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Chantaprasopsuk S, Rees-Punia E, Patel AV. Physical activity, obesity, and bladder cancer incidence. Cancer Causes Control 2023:10.1007/s10552-023-01711-0. [PMID: 37202564 DOI: 10.1007/s10552-023-01711-0] [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: 10/28/2022] [Accepted: 05/03/2023] [Indexed: 05/20/2023]
Abstract
PURPOSE Cigarette smoking is an established risk factor for bladder cancer (BC), but evidence for physical inactivity and obesity is limited. METHODS This analysis included 146,027 participants from the Cancer Prevention Study-II (CPS-II) Nutrition Cohort, a large prospective cohort of cancer incidence established in 1992. Multivariable-adjusted Cox proportional hazards models were used to examine associations between body mass index (BMI), moderate-to-vigorous intensity aerobic physical activity (MVPA), leisure-time spent sitting, and BC risk. Effect modification by stage, smoking status, and sex was examined. RESULTS Only participants accumulating 15.0- < 30.0 MET-hrs/wk of MVPA had a lower risk of BC overall (RR 0.88, 95% CI 0.78, 0.99, compared to > 0-7.5 MET-hrs/wk) in the fully adjusted models. When stratifying on BC stage, MVPA (15- < 30 MET-hrs/wk vs. > 0- < 7.5 MET-hrs/wk, RR 0.83, 95% CI 0.70-0.99) and excess sitting time (≥ 6 h/day vs. 0- < 3 h/day RR 1.22, 95% CI 1.02, 1.47) were associated with risk of invasive BC only. There was no consistent evidence for effect modification by smoking status or sex. CONCLUSION This study supports that MVPA and sitting time may play a role in BC incidence, but associations likely differ by stage at diagnosis. While additional studies are needed to confirm associations by stage, this study adds to the evidence of the importance of being physically active for cancer prevention.
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Affiliation(s)
| | - Erika Rees-Punia
- Department of Population Science, American Cancer Society, Kennesaw, GA, USA
| | - Alpa V Patel
- Department of Population Science, American Cancer Society, Kennesaw, GA, USA
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McCullough ML, Chantaprasopsuk S, Islami F, Um C, Rees-Punia E, Wang Y, Leach C, Sullivan L, Patel AV. Socioeconomic and Geographic Predictors of Poor Diet Quality in a Large U.S. Cohort of Adult Men and Women. Cancer Epidemiol Biomarkers Prev 2022. [PMID: 35775223 DOI: 10.1158/1055-9965.epi-22-0479] [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] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
PURPOSE Poor diet quality is an important determinant of obesity and chronic disease risk. A better understanding of social, economic and geographic factors associated with diet quality can inform public health and policy efforts for advancing health equity. METHODS This cross-sectional analysis of 155,331 adult men and women in the American Cancer Society (ACS) Cancer Prevention Study-3 examined race/ethnicity, socioeconomic (individual-level education and income), and geographic (metropolitan to rural dwelling, residence in food desert) predictors of poor diet quality, mutually adjusted using multivariable logistic regression models. A diet score reflecting concordance with the 2020 ACS dietary recommendations for cancer prevention based on intake of fruit, vegetables, whole grains, red and processed meats, sugar-sweetened beverages (SSBs) and highly processed foods was calculated from responses to a validated food frequency questionnaire, with scores ranging from 0 (worst) to 12 (best) diet quality, and scores 0-3 representing poor diet quality. RESULTS All socioeconomic and geographic characteristics assessed were statistically significant, independent predictors of poor diet quality. Compared to White participants, Black participants had a 16% higher likelihood of poor diet quality, while Hispanic/Latino and Asian/Native Hawaiian/Pacific Islander participants had 16% and 33% lower risk of poor diet quality, respectively. Higher income and education were linearly associated with better diet quality among White participants, but not among other racial/ethnic groups. Even after controlling for other characteristics, non-metropolitan residence was associated with a 61% higher risk of poor diet quality. Additionally, residence in a food desert was associated with a 17% higher risk. All diet score components contributed to disparities observed, particularly red and processed meat and SSBs. CONCLUSIONS Race/ethnicity, socioeconomic and geographic factors independently predicted risk of poor diet quality among a large, diverse adult U.S. POPULATION These findings contribute information to more effectively target behavioral interventions, programs, and policies to improve diet quality for populations at highest risk.
