dyads. J Cardiovasc Nurs 2024; 39:E44-E50. [PMID: 37278650 DOI: 10.1097/jcn.0000000000001011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
We assessed a subset of behavioral indicators from the American Heart Association Life's Essential 8 cardiovascular health (CVH) construct-diet, physical activity, sleep, and nicotine exposure-and quantified associations in scores between members of 12 grandparent-grandchild dyads (grandparents, 52-70 years old; children, 7-12 years old). We also assessed the number of adverse childhood experiences from the dyads. Using the Life's Essential 8 scoring algorithm (0-100, with 100 as optimal), we calculated averages and used Spearman's ρ correlation to quantify associations. Mean score was 67.5 (±12.4) for grandparents and 63.0 (±11.2) for grandchildren. Mean scores for the dyad members were significantly correlated ( r = 0.66, P < .05). The mean numbers of adverse childhood experiences were 7.0 and 5.8 for the grandparents and grandchildren, respectively. The results indicate that CVH in these dyads was suboptimal and interrelated. Adverse childhood experiences in this analysis surpass levels reported as high risk for poor CVH. Our findings suggest that dyadic-based interventions to improve CVH are warranted.
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Marôco JL, Manafi MM, Hayman LL. Race and Ethnicity Disparities in Cardiovascular and Cancer Mortality: the Role of Socioeconomic Status-a Systematic Review and Meta-analysis. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01872-3. [PMID: 38038904 DOI: 10.1007/s40615-023-01872-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 10/24/2023] [Accepted: 11/12/2023] [Indexed: 12/02/2023]
Abstract
To clarify the role of socioeconomic status (SES) in cardiovascular and cancer mortality disparities observed between Black, Hispanic, and Asian compared to White adults, we conducted a meta-analysis of the longitudinal research in the USA. A PubMed, Ovid Medline, Web of Science, and EBSCO search was performed from January 1995 to May 2023. Two authors independently screened the studies and conducted risk assessments, with conflicts resolved via consensus. Studies were required to analyze mortality data using Cox proportional hazard regression. Random-effects models were used to pool hazard ratios (HR) and reporting followed PRISMA guidelines. Twenty-two studies with cardiovascular mortality (White and Black (n = 22), Hispanic (n = 7), and Asian (n = 3) adults) and twenty-three with cancer mortality endpoints (White and Black (n = 23), Hispanic (n = 11), and Asian (n = 10) adults) were included. The meta-analytic sample for cardiovascular mortality endpoints was 6,199,049 adults (White = 4,891,735; Black = 935,002; Hispanic = 295,623; Asian = 76,689), while for cancer-specific mortality endpoints was 7,745,180 adults (White = 5,988,392; Black= 1,070,447; Hispanic= 484,848; Asian = 201,493). Median follow-up was 10 and 11 years in cohorts with cardiovascular and cancer mortality endpoints, respectively. Adjustments for SES attenuated the higher risk for cardiovascular (HR, 1.46; 95% CI, 1.30-1.64) and cancer mortality (HR, 1.35; 95% CI, 1.32-1.38) of Black compared to White adults by 25% (HR, 1.21; 95% CI, 1.15-1.28) and 19% (HR, 1.16; 95% CI, 1.13-1.18), respectively. However, the Hispanic cardiovascular (HR, 0.79; 95% CI, 0.73-0.85) and Asian cancer mortality (HR, 0.81; 95% CI, 0.76-0.86) advantage were independent of SES. These findings emphasize the need to develop strategies focused on SES to reduce cardiovascular and cancer mortality in Black adults.
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Affiliation(s)
- João L Marôco
- Integrative Human Physiology Laboratory, Manning College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, USA.
- Department of Exercise and Health Sciences, Manning College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, USA.
| | - Mahdiyeh M Manafi
- Department of Exercise and Health Sciences, Manning College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, USA
| | - Laura L Hayman
- Department of Nursing, Manning College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, USA
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Mietus-Snyder M, Perak AM, Cheng S, Hayman LL, Haynes N, Meikle PJ, Shah SH, Suglia SF. Next Generation, Modifiable Cardiometabolic Biomarkers: Mitochondrial Adaptation and Metabolic Resilience: A Scientific Statement From the American Heart Association. Circulation 2023; 148:1827-1845. [PMID: 37902008 DOI: 10.1161/cir.0000000000001185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Abstract
Cardiometabolic risk is increasing in prevalence across the life span with disproportionate ramifications for youth at socioeconomic disadvantage. Established risk factors and associated disease progression are harder to reverse as they become entrenched over time; if current trends are unchecked, the consequences for individual and societal wellness will become untenable. Interrelated root causes of ectopic adiposity and insulin resistance are understood but identified late in the trajectory of systemic metabolic dysregulation when traditional cardiometabolic risk factors cross current diagnostic thresholds of disease. Thus, children at cardiometabolic risk are often exposed to suboptimal metabolism over years before they present with clinical symptoms, at which point life-long reliance on pharmacotherapy may only mitigate but not reverse the risk. Leading-edge indicators are needed to detect the earliest departure from healthy metabolism, so that targeted, primordial, and primary prevention of cardiometabolic risk is possible. Better understanding of biomarkers that reflect the earliest transitions to dysmetabolism, beginning in utero, ideally biomarkers that are also mechanistic/causal and modifiable, is critically needed. This scientific statement explores emerging biomarkers of cardiometabolic risk across rapidly evolving and interrelated "omic" fields of research (the epigenome, microbiome, metabolome, lipidome, and inflammasome). Connections in each domain to mitochondrial function are identified that may mediate the favorable responses of each of the omic biomarkers featured to a heart-healthy lifestyle, notably to nutritional interventions. Fuller implementation of evidence-based nutrition must address environmental and socioeconomic disparities that can either facilitate or impede response to therapy.
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Hayman LL, Martyn-Nemeth P. Addressing Cardiovascular Complications of Cancer Therapy. J Cardiovasc Nurs 2023; 38:513-516. [PMID: 37816078 DOI: 10.1097/jcn.0000000000001040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
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Morgan JD, Gazarian P, Hayman LL. An integrated review: connecting Covid-era hospital visiting policies to family engagement. Front Public Health 2023; 11:1249013. [PMID: 37719727 PMCID: PMC10502712 DOI: 10.3389/fpubh.2023.1249013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 08/18/2023] [Indexed: 09/19/2023] Open
Abstract
Introduction Family engagement and patient-family-centered care are vitally important to improve outcomes for patients, families, providers, hospitals, and communities. Both constructs prioritize providers forming partnerships with patients and their families. The domains of family-engaged care include presence, communication, shared-decision making, family needs, contribution to care, and collaboration at the institutional level. This integrative review describes the extent to which the domains of family engagement are present in the literature about Covid-era hospital visiting policies. Methods A search of four databases resulted in 127 articles and one added through data mining. After review, 28 articles were synthesized and analyzed into an integrative review of family engagement in the hospital with Covid-era visiting policies as the backdrop. Results The 28-article review resulted in an international, multidisciplinary perspective of diverse study designs. The review's sample population includes 6,984 patients, 1,126 family members, 1,174 providers, 96 hospitals, 50 health centers, 1 unit, and 257 documents. While all the domains are represented, presence is the prevailing domain, identified in 25 out of the 28 (89%). Discussion Presence is recognized as facilitating the other domains. Because the concept of collaboration is largely absent in the literature, it may provide healthcare institutions with a growth opportunity to facilitate and promote family engagement. This review is the first step in operationalizing family engagement in the hospital setting, especially when presence is challenging.
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Affiliation(s)
- Jennifer D. Morgan
- Manning College of Nursing and Health Science, University of Massachusetts Boston, Boston, MA, United States
- Massachusetts General Hospital, Boston, MA, United States
| | - Priscilla Gazarian
- Manning College of Nursing and Health Science, University of Massachusetts Boston, Boston, MA, United States
- Brigham and Women's Hospital, Boston, MA, United States
| | - Laura L. Hayman
- Manning College of Nursing and Health Science, University of Massachusetts Boston, Boston, MA, United States
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Ferranti EP, Martyn-Nemeth P, Walter K, Hayman LL, Langdon KD, Villavaso CD, VanBrocklin L, Bryant E. A Continued Call to Action: Cardiovascular-Related Maternal Mortality Inequities in Black, Indigenous, and Persons of Color; What Has Changed in the Last 2 Years? J Cardiovasc Nurs 2023; 38:413-414. [PMID: 37467218 DOI: 10.1097/jcn.0000000000001020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
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Perak AM, Baker-Smith C, Hayman LL, Khoury M, Peterson AL, Ware AL, Zachariah JP, Raghuveer G. Toward a Roadmap for Best Practices in Pediatric Preventive Cardiology: A Science Advisory From the American Heart Association. Circ Cardiovasc Qual Outcomes 2023; 16:e000120. [PMID: 37548024 DOI: 10.1161/hcq.0000000000000120] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/08/2023]
Abstract
Cardiovascular disease risk factors are highly prevalent among youth in the United States and Canada. Pediatric preventive cardiology programs have independently developed and proliferated to address cardiovascular risk factors in youth, but there is a general lack of clarity on best practices to optimize and sustain desired outcomes. We conducted surveys of pediatric cardiology division directors and pediatric preventive cardiology clinicians across the United States and Canada to describe the current landscape and perspectives on future directions for the field. We summarize the data and conclude with a call to action for various audiences who seek to improve cardiovascular health in youth, reduce the burden of premature cardiovascular disease, and increase healthy longevity. We call on heart centers, hospitals, payers, and policymakers to invest resources in the important work of pediatric preventive cardiology programs. We urge professional societies to advocate for pediatric preventive cardiology and provide opportunities for training and cross-pollination across programs. We encourage researchers to close evidence gaps. Last, we invite pediatric preventive cardiology clinicians to collaborate and innovate to advance the practice of pediatric preventive cardiology.
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Flike K, Means RH, Chou J, Shi L, Hayman LL. Bridges to Elders: A Program to Improve Outcomes for Older Women Experiencing Homelessness. Health Promot Pract 2023:15248399231192992. [PMID: 37589174 DOI: 10.1177/15248399231192992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/18/2023]
Abstract
Homelessness among older individuals is increasing and women experiencing homelessness have been previously shown to have poorer health outcomes than their male counterparts. To address these concerns, the Bridges to Elders (BTE) program was developed to improve health and social outcomes for older women experiencing or at risk for homelessness. BTE consisted of a nurse practitioner (NP) and community health worker (CHW) dyad who provided intensive case management services for women 55+ with housing instability. This evaluation used a pretest/posttest design to examine three main outcomes from BTE: change in housing status, enrollment with a primary care provider (PCP), and diagnosis of uncontrolled chronic condition. The sample included 96 BTE participants enrolled from January 2017 to December 2018. The average age of participants was 66 years and had a mean BTE enrollment time of 7.6 months. Statistically significant improvements were achieved in all three outcomes measured: 17% (p < .009) increase in stable housing, 35% (p < .001) increase in PCP enrollment, and 47% (p < .001) decrease in the diagnosis of an uncontrolled chronic condition. The results indicated an NP/CHW dyad improved housing status, primary care access, and targeted health outcomes for older women who are experiencing or at risk for homelessness. Future studies examining the impact of NP/CHW dyads on additional social determinants of health and their impact on health outcomes are recommended.
