1
|
Luna E, Springer A, Herrera D, Garcia ME, Brown L, Kelder SH. Identifying Factors That Influence Physical Activity and Healthy Aging Among Older Latino Adults. Health Educ Behav 2024:10901981241228221. [PMID: 38328931 DOI: 10.1177/10901981241228221] [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: 02/09/2024]
Abstract
BACKGROUND For older Latinos, some benefits of leisure-time physical activity (LTPA) include enhanced cognitive functioning, decreased loneliness, and reduced premature mortality. Despite LTPA benefits, adults ≥50 years are one of the most inactive age groups in the United States. METHODS This qualitative study aimed to add to the limited evidence of LTPA in older Latino adults by exploring the barriers and facilitators for fitness class uptake and park use. Guided by a Social-Ecological Model of Health and Social Determinants of Health theoretical and a phenomenological research design, qualitative research data were collected via 27 personal interviews with Latino adults using a semistructured interview guide. Participants were recruited using purposive sampling strategies in collaboration with community partners. Bicultural data collectors conducted the semistructured interviews over Zoom. Thematic analysis was performed using Dedoose, following an inductive and deductive approach. RESULTS The main barriers to fitness class attendance and park use were family and/or work commitments, perceived safety, and perceived discrimination. Conversely, the critical facilitators for participation were socialization into a group, social connectedness with group members, fitness instructor characteristics, and exercise history. CONCLUSIONS Findings from this study hold important implications for the design of fitness programming and park-based recreation, including the need to increase the cultural diversity of recreation staff and culturally relevant programming. Future research is needed on time poverty related to family/work commitments and whether discriminatory practices at fitness centers, like ageism and race/ethnicity, influence physical activity behavior.
Collapse
Affiliation(s)
- Elena Luna
- School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Austin, TX, USA
| | - Andrew Springer
- School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Austin, TX, USA
- Michael & Susan Dell Center for Healthy Living, Austin, TX, USA
| | - Denise Herrera
- School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Austin, TX, USA
| | - Maria Elena Garcia
- School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Austin, TX, USA
| | - Louis Brown
- School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), El Paso, TX, USA
| | - Steven H Kelder
- School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Austin, TX, USA
- Michael & Susan Dell Center for Healthy Living, Austin, TX, USA
| |
Collapse
|
2
|
Mantey DS, Omega-Njemnobi O, Montgomery LT, Kelder SH. Racial and Ethnic Disparities in Adolescent Combustible Tobacco Smoking from 2014 to 2020: Declines are lagging among non-Hispanic Black Youth. Nicotine Tob Res 2024:ntae001. [PMID: 38181207 DOI: 10.1093/ntr/ntae001] [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] [Received: 11/23/2022] [Indexed: 01/07/2024]
Abstract
INTRODUCTION We quantified the linear trend in combustible tobacco smoking among adolescents in the United States from 2014 to 2020, then compared these trends across racial and ethnic category. We also tested the effect of e-cigarette use on these trends for all youth and across racial and ethnic categories. METHODS We pooled and analyzed seven years of National Youth Tobacco Survey (NYTS) data for n=124,151 middle and high school students from 2014 to 2020. Weighted logistic regression analyses calculated the annual change in combustible tobacco smoking (i.e., cigarettes, cigars, and hookah) from 2014 to 2020. Stratified analyses examined linear trends for non-Hispanic White (NHW), NH-Black (NHB), Hispanic/Latino, and NH-Other (NHO) youth. All models controlled for sex, grade level, and past 30-day e-cigarette use. RESULTS Combustible tobacco smoking from 2014 to 2020 dropped by more than 50% for NHW youth, more than 40% for Latino and NHO youth, compared to just 16% among NHB youth. From 2014 to 2020, odds of combustible tobacco smoking declined by 21.5% per year for NHWs, which was significantly greater than Hispanic/Latinos (17% per year; p=0.025), NHOs (15.4% per year; p=0.01), and NHBs (5.1% per year; p<0.001), adjusting for sex, grade, and e-cigarette use. Trends and disparities in trends by race and ethnicity were observed independent of e-cigarette use. CONCLUSIONS Combustible tobacco smoking declined for all youth but at significantly different rates across races and ethnicity. Notably, declines in combustible tobacco smoking are lagging among NHB youth. Interventions are critically needed to address this disparity. IMPLICATIONS A direct, evidence-based intervention to reduce combustible tobacco smoking among NHB youth is critically needed. Such tobacco control initiatives should follow the Best Practices for Comprehensive Tobacco Control Framework, incorporating sustainable funding for school-based intervention, public health education, and adult cessation.
Collapse
Affiliation(s)
- Dale S Mantey
- UTHealth, University of Texas School of Public Health, Department of Health Promotion and Behavioral Science
- Michael & Susan Dell Center for Healthy Living, UTHealth School of Public Health Austin Campus, Austin, Texas, USA
| | - Onyinye Omega-Njemnobi
- Michael & Susan Dell Center for Healthy Living, UTHealth School of Public Health Austin Campus, Austin, Texas, USA
- UTHealth, University of Texas School of Public Health, Department of Epidemiology, Human Genetics & Environmental Sciences
| | - La Trice Montgomery
- University of Cincinnati College of Medicine, Addiction Sciences Division, Department of Psychiatry & Behavioral Neuroscience
| | - Steven H Kelder
- Michael & Susan Dell Center for Healthy Living, UTHealth School of Public Health Austin Campus, Austin, Texas, USA
- UTHealth, University of Texas School of Public Health, Department of Epidemiology, Human Genetics & Environmental Sciences
| |
Collapse
|
3
|
Nyachoti DO, Fwelo P, Springer AE, Kelder SH. Association between Gross National Income per capita and COVID-19 vaccination coverage: a global ecological study. BMC Public Health 2023; 23:2415. [PMID: 38049821 PMCID: PMC10696801 DOI: 10.1186/s12889-023-17241-y] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 11/16/2023] [Indexed: 12/06/2023] Open
Abstract
BACKGROUND Coronavirus 2019 (COVID-19) pandemic has claimed over six million lives and infected more than 650 million people globally. Public health agencies have deployed several strategies, including rolling out vaccination campaigns to curb the pandemic, yet a significant proportion of the global population has not received the COVID-19 vaccine. We assessed differences in COVID-19 vaccination coverage by Gross National Income (GNI) per capita of WHO members (i.e., countries, areas, and territories, n = 192) and by WHO member regions (n = 6). METHODS Using an ecological study design, we analyzed publicly available data from the WHO website merged with the World Bank's GNI per capita data. We included a total of 192 WHO members and six WHO regions in the analysis. We utilized negative binomial regression to assess the associations between the GNI per capita and COVID-19 vaccination coverage (cumulative number of persons fully vaccinated and/or received at least one dose of the vaccine per 100 population), and ANOVA test to assess the differences in vaccination coverage per WHO regions. RESULTS Low GNI per capita WHO members had significantly lower full vaccination coverage (aRR 0.30, 95% CI 0.22-0.40) compared to high GNI per capita WHO members. These members were also 66% less likely to receive at least one dose of the vaccine (aRR 0.34, 0.26-0.44) relative to high GNI per capita WHO members. Africa region had a significantly lower fully vaccination coverage (aRR 0.71, 95% CI 0.36-0.54) and received at least one dose of the COVID-19 vaccine (aRR 0.78, 95% CI 0.62-0.99) than Europe region. Conversely, the Western Pacific region had significantly higher fully vaccination coverage (aRR 1.40 95% CI 1.12-1.74) and received at least one dose of COVID-19 vaccines (aRR 1.40 95% CI 1.14-1.73) relative to European region. CONCLUSION WHO members with low GNI per capita and the African region reported significantly lower COVID-19 vaccination coverage than those with high GNI per capita or other regions. Efforts to strengthen and promote COVID-19 vaccination in low-income WHO countries and African region should be scaled up.
Collapse
Affiliation(s)
- Dennis Ogeto Nyachoti
- Texas Department of State Health Services, Epidemiology and Surveillance Unit, Austin, TX, USA.
- Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston School of Public Health, El Paso, TX, USA.
| | - Pierre Fwelo
- Department of Epidemiology, Human Genetics & Environmental Sciences, The University of Texas Health Science Center at Houston School of Public Health, Houston, TX, USA
| | - Andrew E Springer
- Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston School of Public Health, Austin, TX, USA
| | - Steven H Kelder
- Department of Epidemiology, Human Genetics & Environmental Sciences, The University of Texas Health Science Center at Houston School of Public Health, Austin, TX, USA
| |
Collapse
|
4
|
DeSantis SM, Yaseen A, Hao T, León-Novelo L, Talebi Y, Valerio-Shewmaker MA, Pinzon Gomez CL, Messiah SE, Kohl HW, Kelder SH, Ross JA, Padilla LN, Silberman M, Wylie S, Lakey D, Shuford JA, Pont SJ, Boerwinkle E, Swartz MD. RE: Incidence of SARS-CoV-2 Breakthrough Infections After Vaccination in Adults: A Population-Based Survey Through 1 March 2023. Open Forum Infect Dis 2023; 10:ofad564. [PMID: 38099238 PMCID: PMC10720767 DOI: 10.1093/ofid/ofad564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2023] Open
Affiliation(s)
- Stacia M DeSantis
- School of Public Health in Houston, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Ashraf Yaseen
- School of Public Health in Houston, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Tianyao Hao
- School of Public Health in Houston, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Luis León-Novelo
- School of Public Health in Houston, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Yashar Talebi
- School of Public Health in Houston, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Melissa A Valerio-Shewmaker
- School of Public Health in Brownsville, The University of Texas Health Science Center at Houston, Brownsville, Texas, USA
| | - Cesar L Pinzon Gomez
- School of Public Health in Houston, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Sarah E Messiah
- School of Public Health in Dallas, The University of Texas Health Science Center at Houston, Dallas, Texas, USA
- Center for Pediatric Population Health, UTHealth School of Public Health, Dallas, Texas, USA
| | - Harold W Kohl
- School of Public Health in Austin, The University of Texas Health Science Center at Houston, Austin, Texas, USA
- The University of Texas at Austin, Austin, Texas, USA
| | - Steven H Kelder
- School of Public Health in Austin, The University of Texas Health Science Center at Houston, Austin, Texas, USA
| | - Jessica A Ross
- School of Public Health in Houston, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Lindsay N Padilla
- School of Public Health in Houston, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | | | | | - David Lakey
- The University of Texas System, Austin, Texas, USA
- The University of Texas at Tyler Health Science Center, Tyler, Texas, USA
| | | | - Stephen J Pont
- Texas Department of State Health Services, Austin, Texas, USA
| | - Eric Boerwinkle
- School of Public Health in Houston, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Michael D Swartz
- School of Public Health in Houston, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| |
Collapse
|
5
|
Messiah SE, Talebi Y, Swartz MD, Sabharwal R, Han H, Bergqvist E, Kohl HW, Valerio-Shewmaker M, DeSantis SM, Yaseen A, Kelder SH, Ross J, Padilla LN, Gonzalez MO, Wu L, Lakey D, Shuford JA, Pont SJ, Boerwinkle E. Long-term immune response to SARS-CoV-2 infection and vaccination in children and adolescents. Pediatr Res 2023:10.1038/s41390-023-02857-y. [PMID: 37875728 DOI: 10.1038/s41390-023-02857-y] [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] [Received: 06/21/2023] [Revised: 09/21/2023] [Accepted: 09/26/2023] [Indexed: 10/26/2023]
Abstract
BACKGROUND This analysis examined the durability of antibodies present after SARS-CoV-2 infection and vaccination in children and adolescents. METHODS Data were collected over 4 time points between October 2020-November 2022 as part of a prospective population-based cohort aged 5-to-19 years (N = 810). Results of the (1) Roche Elecsys® Anti-SARS-CoV-2 Immunoassay for detection of antibodies to the SARS-CoV-2 nucleocapsid protein (Roche N-test); and (2) qualitative and semi-quantitative detection of antibodies to the SARS CoV-2 spike protein receptor binding domain (Roche S-test); and (3) self-reported antigen/PCR COVID-19 test results, vaccination and symptom status were analyzed. RESULTS N antibody levels reached a median of 84.10 U/ml (IQR: 20.2, 157.7) cutoff index (COI) ~ 6 months post-infection and increased slightly to a median of 85.25 (IQR: 28.0, 143.0) COI at 12 months post-infection. Peak S antibody levels were reached at a median of 2500 U/mL ~6 months post-vaccination and remained for ~12 months (mean 11.6 months, SD 1.20). CONCLUSIONS This analysis provides evidence of robust durability of nucleocapsid and spike antibodies in a large pediatric sample up to 12 months post-infection/vaccination. This information can inform pediatric SARS-CoV-2 vaccination schedules. IMPACT This study provided evidence of robust durability of both nucleocapsid and spike antibodies in a large pediatric sample up to 12 months after infection. Little is known about the long-term durability of natural and vaccine-induced SARS-CoV-2 antibodies in the pediatric population. Here, we determined the durability of anti-SARS-CoV-2 spike (S-test) and nucleocapsid protein (N-test) in children/adolescents after SARS-CoV-2 infection and/or vaccination lasts at least up to 12 months. This information can inform future SARS-CoV-2 vaccination schedules in this age group.