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Rees-Punia E, Kirkland EG, Rittase MH, Torres CX, Chantaprasopsuk S, Masters M, Patel AV. Racial, Ethnic, and Nativity Disparities in Physical Activity and Sedentary Time among Cancer Prevention Study-3 Participants. Med Sci Sports Exerc 2022; 54:1139-1146. [PMID: 35704439 DOI: 10.1249/mss.0000000000002891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE Understanding racial/ethnic and nativity disparities in physical activity (PA) is important, as certain subgroups bear a disproportionate burden of physical inactivity-related diseases. This descriptive study compared mean leisure-time moderate-to-vigorous intensity physical activity (LTMVPA) by race/ethnicity and nativity. METHODS The Cancer Prevention Study-3 (78.1% women; age, 47.9 ± 9.7 yr) includes 4722 (1.9%) Asian/Pacific Islander; 1232 (0.5%) Black/Indigenous (non-White) Latino; 16,041 (6.5%) White Latino; 9295 (3.8%) non-Latino Black; 2623 (1.1%) Indigenous American; and 210,504 (85.7%) non-Latino White participants across the United States and Puerto Rico. Participants completed validated LTMVPA and 24-h time use surveys at enrollment (2006-2013). Differences in LTMVPA across race/ethnicity and nativity were examined by ANCOVA with paired Tukey tests adjusting for age and sex. The proportion of time spent sitting, sleeping, and on PA by race/ethnicity was also compared. RESULTS There were significant differences in LTMVPA by race/ethnicity (race main effect, P < 0.001; nativity, P = 0.072; interaction, P < 0.001). Pairwise comparisons showed that White participants born abroad were the most active (23.8 MET-h·wk-1) and non-White Latino participants born abroad were the least active (17.9 MET-h·wk-1). Among Latinos, participants born in Puerto Rico were 6.6-7.3 MET-h·wk-1 less active than participants born in Mexico, the United States/Canada, or other countries. There were variations in time use by race/ethnicity, with the largest difference in time spent sitting while watching TV. Black participants spent 14.8% of the day (~3.5 h) sitting watching TV, which was 78 min longer than Asian/Pacific Islander participants. CONCLUSIONS This study suggests that there are differences in LTMVPA accumulation by race, ethnicity, and nativity. Results can be used to identify demographic groups that may benefit from culturally tailored PA interventions.
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Affiliation(s)
- Erika Rees-Punia
- Department of Population Science, American Cancer Society, Kennesaw, GA
| | | | - Melissa H Rittase
- Department of Population Science, American Cancer Society, Kennesaw, GA
| | - Carlos X Torres
- Department of Kinesiology, Recinto Universitario de Mayagüez, Mayagüez, PUERTO RICO
| | | | - Matthew Masters
- Department of Population Science, American Cancer Society, Kennesaw, GA
| | - Alpa V Patel
- Department of Population Science, American Cancer Society, Kennesaw, GA
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McCullough ML, Chantaprasopsuk S, Islami F, Rees-Punia E, Um CY, Wang Y, Leach CR, Sullivan KR, Patel AV. Association of Socioeconomic and Geographic Factors With Diet Quality in US Adults. JAMA Netw Open 2022; 5:e2216406. [PMID: 35679041 PMCID: PMC9185183 DOI: 10.1001/jamanetworkopen.2022.16406] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
IMPORTANCE Poor diet quality is a key factor associated with obesity and chronic disease. Understanding associations of socioeconomic and geographic factors with diet quality can inform public health and policy efforts for advancing health equity. OBJECTIVE To identify socioeconomic and geographic factors associated with diet quality in a large US cohort study. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study included adult men and women who enrolled in the Cancer Prevention Study-3 at American Cancer Society community events in 35 US states, the District of Columbia, and Puerto Rico between 2006 and 2013. Participants completed a validated food frequency questionnaire between 2015 and 2017. Data were analyzed from February to November 2021. EXPOSURES The main exposures included self-reported race and ethnicity, education, and household income. Geocoded addresses were used to classify urbanization level using Rural-Urban Commuting Area codes; US Department of Agriculture's Food Access Research Atlas database classified residence in food desert. MAIN OUTCOMES AND MEASURES Poor diet quality was defined as lowest quartile of dietary concordance with the 2020 American Cancer Society recommendations for cancer prevention score, based on sex-specific intake categories