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Affiliation(s)
| | - Roseanna H Means
- Brigham and Women's Hospital, Boston, MA, USA
- Health Care Without Walls, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Jiyin Chou
- Commonwealth Care Alliance Primary Care, Boston, MA, USA
| | - Ling Shi
- University of Massachusetts Boston, Boston, MA, USA
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Leiter RE, Varas MTB, Miralda K, Muneton-Castano Y, Furtado G, Revette A, Cronin C, Soares HP, Lopez A, Hayman LL, Lindsay AC, Schrag D, Enzinger AC. Adaptation of a Multimedia Chemotherapy Educational Intervention for Latinos: Letting Patient Narratives Speak for Themselves. J Cancer Educ 2023; 38:1353-1362. [PMID: 36773178 PMCID: PMC10772955 DOI: 10.1007/s13187-023-02270-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/29/2023] [Indexed: 06/18/2023]
Abstract
This study aims to adapt a video-based, multimedia chemotherapy educational intervention to meet the needs of US Latinos with advanced gastrointestinal malignancies. A five-step hybrid adaptation process involved (1) creating a multidisciplinary team with diverse Latino subject experts, (2) appraising the parent intervention, (3) identifying key cultural considerations from a systematic literature review and semi-structured Latino patient/caregiver interviews, (4) revising the intervention, highlighting culturally relevant themes through video interviews with Latino cancer patients, and (5) target population review with responsive revisions. We developed a suite of videos, booklets, and websites available in English and Spanish, which convey the risks and benefits of common chemotherapy regimens. After revising the English materials, we translated them into Spanish using a multi-step process. The intervention centers upon conversations with 12 Latino patients about their treatment experiences; video clips highlight culturally relevant themes (personalismo, familismo, faith, communication gaps, prognostic information preferences) identified during the third adaptation step. The adapted intervention materials included a new section on coping, and one titled "how to feel the best you can feel," which reviews principles of side effect management, self-advocacy, proactive communication, and palliative care. Ten Latinos with advanced malignancies reviewed the intervention and found it to be easily understandable, relatable, and helpful. A five-step hybrid model was successful in adapting a chemotherapy educational intervention for Latinos. Incorporation of video interviews with Latino patients enabled the authentic representation of salient cultural themes. Use of authentic patient narratives can be useful for cross-cultural intervention adaptations.
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Affiliation(s)
- Richard E Leiter
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, 450 Brookline Ave, Jimmy Fund 805A, MA, 02215, Boston, USA.
- Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.
- Harvard Medical School, Boston, MA, USA.
| | - Maria Teresa Bejarano Varas
- Department of Oncology Hospital Medicine, Dana-Farber Cancer Institute, Boston, MA, USA
- Department of Medicine, Boston Medical Center, Boston, MA, USA
| | - Keysha Miralda
- Department of Nursing and Patient Care Services, Dana-Farber Cancer Institute, Boston, MA, USA
| | | | - Grace Furtado
- College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, USA
| | - Anna Revette
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Christine Cronin
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Heloisa P Soares
- Division of Oncology, Huntsman Cancer Institute at University of Utah, Salt Lake City, UT, USA
| | - Athalia Lopez
- Department of Patient Care Services, Brigham and Women's Hospital, Boston, MA, USA
| | - Laura L Hayman
- Department of Nursing, College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, USA
| | - Ana Cristina Lindsay
- Department of Exercise and Health Sciences, College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, USA
| | - Deborah Schrag
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Andrea C Enzinger
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, 450 Brookline Ave, Jimmy Fund 805A, MA, 02215, Boston, USA
- Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
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Napolitano MA, Bailey CP, Mavredes MN, Neighbors CJ, Whiteley JA, Long MW, Hayman LL, Malin SK, DiPietro L. Personalized versus generic digital weight loss interventions delivered on university campuses: a 6-month cost-benefit analysis. Transl Behav Med 2023; 13:358-367. [PMID: 37186191 PMCID: PMC10255761 DOI: 10.1093/tbm/ibac081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023] Open
Abstract
Cost-effectiveness analyses of weight loss programs for university students can inform administrator decision-making. This study quantifies and compares the costs and cost-effectiveness of implementing two digitally-delivered weight loss interventions designed for university populations. Healthy Body Healthy U (HBHU) was a randomized controlled trial comparing TAILORED (personalized) versus TARGETED (generic) weight loss interventions adapted specifically for young adults to a CONTROL intervention. Participants (N = 459; 23.3 ± 4.4 years; mean BMI 31.2 ± 4.4 kg/m2) were recruited from two universities. Implementation costs were examined from a payer (i.e., university) perspective, comparing both the average cost effectiveness ratio (ACER) and the incremental cost effectiveness ratio (ICER) of the two interventions. Cost-effectiveness measures were calculated for changes in body weight, abdominal circumference, HDL cholesterol, systolic and diastolic blood pressure, and HbA1c. The overall 6-month implementation costs were $105.66 per person for the TAILORED intervention and $91.44 per person for the TARGETED intervention. The ACER for weight change was $107.82 for the TAILORED and $179.29 for the TARGETED interventions. The ICER comparing TAILORED with TARGETED for change in body weight was $5.05, and was even lower ($2.28) when including only those with overweight and not obesity. The ICERs for change in abdominal circumference, HDL cholesterol, systolic and diastolic blood pressure, and HbA1c were $3.49, $59.37, $1.57, $2.64, and $47.49, respectively. The TAILORED intervention was generally more cost-effective compared with the TARGETED intervention, particularly among those with overweight. Young adults with obesity may require more resource-intensive precision-based approaches.
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Affiliation(s)
- Melissa A Napolitano
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
| | - Caitlin P Bailey
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
| | - Meghan N Mavredes
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
| | - Charles J Neighbors
- Department of Population Health, Grossman School of Medicine, New York University, New York, NY, USA
| | - Jessica A Whiteley
- Departmen of Exercise and Health Sciences, College of Nursing and Health Sciences, The University of Massachusetts at Boston, Boston, MA, USA
| | - Michael W Long
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
| | - Laura L Hayman
- Department of Nursing, College of Nursing and Health Sciences, The University of Massachusetts at Boston, Boston, MA, USA
| | - Steven K Malin
- Department of Kinesiology and Division of Endocrinology, Metabolism and Nutrition, Rutgers University, New Brunswick, NJ, USA
| | - Loretta DiPietro
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
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Ryan HH, Martyn-Nemeth P, Hayman LL. Promoting Holistic Care in Familial Hypercholesterolemia: The Case for Family-Centered Science. J Cardiovasc Nurs 2023:00005082-990000000-00092. [PMID: 37204331 DOI: 10.1097/jcn.0000000000001004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
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Kwan TW, Wong SS, Hong Y, Kanaya AM, Khan SS, Hayman LL, Shah SH, Welty FK, Deedwania PC, Khaliq A, Palaniappan LP. Epidemiology of Diabetes and Atherosclerotic Cardiovascular Disease Among Asian American Adults: Implications, Management, and Future Directions: A Scientific Statement From the American Heart Association. Circulation 2023. [PMID: 37154053 DOI: 10.1161/cir.0000000000001145] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Asian American individuals make up the fastest growing racial and ethnic group in the United States. Despite the substantial variability that exists in type 2 diabetes and atherosclerotic cardiovascular disease risk among the different subgroups of Asian Americans, the current literature, when available, often fails to examine these subgroups individually. The purpose of this scientific statement is to summarize the latest disaggregated data, when possible, on Asian American demographics, prevalence, biological mechanisms, genetics, health behaviors, acculturation and lifestyle interventions, pharmacological therapy, complementary alternative interventions, and their impact on type 2 diabetes and atherosclerotic cardiovascular disease. On the basis of available evidence to date, we noted that the prevalences of type 2 diabetes and stroke mortality are higher in all Asian American subgroups compared with non-Hispanic White adults. Data also showed that atherosclerotic cardiovascular disease risk is highest among South Asian and Filipino adults but lowest among Chinese, Japanese, and Korean adults. This scientific statement discusses the biological pathway of type 2 diabetes and the possible role of genetics in type 2 diabetes and atherosclerotic cardiovascular disease among Asian American adults. Challenges to provide evidence-based recommendations included the limited data on Asian American adults in risk prediction models, national surveillance surveys, and clinical trials, leading to significant research disparities in this population. The large disparity within this population is a call for action to the public health and clinical health care community, for whom opportunities for the inclusion of the Asian American subgroups should be a priority. Future studies of atherosclerotic cardiovascular disease risk in Asian American adults need to be adequately powered, to incorporate multiple Asian ancestries, and to include multigenerational cohorts. With advances in epidemiology and data analysis and the availability of larger, representative cohorts, furthering refining the Pooled Cohort Equations, in addition to enhancers, would allow better risk estimation in segments of the population. Last, this scientific statement provides individual- and community-level intervention suggestions for health care professionals who interact with the Asian American population.
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Rohan A, Giurgescu C, Hayman LL, Pasha VC. Toward Evidence-Based Practice. MCN Am J Matern Child Nurs 2023; 48:172-174. [PMID: 37730768 DOI: 10.1097/nmc.0000000000000904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
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Martyn-Nemeth P, Hayman LL. Digital Technology in Cardiovascular Health: Role and Evidence Supporting Its Use. J Cardiovasc Nurs 2023; 38:207-209. [PMID: 37027125 DOI: 10.1097/jcn.0000000000000985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
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Legor KA, Hayman LL, Foust JB, Blazey ML. Clinical research nurses' perceptions of the unique needs of people of color for successful recruitment to cancer clinical trials. Contemp Clin Trials 2023; 128:107161. [PMID: 36935079 DOI: 10.1016/j.cct.2023.107161] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 03/13/2023] [Accepted: 03/14/2023] [Indexed: 03/19/2023]
Abstract
BACKGROUND Clinical trials (CTs) test new medical products for safety and effectiveness. Despite federal policy aimed at generating greater inclusivity of people of color (POC) in CTs, disparity in (CT) enrollment persists. Non-Hispanic White patients comprise the majority of CT participants while Black and Hispanic patient participation has declined over the past decade. The scope of Clinical Research Nurses (CRNs) includes recruitment of participants for CTs. The aim of this phenomenological study was to describe adult oncology CRNs' lived experiences of recruiting POC cancer patients to participate in CTs. The first paper for this study identified three major themes regarding how CRNs view their role in caring for POC considering or enrolling onto cancer clinical trials (CCTs): CRNs act as advocates, care coordinators and educators. This paper focuses on two additional major themes regarding how CRNs view the unique needs of POC in clinical research: establishing and maintaining trusting relationships and recruitment infrastructure. METHODS Nineteen nurses participated in semi-structured one-to-one interviews and data analysis was based on Colaizzi's method. RESULTS CRNs described a history of past research injustices, disparate access to care, inadequate cultural training, a physician-driven recruitment structure and provider-based implicit biases that hinder POC enrollment in CTs. CONCLUSION Diversity in CCT enrollment requires CRNs to establish trust with POC, advocate for POC when implicit biases are observed and become competent practitioners of culturally sensitive care. Further, meaningful policy change at both federal and organizational levels must occur to ensure equitable access to novel cancer therapies.