Collapse
Affiliation(s)
- Sarah E Messiah
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health (UTHealth) Science Center at Houston, School of Public Health in Dallas, Dallas, TX, USA.
- Center for Pediatric Population Health, UTHealth School of Public Health, Dallas, TX, USA.
- Department of Pediatrics, McGovern Medical School, Houston, TX, USA.
| | - Yashar Talebi
- Department of Biostatistics and Data Science, UTHealth Science Center at Houston, School of Public Health in Houston, Houston, TX, USA
| | - Michael D Swartz
- Department of Biostatistics and Data Science, UTHealth Science Center at Houston, School of Public Health in Houston, Houston, TX, USA
| | - Rachit Sabharwal
- Department of Biostatistics and Data Science, UTHealth Science Center at Houston, School of Public Health in Houston, Houston, TX, USA
| | - Haoting Han
- Department of Biostatistics and Data Science, UTHealth Science Center at Houston, School of Public Health in Houston, Houston, TX, USA
| | - Emma Bergqvist
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health (UTHealth) Science Center at Houston, School of Public Health in Dallas, Dallas, TX, USA
- Center for Pediatric Population Health, UTHealth School of Public Health, Dallas, TX, USA
| | - Harold W Kohl
- Department of Epidemiology, Human Genetics and Environmental Sciences, UTHealth Science Center at Houston, School of Public Health in Austin, Austin, TX, USA
- Department of Kinesiology and Health Education, University of Texas at Austin, Austin, TX, USA
| | - Melissa Valerio-Shewmaker
- Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston, School of Public Health in Brownville, Brownsville, TX, USA
| | - Stacia M DeSantis
- Department of Biostatistics and Data Science, UTHealth Science Center at Houston, School of Public Health in Houston, Houston, TX, USA
| | - Ashraf Yaseen
- Department of Biostatistics and Data Science, UTHealth Science Center at Houston, School of Public Health in Houston, Houston, TX, USA
| | - Steven H Kelder
- Department of Epidemiology, Human Genetics and Environmental Sciences, UTHealth Science Center at Houston, School of Public Health in Austin, Austin, TX, USA
| | - Jessica Ross
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health (UTHealth) Science Center at Houston, School of Public Health in Dallas, Dallas, TX, USA
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston, School of Public Health, Houston, TX, USA
| | - Lindsay N Padilla
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health (UTHealth) Science Center at Houston, School of Public Health in Dallas, Dallas, TX, USA
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston, School of Public Health, Houston, TX, USA
| | - Michael O Gonzalez
- Department of Biostatistics and Data Science, UTHealth Science Center at Houston, School of Public Health in Houston, Houston, TX, USA
| | - Leqing Wu
- Department of Biostatistics and Data Science, UTHealth Science Center at Houston, School of Public Health in Houston, Houston, TX, USA
| | - David Lakey
- University of Texas System, Austin, TX, USA
- The University of Texas Health Science Center Tyler, Tyler, TX, USA
| | | | - Stephen J Pont
- Texas Department of State Health Services, Austin, TX, USA
| | - Eric Boerwinkle
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health (UTHealth) Science Center at Houston, School of Public Health in Dallas, Dallas, TX, USA
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston, School of Public Health, Houston, TX, USA
| |
Collapse
|
6
|
Bteddini DS, LeLaurin JH, Chi X, Hall JM, Theis RP, Gurka MJ, Lee JH, Mobley EM, Khalil GE, Polansky CJ, Kellner AM, Fahnlander AM, Kelder SH, Fiellin LE, Gutter MS, Shenkman EA, Salloum RG. Mixed methods evaluation of vaping and tobacco product use prevention interventions among youth in the Florida 4-H program. Addict Behav 2023; 141:107637. [PMID: 36753933 DOI: 10.1016/j.addbeh.2023.107637] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 01/28/2023] [Accepted: 01/29/2023] [Indexed: 02/05/2023]
Abstract
INTRODUCTION Novel prevention programs are developed to address the increase in e-cigarette use (vaping) among children. However, it remains paramount to test their feasibility in rural settings. This pilot study implemented and evaluated the feasibility and outcomes of two innovative programs, CATCH My Breath and smokeSCREEN, among youth in rural settings in Florida. METHODS We conducted four focus groups with youth aged 11-17 recruited from 4-H rural clubs in Florida. In a subsequent randomized trial, we recruited 82 youth participants and assigned them to one of three arms: CATCH My Breath, smokeSCREEN, or control. CATCH My Breath and smokeSCREEN participants attended online group intervention sessions while the control group received educational material. Pre- and post-surveys were administered to all participants to assess knowledge, susceptibility, perceived positive outcomes and risk perceptions related to tobacco and e-cigarette use. Other feasibility parameters were also assessed. RESULTS Focus group discussions provided insights about feasibility and informed the implementation of both interventions in terms of delivery format, scheduling of sessions and incentives. After the intervention, CATCH My Breath participants significantly improved their general tobacco-related knowledge (post-pre = 16.21-12.92 = 3.3, p <.01) and risk perceptions towards other flavored tobacco products (post-pre = 19.29-17.71 = 1.6, p <.05). smokeSCREEN participants significantly improved their general tobacco knowledge (post-pre = 18.77-13.77 = 5.0, p <.01), knowledge about e-cigarettes (post-pre = 9.08-6.31 = 2.8, p <.01) and risk perception towards e-cigarettes (post-pre = 24.69-21.92 = 2.8, p <.05). CONCLUSIONS This study demonstrated feasibility of delivering the interventions via participant engagement, participants' willingness to be randomized, assessment of outcome measures, and exploration of different recruitment methods. Despite the potential positive influence of CATCH My Breath and smokeSCREEN on youth participants, further evaluation with larger samples is needed.
Collapse
Affiliation(s)
- Dima S Bteddini
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL 32610, USA
| | - Jennifer H LeLaurin
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL 32610, USA
| | - Xiaofei Chi
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL 32610, USA
| | - Jaclyn M Hall
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL 32610, USA
| | - Ryan P Theis
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL 32610, USA
| | - Matthew J Gurka
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL 32610, USA
| | - Ji-Hyun Lee
- Department of Biostatistics, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, FL 32610, USA; Division of Quantitative Sciences, University of Florida Health Cancer Center, University of Florida, Gainesville, FL 32610, USA
| | - Erin M Mobley
- Department of Surgery, University of Florida College of Medicine, Jacksonville, FL 32209, USA
| | - George E Khalil
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL 32610, USA
| | - Caroline J Polansky
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL 32610, USA
| | - Allie M Kellner
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL 32610, USA
| | - Alexandra M Fahnlander
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL 32610, USA
| | - Steven H Kelder
- Michael & Susan Dell Center for Healthy Living, University of Texas Health Science Center School of Public Health, Austin, TX 78701, USA
| | - Lynn E Fiellin
- play2PREVENT Lab at Yale, Department of Internal Medicine, Yale School of Medicine, New Haven, CT 06520, USA
| | - Michael S Gutter
- Institute of Food and Agricultural Sciences, University of Florida, Gainesville, FL 32610, USA
| | - Elizabeth A Shenkman
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL 32610, USA
| | - Ramzi G Salloum
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL 32610, USA.
| |
Collapse
|
7
|
Lanza K, Hunt ET, Mantey DS, Omega-Njemnobi O, Cristol B, Kelder SH. Volunteering, Health, and Well-being of Children and Adolescents in the United States. JAMA Netw Open 2023; 6:e2315980. [PMID: 37252742 DOI: 10.1001/jamanetworkopen.2023.15980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Affiliation(s)
- Kevin Lanza
- University of Texas Health Science Center at Houston, School of Public Health in Austin, Michael & Susan Dell Center for Healthy Living, Austin
| | - Ethan T Hunt
- University of Texas Health Science Center at Houston, School of Public Health in Austin, Michael & Susan Dell Center for Healthy Living, Austin
| | - Dale S Mantey
- University of Texas Health Science Center at Houston, School of Public Health in Austin, Michael & Susan Dell Center for Healthy Living, Austin
| | - Onyinye Omega-Njemnobi
- University of Texas Health Science Center at Houston, School of Public Health in Austin, Michael & Susan Dell Center for Healthy Living, Austin
| | - Benjamin Cristol
- University of Texas Health Science Center at Houston, School of Public Health in Austin, Michael & Susan Dell Center for Healthy Living, Austin
| | - Steven H Kelder
- University of Texas Health Science Center at Houston, School of Public Health in Austin, Michael & Susan Dell Center for Healthy Living, Austin
| |
Collapse
|
8
|
Messiah SE, Swartz MD, Abbas RA, Talebi Y, Kohl HW, Valerio-Shewmaker M, DeSantis SM, Yaseen A, Kelder SH, Ross JA, Padilla LN, Gonzalez MO, Wu L, Lakey D, Shuford JA, Pont SJ, Boerwinkle E. SARS-CoV-2 Serostatus and COVID-19 Illness Characteristics by Variant Time Period in Non-Hospitalized Children and Adolescents. Children (Basel) 2023; 10:children10050818. [PMID: 37238366 DOI: 10.3390/children10050818] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 04/13/2023] [Accepted: 04/27/2023] [Indexed: 05/28/2023]
Abstract
OBJECTIVE To describe COVID-19 illness characteristics, risk factors, and SARS-CoV-2 serostatus by variant time period in a large community-based pediatric sample. DESIGN Data were collected prospectively over four timepoints between October 2020 and November 2022 from a population-based cohort ages 5 to 19 years old. SETTING State of Texas, USA. PARTICIPANTS Participants ages 5 to 19 years were recruited from large pediatric healthcare systems, Federally Qualified Healthcare Centers, urban and rural clinical practices, health insurance providers, and a social media campaign. EXPOSURE SARS-CoV-2 infection. MAIN OUTCOME(S) AND MEASURE(S) SARS-CoV-2 antibody status was assessed by the Roche Elecsys® Anti-SARS-CoV-2 Immunoassay for detection of antibodies to the SARS-CoV-2 nucleocapsid protein (Roche N-test). Self-reported antigen or PCR COVID-19 test results and symptom status were also collected. RESULTS Over half (57.2%) of the sample (N = 3911) was antibody positive. Symptomatic infection increased over time from 47.09% during the pre-Delta variant time period, to 76.95% during Delta, to 84.73% during Omicron, and to 94.79% during the Omicron BA.2. Those who were not vaccinated were more likely (OR 1.71, 95% CI 1.47, 2.00) to be infected versus those fully vaccinated. CONCLUSIONS Results show an increase in symptomatic COVID-19 infection among non-hospitalized children with each progressive variant over the past two years. Findings here support the public health guidance that eligible children should remain up to date with COVID-19 vaccinations.