of vegetables and legumes, whole fruits, whole grains, red and processed meat, highly processed foods and refined grains, and sugar-sweetened beverages. RESULTS Among 155 331 adults, 123 115 were women (79.3%), and the mean (SD) age was 52 (9.7) years), and there were 1408 American Indian or Alaskan Native individuals (0.9%); 2721 Asian, Native Hawaiian, or Pacific Islander individuals (1.8%); 3829 Black individuals (2.5%); 7967 Hispanic individuals (5.1%); and 138 166 White individuals (88.9%). All key exposures assessed were statistically significantly and independently associated with poor diet quality. Compared with White participants, Black participants had a 16% (95% CI, 8%-25%) higher risk of poor diet quality, while Hispanic/Latino had 16% (95% CI, 12%-21%) lower risk and Asian, Native Hawaiian, and Pacific Islander participants had 33% (95% CI, 26%-40%) lower risk of poor diet quality. After controlling for other characteristics, rural residence was associated with a 61% (95% CI, 48%-75%) higher risk of poor diet quality, and living in a food desert was associated with a 17% (95% CI, 12%-22%) higher risk. Associations of income with diet quality and education with diet quality varied by race and ethnicity (income: P for interaction = .01; education: P for interaction < .001). All diet score components were associated with disparities observed. CONCLUSIONS AND RELEVANCE This cross-sectional study found that multiple individual-level socioeconomic and geographic variables were independently associated with poor diet quality among a large, racially and ethnically and geographically diverse US cohort. These findings could help to identify groups at highest risk of outcomes associated with poor diet to inform future approaches for advancing health equity.
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Affiliation(s)
| | | | - Farhad Islami
- Department of Surveillance and Health Equity Science, American Cancer Society, Kennesaw, Georgia
| | - Erika Rees-Punia
- Department of Population Science, American Cancer Society, Kennesaw, Georgia
| | - Caroline Y. Um
- Department of Population Science, American Cancer Society, Kennesaw, Georgia
| | - Ying Wang
- Department of Population Science, American Cancer Society, Kennesaw, Georgia
| | - Corinne R. Leach
- Department of Population Science, American Cancer Society, Kennesaw, Georgia
| | - Kristen R. Sullivan
- Department of Population Science, American Cancer Society, Kennesaw, Georgia
| | - Alpa V. Patel
- Department of Population Science, American Cancer Society, Kennesaw, Georgia
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Leach CR, Hudson SV, Diefenbach MA, Wiseman KP, Sanders A, Coa K, Chantaprasopsuk S, Stephens RL, Alfano CM. Cancer health self-efficacy improvement in a randomized controlled trial. Cancer 2022; 128:597-605. [PMID: 34668569 PMCID: PMC9930867 DOI: 10.1002/cncr.33947] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 03/25/2021] [Revised: 06/21/2021] [Accepted: 08/30/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND eHealth interventions can help cancer survivors self-manage their health outside the clinic. Little is known about how best to engage and assist survivors across the age and cancer treatment spectra. METHODS The American Cancer Society conducted a randomized controlled trial that assessed efficacy of, and engagement with, Springboard Beyond Cancer, an eHealth self-management program for cancer survivors. Intent-to treat analyses assessed effects of intervention engagement for treatment (on-treatment vs completed) overall (n = 176; 88 control, 88 intervention arm) and separately by age (<60 years vs older). Multiple imputation was used to account for participants who were lost to follow-up (n = 41) or missing self-efficacy data (n = 1) at 3 months follow-up. RESULTS Self-efficacy for managing cancer, the primary outcome of this trial, increased significantly within the intervention arm and for those who had completed treatment (Cohen's d = 0.26, 0.31, respectively). Additionally, participants with moderate-to-high engagement in the text and/or web intervention (n = 30) had a significantly greater self-efficacy for managing cancer-related issues compared to the control group (n = 68), with a medium effect size (Cohen's d = 0.44). Self-efficacy did not differ between the intervention and control arm at 3 months post-baseline. CONCLUSIONS Study results suggest that cancer survivors benefit variably from eHealth tools. To maximize effects of such tools, it is imperative to tailor information to a priori identified survivor subgroups and increase engagement efforts.