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Affiliation(s)
- Kristen A Legor
- Dana- Farber Cancer Institute, 450 Brookline Avenue, SW-411C, Boston, MA 02215, USA.
| | - Laura L Hayman
- University of Massachusetts Boston, 100 William T. Morrissey Blvd., Boston, MA 02125, USA.
| | - Janice B Foust
- University of Massachusetts Boston, 100 William T. Morrissey Blvd., Boston, MA 02125, USA.
| | - Meghan L Blazey
- University of Rochester, 500 Joseph C. Wilson Blvd., Rochester, NY 14627, USA.
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17
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Song M, Musil CC, Hayman LL. Abstract P265: Do Social Determinants of Health for Children’s Cardiometabolic Health Differ by Family Structure Type? Circulation 2023. [DOI: 10.1161/circ.147.suppl_1.p265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
Introduction:
Social determinants of health (SDoH) impact cardiometabolic health, and certain SDoH that critically influence cardiometabolic health, such as adverse childhood experiences (ACEs), differ by family structure type. In particular, children living in grandparent-headed households experience a higher number of ACEs, on average, than children living in parent-headed households. Yet, there is limited understanding of whether/how SDoH might impact cardiometabolic health risk in children by family structure type.
Purpose:
We assessed selected SDoH factors known to influence children’s cardiometabolic health risk, stratified by family structure type (two-parent, single-parent, and grandparent-headed households).
Methods:
Utilizing data from the 2019-2020 National Survey of Children’s Health, we evaluated 9 SDoH (race/ethnicity, ACEs, health insurance status, received medical care for health conditions, received preventive check-ups, received food/cash assistance, food insufficiency, school engagement, and living in a safe neighborhood). All these factors were compared by family structure type by using a second-order Rao and Scott X
2
tests.
Results:
Among children aged 6-17 years (n=48,901), we found all 9 SDoH significantly differed by family structure type at p<0.05. Results for each SDoH were as follows, with proportions shown for two-parent, single-parent, and grandparent-headed households, respectively, for each SDoH. Racial/ethnic minorities: 44%, 63%, and 59%; children experiencing ≥ 2 ACEs: 13.3%, 44.2%, and 54.1%; proportion uninsured: 6.3%, 8.3%, and 8.5%; proportion received medical care during past 12 months: 84.1%, 78.3%, and 78.4%; proportion received preventive check-ups during past 12 months; 80.1%, 72.5%, and 74.3%; proportion with food insufficiency: 26.2%, 45.1%, and 38.4%; proportion receiving food/cash assistance: 32.2%, 61.2%, and 73.1%; proportion with children “engaged in school”: 85.8%, 77.3%, and 79.4%; proportion living in unsafe neighborhoods: 4.3%, 8.8%, and 5.4%.
Conclusions:
Our findings show children living in grandparent-headed and single-headed households are more adversely affected by these cardiometabolic health-related SDoH than those living in two-parent households, and thus may be populations at particularly high risk for poor cardiometabolic health. Further investigations are needed to help identify modifiable factors that may influence the associations among family structure type, SDoH, and cardiometabolic health risk in children.
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18
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Song M, Dieckmann NF, Musil CM, Hayman LL. Abstract 33: Using the AHA's Life Essential 8 Criteria to Assess Sleep Duration and Its Association With Social Determinants of Health in U.S. Children. Circulation 2023. [DOI: 10.1161/circ.147.suppl_1.33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
Introduction:
In 2010, the American Heart Association (AHA) began using 7 indicators to measure cardiovascular health, known collectively as Life’s Simple 7. In June 2022, the AHA added an 8
th
indicator: sleep duration. Although earlier studies have examined whether/how the indicators in Life’s Simple 7 might be impacted by social determinants of health (SDoH), few epidemiological studies have examined how SDoH influence the 8
th
indicator in U.S. children.
Purpose:
We used the AHA Life Essential 8 scoring criteria to assess sleep duration among U.S. children and whether certain SDoH were associated with sleep duration.
Methods:
We utilized data from the 2019-2020 National Survey of Children’s Health. For all children, we calculated the score for sleep duration (range 0 [lowest] to 100 [highest]). Based on the AHA scoring algorithm and the distribution of sleep duration, participants were divided into three mutually exclusive subgroups: (1) those who met age-appropriate
optimal
sleep duration; (2) those who had 1-<2 hour below or ≥ 1 hour above optimal sleep duration; and (3) those who had ≥ 2 hours below optimal sleep duration. Multinomial logistic regressions were used to assess the association of sleep duration with 4 SDoH factors (adverse childhood experiences [ACEs], received preventive care during past 12 months, food insufficiency, and living in unsafe neighborhoods). We controlled for child’s sex, age, race/ethnicity, and household poverty level.
Results:
Among children aged 6 to 17 years (n=49,821), the mean sleep duration score was 77.1 (95% CI 76.4 to 77.7) and 65.5% of the children had age-appropriate optimal sleep scores. Three SDoH factors were associated with higher likelihood of suboptimal sleep duration. Adjusting for covariates, for each point increase in number of ACEs the likelihood of having suboptimal sleep duration was increased (relative risk ratios [RR]:1.05 [95% CI 1.02 to 1.09]; 1.21 [95% CI 1.15 to 1.27]). The likelihood of having suboptimal sleep duration was also increased for those who reported food insufficiency at home (RR:1.19 [95% CI 1.06 to 1.33]; 1.67 [95% CI 1.40 to 1.98]) as well as for those who reported living in an unsafe neighborhood (RR: 1.34 [95% CI 1.04 to 1.71]; 1.63 [95% CI 1.19 to 2.23]).
Conclusions:
Our findings show that using the AHA’s Life Essential 8 scoring criteria, one third of U.S. children do not meet optimal sleep duration standards. These findings highlight the need for greater attention to social and systemic influences on children's sleep health. It is critical for healthcare providers to recognize that suboptimal sleep duration is a risk factor for poor cardiovascular health, and that certain SDoH are associated with suboptimal sleep duration.
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19
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Muchira JM, Gona PN, Mogos MF, Stuart-Shor EM, Leveille SG, Piano MR, Hayman LL. Association of Parental Cardiovascular Health With Disability-Adjusted Life Years in the Offspring: Results From the Framingham Heart Study. Circ Cardiovasc Qual Outcomes 2023; 16:e008809. [PMID: 36484252 DOI: 10.1161/circoutcomes.121.008809] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Disability-adjusted life years (DALYs) are used to evaluate the relative burden of diseases in populations to help set prevention or treatment priorities. The impact of parental cardiovascular health (CVH) on healthy life years lost from cardiovascular disease (CVD) in adult offspring is unknown. We compared parent-offspring CVD DALYs trends over the life course and examined the association of parental CVH with offspring CVD DALYs. METHODS Using data from the Framingham Heart Study, 4814 offspring-mother-father trios were matched for age at selected baseline exams. CVH score was computed from the number of CVH metrics attained at recommended levels: poor (0-2), intermediate (3-4), and ideal (5-7). CVD DALYs were defined as the sum of years of life lost and years lived with CVD. Age-sex-standardized life expectancy and disability weights were derived from the actuarial life tables and Global Burden of Disease study, respectively. Multivariable-adjusted linear regression was used to investigate the association of parental CVH with offspring CVD DALYs. RESULTS Over an equal 47-year follow-up, parents lost nearly twice the number of CVD DALYs compared to their offspring (23 234 versus 12 217). However, age-adjusted CVD DALYs were higher at younger ages and similar along the life course for parents and offspring. One-unit increase in parental CVH was associated with 5 healthy life months saved in offspring. Offspring of mothers with ideal versus poor CVH had 3 healthy life years saved (β=-3.0 DALYs [95% CI, -5.6 to -0.3]). No statistically significant association was found between paternal CVH categories and offspring CVD DALYs. CONCLUSIONS Higher maternal and paternal CVH were associated with increased healthy life years in offspring; however, the association was strongest between mothers and offspring. Investment in CVH promotion along the life course has the potential to reduce the burden of CVD in the current and future generation of adults.
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Affiliation(s)
- James M Muchira
- Center for Research Development and Scholarship, Vanderbilt University School of Nursing, Nashville, TN (J.M.M., M.F.M., M.R.P.)
| | - Philimon N Gona
- Robert and Donna Manning College of Nursing and Health Sciences, University of Massachusetts Boston (P.N.G., E.S.-S., S.G.L., L.L.H.)
| | - Mulubrhan F Mogos
- Center for Research Development and Scholarship, Vanderbilt University School of Nursing, Nashville, TN (J.M.M., M.F.M., M.R.P.)
| | - Eileen M Stuart-Shor
- Robert and Donna Manning College of Nursing and Health Sciences, University of Massachusetts Boston (P.N.G., E.S.-S., S.G.L., L.L.H.).,Beth Israel Deaconess Medical Center, Boston, MA (E.S.-S., S.G.L.)
| | - Suzanne G Leveille
- Robert and Donna Manning College of Nursing and Health Sciences, University of Massachusetts Boston (P.N.G., E.S.-S., S.G.L., L.L.H.).,Beth Israel Deaconess Medical Center, Boston, MA (E.S.-S., S.G.L.).,Harvard Medical School, Boston, MA (S.G.L.)
| | - Mariann R Piano
- Center for Research Development and Scholarship, Vanderbilt University School of Nursing, Nashville, TN (J.M.M., M.F.M., M.R.P.)
| | - Laura L Hayman
- Robert and Donna Manning College of Nursing and Health Sciences, University of Massachusetts Boston (P.N.G., E.S.-S., S.G.L., L.L.H.).,Department of Population & Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA (L.L.H.)