Collapse
Affiliation(s)
- Sarah E Messiah
- Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health in Dallas, The University of Texas (UT) Health Science Center at Houston, Dallas, TX 77030, USA
- Center for Pediatric Population Health, UTHealth School of Public Health, Dallas, TX 75207, USA
- Department of Pediatrics, McGovern Medical School, Houston, TX 77030, USA
| | - Michael D Swartz
- Department of Biostatistics and Data Sciences, School of Public Health in Houston, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Rhiana A Abbas
- Department of Biostatistics and Data Sciences, School of Public Health in Houston, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Yashar Talebi
- Department of Biostatistics and Data Sciences, School of Public Health in Houston, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Harold W Kohl
- School of Public Health in Austin, The University of Texas Health Science Center at Houston, Austin, TX 78701, USA
- Department of Epidemiology, Human Genetics and Environmental Sciences, University of Texas at Austin, Austin, TX 78705, USA
| | - Melissa Valerio-Shewmaker
- School of Public Health in Brownville, The University of Texas Health Science Center at Houston, Brownsville, TX 78520, USA
| | - Stacia M DeSantis
- Department of Biostatistics and Data Sciences, School of Public Health in Houston, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Ashraf Yaseen
- Department of Biostatistics and Data Sciences, School of Public Health in Houston, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Steven H Kelder
- School of Public Health in Austin, The University of Texas Health Science Center at Houston, Austin, TX 78701, USA
| | - Jessica A Ross
- Department of Biostatistics and Data Sciences, School of Public Health in Houston, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Lindsay N Padilla
- Department of Biostatistics and Data Sciences, School of Public Health in Houston, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Michael O Gonzalez
- Department of Biostatistics and Data Sciences, School of Public Health in Houston, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Leqing Wu
- Department of Biostatistics and Data Sciences, School of Public Health in Houston, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - David Lakey
- Administration Division, University of Texas System, Austin, TX 78701, USA
- Department of Medicine, The University of Texas Health Science Center Tyler, Tyler, TX 75708, USA
| | | | - Stephen J Pont
- Texas Department of State Health Services, Austin, TX 78711, USA
| | - Eric Boerwinkle
- Department of Biostatistics and Data Sciences, School of Public Health in Houston, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| |
Collapse
|
9
|
Hébert ET, Vandewater EA, Businelle MS, Harrell MB, Kelder SH, Perry CL. Tobacco advertising exposure and product use among young adults: An ecological momentary assessment approach. Addict Behav 2023; 139:107601. [PMID: 36592525 PMCID: PMC9872832 DOI: 10.1016/j.addbeh.2022.107601] [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] [Received: 07/01/2022] [Revised: 12/20/2022] [Accepted: 12/22/2022] [Indexed: 12/25/2022]
Abstract
INTRODUCTION Tobacco-related content is prevalent on social media, yet many methods of measuring exposure are inadequate due to the personalized nature of online marketing. The purpose of this paper is to examine the association between exposure to pro-tobacco messages (both industry-sponsored and user-generated) and the use of tobacco products, as reported via ecological momentary assessment (EMA). METHODS Young adults (n = 175) were instructed to record all sightings of marketing (both in-person and online) related to tobacco for 28 days. Tobacco product use and recall of message encounters were assessed daily using app-initiated EMA. RESULTS Participants who reported exposure to tobacco messages were significantly more likely to report using tobacco, adjusting for gender, age, race/ethnicity, baseline use of any tobacco product, and having friends who use tobacco and e-cigarettes (p <.001). For each industry-sponsored message viewed, the odds of using tobacco or e-cigarettes in a given day increased by a factor of 1.77 (95 % CI = 1.41, 2.23). For each user-generated message viewed, the odds of using tobacco or e-cigarettes in a given day increased by a factor of 1.52 (95 % CI = 1.27, 1.83). DISCUSSION To our knowledge, this is the first study to specifically examine the association between exposure to user-generated messages and daily tobacco use. The findings suggests that there is a unique element to user-generated messages that distinguishes them from both traditional marketing and from simple peer influence.
Collapse
Affiliation(s)
- Emily T Hébert
- University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin Campus, Austin, TX, United States.
| | | | - Michael S Businelle
- TSET Health Promotion Research Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States; Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Melissa B Harrell
- University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin Campus, Austin, TX, United States
| | - Steven H Kelder
- University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin Campus, Austin, TX, United States
| | - Cheryl L Perry
- University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin Campus, Austin, TX, United States
| |
Collapse
|
10
|
DeSantis SM, Yaseen A, Hao T, León-Novelo L, Talebi Y, Valerio-Shewmaker MA, Pinzon Gomez CL, Messiah SE, Kohl HW, Kelder SH, Ross JA, Padilla LN, Silberman M, Tuzo S, Lakey D, Shuford JA, Pont SJ, Boerwinkle E, Swartz MD. Incidence and predictors of breakthrough and severe breakthrough infections of SARS-CoV-2 after primary series vaccination in adults: A population-based survey of 22,575 participants. J Infect Dis 2023; 227:1164-1172. [PMID: 36729177 DOI: 10.1093/infdis/jiad020] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [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: 10/20/2022] [Revised: 01/18/2023] [Accepted: 01/27/2023] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Breakthrough infections of SARS-CoV-2 are well-documented. The current study estimates breakthrough incidence across pandemic waves, and evaluates predictors of breakthrough and severe breakthrough infections (defined as those requiring hospitalization). METHODS 89,762 participants underwent longitudinal antibody surveillance. Incidence rates were calculated using total person-days contributed. Bias-corrected and age-adjusted logistic regression determined multivariable predictors of breakthrough and severe breakthrough infection, respectively. RESULTS The incidence was 0.45 (0.38, 0.50) during pre-Delta, 2.80 (2.25, 3.14) during Delta, and 11.2 (8.80, 12.95) during Omicron, per 10,000 person-days. Factors associated with elevated odds of breakthrough included Hispanic ethnicity (vs non-Hispanic White, OR=1.243[1.073, 1.441]), larger household size (OR=1.251 [1.048, 1.494] for 3-5 vs. 1 and OR=1.726 [1.317, 2.262] for more than 5 vs. 1 person), rural vs urban living (OR=1.383 [1.122, 1.704]), receiving Pfizer or Johnson&Johnson vs. Moderna, and multiple comorbidities. Of the 1,700 breakthrough infections, 1,665 reported on severity; 112 (6.73%) were severe. Higher BMI, Hispanic ethnicity, vaccine type, asthma, and hypertension predicted severe breakthroughs. CONCLUSION Breakthrough infection was 4-25 times more common during the Omicron-dominant wave versus earlier waves. Higher burden of severe breakthrough infections was identified in subgroups.
Collapse
Affiliation(s)
- Stacia M DeSantis
- The University of Texas Health Science Center at Houston, School of Public Health in Houston, Houston, TX, US
| | - Ashraf Yaseen
- The University of Texas Health Science Center at Houston, School of Public Health in Houston, Houston, TX, US
| | - Tianyao Hao
- The University of Texas Health Science Center at Houston, School of Public Health in Houston, Houston, TX, US
| | - Luis León-Novelo
- The University of Texas Health Science Center at Houston, School of Public Health in Houston, Houston, TX, US
| | - Yashar Talebi
- The University of Texas Health Science Center at Houston, School of Public Health in Houston, Houston, TX, US
| | - Melissa A Valerio-Shewmaker
- The University of Texas Health Science Center at Houston, School of Public Health in Brownsville, Brownsville, TX, USA
| | - Cesar L Pinzon Gomez
- The University of Texas Health Science Center at Houston, School of Public Health in Houston, Houston, TX, US
| | - Sarah E Messiah
- The University of Texas Health Science Center at Houston, School of Public Health in Dallas, Dallas, TX, USA.,Center for Pediatric Population Health, UTHealth School of Public Health, Dallas, TX, USA
| | - Harold W Kohl
- The University of Texas Health Science Center at Houston, School of Public Health in Austin, Austin, TX, USA.,The University of Texas at Austin, Austin, TX, USA
| | - Steven H Kelder
- The University of Texas Health Science Center at Houston, School of Public Health in Austin, Austin, TX, USA
| | - Jessica A Ross
- The University of Texas Health Science Center at Houston, School of Public Health in Houston, Houston, TX, US
| | - Lindsay N Padilla
- The University of Texas Health Science Center at Houston, School of Public Health in Houston, Houston, TX, US
| | | | | | - David Lakey
- The University of Texas System, Austin, TX, USA.,The University of Texas at Tyler Health Science Center, Tyler, TX, USA
| | | | - Stephen J Pont
- Texas Department of State Health Services, Austin, TX, USA
| | - Eric Boerwinkle
- The University of Texas Health Science Center at Houston, School of Public Health in Houston, Houston, TX, US
| | - Michael D Swartz
- The University of Texas Health Science Center at Houston, School of Public Health in Houston, Houston, TX, US
| |
Collapse
|
11
|
Mantey DS, Omega-Njemnobi O, Ruiz FA, Chen B, Springer AE, Kelder SH. Remote Versus In-Person Learning During COVID-19: Comparison of E-Cigarette Susceptibility and Ever Use Among a Diverse Cohort of 6th-Grade Students in Texas. Nicotine Tob Res 2023; 25:254-260. [PMID: 35366321 PMCID: PMC8992352 DOI: 10.1093/ntr/ntac084] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 03/02/2022] [Accepted: 03/30/2022] [Indexed: 01/13/2023]
Abstract
BACKGROUND In response to SARS-CoV2 (COVID-19), school districts incorporated remote learning as a mitigation strategy. This study examines the association between classroom setting (ie, on-campus versus remote) and e-cigarette susceptibility or ever use among a sample of Texas public middle school students. METHODS Data from n = 985 students enrolled in the CATCH My Breath E-Cigarette Prevention Program trial were collected in Spring 2021. Participants were 6th-grade students in urban Texas. E-cigarette use was examined using the "at-risk" definition described by FDA, indicating either: (1) susceptible never user; or (2) experimental ever use. A multilevel, logistic regression model examined the association between classroom setting and e-cigarette susceptibility/ever use. Covariates included sex, race/ethnicity, academic achievement, household e-cigarette use, perceived school connectedness, and school-level economic status. Models account for nesting within school district. Analyses stratified by race/ethnicity were also conducted. RESULTS Overall, 36.3% of the sample were susceptible never users or ever e-cigarette users. The sample was comprised of 55.0% on-campus and 45.0% remote learners. On-campus learners had greater odds of reporting e-cigarette susceptibility or ever use (aOR: 1.45; p = .014). These findings were observed among Latino (aOR: 1.77; p = .026) and White (aOR: 2.10; p = .099) but not African American/Black (aOR: 0.86; p = .728) youth. CONCLUSIONS On-campus learning during the Spring 2021 semester was associated with greater risk for e-cigarette susceptibility or ever use among a diverse sample of 6th-grade students. E-cigarette susceptibility and ever use is a risk factor for progression to long-term e-cigarette use in later adolescence. IMPLICATIONS As school districts prepare to return to on-campus learning in 2022, a focused approach to e-cigarette prevention may be needed to prevent widespread e-cigarette initiation and continued use. Further, study findings demonstrate a need for further research on the school environment as a determinant of e-cigarette use.