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Leach CR, Rees-Punia E, Newton CC, Chantaprasopsuk S, Patel AV, Westmaas JL. Stressors and Other Pandemic-related Predictors of Prospective Changes in Psychological Distress. Lancet Reg Health Am 2021; 4:100069. [PMID: 34518825 PMCID: PMC8427739 DOI: 10.1016/j.lana.2021.100069] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 08/13/2021] [Accepted: 08/24/2021] [Indexed: 01/03/2023]
Abstract
Background Numerous studies have documented mental health challenges during the COVID-19 pandemic. Few studies included pre-pandemic levels of mental health or were comprehensive in assessing factors likely associated with longer-term mental health impacts. Methods Analyses used prospective data from a subset of participants in the nationwide Cancer Prevention Study-3 (CPS-3) United States cohort (N=2,359; 1,534 women; 825 men) who completed surveys in 2018 and during the COVID-19 pandemic (July-September 2020). Logistic regressions examined associations of pandemic-related stressors, sociodemographic and other predictors with (i) overall psychological distress (PD) and depression and anxiety separately during the COVID-19 pandemic and (ii) change in PD from 2018 to during the pandemic (low/low; high to low; low to high; high/high). Findings During the pandemic, 10% of participants reported moderate-to-severe PD and almost half (42%) reported at least mild PD. Pandemic PD levels were associated with pre-pandemic PD (female OR=5.65; male OR=9.70), financial stressors (female OR=2.48; male OR=3.68), and work/life balance stressors (female OR=3.03; male OR=3.33) experienced since the pandemic began. These stressors also predicted an escalation from low PD in 2018 to high PD during the pandemic. Factors associated with high PD at both time points included younger age, female sex, and financial stressors. Interpretation These results highlight the importance of regular mental health assessment and support among those with a history of mental health problems and those experiencing pandemic-related stressors, such as those with caregiving responsibilities or job changes. Funding The American Cancer Society funds the creation, maintenance, and updating of the CPS-3.
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Affiliation(s)
- Corinne R Leach
- Department of Population Science, American Cancer Society, Atlanta GA
| | - Erika Rees-Punia
- Department of Population Science, American Cancer Society, Atlanta GA
| | | | | | - Alpa V Patel
- Department of Population Science, American Cancer Society, Atlanta GA
| | - J Lee Westmaas
- Department of Population Science, American Cancer Society, Atlanta GA
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Rees-Punia E, Newton CC, Westmaas JL, Chantaprasopsuk S, Patel AV, Leach CR. Prospective COVID-19 related changes in physical activity and sedentary time and associations with symptoms of depression and anxiety. Ment Health Phys Act 2021; 21:100425. [PMID: 34611463 PMCID: PMC8483810 DOI: 10.1016/j.mhpa.2021.100425] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 08/25/2021] [Accepted: 09/23/2021] [Indexed: 11/25/2022]
Abstract
PROBLEM The COVID-19 pandemic is associated with psychological distress. Decreased moderate-vigorous physical activity (MVPA) and increased sedentary time may be exacerbating pandemic-related symptoms of anxiety and depression, but existing studies exploring these associations are almost entirely cross-sectional. METHODS Reported data from 2018 and Summer 2020 were used to create change categories based on compliance with MVPA guidelines and relative sedentary time. Participants completed the Patient Health Questionnaire-4 (PHQ-4) in Summer 2020. Associations among changes in MVPA and sedentary time (separately and jointly) with psychological distress (total PHQ-4 score) were examined with ordinal logistic regression and associations with depressive or anxiety symptoms were examined with logistic regression. RESULTS Among 2,240 participants (65% women, mean age 57.5 years), 67% increased sedentary time and 21% became inactive between the two time points. After multivariate adjustment, participants who became (OR = 1.71, 95% CI: 1.05-2.78) or remained inactive (OR = 2.07, 1.34-3.22) were more likely to experience depressive symptoms compared to those who remained active. Participants who increased sedentary time were also more likely to experience depressive symptoms compared to those who maintained sedentary time (OR = 1.78, 1.13-2.81). Jointly, those who increased sedentary time while remaining (OR = 3.67, 1.83-7.38) or becoming inactive (OR = 3.02, 1.44-6.34) were much more likely to have depressive symptoms compared to the joint referent (remained active/maintained sedentary time). Associations with anxiety symptoms were not statistically significant. CONCLUSIONS These findings support the value of promoting MVPA and limiting sedentary time during stressful events associated with psychological distress, like the COVID-19 pandemic.