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20
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Flike K, Hayman LL, Byrne T, Song Q, Aronowitz T. The impact of patient-centred care on the relationship between access to care and subjective health outcomes amongst people experiencing homelessness: A mediation analysis. Health Soc Care Community 2022; 30:e5755-e5764. [PMID: 36093584 DOI: 10.1111/hsc.14007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 08/10/2022] [Accepted: 08/20/2022] [Indexed: 06/15/2023]
Abstract
People experiencing homelessness (PEH) have stated that impersonal care and feelings of discrimination are barriers to accessing healthcare which is associated with poor health outcomes amongst PEH. This study examined whether patient-centred care (PCC) mediates the relationship between access to care and subjective health outcomes. Using the 2014-15 Healthcare Center Patient Survey, we identified 1873 homeless and vulnerably housed adults. Items related to the delay or inability to receive primary or mental healthcare, PCC provided by healthcare providers, general health status, and the Kessler-6 psychological distress scale were selected. Ordinary least squares analyses were used to perform mediation analysis. We found that both access to primary care and access to mental healthcare were positively associated with physical health status (β = 0.492, p < 0.001; β = 0.311, p < 0.001) and negatively associated with psychological distress (β = -2.53, p < 0.001; β = -1.85, p < 0.001). PCC partially mediated all associations, but the mediation was stronger in the relationships between access to primary care and health outcomes (ab = 0.25, 95% CI [0.002, 0.052]; ab = -0.21, 95% CI [-0.37, -0.07]) compared to mental healthcare (ab = 0.02, 95% CI [0.01, 0.04]; ab = -0.14, 95% CI [-0.25, -0.06]). The results of this study indicated access to primary and mental healthcare is important in the patient-centred health outcomes of PEH. Additionally, the partial mediation of PCC in these relationships indicated that participants' perception of collaborative, trustworthy, respectful care from healthcare providers impacted the relationship between access to healthcare and health outcomes.
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Affiliation(s)
- Kimberlee Flike
- Center for Healthcare Organization and Implementation Research (CHOIR), Bedford VA Healthcare System, Bedford, Massachusetts, USA
| | - Laura L Hayman
- Robert and Donna Manning College Nursing & Health Sciences, University of Massachusetts, Boston, Massachusetts, USA
| | - Thomas Byrne
- School of Social Work, Boston University, Boston, Massachusetts, USA
| | - Qian Song
- McCormack Graduate School of Policy and Global Studies, University of Massachusetts, Boston, Massachusetts, USA
| | - Teri Aronowitz
- Tan Chingfen Graduate School of Nursing, UMass Chan Medical School, Worcester, Massachusetts, USA
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21
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22
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Park JK, Ahn JA, Hayman LL, Park JS, Kim CJ. Predictive Model for Quality of Life in Patients With Heart Failure. J Cardiovasc Nurs 2022; 38:00005082-990000000-00038. [PMID: 36103454 DOI: 10.1097/jcn.0000000000000942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Although many studies have been conducted to examine predictors of quality of life (QoL), little information exists on the real-world application of Rector's conceptual model for QoL related to heart failure (HF). OBJECTIVES In this study, we aimed to examine a hypothetical model of QoL based on Rector's conceptual model for QoL in relation to HF and the existing literature on patients with HF. METHODS Using a cross-sectional survey, 165 patients with HF were recruited from an outpatient clinic in Korea. Data were collected based on Rector's model constructs, such as cardiac function, symptoms, functional limitation, depression, distress, and QoL. Left ventricular ejection fraction for cardiac function was measured using echocardiography. RESULTS Functional limitation, depression, and distress, but not symptoms, had a direct effect on QoL (all Ps < .001). Cardiac function and symptoms directly affected functional limitation (β = 0.186, P = .004, and β = -0.488, P = < .001, respectively), whereas cardiac function, symptoms, and depression affected QoL through functional limitation and distress. CONCLUSIONS These results confirm that the Rector's model is suitable for predicting QoL in patients with HF. These findings have potential to guide and inform intervention programs designed to alleviate symptoms in patients with HF, enhance their physical functioning, and moderate their psychological distress with the ultimate goal of improving their QoL.
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23
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Abstract
There is no single accepted definition used in policy or research for the concepts of homelessness and vulnerably housed. Neuman's systems model (NSM) was the framework for this mixed-studies review, with the client system defined as these social issues and categorized as environmental stressors. Eighteen unique definitions of the concepts were identified in 30 studies. Extrapersonal stressors included housing history, interpersonal stressors included dependence on others for housing, and intrapersonal stressors included self-identification. Each level of stressor should be considered when defining these populations for inclusion in future research. Proposed definitions were formulated from the analysis of the results.
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Affiliation(s)
- Kimberlee Flike
- Center for Healthcare Organization and Implementation Research (CHOIR), VA Bedford Healthcare System, Bedford, MA, USA
| | - Janice B Foust
- Robert and Donna Manning College of Nursing & Health Sciences, University of Massachusetts Boston, Boston, MA, USA
| | - Laura L Hayman
- Robert and Donna Manning College of Nursing & Health Sciences, University of Massachusetts Boston, Boston, MA, USA
| | - Teri Aronowitz
- Tan Chingfen Graduate School of Nursing, UMass Chan Medical School, Worcester, MA, USA
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24
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Hayman LL, Martyn-Nemeth P. Transitioning Adolescents and Young Adults With Congenital Heart Disease to Adult-Centered Care: Challenges and Opportunities. J Cardiovasc Nurs 2022; 37:310-311. [PMID: 37707964 DOI: 10.1097/jcn.0000000000000924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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25
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Bailey CP, DiPietro L, Hayman LL, Ahmad Z, Napolitano MA. Meeting Specific 24-Hour Movement Guidelines Is Associated With BMI Among University Students With Overweight/Obesity. Am J Lifestyle Med 2022. [DOI: 10.1177/15598276221090190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: Approximately 40% of college/university students have overweight/obesity; physical activity and sleep play a role. To address these interrelated behaviors, Canada recently released 24-Hour Movement Guidelines. This study aimed to determine (1) the percent of students with overweight/obesity meeting Canadian 24-Hour Movement Guidelines, (2) whether health behaviors differ by demographics, and (3) whether meeting guidelines is associated with BMI. Methods: University students 18–35 years (n = 459) enrolled in a randomized controlled weight management trial completed 1 week of ActiGraph measured activity, self-reported sleep duration, researcher-measured height/weight, and demographics at baseline. ANOVA and t-tests determined differences in student demographics and BMI among those meeting vs not meeting each guideline. Results: Of the analytic sample (n = 403), 341 (84.6%) met the MVPA guideline, 284 (70.5%) met the LIPA guideline, 236 (58.6%) met the sleep guideline, 62 (15.4%) met the sedentary time guideline, and 34 (8.4%) met all guidelines. Students meeting MVPA (30.8±4.3 vs 32.5±4.5, P = .008) or sleep (30.7±4.4 vs 31.6±4.3, P = .04) guidelines had significantly lower BMIs compared to those not meeting each guideline. Percent of students meeting sleep ( P = .039) or all guidelines ( P = .012) differed by race/ethnicity. Conclusion: Meeting MVPA/sleep guidelines is associated with lower BMI; these behaviors are important targets for future weight management programs.
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Affiliation(s)
- Caitlin P. Bailey
- Department of Prevention and Community Health, The George Washington University Milken Institute School of Public Health, Washington, DC, USA
| | - Loretta DiPietro
- Department of Exercise and Nutrition Sciences, The George Washington University Milken Institute School of Public Health, Washington, DC, USA
| | - Laura L. Hayman
- Robert and Donna Manning College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, USA
| | - Zohaa Ahmad
- Department of Prevention and Community Health, The George Washington University Milken Institute School of Public Health, Washington, DC, USA
| | - Melissa A. Napolitano
- Department of Prevention and Community Health, The George Washington University Milken Institute School of Public Health, Washington, DC, USA
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26
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Flynn JT, Urbina EM, Brady TM, Baker-Smith C, Daniels SR, Hayman LL, Mitsnefes M, Tran A, Zachariah JP. Ambulatory Blood Pressure Monitoring in Children and Adolescents: 2022 Update: A Scientific Statement From the American Heart Association. Hypertension 2022; 79:e114-e124. [PMID: 35603599 DOI: 10.1161/hyp.0000000000000215] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Use of ambulatory blood pressure monitoring in children and adolescents has markedly increased since publication of the last American Heart Association scientific statement on pediatric ambulatory blood pressure monitoring in 2014. In addition, there has also been significant expansion of the evidence base for use of ambulatory blood pressure monitoring in the pediatric population, including new data linking ambulatory blood pressure levels with the development of blood pressure-related target organ damage. Last, additional data have recently been published that enable simplification of the classification of pediatric ambulatory monitoring studies. This scientific statement presents a succinct review of this new evidence, guidance on optimal application of ambulatory blood pressure monitoring in the clinical setting, and an updated classification scheme for the interpretation of ambulatory blood pressure monitoring in children and adolescents. We also highlight areas of uncertainty where additional research is needed.
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27
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Rohan AJ, Adams ED, Giurgescu C, Hayman LL. Toward Evidence-Based Practice. MCN Am J Matern Child Nurs 2022; 47:172-174. [PMID: 37730662 DOI: 10.1097/nmc.0000000000000815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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28
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Garvey ME, Shi L, Lichtenstein AH, Must A, Hayman LL, Crouter SE, Camhi SM. Association of Bone Mineral Density with Lean Mass, Fat Mass, and Physical Activity in Young Overweight and Obese Women. Int J Exerc Sci 2022; 15:585-598. [PMID: 36896025 PMCID: PMC9987430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 03/11/2023]
Abstract
To examine the associations between bone mineral density (BMD), body composition and habitual physical activity in women who are overweight/obese. We measured whole-body bone, and body composition (lean mass, fat mass, and total fat percent) via dual-energy x-ray absorptiometry (model General Electric Lunar whole-body scanner) in a diverse group of women (N=48, age 26.6+/-4.7 years, 63% Black) living in an urban setting. The relations between BMD with total fat percent [%]), lean mass (kg), fat mass (kg), and physical activity were examined using Pearson correlations and multiple linear regression models, adjusted for race, age, and dietary calcium. BMD was positively correlated with lean mass (r=0.43, p=0.002) and negatively correlated with total fat percentage (r=-0.31, p=0.03). Multiple linear regression models indicated BMD was positively associated with lean mass (β: 0.007, p<0.001), and negatively associated with fat mass (kg) and total fat percentage (β: -0.003, p=0.03; β: -0.004, p=0.03, respectively). When stratified by race, these relations were maintained in white women but only lean mass in Black women. When stratified by age, the positive correlation between BMD and lean mass was significant in younger women (<30y) only. There were no significant relationships between BMD and any physical activity measures. Our results indicate that in young women who are overweight/obese BMD is significantly associated with body composition, both lean mass and total fat percentage, but not habitual physical activity. An emphasis on lean mass accrual may be valuable for young women, particularly Black women, to improve bone health.