Collapse
Affiliation(s)
- Dale S Mantey
- UT Health Science Center at Houston, UT Health, School of Public Health in Austin, Austin, TX, USA
| | - Onyinye Omega-Njemnobi
- UT Health Science Center at Houston, UT Health, School of Public Health in Austin, Austin, TX, USA
| | - Felisa A Ruiz
- UT Health Science Center at Houston, UT Health, School of Public Health in Austin, Austin, TX, USA
| | - Baojiang Chen
- UT Health Science Center at Houston, UT Health, School of Public Health in Austin, Austin, TX, USA
| | - Andrew E Springer
- UT Health Science Center at Houston, UT Health, School of Public Health in Austin, Austin, TX, USA
| | - Steven H Kelder
- UT Health Science Center at Houston, UT Health, School of Public Health in Austin, Austin, TX, USA
| |
Collapse
|
12
|
Springer AE, Mantey DS, Omega-Njemnobi O, Ruiz F, Attri S, Chen B, Marshall A, Kelder SH. School Connectedness and E-cigarette Susceptibility/ Ever Use in Texas 6 th-Grade Students. Am J Health Behav 2022; 46:673-682. [PMID: 36721289 DOI: 10.5993/ajhb.46.6.10] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Objectives: We examined the association between school connectedness (SC) and e-cigarette susceptibility/ ever use in a diverse sample of Texas 6th graders, with a secondary aim to explore the association stratified by gender and classroom setting (in-person vs remote). Methods: A cross-sectional analysis was conducted of CATCH My Breath baseline data, representing 985 6th -graders from 21 public schools. SC was based on National Longitudinal Study of Adolescent Health measures; e-cigarette susceptibility/ever use was based on the FDA's definition of "at-risk" for long-term use. We conducted multi-level logistic regression analyses.Results: Over half the sample was Hispanic (57.6%), with 36.2% reporting susceptibility/ever use. Lower SC was associated with increased odds of e-cigarette susceptibility/ever use (low SC: aOR: 5.17, 95% CI: 3.54, 7.55; medium SC: aOR: 2.15, 95% CI: 1.44, 2.91; high SC= referent). The association held across gender groups, with low SC girls reporting the highest odds of susceptibility/ever use (aOR: 7.83, 95% CI: 4.51, 13.61). Low SC in- person and remote students were 6 and 4 times, respectively, more likely to report susceptibility/ever use as high SC students (p<.05). Conclusion: SC protected against e-cigarette susceptibility/ever use in this sample.
Collapse
Affiliation(s)
- Andrew E Springer
- Andrew E. Springer, Michael & Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston School of Public Health (UTHealth School of Public Health) Austin Campus, Austin, TX, United States;,
| | - Dale S Mantey
- Dale S. Mantey, Michael & Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston School of Public Health (UTHealth School of Public Health) Austin Campus, Austin, TX, United States
| | - Onyinye Omega-Njemnobi
- Onyinye Omega-Njemnobi, Michael & Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston School of Public Health (UTHealth School of Public Health) Austin Campus, Austin, TX, United States
| | - Felisa Ruiz
- Felisa Ruiz, Michael & Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston School of Public Health (UTHealth School of Public Health) Austin Campus, Austin, TX, United States
| | - Sarina Attri
- Sarina Attri, University of Texas at Austin, Austin, TX, United States
| | - Baojiang Chen
- Baojiang Chen, Michael & Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston School of Public Health (UTHealth School of Public Health) Austin Campus, Austin, TX, United States
| | - Allison Marshall
- Allison Marshall, UTHealth Czik School of Nursing, Houston, TX, United States
| | - Steven H Kelder
- Steven H. Kelder, Michael & Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston School of Public Health (UTHealth School of Public Health) Austin Campus, Austin, TX, United States
| |
Collapse
|
13
|
Harrell MB, Mantey DS, Chen B, Kelder SH, Barrington-Trimis J. Impact of the e-cigarette era on cigarette smoking among youth in the United States: A population-level study. Prev Med 2022; 164:107265. [PMID: 36152819 PMCID: PMC10381788 DOI: 10.1016/j.ypmed.2022.107265] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 08/28/2022] [Accepted: 09/17/2022] [Indexed: 11/19/2022]
Abstract
To examine and compare trends in past 30-day cigarette smoking among adolescents in the US from 2002 to 2019, before and after the onset of the "e-cigarette era" in 2014. Using National Youth Tobacco Survey (NYTS) data from 2002 to 2019, we modeled the prevalence of past 30-day cigarette smoking over time. A total of n = 274,551 (weighted N = 340,403,754) middle and high school students were included in this study. Interrupted time series analyses were used to examine changes in cigarette smoking over time and compare trends in cigarette smoking pre- and post-2014. Models were applied to the full sample and stratified by middle (6th-8th grade) and high school (9th-12th grade). The observed number of current adolescent cigarette smokers post-2014 was compared to the predicted number, given trends in cigarette smoking prevalence observed pre-2014. Among all students, past 30-day cigarette smoking declined by approximately 0.75% per year from 2002 to 2013 (p < 0.001). Following a significant drop in prevalence from 2013 to 2014 (1.64%; p < 0.001), the decline in past 30-day cigarette smoking slowed significantly to approximately 0.37% per year (p < 0.001), from 2015 to 2019. We estimate that the onset of the "e-cigarette era" in 2014 corresponded to over 1.66 million (95% CI: 1.57 m - 1.75 m) more past 30-day cigarette smokers from 2015 to 2019, cumulatively. The rate of decline in past 30-day cigarette smoking prevalence among adolescents observed since 2002 slowed with the onset of the "e-cigarette era" in 2014, providing evidence at a population-level for the "gateway effect."
Collapse
Affiliation(s)
- Melissa B Harrell
- University of Texas School of Public Health, Austin, TX, United States of America; Michael & Susan Dell Center for Healthy Living, UTHealth School of Public Health Austin Campus, Austin, Texas, USA
| | - Dale S Mantey
- University of Texas School of Public Health, Austin, TX, United States of America; Michael & Susan Dell Center for Healthy Living, UTHealth School of Public Health Austin Campus, Austin, Texas, USA.
| | - Baojiang Chen
- University of Texas School of Public Health, Austin, TX, United States of America; Michael & Susan Dell Center for Healthy Living, UTHealth School of Public Health Austin Campus, Austin, Texas, USA
| | - Steven H Kelder
- University of Texas School of Public Health, Austin, TX, United States of America; Michael & Susan Dell Center for Healthy Living, UTHealth School of Public Health Austin Campus, Austin, Texas, USA
| | - Jessica Barrington-Trimis
- University of Southern California, Keck School of Medicine, Los Angeles, CA, United States of America
| |
Collapse
|
14
|
Mantey DS, Omega-Njemnobi O, Hunt ET, Lanza K, Cristol B, Kelder SH. Home Smoke-Free Policies as Children Age: Urban, Rural, and Suburban Differences. Nicotine Tob Res 2022; 24:1985-1993. [PMID: 35901848 PMCID: PMC9653085 DOI: 10.1093/ntr/ntac186] [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] [Received: 04/29/2022] [Revised: 06/30/2022] [Accepted: 07/26/2022] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Parents/guardians can effectively reduce tobacco smoking and secondhand smoke exposure among youth by adopting and enforcing rules against indoor tobacco smoking (ie, home smoke-free policies). We investigate home smoke-free policies from childhood to adolescence in the United States and across rural, suburban, and urban households. AIMS AND METHODS We analyzed 2019-2020 National Survey of Children's Health data from n = 5,955 parents of youth aged 0-17, living at home with a tobacco smoker in the United States (U.S). Geographical categories were: rural, suburban, and urban. Home smoke-free policy reflected prohibiting tobacco smoking inside the home. Weighted logistic regressions examined the (1) association between youth age and home smoke-free policies, (2) interaction between geographic category and youth age, and (3) differing associations between youth age and home smoke-free policies by geography. Models controlled for youth race, ethnicity, sex, parental education, household annual income, and home structure. RESULTS Approximately 13.2% of U.S. households with a smoker did not have a home smoke-free policy. Stratified analyses found one-year increase in youth age was associated with lower odds of having a home smoke-free policy in rural (aOR:0.91; 95%CI: 0.87-0.95) and urban (aOR: 0.96; 95%CI: 0.92-1.00; p = .039), but not suburban (aOR:1.00; 95%CI: 0.95-1.05) households, controlling for covariates. CONCLUSION Odds of having a smoke-free home in the U.S. declined significantly in rural (9% per year) and urban (4%) but not suburban (0%) households. We quantify declines in home smoke-free policies as children age and identify geographic disparities for this environmental determinant of health. IMPLICATIONS Health promotion efforts targeting secondhand smoke prevention is needed, particularly for parents of older youth. Furthermore, there is a clear geographic bias in secondhand smoke exposure among all youth particularly older youth. Tailored interventions are needed to address geographic disparities in secondhand smoke exposure among rural and urban youth.
Collapse
Affiliation(s)
- Dale S Mantey
- Corresponding Author: Dale S. Mantey, PhD, MPA, UT Health Science Center at Houston, UT Health, School of Public Health in Austin, 1616 Guadalupe, Suite 6.300, Austin, TX 78701, USA. Telephone: 254-541-2797; Fax: 512-482-6185; E-mail:
| | - Onyinye Omega-Njemnobi
- UT Health Science Center at Houston, UT Health, School of Public Health in Austin, 1616 Guadalupe, Suite 6.300, Austin, TX 78701, USA
| | - Ethan T Hunt
- UT Health Science Center at Houston, UT Health, School of Public Health in Austin, 1616 Guadalupe, Suite 6.300, Austin, TX 78701, USA
| | - Kevin Lanza
- UT Health Science Center at Houston, UT Health, School of Public Health in Austin, 1616 Guadalupe, Suite 6.300, Austin, TX 78701, USA
| | - Benjamin Cristol
- UT Health Science Center at Houston, UT Health, School of Public Health in Austin, 1616 Guadalupe, Suite 6.300, Austin, TX 78701, USA
| | - Steven H Kelder
- UT Health Science Center at Houston, UT Health, School of Public Health in Austin, 1616 Guadalupe, Suite 6.300, Austin, TX 78701, USA
| |
Collapse
|
15
|
Messiah SE, DeSantis SM, Leon-Novelo LG, Talebi Y, Brito FA, Kohl HW, Valerio-Shewmaker MA, Ross JA, Swartz MD, Yaseen A, Kelder SH, Zhang S, Omega-Njemnobi OS, Gonzalez MO, Wu L, Boerwinkle E, Lakey DL, Shuford JA, Pont SJ. Durability of SARS-CoV-2 Antibodies From Natural Infection in Children and Adolescents. Pediatrics 2022; 149:185412. [PMID: 35301530 DOI: 10.1542/peds.2021-055505] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/03/2022] [Indexed: 11/24/2022] Open
Affiliation(s)
- Sarah E Messiah
- Center for Pediatric Population Health.,The University of Texas Health Science Center at Houston, School of Public Health in Dallas, Dallas,Texas.,Children's Health System of Texas, Dallas, Texas
| | - Stacia M DeSantis
- The University of Texas Health Science Center at Houston, School of Public Health in Houston, Houston, Texas
| | - Luis G Leon-Novelo
- The University of Texas Health Science Center at Houston, School of Public Health in Houston, Houston, Texas
| | - Yashar Talebi
- The University of Texas Health Science Center at Houston, School of Public Health in Houston, Houston, Texas
| | - Frances A Brito
- The University of Texas Health Science Center at Houston, School of Public Health in Houston, Houston, Texas
| | - Harold W Kohl
- The University of Texas Health Science Center at Houston, School of Public Health in Austin, Austin, Texas.,The University of Texas System, Austin, Texas
| | - Melissa A Valerio-Shewmaker
- The University of Texas Health Science Center at Houston, School of Public Health in Brownsville, Brownsville, Texas
| | - Jessica A Ross
- The University of Texas Health Science Center at Houston, School of Public Health in Houston, Houston, Texas
| | - Michael D Swartz
- The University of Texas Health Science Center at Houston, School of Public Health in Houston, Houston, Texas
| | - Ashraf Yaseen
- The University of Texas Health Science Center at Houston, School of Public Health in Houston, Houston, Texas
| | - Steven H Kelder
- The University of Texas Health Science Center at Houston, School of Public Health in Austin, Austin, Texas
| | - Shiming Zhang
- The University of Texas Health Science Center at Houston, School of Public Health in Houston, Houston, Texas
| | - Onyinye S Omega-Njemnobi
- The University of Texas Health Science Center at Houston, School of Public Health in Austin, Austin, Texas
| | - Michael O Gonzalez
- The University of Texas Health Science Center at Houston, School of Public Health in Houston, Houston, Texas
| | - Leqing Wu
- The University of Texas Health Science Center at Houston, School of Public Health in Houston, Houston, Texas
| | - Eric Boerwinkle
- The University of Texas Health Science Center at Houston, School of Public Health in Houston, Houston, Texas
| | | | | | - Stephen J Pont
- Texas Department of State Health Services, Austin, Texas
| |
Collapse
|
16
|
Swartz MD, DeSantis SM, Yaseen A, Brito FA, Valerio-Shewmaker MA, Messiah SE, Leon-Novelo LG, Kohl HW, Pinzon-Gomez CL, Hao T, Zhang S, Talebi Y, Yoo J, Ross JR, Gonzalez MO, Wu L, Kelder SH, Silberman M, Tuzo S, Pont SJ, Shuford JA, Lakey D, Boerwinkle E. Antibody Duration After Infection From SARS-CoV-2 in the Texas Coronavirus Antibody Response Survey. J Infect Dis 2022; 227:193-201. [PMID: 35514141 PMCID: PMC9833436 DOI: 10.1093/infdis/jiac167] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 04/22/2022] [Accepted: 05/03/2022] [Indexed: 01/20/2023] Open
Abstract
Understanding the duration of antibodies to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus that causes COVID-19 is important to controlling the current pandemic. Participants from the Texas Coronavirus Antibody Response Survey (Texas CARES) with at least 1 nucleocapsid protein antibody test were selected for a longitudinal analysis of antibody duration. A linear mixed model was fit to data from participants (n = 4553) with 1 to 3 antibody tests over 11 months (1 October 2020 to 16 September 2021), and models fit showed that expected antibody response after COVID-19 infection robustly increases for 100 days postinfection, and predicts individuals may remain antibody positive from natural infection beyond 500 days depending on age, body mass index, smoking or vaping use, and disease severity (hospitalized or not; symptomatic or not).