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Affiliation(s)
- Erika Rees-Punia
- Dept. of Population Science, American Cancer Society 3380 Chastain Meadows Pkwy NW Kennesaw, GA 30144 USA
| | - Christina C Newton
- Dept. of Population Science, American Cancer Society 3380 Chastain Meadows Pkwy NW Kennesaw, GA 30144 USA
| | - J Lee Westmaas
- Dept. of Population Science, American Cancer Society 3380 Chastain Meadows Pkwy NW Kennesaw, GA 30144 USA
| | - Sicha Chantaprasopsuk
- Dept. of Population Science, American Cancer Society 3380 Chastain Meadows Pkwy NW Kennesaw, GA 30144 USA
| | - Alpa V Patel
- Dept. of Population Science, American Cancer Society 3380 Chastain Meadows Pkwy NW Kennesaw, GA 30144 USA
| | - Corinne R Leach
- Dept. of Population Science, American Cancer Society 3380 Chastain Meadows Pkwy NW Kennesaw, GA 30144 USA
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Rees-Punia E, Kirkland E, Rittase M, Chantaprasopsuk S, Masters M, Patel AV. Racial, Ethnic, And Nativity Disparities In Physical Activity Among Cancer Prevention Study-3 Participants. Med Sci Sports Exerc 2021. [DOI: 10.1249/01.mss.0000764960.77802.9f] [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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Leach C, Hudson S, Diefenbach M, Chantaprasopsuk S, Alfano C. Age-Related Engagement and Outcomes in a Cancer Survivor Self-Management eHealth Program. Innov Aging 2020. [PMCID: PMC7742519 DOI: 10.1093/geroni/igaa057.2240] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
While eHealth programs equip survivors with tools at where and when they need, their benefit to and engagement patterns among older adults are less known. Data come from the Springboard Beyond Cancer RCT, a cancer survivor self-management program (N=176; 88 control, 88 intervention arm) and the corresponding qualitative evaluation/user testing (N=40). Younger survivors, but not older, preferred socially interactive and personalized long-in features which enable greater tailoring of the program. However, the older survivors who did enroll in the RCT were equally as likely as their younger counterparts to engage with one or more aspects of program. Health self-efficacy improvement from baseline to 3 months was significant among younger participants in the intervention (p<.05) but not the control arm (p=.54) (d=.20) and marginally significant among older survivors (age 60+) in intervention (p=.06) but not the control arm (p=.58) (d=.28). Results suggest that the program may benefit survivors regardless of age. Part of a symposium sponsored by the Cancer and Aging Interest Group.
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Affiliation(s)
- Corinne Leach
- American Cancer Society, Atlanta, Georgia, United States
| | - Shawna Hudson
- Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, United States
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Guglielmo D, Chantaprasopsuk S, Kay CM, Hyde ET, Stewart C, Gazmararian JA. Nutrition Policies, Practices, and Environments in Low-Income Georgia Elementary Schools, United States, 2015-2017. J Sch Health 2020; 90:278-285. [PMID: 31997370 DOI: 10.1111/josh.12874] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 07/27/2018] [Revised: 02/06/2019] [Accepted: 02/07/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND A nutritious diet can prevent obesity and chronic disease and improve academic performance, yet many children have energy-dense, nutrient-poor diets. The objective of this study was to assess nutrition policies, practices, and environments in Georgia Supplemental Nutrition Assistance Program Education (SNAP-Ed) elementary schools and compare them across school-level demographic characteristics. METHODS We distributed a cross-sectional online survey to administrators, grade level chairs, and nutrition managers from 113 Georgia SNAP-Ed elementary schools during 2015-2017. Logistic regression, one-way ANOVA, and Tukey's tests were performed to assess differences by free and reduced-price lunch eligibility and percentage black. Fisher's exact and Rao-Scott chi-square tests were performed to assess differences by school size and geography. RESULTS The majority of schools established wellness policies and committees, provided nutrition education, and offered fresh fruits and/or vegetables daily. Fewer schools had policies limiting sugar-sweetened foods within classrooms or had established a school garden. There were minimal significant differences in survey responses across school-level demographics. CONCLUSIONS Georgia SNAP-Ed elementary schools are providing healthy nutrition settings for their students in a number of areas, and can further improve by establishing more comprehensive wellness policies, a committee to enforce them, and engaging children in hands-on nutrition education activities.