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Affiliation(s)
- Meghan E Garvey
- Department of Exercise and Health Sciences, University of Massachusetts, Boston, MA, USA
| | - Ling Shi
- Department of Nursing, University of Massachusetts, MA USA
| | | | - Aviva Must
- Department of Public Health and Community Medicine, Tufts University School of Medicine; Boston, MA
| | - Laura L Hayman
- Department of Nursing, University of Massachusetts, MA USA
| | - Scott E Crouter
- Department of Kinesiology, Recreation, and Sports Studies, The University of Tennessee Knoxville; Knoxville, TN, USA
| | - Sarah M Camhi
- Department of Exercise and Health Sciences, University of Massachusetts, Boston, MA, USA
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29
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Peng C, Hayman LL, Mutchler JE, Burr JA. Friendship and Cognitive Functioning among Married and Widowed Chinese Older Adults. J Gerontol B Psychol Sci Soc Sci 2021; 77:567-576. [PMID: 34791248 DOI: 10.1093/geronb/gbab213] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Guided by the social convoy model, this study investigated the association between friendship and cognitive functioning among older Chinese adults, as well as the moderating effect of marital status (married vs. widowed). We also explored whether depression might account for the link between friendship and cognitive functioning. METHOD We used data from the China Longitudinal Aging Social Survey in 2014 (N = 8,482). Cognitive functioning was measured with the Mini-Mental State Examination instrument and friendship was assessed with a three-item Lubben Social Network Scale. Linear regression and path analyses within a structural equation modeling framework were performed to examine the hypotheses. RESULTS Results indicated that friendship was significantly related to better cognitive functioning among older Chinese adults (β = 0.083, p <.001) and marital status moderated this association (β = -0.058, p <.01). In addition, depression partially mediated the relationship between friendship and cognitive functioning (β = 0.015, p <.001). DISCUSSION The results implied that friendship is important for maintaining cognitive functioning in later life and widowed older Chinese adults may benefit more from friendship in its relationship to cognitive functioning than married older Chinese adults. Further, one potential pathway linking friendship to cognitive functioning may be through depression; however, more research is needed to support this finding. Intervention programs aimed at building friendship opportunities may be one way to achieve better cognitive aging.
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Affiliation(s)
- Changmin Peng
- Department of Gerontology, McCormack Graduate School of Public and Global Studies, University of Massachusetts Boston
| | - Laura L Hayman
- Department of Nursing, College of Nursing and Health Sciences, University of Massachusetts Boston
| | - Jan E Mutchler
- Department of Gerontology, McCormack Graduate School of Public and Global Studies, University of Massachusetts Boston
| | - Jeffrey A Burr
- Department of Gerontology, McCormack Graduate School of Public and Global Studies, University of Massachusetts Boston
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30
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Legor KA, Hayman LL, Foust JB, Blazey ML. The role of clinical research nurses in minority recruitment to cancer clinical trials. Contemp Clin Trials 2021; 110:106590. [PMID: 34634475 DOI: 10.1016/j.cct.2021.106590] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 09/29/2021] [Accepted: 09/30/2021] [Indexed: 11/17/2022]
Abstract
Clinical trials (CTs) are the established research mechanism designed to examine how new medical therapies are tested for safety and effectiveness. Specifically, non-Hispanic White patients still account for most CT participants and Black patient participation has declined over the past decade. Clinical Research Nurses (CRNs) whose scope of practice includes the recruitment of participants for CTs, have the potential to significantly increase minority patients participation in cancer clinical trials (CCTs). The aim of this phenomenological study was to describe adult oncology CRNs' lived experiences of recruiting minority cancer patients to participate in CTs. A total of 19 nurses participated in semi-structured one-to-one interviews and data analysis was based on Colaizzi's method. The role of CRNs was described as advocates who coordinate care, establish trust, and provide education for CT patients within physician-driven recruitment structures. The CRN's role was also described as self-taught or learn on the go with no formalized recruitment training and lack of robust cultural training. To achieve diverse patient enrollment in CCTs, CRNs and study staff need to receive training on culturally competent clinical research care and the diversity of CRNs and study teams must be increased. Further, meaningful federal and hospital policy change must occur so that minority patients have equitable access to novel cancer therapies and the role of the CRN is delineated from other healthcare staff to optimize research patient care.
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Affiliation(s)
- Kristen A Legor
- Dana- Farber Cancer Institute, 450 Brookline Avenue, SW-411C, Boston, MA 02215, USA.
| | - Laura L Hayman
- University of Massachusetts Boston, 100 William T. Morrissey Blvd., Boston, MA 02125, USA.
| | - Janice B Foust
- University of Massachusetts Boston, 100 William T. Morrissey Blvd., Boston, MA 02125, USA.
| | - Meghan L Blazey
- University of Rochester, 500 Joseph C. Wilson Blvd., Rochester, NY 14627, USA.
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31
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Mitsnefes M, Flynn JT, Brady T, Baker-Smith C, Daniels SR, Hayman LL, Tran A, Zachariah JP, Urbina EM. Pediatric Ambulatory Blood Pressure Classification: The Case for a Change. Hypertension 2021; 78:1206-1210. [PMID: 34601972 PMCID: PMC8516706 DOI: 10.1161/hypertensionaha.121.18138] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
In 1997, Soergel et al1 published the first set of normative values for ambulatory blood pressure monitoring (ABPM) in children. Since then, the clinical utility of ABPM has increased dramatically, and now, ABPM is accepted as the standard method to confirm the diagnosis of hypertension in children. Despite significant progress in the field of pediatric ABPM, many important questions remain unanswered. One of the most controversial issues is how to define ambulatory hypertension in children. The purpose of this review is to discuss the limitations of the current pediatric ABPM classification scheme and to provide the justification and rationale for a new classification.
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Affiliation(s)
- Mark Mitsnefes
- Cincinnati Children's Hospital Medical Center, University of Cincinnati, OH (M.M., E.M.U.)
| | - Joseph T Flynn
- University of Washington and Seattle Children's Hospital (J.T.F.)
| | - Tammy Brady
- Johns Hopkins University, Baltimore, MD (T.B.)
| | | | | | | | - Andrew Tran
- Nationwide Children's Hospital, The Ohio State University, Columbus (A.T.)
| | | | - Elaine M Urbina
- Cincinnati Children's Hospital Medical Center, University of Cincinnati, OH (M.M., E.M.U.)
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32
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Odukoya O, Fox RS, Hayman LL, Penedo FJ. The International Society for Behavioral Medicine (ISBM) and the Society of Behavioral Medicine (SBM) advocate for the inclusion of behavioral scientists in the implementation of the Global Action Plan for the prevention of non-communicable diseases (NCDs) in low- and middle-income countries. Transl Behav Med 2021; 11:1286-1288. [PMID: 33410489 DOI: 10.1093/tbm/ibaa128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Non-communicable diseases (NCDs) are the leading cause of death and disability in the world with the majority of deaths occurring in low- and middle-income countries (LMICs). The financial implications of disease and disability due to NCDs, combined with the costs of long-term management, are major causes of impoverishment and serve as barriers to socio-economic development. The transition from infectious diseases to NCDs as leading causes of mortality in LMICs is driven by several factors, primarily increasing globalization, urbanization, ageing of populations and economic development. Responding to these challenges will require local and comprehensive primary and secondary prevention efforts. The World Health Organization's Global Action Plan provides a road map and an array of policy options to achieve nine voluntary global targets by 2025. The primary responsibility of governments in responding to the challenge of NCDs includes international scientific cooperation to support national and local efforts. The implementation of such efforts to prioritize the prevention of NCDs will create an environment in which the rising trend of the NCD burden could be potentially halted and reversed. When developing NCD policies, stakeholders should consider evidence-based strategies which can be implemented by multidisciplinary teams that are led or have the participation of behavioral medicine scientists. Behavioral medicine strategies should be incorporated into the policy and intervention framework developed to target NCDs in LMICs.
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Affiliation(s)
- Oluwakemi Odukoya
- Department of Community Health and Primary Care, University of Lagos, Nigeria
| | - Rina S Fox
- Department of Medical Social Sciences, Northwestern, Chicago, IL
| | - Laura L Hayman
- Department of Nursing, University of Massachusetts Boston, Boston, MA
| | - Frank J Penedo
- Departments of Psychology and Medicine, University of Miami, Coral Gables, FL
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Whiteley JA, Faro JM, Mavredes M, Hayman LL, Napolitano MA. Application of social marketing to recruitment for a digital weight management intervention for young adults. Transl Behav Med 2021; 11:484-494. [PMID: 32293670 DOI: 10.1093/tbm/ibaa032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Recruiting young adults into weight loss interventions poses challenges that may be mitigated by the use of novel social marketing strategies. The purpose of this study is to describe how social marketing principles were applied to recruitment for a digitally delivered randomized controlled trial for weight management among young adults and report recruitment data and demographics on those who enrolled and did not enroll in the study. The marketing mix of the 7Ps (i.e., product, price, place, promotion, packaging, positioning, and people) was applied to intervention recruitment. Prior to enrollment, respondents completed a screening survey, which was examined to determine optimal strategies for study awareness and enrollment. Of the initial 5,731 who initiated a screener, 3,059 provided data on the source of where they heard about the study. Subsequently, 460 (12.5%) were enrolled in the study, 409 (51.3% non-White; 78.7% female; body mass index: 30.6 ± 4.3) provided data on recruitment source, with emails (72.5%), cited most often followed by flyers/posters (8.8%), "other" (6.7%), and multiple sources (6.6%). Although email remained the most frequently cited promotion source, Pearson's chi-squared tests revealed that, compared to those not enrolled in the study, those who enrolled were more likely to hear about the study via flyers/posters (enrolled = 14.4%; not enrolled = 7.9%; p < .001) and multiple sources (enrolled = 11.7%; not enrolled 5.85%; p < .01) and less likely to hear via email (enrolled = 62.1%; not enrolled = 74.2%; p < .01). This study applied social marketing principles to successfully recruit a large and diverse group of young adults. While email emerged as the most effective source of study awareness, multiple channels and a mix of marketing principles are recommended for recruiting in university settings.