Collapse
Affiliation(s)
- Michael D Swartz
- Correspondence: Michael D. Swartz, PhD, Department of Biostatistics and Data Science, School of Public Health, The University of Texas Health Science Center at Houston, 1200 Pressler Street, Houston, TX 77030 ()
| | - Stacia M DeSantis
- The University of Texas Health Science Center in Houston, School of Public Health in Houston, Houston, Texas, USA
| | - Ashraf Yaseen
- The University of Texas Health Science Center in Houston, School of Public Health in Houston, Houston, Texas, USA
| | - Frances A Brito
- The University of Texas Health Science Center in Houston, School of Public Health in Houston, Houston, Texas, USA
| | - Melissa A Valerio-Shewmaker
- The University of Texas Health Science Center in Houston, School of Public Health in Brownsville, Brownsville, Texas, USA
| | - Sarah E Messiah
- The University of Texas Health Science Center in Houston, School of Public Health in Dallas, Dallas, Texas, USA
| | - Luis G Leon-Novelo
- The University of Texas Health Science Center in Houston, School of Public Health in Houston, Houston, Texas, USA
| | - Harold W Kohl
- The University of Texas Health Science Center in Houston, School of Public Health in Austin, Austin, Texas, USA,The University of Texas at Austin, College of Education, Department of Kinesiology and Health Education, Austin, Texas, USA
| | - Cesar L Pinzon-Gomez
- The University of Texas Health Science Center in Houston, School of Public Health in Houston, Houston, Texas, USA
| | - Tianyao Hao
- The University of Texas Health Science Center in Houston, School of Public Health in Houston, Houston, Texas, USA
| | - Shiming Zhang
- The University of Texas Health Science Center in Houston, School of Public Health in Houston, Houston, Texas, USA
| | - Yashar Talebi
- The University of Texas Health Science Center in Houston, School of Public Health in Houston, Houston, Texas, USA
| | - Joy Yoo
- The University of Texas Health Science Center in Houston, School of Public Health in Houston, Houston, Texas, USA
| | - Jessica R Ross
- The University of Texas Health Science Center in Houston, School of Public Health in Houston, Houston, Texas, USA
| | - Michael O Gonzalez
- The University of Texas Health Science Center in Houston, School of Public Health in Houston, Houston, Texas, USA
| | - Leqing Wu
- The University of Texas Health Science Center in Houston, School of Public Health in Houston, Houston, Texas, USA
| | - Steven H Kelder
- The University of Texas Health Science Center in Houston, School of Public Health in Austin, Austin, Texas, USA
| | | | | | - Stephen J Pont
- Texas Department of State Health Services, Austin, Texas, USA
| | | | - David Lakey
- University of Texas System, Office of Health Affairs, Austin, Texas, USA
| | | |
Collapse
|
17
|
Mantey D, Harrell M, Chen B, Kelder SH, Perry C, Loukas A. Multiple tobacco product use among cigarette smokers: a longitudinal examination of menthol and non-menthol smokers during young adulthood. Tob Control 2022; 31:411-415. [PMID: 33452208 PMCID: PMC8280244 DOI: 10.1136/tobaccocontrol-2020-055922] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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] [Received: 05/12/2020] [Revised: 10/28/2020] [Accepted: 11/09/2020] [Indexed: 01/03/2023]
Abstract
BACKGROUND Multiple tobacco product (MTP) use is common among young adults. Most MTP users are combustible cigarette smokers that use one or more other tobacco products. This study aims to explore menthol as a risk factor for MTP use among a cohort of young adult cigarette smokers. METHODS Participants were 18-29 years cigarette smokers at 24 Texas colleges in a 6-wave study. Participants (n=4700 observations) were classified as: single product users (ie, exclusive cigarette smoking); dual product users and poly product users. A multilevel, ordered logistic regression model was used to examine the association between menthol cigarette smoking and MTP use. Two longitudinal, multilevel, multinomial logistic regressions were used to examine the relationship between menthol cigarette smoking and number of tobacco products used. RESULTS Overall, 40.7% of the sample were single product users, 33.7% were dual product users and 25.6% were poly product users. Menthol was associated with 1.28 greater odds of MTP use. Further, menthol was associated with 1.19 greater risk of dual and 1.40 greater risk of poly product use, relative to single product use. Lastly, menthol cigarette smoking was associated with 1.18 greater risk of poly product use, relative to dual product use. CONCLUSIONS There was a gradient relationship between menthol cigarette smoking and number of tobacco products used among young adult cigarette smokers. Findings provide for greater regulatory and programmatic efforts to reduce the use of menthol cigarettes.
Collapse
Affiliation(s)
- Dale Mantey
- UT Health, School of Public Health, Austin, Texas, USA
| | | | - Baojiang Chen
- UT Health, School of Public Health, Austin, Texas, USA
| | | | - Cheryl Perry
- UT Health, School of Public Health, Austin, Texas, USA
| | - Alexandra Loukas
- Department of Kinesiology and Health Education, The University of Texas, Austin, Texas, USA
| |
Collapse
|
18
|
Valerio-Shewmaker MA, DeSantis S, Swartz M, Yaseen A, Gonzalez MO, Kohl HWI, Kelder SH, Messiah SE, Aguillard KA, Breaux C, Wu L, Shuford J, Pont S, Lakey D, Boerwinkle E. Strategies to Estimate Prevalence of SARS-CoV-2 Antibodies in a Texas Vulnerable Population: Results From Phase I of the Texas Coronavirus Antibody Response Survey. Front Public Health 2022; 9:753487. [PMID: 34970525 PMCID: PMC8712464 DOI: 10.3389/fpubh.2021.753487] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 11/09/2021] [Indexed: 12/24/2022] Open
Abstract
Introduction: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and immunity remains uncertain in populations. The state of Texas ranks 2nd in infection with over 2.71 million cases and has seen a disproportionate rate of death across the state. The Texas CARES project was funded by the state of Texas to estimate the prevalence of SARS-CoV-2 antibody status in children and adults. Identifying strategies to understand natural as well as vaccine induced antibody response to COVID-19 is critical. Materials and Methods: The Texas CARES (Texas Coronavirus Antibody Response Survey) is an ongoing prospective population-based convenience sample from the Texas general population that commenced in October 2020. Volunteer participants are recruited across the state to participate in a 3-time point data collection Texas CARES to assess antibody response over time. We use the Roche Elecsys® Anti-SARS-CoV-2 Immunoassay to determine SARS-CoV-2 antibody status. Results: The crude antibody positivity prevalence in Phase I was 26.1% (80/307). The fully adjusted seroprevalence of the sample was 31.5%. Specifically, 41.1% of males and 21.9% of females were seropositive. For age categories, 33.5% of those 18–34; 24.4% of those 35–44; 33.2% of those 45–54; and 32.8% of those 55+ were seropositive. In this sample, 42.2% (89/211) of those negative for the antibody test reported having had a COVID-19 test. Conclusions: In this survey we enrolled and analyzed data for 307 participants, demonstrating a high survey and antibody test completion rate, and ability to implement a questionnaire and SARS-CoV-2 antibody testing within clinical settings. We were also able to determine our capability to estimate the cross-sectional seroprevalence within Texas's federally qualified community centers (FQHCs). The crude positivity prevalence for SARS-CoV-2 antibodies in this sample was 26.1% indicating potentially high exposure to COVID-19 for clinic employees and patients. Data will also allow us to understand sex, age and chronic illness variation in seroprevalence by natural and vaccine induced. These methods are being used to guide the completion of a large longitudinal survey in the state of Texas with implications for practice and population health.
Collapse
Affiliation(s)
| | - Stacia DeSantis
- School of Public Health, University of Texas Health Science Center, Brownsville, TX, United States
| | - Michael Swartz
- School of Public Health, University of Texas Health Science Center, Brownsville, TX, United States
| | - Ashraf Yaseen
- School of Public Health, University of Texas Health Science Center, Brownsville, TX, United States
| | - Michael O Gonzalez
- School of Public Health, University of Texas Health Science Center, Brownsville, TX, United States
| | - Harold W Iii Kohl
- School of Public Health, University of Texas Health Science Center, Austin, TX, United States.,Texas Department of State Health Services, Austin, TX, United States.,University of Texas System, Population Health, Austin, TX, United States
| | - Steven H Kelder
- School of Public Health, University of Texas Health Science Center, Austin, TX, United States.,Texas Department of State Health Services, Austin, TX, United States
| | - Sarah E Messiah
- School of Public Health, University of Texas Health Science Center, Dallas, TX, United States
| | - Kimberly A Aguillard
- School of Public Health, University of Texas Health Science Center, Brownsville, TX, United States.,School of Public Health, University of Texas Health Science Center, Dallas, TX, United States
| | - Camille Breaux
- School of Public Health, University of Texas Health Science Center, Brownsville, TX, United States.,School of Public Health, University of Texas Health Science Center, Dallas, TX, United States
| | - Leqing Wu
- School of Public Health, University of Texas Health Science Center, Brownsville, TX, United States.,School of Public Health, University of Texas Health Science Center, Dallas, TX, United States
| | - Jennifer Shuford
- Texas Department of State Health Services, Austin, TX, United States
| | - Stephen Pont
- Texas Department of State Health Services, Austin, TX, United States
| | - David Lakey
- University of Texas System, Population Health, Austin, TX, United States
| | - Eric Boerwinkle
- School of Public Health, University of Texas Health Science Center, Brownsville, TX, United States
| |
Collapse
|
19
|
Affiliation(s)
- Dale S Mantey
- Department of Health Promotion and Behavioral Science, University of Texas School of Public Health, Austin
| | - Steven H Kelder
- Michael & Susan Dell Center for Healthy Living, University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Austin
| |
Collapse
|
20
|
Mantey DS, Case KR, Omega-Njemnobi O, Springer AE, Kelder SH. Use frequency and symptoms of nicotine dependence among adolescent E-cigarette users: Comparison of JUUL and Non-JUUL users. Drug Alcohol Depend 2021; 228:109078. [PMID: 34614433 PMCID: PMC8595823 DOI: 10.1016/j.drugalcdep.2021.109078] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 09/07/2021] [Accepted: 09/08/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Nicotine exposure among adolescent e-cigarette users remains a public health concern. JUUL, a popular e-cigarette brand among youth, is particularly alarming given the high nicotine delivery (59 mg/mL). This study compares e-cigarette use frequency and symptoms of nicotine dependence among adolescent JUUL and non-JUUL users. METHODS We analyzed data from the 2020 National Youth Tobacco Survey. Participants were n = 1713 U.S. middle and high school students who reported past 30-day e-cigarette use. We compared adolescent e-cigarette users who reported JUUL use to those who did not. Outcomes were: (1) symptoms of nicotine dependence (i.e. nicotine cravings; use within 30 min of waking); (2) past 30-day e-cigarette use frequency, categorized as 1-5 days, 6-19 days, and 20-30 days. Covariates were sex, race/ethnicity, other tobacco product use, primary e-cigarette device type (i.e., disposable; pod; mod/tank). RESULTS Overall, 49.5% of adolescent e-cigarette users reported using JUUL in the past 30 days, 40.1% reported symptoms of nicotine dependence, and 36.2% reported using an e-cigarette on 20-30 days. JUUL users were 1.77 (95% CI: 1.36-2.31) times as likely to report symptoms of nicotine dependence and 1.43 (95% CI: 1.02-2.01) time as likely to report using e-cigarettes on 20-30 days, compared to 1-5 days, relative to non-JUUL users, controlling for covariates. CONCLUSION JUUL use was associated with greater odds of nicotine dependence and more frequent e-cigarette use among adolescents. Greater prevention and regulatory efforts should be made to prevent adolescent use of high dose nicotine devices such as JUUL.