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Affiliation(s)
- Dana Guglielmo
- Emory University, Rollins School of Public Health, Department of Behavioral Sciences and Health Education, 1518 Clifton Road NE, Atlanta, GA, 30322
| | - Sicha Chantaprasopsuk
- Emory University, Rollins School of Public Health, Department of Epidemiology, Atlanta, GA, 30322
| | | | - Eric T Hyde
- Emory University, Rollins School of Public Health, Department of Epidemiology, Atlanta, GA, 30322
| | | | - Julie A Gazmararian
- Emory University, Rollins School of Public Health, Department of Epidemiology, Atlanta, GA, 30322
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Rees-Punia E, Patel AV, Nocera JR, Chantaprasopsuk S, Demark-Wahnefried W, Leach CR, Smith TG, Cella D, Gapstur SM. Self-reported physical activity, sitting time, and mental and physical health among older cancer survivors compared with adults without a history of cancer. Cancer 2020; 127:115-123. [PMID: 33079415 PMCID: PMC9105766 DOI: 10.1002/cncr.33257] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 07/09/2020] [Revised: 08/28/2020] [Accepted: 09/20/2020] [Indexed: 01/19/2023]
Abstract
BACKGROUND To the authors' knowledge, few studies to date have examined associations between moderate to vigorous physical activity (MVPA) and sitting time with quality of life in cancer survivors compared with a cancer-free group. The current study examined differences in global mental health (GMH) and global physical health (GPH) across levels of MVPA and sitting among cancer survivors and cancer-free participants. METHODS Cancer Prevention Study II participants (59.9% of whom were female with an age of 77.8 ± 5.8 years) were grouped as: 1) survivors who were 1 to 5 years after diagnosis (3718 participants); 2) survivors who were 6 to 10 years after diagnosis (4248 participants); and 3) cancer-free participants (ie, no history of cancer; 69,860 participants). In 2009, participants completed MVPA, sitting, and Patient-Reported Outcomes Measurement Information System GMH/GPH surveys. Mean differences in GMH and GPH T scores across MVPA (none, 0 to <7.5, 7.5 to <15, 15 to <22.5, and ≥22.5 metabolic equivalent [MET]-hours/week) and sitting (0 to <3, 3 to <6, and ≥6 hours/day) were assessed using multivariate generalized linear models. RESULTS The mean GMH and GPH scores were statistically significantly higher in cancer-free participants compared with cancer survivor groups, although the differences were not clinically meaningful (mean difference of 0.52 for GMH and 0.88 for GPH). More MVPA was associated with higher GMH and GPH scores for all 3 groups (P for trend <.001), and differences between the least and most active participants were found to be clinically meaningful (mean differences of ≥4.34 for GMH and ≥6.39 for GPH). Similarly, a lower duration of sitting was associated with higher GMH and GPH scores for all groups (P for trend <.001), with clinically meaningful differences observed between the least and most sedentary participants (mean differences of ≥2.74 for GMH and ≥3.75 for GPH). CONCLUSIONS The findings of the current study provide evidence of the importance of increased MVPA and decreased sitting for improved health in older adults with or without a prior cancer diagnosis.
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Affiliation(s)
- Erika Rees-Punia
- Department of Population Science, American Cancer Society, Atlanta, Georgia
| | - Alpa V. Patel
- Department of Population Science, American Cancer Society, Atlanta, Georgia
| | - Joseph R. Nocera
- Department of Neurology, Emory University, Atlanta, Georgia,Department of Rehabilitation Medicine, Emory University, Atlanta, Georgia,Center for Visual and Neurocognitive Rehabilitation, Atlanta VA Medical Center, Atlanta, Georgia,Cancer Prevention and Control Program, Winship Cancer Institute, Atlanta, Georgia
| | | | - Wendy Demark-Wahnefried
- O’Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, Alabama
| | - Corinne R. Leach
- Department of Population Science, American Cancer Society, Atlanta, Georgia
| | - Tenbroeck G. Smith
- Department of Population Science, American Cancer Society, Atlanta, Georgia
| | - David Cella
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Susan M. Gapstur
- Department of Population Science, American Cancer Society, Atlanta, Georgia
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