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Affiliation(s)
- Jessica A Whiteley
- Department of Exercise and Health Sciences, University of Massachusetts Boston, Boston, MA, USA
| | - Jamie M Faro
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
| | - Meghan Mavredes
- Department of Prevention and Community Health, The George Washington University, Washington, DC, USA
| | - Laura L Hayman
- Departments of Prevention and Community Health and Exercise and Nutrition Sciences, Boston, MA, USA
| | - Melissa A Napolitano
- Department of Prevention and Community Health, The George Washington University, Washington, DC, USA
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Napolitano MA, Whiteley JA, Mavredes M, Tjaden AH, Simmens S, Hayman LL, Faro J, Winston G, Malin S, DiPietro L. Effect of tailoring on weight loss among young adults receiving digital interventions: an 18 month randomized controlled trial. Transl Behav Med 2021; 11:970-980. [PMID: 33739422 DOI: 10.1093/tbm/ibab017] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Weight loss outcomes among young adults in technology-based programs have been equivocal. The purpose of this study was to deliver digital weight loss treatments to young adults and examine the 6, 12, and 18 month effects on weight loss. Young adults with overweight/obesity (N = 459; 23.3 ± 4.4 years) were recruited from two university sites and randomly assigned to receive through Facebook and text messaging either personalized (TAILORED; n = 150) or generic (TARGETED; n = 152) weight loss information, messages, and feedback or general healthy body content (e.g., body image, sleep; CONTROL; n = 157). The study was powered to detect a 2.1-kg difference at all time points with the primary outcome being 18 months. There was no overall effect of treatment group on 6, 12, or 18 month weight loss (ps = NS). However, at 6 months, those in TAILORED who were highly engaged (completing >66%) lost more weight compared to CONTROL (-2.32 kg [95% confidence intervals: -3.90, -0.74]; p = .004), with the trend continuing at 12 months. A significant baseline body mass index (BMI) by treatment group interaction (p = .004) was observed at 6 months. Among participants in the lowest baseline BMI category (25-27.5 kg/m2), those in TAILORED lost 2.27 kg (-3.86, -0.68) more, and those in TARGETED lost 1.72 kg (-3.16, -0.29) more than CONTROL after adjusting for covariates. Among participants with a BMI between 27.5 and 30 kg/m2, those in TAILORED lost 2.20 kg (-3.90, -0.51) more than participants in TARGETED. Results did not persist over time with no treatment interaction at 12 or 18 months. Initial body weight should be considered when recommending weight loss treatments for young adults. More intensive interventions or stepped care approaches may be needed for young adults with obesity.
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Affiliation(s)
- Melissa A Napolitano
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave, 3rd Floor, Washington, DC 20052, USA.,Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave, 2nd Floor, Washington, DC 20052, USA
| | - Jessica A Whiteley
- College of Nursing and Health Sciences, The University of Massachusetts at Boston, Boston, MA 02125, USA
| | - Meghan Mavredes
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave, 3rd Floor, Washington, DC 20052, USA
| | - Ashley Hogan Tjaden
- Department of Epidemiology, Milken Institute School of Public Health, The George Washington University, Washington, DC 20052, USA
| | - Samuel Simmens
- Department of Biostatistics and Bioinformatics, Milken Institute School of Public Health, The George Washington University, Washington, DC 20052, USA
| | - Laura L Hayman
- College of Nursing and Health Sciences, The University of Massachusetts at Boston, Boston, MA 02125, USA
| | - Jamie Faro
- Department of Population and Quantitative Health Sciences, The University of Massachusetts Medical School, Worcester, MA 01605, USA
| | - Ginger Winston
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave, 3rd Floor, Washington, DC 20052, USA.,Medical Faculty Associates, The George Washington University, Washington, DC 20052, USA
| | - Steven Malin
- Departments of Kinesiology and Division of Endocrinology, Metabolism and Nutrition, Rutgers University, New Brunswick, NJ 08901, USA
| | - Loretta DiPietro
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave, 2nd Floor, Washington, DC 20052, USA
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Moxley E, Webber-Ritchey KJ, Hayman LL. Global impact of physical inactivity and implications for public health nursing. Public Health Nurs 2021; 39:180-188. [PMID: 34387002 DOI: 10.1111/phn.12958] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 06/03/2021] [Accepted: 07/25/2021] [Indexed: 01/22/2023]
Abstract
Physicalinactivity has been a public health problem worldwide for more than a decade. Of those who are physically active, a substantial percentage engage solely in low or very low physical activity (PA) levels. In the last 3 decades, the prevalence of PA in the United States has decreased with approximately 80% of adults not meeting the recommended guidelines for aerobic and muscle strengthening PA. The PA levels of youth have dramatically decreased with 85% of adolescents reporting no PA. Regular PA participation can aid in preventing chronic diseases. A strong inverse dose-response relationship exists between PA and the incidence of cardiovascular disease, all-cause and cardiovascular mortality. Moreover, low cardiorespiratory fitness levels are a risk factor for cardiovascular diseases: the leading cause of death and disability globally. Conversely, high amounts of moderate-to-vigorous intensity PA at levels 3-5 times recommended in guidelines reduce risk for all cause mortality. Socio-ecological determinants of PA are essential considerations for promoting across the life course. In health care and community settings, public health nurses have opportunities to promote PA through a socio-ecological approach across the life course of individuals and diverse populations.
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Affiliation(s)
- Elizabeth Moxley
- School of Nursing, Northern Illinois University, DeKalb, Illinois
| | | | - Laura L Hayman
- Department of Nursing, College of Nursing & Health Sciences, University of Massachusetts Boston, Boston, Massachusetts
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Ferranti EP, Jones EJ, Bush S, Hayman LL, Larimer K, Martyn-Nemeth P, Villavaso CD, Coke LA. A Call to Action: Cardiovascular-Related Maternal Mortality: Inequities in Black, Indigenous, and Persons of Color. J Cardiovasc Nurs 2021; 36:310-311. [PMID: 36036984 PMCID: PMC9428945 DOI: 10.1097/jcn.0000000000000823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Adams ED, Giurgescu C, Hayman LL, Rohan A. Toward Evidence-Based Practice. MCN Am J Matern Child Nurs 2021; 46:180-182. [PMID: 38019065 DOI: 10.1097/nmc.0000000000000717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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38
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Vasbinder A, Tinker LF, Neuhouser ML, Pettinger M, Hale L, Di C, Zaslavsky O, Hayman LL, Lin X, Eaton C, Wang D, Scherman A, Stefanick ML, Barrington WE, Reding KW. Risk of metabolic syndrome and metabolic phenotypes in relation to biomarker-calibrated estimates of energy and protein intakes: an investigation from the Women's Health Initiative. Am J Clin Nutr 2020; 113:706-715. [PMID: 33381804 PMCID: PMC7948844 DOI: 10.1093/ajcn/nqaa334] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 10/22/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Metabolic syndrome (MetS) is associated with increased mortality independent of BMI, resulting in discordant metabolic phenotypes, such as metabolically healthy obese and metabolically unhealthy normal-weight individuals. Studies investigating dietary intake in MetS have reported mixed results, due in part to the limitations of self-reported measures. OBJECTIVES To investigate the role of biomarker-calibrated estimates of energy and protein in MetS and metabolic phenotypes. METHODS Postmenopausal participants from the Women's Health Initiative (WHI) study who were free of MetS at baseline, had available data from FFQs at baseline, and had components of MetS at Year 3 (n = 3963) were included. Dietary energy and protein intakes were estimated using biomarker calibration methods. MetS was defined as 3 or more of the following: elevated serum triglycerides (≥150 mg/dL), low HDL cholesterol (<50 mg/dL), hypertension [systolic blood pressure (BP) ≥130 or diastolic BP ≥85 mmHg], elevated serum glucose (>100 mg/dL), and abdominal adiposity (waist circumference > 89 cm). Models were adjusted for age, WHI study component, race/ethnicity, education, income, smoking, recreational physical activity, disease history, and parity. RESULTS For every 10% increment in total calibrated energy intake, women were at a 1.37-fold elevated risk of MetS (95% CI, 1.15-1.63); a 10% increment in calibrated total protein intake was associated with a 1.21-fold elevated risk of MetS (95% CI, 1.00-1.47). Specifically, animal protein intake was associated with MetS (OR, 1.08; 95% CI, 1.02-1.14), whereas vegetable protein intake was not (OR, 0.99; 95% CI, 0.95-1.03). No differences were seen when examining metabolic phenotypes. CONCLUSIONS We found that higher calibrated total energy, total protein, and total animal protein intakes were strongly associated with MetS. If replicated in clinical trials, these results will have implications for the promotion of energy and animal protein restrictions for the reduction of MetS risks.
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Affiliation(s)
- Alexi Vasbinder
- Biobehavioral Nursing and Health Informatics, University of Washington School of Nursing, Seattle, WA, USA
| | - Lesley F Tinker
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Marian L Neuhouser
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Mary Pettinger
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Lauren Hale
- Program in Public Health, Department of Family, Population, and Preventive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Chongzhi Di
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Oleg Zaslavsky
- Biobehavioral Nursing and Health Informatics, University of Washington School of Nursing, Seattle, WA, USA
| | - Laura L Hayman
- Department of Nursing, University of Massachusetts Boston, Boston, MA, USA,Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Boston, MA, USA
| | - Xioachen Lin
- Department of Epidemiology, Center for Global Cardiometabolic Health, Brown University, Providence, RI, USA
| | - Charles Eaton
- Department of Family Medicine and Epidemiology, Alpert Medical School, Brown University, Providence, RI, USA
| | - Di Wang
- Biobehavioral Nursing and Health Informatics, University of Washington School of Nursing, Seattle, WA, USA
| | - Ashley Scherman
- Biobehavioral Nursing and Health Informatics, University of Washington School of Nursing, Seattle, WA, USA
| | - Marcia L Stefanick
- Department of Medicine, Stanford Prevention Research Center, Stanford, CA, USA
| | - Wendy E Barrington
- Child, Family, Population Health Nursing, University of Washington School of Nursing, Seattle, WA, USA
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Muchira JM, Gona PN, Mogos MF, Stuart-Shor E, Leveille SG, Piano MR, Hayman LL. Parental cardiovascular health predicts time to onset of cardiovascular disease in offspring. Eur J Prev Cardiol 2020; 29:883-891. [PMID: 33624039 DOI: 10.1093/eurjpc/zwaa072] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 07/18/2020] [Accepted: 09/07/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Cardiovascular disease (CVD) risk factors are transmitted from parents to children. We prospectively examined the association between parental cardiovascular health (CVH) and time to onset of CVD in the offspring. METHODS AND RESULTS The study consisted of a total of 5967 offspring-mother-father trios derived from the Framingham Heart Study. Cardiovascular health score was defined using the seven American Heart Association's CVH metrics attained at ideal levels: poor (0-2), intermediate (3-4), and ideal CVH (5-7). Multivariable-adjusted Cox proportional hazards regression models, Kaplan-Meier plots, and Irwin's restricted mean were used to examine the association and sex-specific differences between parental CVH and offspring's CVD-free survival. In a total of 71 974 person-years of follow-up among the offspring, 718 incident CVD events occurred. The overall CVD incidence rate was 10 per 1000 person-years [95% confidence interval (CI) 9.3-10.7]. Offspring of mothers with ideal CVH lived 9 more years free of CVD than offspring of mothers with poor CVH (P < 0.001). Maternal poor CVH was associated with twice as high hazard of early onset of CVD compared with maternal ideal CVH (adjusted Hazard Ratio 2.09, 95% CI 1.50-2.92). No statistically significant association was observed in the hazards of CVD-free survival by paternal CVH categories. CONCLUSIONS We found that offspring of parents with ideal CVH had a greater CVD-free survival. Maternal CVH was a more robust predictor of offspring's CVD-free survival than paternal CVH, underscoring the need for clinical and policy interventions that involve mothers to break the intergenerational cycle of CVD-related morbidity and mortality.