Collapse
Affiliation(s)
- Dale S Mantey
- Department of Health Promotion and Behavioral Science, University of Texas School of Public Health, 1616 Guadalupe, Suite 6.300, Austin, TX 78701, United States.
| | - Kathleen R Case
- Department of Medicine, Joe R. and Teresa Lozano Long School of Medicine, The University of Texas Health Science Center at San Antonio, 7411 John Smith Drive, Suite 1050, San Antonio, TX 78229, United States.
| | - Onyinye Omega-Njemnobi
- Michael & Susan Dell Center for Healthy Living, University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Austin, TX, United States.
| | - Andrew E Springer
- Department of Health Promotion and Behavioral Science, University of Texas School of Public Health, 1616 Guadalupe, Suite 6.300, Austin, TX 78701, United States.
| | - Steven H Kelder
- Department of Health Promotion and Behavioral Science, University of Texas School of Public Health, 1616 Guadalupe, Suite 6.300, Austin, TX 78701, United States.
| |
Collapse
|
21
|
Mantey DS, Harrell MB, Chen B, Kelder SH, Perry CL, Loukas A. A Longitudinal Examination of Behavioral Transitions among Young Adult Menthol and Non-Menthol Cigarette Smokers Using a Three-State Markov Model. Nicotine Tob Res 2021; 23:1047-1054. [PMID: 33245357 DOI: 10.1093/ntr/ntaa240] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 11/20/2020] [Indexed: 01/11/2023]
Abstract
INTRODUCTION Young adult cigarette smoking behaviors are complex and dynamic. Emerging research suggests a growing rate of switching from non-menthol to menthol cigarettes. Transitions across cigarette smoking states are not well understood. This research longitudinally explores transitions in cigarette smoking behaviors among 18-29 year olds. METHODS We applied a Markov model to data collected biannually for 1542 initially 18-29 year old young adults (mean age: 20.9 years; SD = 2.6) in Texas, who provided 7021 total observations from Fall 2014 to Spring 2017. All participants were past 30 day menthol or non-menthol cigarette smokers at first observation. We examined transitions across three states of cigarette smoking (menthol, non-menthol, and nonsmoking) and compared predictors of each transition, during young adulthood. RESULTS Descriptively, 22.2% of menthol and 14.3% of non-menthol smokers switched products while 25.6% of menthol and 26.0% of non-menthol smokers quit smoking. Among quitters, 20.0% relapsed via menthol and 28.2% relapsed via non-menthol cigarettes. Results from Markov model indicated that Hispanic/Latinos (Hazard Ratio [HR]: 3.69) and Asians (HR: 2.85) were significantly more likely to switch from non-menthol to menthol cigarettes, relative to non-Hispanic whites. Among recent quitters, the use of non-cigarette products was associated with increased risk of relapse via menthol (HR: 1.54) and non-menthol (HR: 1.85) cigarettes. CONCLUSION A substantial proportion of young adult cigarette smokers transitioned across cigarette smoking states over the course of 2.5 years. Other tobacco use and nicotine dependence were impediments to becoming and remaining a non-smoker. Hispanic/Latinos and Asians, relative to non-Hispanic whites, had greater odds of transitioning from non-menthol smoking to both non-smoking and to menthol smoking. Findings suggest racial/ethnic differences in cigarette smoking transitions during young adulthood. IMPLICATIONS This paper examined multidirectional transitions across cigarette smoking, including switching between menthol and non-menthol cigarettes, among young adults. Results indicate that Hispanic/Latino and Asian young adults are at increased risk of transition to menthol cigarette smoking compared with non-Hispanic white young adults. Findings highlight need for further study of Hispanic/Latino and Asian young adult smoking behaviors.
Collapse
Affiliation(s)
- Dale S Mantey
- UT Health Science Center at Houston, UT Health, School of Public Health in Austin, Austin, TX
| | - Melissa B Harrell
- UT Health Science Center at Houston, UT Health, School of Public Health in Austin, Austin, TX
| | - Baojiang Chen
- UT Health Science Center at Houston, UT Health, School of Public Health in Austin, Austin, TX
| | - Steven H Kelder
- UT Health Science Center at Houston, UT Health, School of Public Health in Austin, Austin, TX
| | - Cheryl L Perry
- UT Health Science Center at Houston, UT Health, School of Public Health in Austin, Austin, TX
| | - Alexandra Loukas
- Department of Kinesiology and Health Education, University of Texas at Austin, Austin, TX
| |
Collapse
|
22
|
Salazar-Collier CL, Reininger BM, Wilkinson AV, Kelder SH. Exploration of Fatalism and Religiosity by Gender and Varying Levels of Engagement Among Mexican-American Adults of a Type 2 Diabetes Management Program. Front Public Health 2021; 9:652202. [PMID: 34646799 PMCID: PMC8502957 DOI: 10.3389/fpubh.2021.652202] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 08/30/2021] [Indexed: 11/18/2022] Open
Abstract
Objectives: Purpose of study is to explore the roles religiosity and fatalistic beliefs play in diabetes management among newly, currently, and long-term enrolled Mexican-American participants in a Type 2 diabetes mellitus (T2DM) chronic care management program. Methods: In 2017, study participants (n = 15) completed a semi-structured interview in their preferred language (English or Spanish). Sample was stratified by amount of time individual had been enrolled as a participant of the Salud y Vida program: newly, currently, or long-term. Interviews assessed religious beliefs, beliefs concerning the cause(s) of diabetes, perceived relationship between religiosity and fatalistic beliefs with T2DM management, and the appropriateness of discussing such topics with a health professional. Interview responses were analyzed using ATLAS.ti 8. Results: Themes identified included: perceived autonomy over diabetes prognosis, motivators for self-care, discussions of personal beliefs in the healthcare setting, and the church's role in diabetes management. Conclusions: Among this sample, religiosity and religious fatalism played a complex role in coping with and managing diabetes. Long-term enrolled and male participants expressed beliefs of divine control over health, and a connection between religiosity and health behavior. Long-term enrolled participants felt religious and fatalistic beliefs may be suitable and beneficial to discuss in the healthcare setting.
Collapse
Affiliation(s)
- Cindy Lynn Salazar-Collier
- Department of Public Health, College of Nursing and Health Sciences, Texas A&M International University, Laredo, TX, United States
| | - Belinda M Reininger
- Department of Health Promotion & Behavioral Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Brownsville, TX, United States
| | - Anna V Wilkinson
- Deaprtment of Epidemiology, Human Genetics & Environmental Sciences, School of Public Health, The University of Texas Health Science at Houston, Austin, TX, United States
| | - Steven H Kelder
- Deaprtment of Epidemiology, Human Genetics & Environmental Sciences, School of Public Health, The University of Texas Health Science at Houston, Austin, TX, United States
| |
Collapse
|
23
|
Sanchez R, Ranjit N, Kelder SH, Gill M, Hoelscher DM. Intention to lose weight and use of electronic cigarettes among adolescents. Prev Med Rep 2021; 23:101406. [PMID: 34136339 PMCID: PMC8181191 DOI: 10.1016/j.pmedr.2021.101406] [Citation(s) in RCA: 4] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 05/05/2021] [Accepted: 05/09/2021] [Indexed: 11/17/2022] Open
Abstract
Electronic cigarette use among American adolescents is a major public health concern given the negative health consequences of nicotine in youth. Recent literature has shown that weight control may be one motivation for use in this population. This study examined associations between intention to lose weight and e-cigarette use among adolescents having overweight or obesity from an ethnically diverse sample of Texas youth by gender. We performed a cross-sectional analysis of a state representative sample of 9056 eighth and eleventh grade students from the 2015-2016 Texas School Physical Activity and Nutrition (Texas SPAN) study. Validated survey items assessed weight intentions and e-cigarette use. Staff collected anthropometric measures. Logistic regression analysis was conducted to assess the relationship between e-cigarette use and weight intentions with gender interaction, adjusting for grade, race/ethnicity, economic status, weight-behaviors and stratified by BMI class. More than half (50.9%) of the weighted sample were Hispanic and 12.5% were Non-Hispanic Black; 8.5% used e-cigarettes; and 50.0% intended to lose weight. Of the 40.2% of the sample having overweight or obesity, 82.9% intended to lose weight. Among respondents with obesity, use of e-cigarettes was significantly higher among males intending to lose weight than among females intending to lose weight (12% versus 6%, p = 0.007). These findings contrast with previous research suggesting that e-cigarette use in females is more likely to be motivated by an intent to lose weight. The ethnic diversity of the Texas SPAN population may explain this discrepancy.
Collapse
Affiliation(s)
- Ruth Sanchez
- Michael & Susan Dell Center for Healthy Living, University of Texas School of Public Health, Austin Regional Campus, 1616 Guadalupe St., Suite 6.300, Austin TX 78701, USA
- Corresponding author.
| | - Nalini Ranjit
- Michael & Susan Dell Center for Healthy Living, University of Texas School of Public Health, Austin Regional Campus, 1616 Guadalupe St., Suite 6.300, Austin TX 78701, USA
| | - Steven H. Kelder
- Michael & Susan Dell Center for Healthy Living, University of Texas School of Public Health, Austin Regional Campus, 1616 Guadalupe St., Suite 6.300, Austin TX 78701, USA
| | - Montana Gill
- Texas Department of State Health Services, Division of Community Health Improvement, 110 West 49 St., Austin, TX 78756, USA
| | - Deanna M. Hoelscher
- Michael & Susan Dell Center for Healthy Living, University of Texas School of Public Health, Austin Regional Campus, 1616 Guadalupe St., Suite 6.300, Austin TX 78701, USA
| |
Collapse
|
24
|
Mantey DS, Omega-Njemnobi O, Ruiz FA, Vaughn TL, Kelder SH, Springer AE. Association between observing peers vaping on campus and E-cigarette use and susceptibility in middle and high school students. Drug Alcohol Depend 2021; 219:108476. [PMID: 33360854 PMCID: PMC7975070 DOI: 10.1016/j.drugalcdep.2020.108476] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 11/23/2020] [Accepted: 11/23/2020] [Indexed: 01/02/2023]
Abstract
BACKGROUND This study examines the association between exposure to e-cigarette use on school campus and e-cigarette use behaviors among adolescents in the United States. METHODS Data were obtained from the 2019 National Youth Tobacco Survey. First, two multivariate logistic regression models examined the association between in-school exposure to e-cigarette use and ever and past 30-day (i.e., current) e-cigarette use. Next, a multivariate logistic regression model to examine the relationship between in-school exposure to e-cigarette use and susceptibility to use was conducted among a subsample (n = 11,958) of never e-cigarette users. Covariates included grade, race/ethnicity, marketing exposure, and ever use of other tobacco products. RESULTS Approximately 64.3 % of adolescents reported seeing someone use an e-cigarette on school campus; the most common locations being in the bathroom/locker room (34.4 %) and parking lot (34.0 %). In-school exposure to e-cigarette use was associated with greater odds of ever (Adj OR: 2.06; 95 % CI: 1.82-2.33) and current (Adj OR: 1.70; 95 % CI: 1.46-1.98) e-cigarette use among adolescents as well as greater odds of susceptibility to use (Adj OR: 2.00; 95 % CI: 1.82-2.20) among never e-cigarette users. CONCLUSIONS Observing e-cigarette use on school campus was associated with greater odds of e-cigarette use and susceptibility. It is plausible that observing e-cigarette use on campus reinforces the social acceptability of adolescent e-cigarette use. Findings inform on the prevalence of e-cigarettes use on-campus as well as how this phenomenon may influence e-cigarette use/susceptibility among youth. The observed relationship highlights the role of schools in the efforts to reduce adolescent e-cigarette use.