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Affiliation(s)
- James M Muchira
- Center for Research Development and Scholarship, Vanderbilt University, School of Nursing, 461 21st Ave S, Nashville, TN 37240, USA.,College of Nursing and Health Sciences, University of Massachusetts Boston, 100 William T Morrissey Blvd, Boston, MA 02125, USA
| | - Philimon N Gona
- College of Nursing and Health Sciences, University of Massachusetts Boston, 100 William T Morrissey Blvd, Boston, MA 02125, USA
| | - Mulubrhan F Mogos
- Center for Research Development and Scholarship, Vanderbilt University, School of Nursing, 461 21st Ave S, Nashville, TN 37240, USA
| | - Eileen Stuart-Shor
- College of Nursing and Health Sciences, University of Massachusetts Boston, 100 William T Morrissey Blvd, Boston, MA 02125, USA.,Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02215, USA
| | - Suzanne G Leveille
- College of Nursing and Health Sciences, University of Massachusetts Boston, 100 William T Morrissey Blvd, Boston, MA 02125, USA.,Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02215, USA.,Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA
| | - Mariann R Piano
- Center for Research Development and Scholarship, Vanderbilt University, School of Nursing, 461 21st Ave S, Nashville, TN 37240, USA
| | - Laura L Hayman
- College of Nursing and Health Sciences, University of Massachusetts Boston, 100 William T Morrissey Blvd, Boston, MA 02125, USA.,Division of Preventive & Behavioral Medicine, Department of Population & Quantitative Health Sciences, UMass Medical School, 368 Plantation Street, Worcester, MA 01605, USA
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Vadiveloo M, Lichtenstein AH, Anderson C, Aspry K, Foraker R, Griggs S, Hayman LL, Johnston E, Stone NJ, Thorndike AN. Rapid Diet Assessment Screening Tools for Cardiovascular Disease Risk Reduction Across Healthcare Settings: A Scientific Statement From the American Heart Association. Circ Cardiovasc Qual Outcomes 2020; 13:e000094. [PMID: 32762254 DOI: 10.1161/hcq.0000000000000094] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
It is critical that diet quality be assessed and discussed at the point of care with clinicians and other members of the healthcare team to reduce the incidence and improve the management of diet-related chronic disease, especially cardiovascular disease. Dietary screening or counseling is not usually a component of routine medical visits. Moreover, numerous barriers exist to the implementation of screening and counseling, including lack of training and knowledge, lack of time, sense of futility, lack of reimbursement, competing demands during the visit, and absence of validated rapid diet screener tools with coupled clinical decision support to identify actionable modifications for improvement. With more widespread use of electronic health records, there is an enormous unmet opportunity to provide evidence-based clinician-delivered dietary guidance using rapid diet screener tools that must be addressed. In this scientific statement from the American Heart Association, we provide rationale for the widespread adoption of rapid diet screener tools in primary care and relevant specialty care prevention settings, discuss the theory- and practice-based criteria of a rapid diet screener tool that supports valid and feasible diet assessment and counseling in clinical settings, review existing tools, and discuss opportunities and challenges for integrating a rapid diet screener tool into clinician workflows through the electronic health record.
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Abstract
PURPOSE OF REVIEW Atherosclerotic-CVD processes begin early in life and are influenced over the life course by interaction of genetic and potential modifiable risk factors, behaviors, and environmental exposures. The purpose of this review is to highlight importance of primordial and primary prevention beginning early in the life course. RECENT FINDINGS Evidence-based guidelines and recommendations for primordial and primary prevention support importance of individual/clinical and population-based approaches to CVD prevention beginning early in life with goal of reducing the risk and burden of CVD. Substantial evidence supports the individual and societal benefits of prevention of CVD and promotion of optimal cardiovascular health beginning early in life and extending across the life course and the need for additional research to guide and inform practices and policies enabling optimal cardiovascular health for all.
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Affiliation(s)
- Laura L Hayman
- Department of Nursing, College of Nursing and Health Sciences, University of Massachusetts Boston, 100 Morrissey Blvd., Quinn Building-Second Floor, Boston, MA, 02125-3393, USA. .,Division of Preventive & Behavioral Medicine, Department of Population & Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA.
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Camhi SM, Wright J, Lindsay AC, Troped PJ, Hayman LL. Individual, Interpersonal And Environmental Factors Associated With Exercise Prescription Utilization In Urban Minority Women. Med Sci Sports Exerc 2020. [DOI: 10.1249/01.mss.0000679164.91085.08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Muchira JM, Gona PN, Mogos MF, Stuart‐Shor E, Leveille SG, Piano MR, Hayman LL. Temporal Trends and Familial Clustering of Ideal Cardiovascular Health in Parents and Offspring Over the Life Course: An Investigation Using The Framingham Heart Study. J Am Heart Assoc 2020; 9:e016292. [PMID: 32486880 PMCID: PMC7429037 DOI: 10.1161/jaha.120.016292] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Background Evidence suggests familial aggregation and intergenerational associations for individual cardiovascular health (CVH) metrics. Over a 53‐year life course, we examined trends and association of CVH between parents and their offspring at similar mean ages. Methods and Results We conducted a series of cross‐sectional analyses of the FHS (Framingham Heart Study). Parent‐offspring pairs were assessed at exams where their mean age distributions were similar. Ideal CVH was defined using 5 CVH metrics: blood pressure (<120/<80 mm Hg), fasting blood glucose (<100 mg/dL), blood cholesterol (<200 mg/dL), body mass index (<25 kg/m2), and non‐smoking. Joinpoint regression and Chi‐squared test were used to assess linear trend; proportional‐odds regression was used to examine the association between parents and offspring CVH. A total of 2637 parents were paired with 3119 biological offspring throughout 6 exam cycles. Similar patterns of declining ideal CVH with advancing age were observed in parents and offspring. Small proportions of parents (4%) and offspring (17%) achieved 5 CVH metrics at ideal levels (P‐trend <0.001). Offspring of parents with poor CVH had more than twice the odds of having poor CVH (pooled odds ratio, 2.59; 95% CI, 1.98–3.40). Over time, elevated glucose levels and obesity doubled among the offspring and were the main drivers for declining ideal CVH trends. Conclusions Parental CVH was positively associated with offspring CVH. However, intergenerational CVH gains from declining smoking rates, cholesterol, and blood pressure were offset by rising offspring obesity and elevated glucose levels. This suggests an intergenerational phenotypic shift of risk factors and the need for a family‐centered approach to cardiovascular care.
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Affiliation(s)
- James M. Muchira
- Center for Research Development and ScholarshipVanderbilt University, School of NursingNashvilleTN
- College of Nursing and Health SciencesUniversity of Massachusetts BostonBostonMA
| | - Philimon N. Gona
- College of Nursing and Health SciencesUniversity of Massachusetts BostonBostonMA
| | - Mulubrhan F. Mogos
- Center for Research Development and ScholarshipVanderbilt University, School of NursingNashvilleTN
| | - Eileen Stuart‐Shor
- College of Nursing and Health SciencesUniversity of Massachusetts BostonBostonMA
- Beth Israel Deaconess Medical CenterBostonMA
| | - Suzanne G. Leveille
- College of Nursing and Health SciencesUniversity of Massachusetts BostonBostonMA
- Beth Israel Deaconess Medical CenterBostonMA
- Harvard Medical SchoolBostonMA
| | - Mariann R. Piano
- Center for Research Development and ScholarshipVanderbilt University, School of NursingNashvilleTN
| | - Laura L. Hayman
- College of Nursing and Health SciencesUniversity of Massachusetts BostonBostonMA
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Kang AW, Freedland KE, Janke A, Sumner JA, Hayman LL, Fitzgibbon M, Buscemi J, Dulin A. Society of Behavioral Medicine position statement: Support the updated hypertension guidelines and modify Medicare Part B to improve hypertension management. Transl Behav Med 2020; 10:495-497. [PMID: 31228195 DOI: 10.1093/tbm/ibz104] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Hypertension contributes to significant global health and economic burdens. The American College of Cardiology/American Heart Association's latest guideline lowers the blood pressure threshold for hypertension, and as a result, the number of adults with hypertension has increased. Hypertension is a major risk factor for cardiovascular morbidity, especially among older adults. Many individuals who are diagnosed with hypertension at the new, lower threshold may benefit from lifestyle counseling, but changes to existing Medicare policies are required to increase utilization of evidence-based lifestyle counseling approaches to hypertension management. We recommend appropriate funding for the reimbursement of evidence-based lifestyle counseling for hypertension management, the expansion of medical nutrition therapy counseling coverage as an option for Medicare beneficiaries with hypertension, the inclusion of home-based blood pressure monitoring devices in the list of Durable Medical Equipment Coverage, and modifications to the Medicare Benefit Policy Manual to prioritize evidence-based programs such as Dietary Approaches to Stop Hypertension, American Heart Association, and plant-predominant dietary programs.
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Affiliation(s)
- Augustine W Kang
- Department of Behavioral and Social Sciences, Brown School of Public Health, Providence, RI, USA
| | - Kenneth E Freedland
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Amy Janke
- Department of Behavioral and Social Sciences, University of the Sciences, Philadelphia, PA, USA
| | - Jennifer A Sumner
- Center for Behavioral Cardiovascular Health, Columbia University Medical Center, New York, NY, USA
| | - Laura L Hayman
- Department of Nursing, University of Massachusetts Boston, Boston, MA, USA
| | - Marian Fitzgibbon
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA
| | - Joanna Buscemi
- Department of Psychology, DePaul University, Chicago, IL, USA
| | - Akilah Dulin
- Department of Behavioral and Social Sciences, Brown School of Public Health, Providence, RI, USA
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Wood AC, Blissett JM, Brunstrom JM, Carnell S, Faith MS, Fisher JO, Hayman LL, Khalsa AS, Hughes SO, Miller AL, Momin SR, Welsh JA, Woo JG, Haycraft E. Caregiver Influences on Eating Behaviors in Young Children: A Scientific Statement From the American Heart Association. J Am Heart Assoc 2020; 9:e014520. [PMID: 32389066 PMCID: PMC7660848 DOI: 10.1161/jaha.119.014520] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
A substantial body of research suggests that efforts to prevent pediatric obesity may benefit from targeting not just what a child eats, but how they eat. Specifically, child obesity prevention should include a component that addresses reasons why children have differing abilities to start and stop eating in response to internal cues of hunger and satiety, a construct known as eating self‐regulation. This review summarizes current knowledge regarding how caregivers can be an important influence on children's eating self‐regulation during early childhood. First, we discuss the evidence supporting an association between caregiver feeding and child eating self‐regulation. Second, we discuss what implications the current evidence has for actions caregivers may be able to take to support children's eating self‐regulation. Finally, we consider the broader social, economic, and cultural context around the feeding environment relationship and how this intersects with the implementation of any actions. As far as we are aware, this is the first American Heart Association (AHA) scientific statement to focus on a psychobehavioral approach to reducing obesity risk in young children. It is anticipated that the timely information provided in this review can be used not only by caregivers within the immediate and extended family but also by a broad range of community‐based care providers.
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DiPietro L, Zhang Y, Mavredes M, Simmens SJ, Whiteley JA, Hayman LL, Faro J, Malin SK, Winston G, Napolitano MA. Physical Activity and Cardiometabolic Risk Factor Clustering in Young Adults with Obesity. Med Sci Sports Exerc 2020; 52:1050-1056. [PMID: 31764468 PMCID: PMC7166161 DOI: 10.1249/mss.0000000000002214] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
INTRODUCTION There is a paucity of information on the clustering of cardiometabolic risk factors in young adults and how this clustering may vary based on whether or not they perform sufficient levels of physical activity. METHODS We analyzed baseline data from 346 young adults (23.3 ± 4.4 yr) participating in the Healthy Body Healthy U clinical trial from 2015 to 2018. Cardiometabolic risk factors were measured according to standard procedures and moderate- to vigorous-intensity physical activity (MVPA) was determined by accelerometry. A cardiometabolic clustering score (ranging from 0 to 5) was created from five biomarkers according to whether or not a standard clinical risk cut point was exceeded (0, no; 1, yes): abdominal circumference (>102 cm (men) or >88 cm (women)), hemoglobin A1c (≥5.7%), HDL cholesterol (<40 mg·dL (men) or <50 mg·dL (women)), systolic blood pressure (≥130 mm Hg), and diastolic blood pressure (≥85 mm Hg). Cardiometabolic dysregulation (CD) was defined as a cardiometabolic clustering score ≥3. Multiple logistic regression determined the independent association between level of MVPA and CD, while adjusting for sex, race/ethnicity, sedentary time, and smoking. RESULTS The prevalence of CD was 18% (22% in men, 17% in women). We observed a nonlinear graded association between MVPA and CD. Participants performing 150-300 min·wk of MVPA significantly lowered their odds of CD by 66% (odds ratio, 0.34; 95% confidence interval, 0.16-0.75), whereas those exceeding 300 min·wk lowered their odds by 61% (odds ratio, 0.39; 95% confidence interval, 0.18-0.86) compared with those performing <150 min·wk, independent of obesity and the other covariables. CONCLUSION Recommended levels of moderate-intensity physical activity is significantly associated with lower odds of CD and thus may prevent or diminish the need for expensive pharmaceutical treatment over the remainder of the life-span.
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Affiliation(s)
- Loretta DiPietro
- Departments of Exercise & Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC
| | - Yuqing Zhang
- Departments of Prevention & Community Health, Milken Institute School of Public Health, The George Washington University, Washington, DC
| | - Meghan Mavredes
- Departments of Prevention & Community Health, Milken Institute School of Public Health, The George Washington University, Washington, DC
| | - Samuel J Simmens
- Departments of Epidemiology & Biostatistics, Milken Institute School of Public Health, The George Washington University, Washington, DC
| | - Jessica A Whiteley
- Departments of Exercise & Health Sciences, University of Massachusetts Boston, Boston, MA
| | - Laura L Hayman
- Department of Nursing, University of Massachusetts Boston, Boston, MA
| | - Jamie Faro
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA
| | - Steven K. Malin
- Department of Kinesiology, University of Virginia, Charlottesville, VA
| | - Ginger Winston
- Medical Faculty Associates, The George Washington University, Washington, DC
| | - Melissa A Napolitano
- Departments of Exercise & Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC
- Departments of Prevention & Community Health, Milken Institute School of Public Health, The George Washington University, Washington, DC
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Abstract
BACKGROUND Diabetes treatment and management provide a unique opportunity for examination of the effectiveness of electronic health records (EHRs) on patient health outcomes, continuity of care, and areas for further development. This systematic literature review was designed to identify the strengths and limitations of EHR and opportunities for improvement proposed in original research and recent rigorous systematic reviews. METHODS This review utilized methodology adapted from PRISMA. Inclusion criteria for original research were published between March 2003 and November 2017; included randomized controlled trial design with participants ≥18 years of age with diabetes diagnosis ≥1 year; measured outcomes included HbA1c, blood pressure, and LDL cholesterol levels. Criteria for systematic reviews included research focused on EHR outcomes, improvement of care for patients with diabetes, prevention of adverse outcomes, web-based communication, and limitations of EHR regarding chronic disease management. Thirteen articles qualified for inclusion. RESULTS Meta-synthesis of articles suggests that chronic disease patients benefit most by decision support tools that alert physicians of drug interactions, communication tools that keep them informed and engaged in their treatment regimens and detailed reporting and tracking designed to inform progress. Collective results suggest that EHR technology is advancing rapidly; however, patient outcomes documented via EHR systems remain largely unknown. CONCLUSION A fertile area for inquiry designed to enhance patient outcomes in diabetes and chronic disease management is determining how EHR systems can be utilized for new drug and treatment options in addition to enhancing the quality, cost-effectiveness, and continuity of care.
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Affiliation(s)
- Stephanie E. Lessing
- University of Massachusetts Boston,
Boston, MA, USA
- Stephanie E. Lessing, MS, University of
Massachusetts Boston, 100 Morrissey Blvd, Boston, MA 02125, USA.
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Hayman LL, Muchira JM. Primordial/Primary Prevention: Implications and Challenges for Families and Children. Lifestyle Medicine 2019. [DOI: 10.1201/9781315201108-72] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Cooley ME, Blonquist TM, Hong F, Nayak MM, Crouter SE, Hayman LL, Jaklitsch MT, Emmons KM, Bueno R. The effect of a lifestyle risk reduction intervention on lifestyle adherence and health-related quality of life in nonsmall cell lung cancer survivors: Feasibility study outcomes. Psychooncology 2019; 28:920-923. [PMID: 30673155 DOI: 10.1002/pon.5002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 12/30/2018] [Accepted: 01/03/2019] [Indexed: 11/09/2022]
Affiliation(s)
- Mary E Cooley
- Phyllis F. Cantor Center for Research in Nursing and Patient Care Services, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Traci M Blonquist
- Division of Biostatistics, Department of Data Sciences, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Fangxin Hong
- Division of Biostatistics, Department of Data Sciences (Dana-Farber Cancer Institute) and Department of Biostatistics, Harvard T.H. Chan School of Public Health, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Manan M Nayak
- Phyllis F. Cantor Center for Research in Nursing and Patient Care Services, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Scott E Crouter
- College of Education, Health and Human Sciences, University of Tennesee, Knoxville, USA
| | - Laura L Hayman
- College of Nursing and Health Sciences, University of Massachusetts-, Boston, Tennessee, USA
| | - Michael T Jaklitsch
- Division of Thoracic Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Karen M Emmons
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Raphael Bueno
- Division of Thoracic Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA
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Somayaji D, Blok AC, Hayman LL, Colson Y, Jaklisch M, Cooley ME. Enhancing behavioral change among lung cancer survivors participating in a lifestyle risk reduction intervention: a qualitative study. Support Care Cancer 2019; 27:1299-1308. [PMID: 30643990 DOI: 10.1007/s00520-018-4631-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 12/27/2018] [Indexed: 11/30/2022]
Abstract
PURPOSE Early detection and improved treatment have increased lung cancer survival. Lung cancer survivors have more symptom distress and lower function compared with other cancer survivors; however, few interventions are available to improve health-related quality of life (HR-QOL). Lifestyle risk reduction interventions have improved HR-QOL in other cancer survivors. The purpose of this study was to explore lung cancer survivor perspectives on making behavioral changes in the context of a lifestyle risk reduction intervention. METHODS Twenty-two lung cancer survivors participated in interviews after completing the Healthy Directions (HD) intervention. Interviews were audiotaped, transcribed, and analyzed using inductive content analysis. Demographic and clinical characteristics were gathered through a survey and analyzed using descriptive statistics. RESULTS Five main themes were identified: (1) the diagnosis was a motivator for behavior change, (2) participants had to deal with disease consequences, (3) the coach provided guidance, (4) strategies for change were initiated, and (5) social support sustained behavioral changes. Other important subthemes were the coach helped interpret symptoms, which supported self-efficacy and goal setting, and survivors employed self-monitoring behaviors. Several participants found the recommended goals for physical activity were difficult and were discouraged if unable to attain the goal. Findings underscore the need for individualized prescriptions of physical activity, especially for sedentary survivors. CONCLUSIONS Lung cancer survivors described the benefits of coaching to enhance their engagement in behavioral change. Additional research is needed to validate the benefit of the HD intervention to improve HR-QOL among this vulnerable and understudied group of cancer survivors.
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Affiliation(s)
- Darryl Somayaji
- University at Buffalo, 3435 Main Street, 201C, Buffalo, NY, 14214, USA.
| | - Amanda C Blok
- Center for Healthcare Organization and Implementation Research (CHOIR), Edith Nourse Rogers Memorial Hospital, United States Department of Veterans Affairs, 200 Springs Road, Building 70 (152), Bedford, MA, 01730, USA.,Graduate School of Nursing and Department of Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA, 01605, USA
| | - Laura L Hayman
- College of Nursing and Health Sciences, University of Massachusetts Boston, 100 Morrissey Blvd., Boston, MA, 02125-3393, USA
| | - Yolanda Colson
- Division of Thoracic Surgery, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115, USA
| | - Michael Jaklisch
- Division of Thoracic Surgery, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115, USA
| | - Mary E Cooley
- Dana-Farber Cancer Institute, 450 Brookline Ave, LW-512, Boston, MA, 02215, USA
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