Collapse
Affiliation(s)
- Dale S Mantey
- UT Health Science Center at Houston, UT Health, School of Public Health in Austin, 1616 Guadalupe, Suite 6.300, Austin, TX 78701, USA.
| | - Onyinye Omega-Njemnobi
- UT Health Science Center at Houston, UT Health, School of Public Health in Austin, 1616 Guadalupe, Suite 6.300, Austin, TX 78701, USA
| | - Felisa A Ruiz
- UT Health Science Center at Houston, UT Health, School of Public Health in Austin, 1616 Guadalupe, Suite 6.300, Austin, TX 78701, USA
| | - Tara L Vaughn
- UT Health Science Center at Houston, UT Health, School of Public Health in Austin, 1616 Guadalupe, Suite 6.300, Austin, TX 78701, USA
| | - Steven H Kelder
- UT Health Science Center at Houston, UT Health, School of Public Health in Austin, 1616 Guadalupe, Suite 6.300, Austin, TX 78701, USA
| | - Andrew E Springer
- UT Health Science Center at Houston, UT Health, School of Public Health in Austin, 1616 Guadalupe, Suite 6.300, Austin, TX 78701, USA
| |
Collapse
|
25
|
Kelder SH, Mantey DS, Van Dusen D, Vaughn T, Bianco M, Springer AE. Dissemination of CATCH My Breath, a middle school E-Cigarette prevention program. Addict Behav 2021; 113:106698. [PMID: 33130463 DOI: 10.1016/j.addbeh.2020.106698] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 10/05/2020] [Accepted: 10/06/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVES In 2016, the US Surgeon General issued a Call to Action to address adolescent e-cigarette use and school-based prevention interventions are an effective component of comprehensive tobacco control. This study describes the development and dissemination of CATCH My Breath, an e-cigarette prevention program for middle and high school students. METHODS Starting in 2014, a university and nonprofit collaboration designed, formatively evaluated, pilot tested, and disseminated the CATCH My Breath Program (CMB). The team used Social Cognitive Theory to develop the program and Diffusion of Innovations Theory to disseminate the program. Dissemination strategies were applied beginning in 2016. This paper describes the application of both theories and the resulting reach of CMB. RESULTS Since dissemination began, CMB has been rapidly adopted, following the typical diffusion normal curve. As of June 2020, approximately 4,000 schools in the United States have adopted the program, 70,000 teachers have taught the program, and 1,400,000 students have been exposed to program materials. CONCLUSION The application of Social Cognitive Theory and Diffusion of Innovation Theory resulted in effective prevention results and rapid, widespread adoption of the CMB. This level of adoption and implementation represents 25% of the school marketplace. CMB should be considered as the school component of the recommended combustible and e-cigarette prevention and control toolkit, alongside mass media, marketing restrictions, retail access, taxation, flavor ban, and FDA premarket approval. Other public health interventions seeking rapid adoption should consider applying principles of Diffusion of Innovation as a guide for development and dissemination.
Collapse
|
26
|
Mantey DS, Omega-Njemnobi O, Kelder SH. Self-reported history of concussions is associated with risk factors for suicide completion among middle school students: A cross-sectional study. J Psychiatr Res 2021; 132:191-194. [PMID: 33126012 PMCID: PMC7780371 DOI: 10.1016/j.jpsychires.2020.10.022] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 07/06/2020] [Accepted: 10/16/2020] [Indexed: 12/28/2022]
Abstract
PURPOSE This study aims to examine the relationship between self-reported history of concussion and risk factors for completed suicide among middle school students. METHODS We analyzed state-level data from the 2017 YRBS. The study sample was n = 19,254 middle school students in 7 States: Delaware, Florida, Hawaii, Kentucky, Nevada, Rhode Island, and Virginia. We conducted multi-level, multivariate logistic regression models to assess the relationship between self-reported concussions and suicidal ideations, planned suicide attempt, and past suicide attempt. RESULTS Approximately 17.8% of the sample self-reported a history of concussion. Self-reported history of concussion was significantly associated with greater odds for history of suicidal ideation (Adj OR: 1.31), planned suicide attempt (Adj OR: 1.36), and past suicide attempt (Adj OR: 1.67). CONCLUSIONS This is the first study to examine the relationship between self-reported concussion and risk factor for completed suicide among middle school students. Research findings mirror similar study done among high school students and young adults. Findings suggest the need to expand prevention programs, intervention strategies and education campaigns to include middle school students.
Collapse
Affiliation(s)
- Dale S. Mantey
- Department of Health Promotion and Behavioral Science, University of Texas School of Public Health
| | - Onyinye Omega-Njemnobi
- Department of Health Promotion and Behavioral Science, University of Texas School of Public Health
| | - Steven H. Kelder
- Department of Health Promotion and Behavioral Science, University of Texas School of Public Health
| |
Collapse
|
27
|
Mantey DS, Omega-Njemnobi O, Kelder SH. E-Cigarette Use Is Associated With Intentions to Lose Weight Among High School Students. Nicotine Tob Res 2020; 22:838-842. [PMID: 30452714 DOI: 10.1093/ntr/nty245] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 11/12/2018] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Recent literature has demonstrated individuals may be using electronic cigarettes (e-cigarettes) as a method of weight loss and/or management. Furthermore, e-cigarette companies are developing and patenting technologies related to e-cigarettes and weight loss. This study aims to determine the association between intentions to lose weight and e-cigarette use behaviors among a nationally representative sample of high school students. METHODS Data were obtained from the 2015 Youth Risk Behavior Surveillance survey. Participants were 12 847 students in grades 9-12 in the United States. Multivariate multinomial logistic regression models assessed the association between past 30-day e-cigarette use and weight loss intentions among 9-12 grade students. Subsample analyses were conducted, stratified by sex. Covariates included perceived weight, sex, race/ethnicity, grade, and past 30-day tobacco use. RESULTS Overall, 23.7% of the sample used e-cigarettes in the past 30 days. E-cigarette use was associated with 1.38 (95% CI = 1.07% to 1.78%) greater risk of intentions to lose weight among the full sample, controlling for covariates. Among girls, e-cigarette use was associated with 1.44 (95% CI = 1.05% to 1.97%) greater risk of intentions to lose weight, controlling for covariates. Among boys, e-cigarette use was associated with 1.40 (95% CI = 1.04% to 1.88%) greater odds of intentions to gain weight, controlling for covariates. CONCLUSION Findings show a significant association between e-cigarette use and intentions to lose weight among high school students, among the full sample. Interestingly, e-cigarette use was statistically associated with intentions to gain weight among boys. Longitudinal study is needed to further examine this relationship. IMPLICATIONS AND CONTRIBUTION This is the one of the first studies reporting on e-cigarette use and weight loss intentions among adolescents, both highly prevalent among this population. These findings are an important development in the study of e-cigarette use given the established link between conventional cigarette smoking and weight loss and/or management.
Collapse
Affiliation(s)
- Dale S Mantey
- Division of Health Promotion and Behavioral Sciences, UTHealth School of Public Health, Austin, TX
| | - Onyinye Omega-Njemnobi
- Division of Health Promotion and Behavioral Sciences, UTHealth School of Public Health, Austin, TX
| | - Steven H Kelder
- Division of Health Promotion and Behavioral Sciences, UTHealth School of Public Health, Austin, TX
| |
Collapse
|
28
|
Barroso CS, Springer AE, Ledingham CM, Kelder SH. A qualitative analysis of the social and cultural contexts that shape screen time use in Latino families living on the U.S.-Mexico border. Int J Qual Stud Health Well-being 2020; 15:1735766. [PMID: 32118520 PMCID: PMC7067164 DOI: 10.1080/17482631.2020.1735766] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Purpose: The purpose of this study was to understand how first generation Latino parents, whose primary language is Spanish and live in a colonia on the U.S.-Mexico border, use screen time in their homes. Methods: A purposeful sampling approach was used to recruit eligible parents of pre-adolescents (ages 9–14) who were native Spanish speakers, and living on the U.S.-Mexico border. Three focus groups in Spanish (two with mothers and one with fathers) were conducted. Data were codified using a general inductive approach based on grounded theory. A consensus process was repeated until a final codebook was developed. Results: Screen time allowed parents to foster familismo (family cohesiveness and bonding) and respeto (respect). Parents knew that a healthy balance of media use is important, but broader social contexts (marital discord and economics) challenged the enforcement of familial screen time rules and parents were often permissive. Conclusions: Our study addressed research gaps by examining the understudied social and cultural contexts (practices, routines, rules, and beliefs) that shape children’s screen time use among a sample of Latino immigrants living on the U.S.-Mexico border. This sample of parents indicated that familismo and respeto (i.e., cohesiveness and bonding) influence familial decision-making including screen time.
Collapse
Affiliation(s)
- Cristina S Barroso
- Department of Public Health, University of Tennessee, Knoxville, TN, USA
| | - Andrew E Springer
- Michael & Susan Dell Center for Healthy Living, Department of Health Promotion and Behavioral Sciences, School of Public Health, University of Texas Health, Austin, TX, USA
| | - Christopher M Ledingham
- Health and Human Performance, The University of Texas Rio Grande Valley, Brownsville, TX, USA
| | - Steven H Kelder
- Michael & Susan Dell Center for Healthy Living, Department of Epidemiology, Human Genetics, and Environmental Sciences, School of Public Health, University of Texas Health, Austin, TX, USA
| |
Collapse
|
29
|
Mantey DS, Omega-Njemnobi O, Barroso CS, Kelder SH. Self-reported history of concussions is associated with risk factors for suicide completion among high school students. J Affect Disord 2020; 263:684-691. [PMID: 31740108 DOI: 10.1016/j.jad.2019.11.047] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 09/16/2019] [Accepted: 11/09/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND Suicide is the third leading cause of death among adolescents. While research has found concussions to be a risk factor for suicide in adults, this relationship is not well studied in nationally representative samples of youth. This study examines the relationship between self-reported history of sports-related concussion and five risk factors for suicide completion. METHODS Data were obtained from the 2017 Youth Risk Behavior Surveillance Survey (n=13,353). Multivariate logistic regression models assessed the relationship between self-reported, sports-related concussion and five risk factors for suicide completion. Analyses controlled for sex, race/ethnicity, grade, bullying victimization, and sexual orientation. Subsample analyses were conducted stratified by sex. Interaction models examined biological sex as a possible effect modifier. RESULTS Overall, 15.0% of high school students reported a sports-related concussion in the past 12-months. Self-reported, sports-related concussion was significantly associated with greater odds of feeling sad/hopeless (Adj OR: 1.20; 95% CI:1.02-1.42), suicidal ideations (Adj OR: 1.25; 95% CI:1.02-1.55), suicide attempt (Adj OR: 1.60; 95% CI:1.31-1.96), and suicide attempt treated by a doctor/nurse (Adj OR: 2.35; 95% CI:1.68-3.29), adjusting for covariates. Stratified analyses demonstrated differences by sex, however, no direct evidence of effect modification was observed in interaction models. LIMITATIONS Data are cross-sectional, prohibiting causal inferences. Measures were assessed via self-report. No pre-concussion measures of mental health. CONCLUSION Self-reported sports-related concussion was associated with risk factors for suicide completion. No direct evidence of effect modification was observed but stratified analyses suggest biological sex may impact the observed relationship.
Collapse
Affiliation(s)
- Dale S Mantey
- University of Texas School of Public Health, 1616 Guadalupe, Suite 6.300, Austin, Texas 78701, USA.
| | - Onyinye Omega-Njemnobi
- University of Texas School of Public Health, 1616 Guadalupe, Suite 6.300, Austin, Texas 78701, USA
| | - Cristina S Barroso
- Department of Public Health, College of Education, Health, and Human Sciences, University of Tennessee, United States
| | - Steven H Kelder
- University of Texas School of Public Health, 1616 Guadalupe, Suite 6.300, Austin, Texas 78701, USA
| |
Collapse
|
30
|
Kelder SH, Mantey DS, Van Dusen D, Case K, Haas A, Springer AE. A Middle School Program to Prevent E-Cigarette Use: A Pilot Study of "CATCH My Breath". Public Health Rep 2020; 135:220-229. [PMID: 31968177 DOI: 10.1177/0033354919900887] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [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: 12/28/2022] Open
Abstract
OBJECTIVES From 2017 to 2018, electronic cigarette (e-cigarette) use increased 78% among high school students and 48% among middle school students in the United States. However, few e-cigarette prevention interventions have been evaluated. We determined the feasibility and initial effectiveness of "CATCH My Breath," an e-cigarette prevention program, among a sample of middle schools in central Texas. METHODS Twelve middle schools in Texas (6 intervention schools and 6 control schools) participated in the CATCH My Breath pilot program during 2016-2017. CATCH My Breath is rooted in social cognitive theory, consists of 4 interactive in-class modules, and is collaboratively administered via classroom and physical education teachers, student-peer leaders, and social messaging (eg, school posters). We collected 3 waves of data: baseline (January 2017), 4-month follow-up (May 2017), and 16-month follow-up (May 2018). Using school as the unit of analysis, we tested a repeated cross-sectional, condition-by-time interaction on e-cigarette ever use, psychosocial determinants of use, and other tobacco use behaviors. Analyses controlled for school-level sociodemographic characteristics (eg, sex, race/ethnicity, and percentage of students eligible for free or reduced-price lunch). RESULTS From baseline to 16-month follow-up, increases in ever e-cigarette use prevalence were significantly lower among intervention schools (2.8%-4.9%) than among control schools (2.7%-8.9%), controlling for covariates (P = .01). Intervention schools also had significantly greater improvements in e-cigarette knowledge (β = 0.71; 95% confidence interval [CI], 0.21-1.21; P = .008) and perceived positive outcomes (β = -0.12; 95% CI, -0.23 to -0.02; P = .02) than control schools, controlling for covariates from baseline to 16-month follow-up. CONCLUSION Ever e-cigarette use was lower among middle schools that implemented the CATCH My Breath program than among those that did not. Replication of findings among a larger sample of schools, using a group-randomized, longitudinal study design and a longer follow-up period, is needed.
Collapse
Affiliation(s)
- Steven H Kelder
- Michael & Susan Dell Center for Healthy Living, University of Texas Health Science Center at Houston (UTHealth) School of Public Health-Austin, Austin, TX, USA
| | - Dale S Mantey
- Michael & Susan Dell Center for Healthy Living, University of Texas Health Science Center at Houston (UTHealth) School of Public Health-Austin, Austin, TX, USA
| | | | - Kathleen Case
- Michael & Susan Dell Center for Healthy Living, University of Texas Health Science Center at Houston (UTHealth) School of Public Health-Austin, Austin, TX, USA
| | - Alexandra Haas
- Michael & Susan Dell Center for Healthy Living, University of Texas Health Science Center at Houston (UTHealth) School of Public Health-Austin, Austin, TX, USA
| | - Andrew E Springer
- Michael & Susan Dell Center for Healthy Living, University of Texas Health Science Center at Houston (UTHealth) School of Public Health-Austin, Austin, TX, USA
| |
Collapse
|
31
|
Nicksic NE, Massie AW, Byrd-Williams CE, Kelder SH, Sharma SV, Butte NF, Hoelscher DM. Dietary Intake, Attitudes toward Healthy Food, and Dental Pain in Low-Income Youth. JDR Clin Trans Res 2019; 3:279-287. [PMID: 30938601 DOI: 10.1177/2380084418774039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 11/17/2022] Open
Abstract
Few studies have examined the relation between food consumption and related attitudes and dental pain among children. The objective of this study is to examine the associations of healthy and unhealthy food items, attitudes toward healthy food, and self-efficacy of eating healthy with dental pain among children. A cross-sectional analysis was performed using child survey data from the Texas Childhood Obesity Research Demonstration (TX CORD) project. Fifth-grade students ( n = 1,020) attending 33 elementary schools in Austin and Houston, Texas, completed the TX CORD Child Survey, a reliable and valid survey instrument focused on nutrition and physical activity behaviors. All nutrition questions ask about the number of times food and beverage items were consumed on the previous day. Dental pain was reported as mouth or tooth pain in the past 2 wk that made their mouth hurt so much that they could not sleep at night. Mixed-effects logistic regression models were used to test the association between 10 unhealthy food items, 9 healthy food items, 2 health attitudes, and self-efficacy with dental pain. All models controlled for sociodemographic variables. In total, 99 (9.7%) students reported dental pain. Dental pain was associated with intake of the following unhealthy items: soda, fruit juice, diet soda, frozen desserts, sweet rolls, candy, white rice/pasta, starchy vegetables, French fries/chips, and cereal (adjusted odds ratio [AOR], 1.27-1.81, P < 0.01). The intake of other vegetables (AOR, 1.56; P < 0.01), a healthy item, and the attitude that healthy food tastes good (AOR, 1.59; P = 0.04) were also positively associated with dental pain. The attitude of eating healthier leads to fewer health problems (AOR, 0.50) and self-efficacy for healthy eating (AOR, 0.44) were negatively associated with dental pain ( P < 0.01). Interventions should focus on improving oral health by reducing intake of unhealthy foods and educating children and families on the importance of diet as a means of reducing dental caries. Knowledge Transfer Statement: The results of this study can be used to inform researchers on potential food items and psychosocial measures to examine in low-income, minority populations for longitudinal research. These results would also be useful to educators who could incorporate oral health care and nutrition education into school curriculums.
Collapse
Affiliation(s)
- N E Nicksic
- 1 University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Austin, TX, USA
| | - A W Massie
- 2 Michael & Susan Dell Center for Healthy Living, University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Austin, TX, USA
| | - C E Byrd-Williams
- 2 Michael & Susan Dell Center for Healthy Living, University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Austin, TX, USA
| | - S H Kelder
- 2 Michael & Susan Dell Center for Healthy Living, University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Austin, TX, USA
| | - S V Sharma
- 3 Michael & Susan Dell Center for Healthy Living, University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Houston, TX, USA
| | - N F Butte
- 4 USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - D M Hoelscher
- 2 Michael & Susan Dell Center for Healthy Living, University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Austin, TX, USA
| |
Collapse
|
32
|
Case KR, Mantey DS, Creamer MR, Harrell MB, Kelder SH, Perry CL. E-cigarette- specific symptoms of nicotine dependence among Texas adolescents. Addict Behav 2018; 84:57-61. [PMID: 29627634 DOI: 10.1016/j.addbeh.2018.03.032] [Citation(s) in RCA: 75] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 03/28/2018] [Accepted: 03/29/2018] [Indexed: 01/12/2023]
Abstract
INTRODUCTION The potential of e-cigarettes to elicit symptoms of nicotine dependence has not been adequately studied, particularly in adolescent populations. The present study examined the prevalence of e-cigarette-specific symptoms of nicotine dependence ("symptoms of e-cigarette dependence") and the associations between these symptoms, e-cigarette usage group, and e-cigarette cessation-related items among Texas adolescents. METHODS This study involved a cross-sectional analysis of adolescents from Wave 4 of the Texas Adolescent Tobacco and Marketing Surveillance System (TATAMS) (n = 2891/N = 461,069). Chi-Square analyses examined differences in the prevalence of symptoms of dependence by e-cigarette usage group (exclusive versus dual users of e-cigarettes and combustible tobacco products) and demographic characteristics. Weighted multivariable logistic regression analyses examined the associations between symptoms of e-cigarette dependence, e-cigarette usage group, and e-cigarette cessation items. RESULTS Exclusive e-cigarette users experienced symptoms of e-cigarette dependence, although the prevalence of most of the symptoms was higher for dual users. Adolescents who reported more symptoms of dependence were less likely to report both wanting to quit e-cigarettes and a past-year quit attempt for e-cigarettes (adjusted odds ratio "AOR" = 0.61 (95% CI = 0.41, 0.92) and AOR = 0.52 (95% CI = 0.30, 0.92), respectively). CONCLUSIONS This study is the first to demonstrate that adolescent e-cigarette users are experiencing symptoms of dependence specific to e-cigarettes. In addition, symptoms of dependence may be barriers to e-cigarette cessation. Future research is needed to determine if characteristics of e-cigarette use (e.g. frequency and intensity) are associated with dependence.
Collapse
|
33
|
Springer AE, Davis C, Van Dusen D, Grayless M, Case KR, Craft M, Kelder SH. School socioeconomic disparities in e-cigarette susceptibility and use among central Texas middle school students. Prev Med Rep 2018; 11:105-108. [PMID: 30023161 PMCID: PMC6047056 DOI: 10.1016/j.pmedr.2018.05.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Accepted: 05/18/2018] [Indexed: 12/02/2022] Open
Abstract
Social-ecological theory posits that health-related behavior is shaped by the environments and settings that surround us. We examined e-cigarette susceptibility and ever use prevalence among central Texas middle school students by the level of economic disadvantage (ED) of their school. As a secondary aim, we explored gender and ethnic differences (Hispanic vs. White) in e-cigarette susceptibility across school ED levels. A cross-sectional analysis was conducted of baseline data collected in 2017 as part of the CATCH My Breath study. Participants (n = 5278) were 6th grade students from 23 central Texas public middle schools. E-cigarette susceptibility/use and demographics were self-reported; school ED was determined by Texas Education Agency. Analyses included chi-square tests and multi-level logistic regression. E-cigarette susceptibility and use varied by school ED for total sample (p < .0001) and by ethnicity (p ≤ .003). While e-cigarette susceptibility was higher in boys (p < .001), no gender differences were found for e-cigarette use. Students in the highest school ED quartile (Q4) (lowest SES) had significantly higher odds of e-cigarette susceptibility (AOR = 2.01; 95% CI: 1.49–2.71) and use (AOR = 8.12, 95% CI: 2.58–26.30) compared with Q1 students. Significant gender differences in e-cigarette susceptibility persisted within school ED quartiles 1–3 (p ≤ .001); no gender differences were found for Q4 (p = .537). Despite overall higher e-cigarette susceptibility for Hispanic students, they had similar prevalence as White students within three school ED quartiles. Findings underscore a higher risk for e-cigarette susceptibility/use among central Texas sixth graders attending high ED schools and provide foundation for further exploration of the school socioeconomic context in adolescent e-cigarette use.
Collapse
Affiliation(s)
- Andrew E Springer
- Michael & Susan Dell Center for Healthy Living, University of Texas Health Science Center at Houston (UTHealth) School of Public Health - Austin, Austin, TX, United States
| | - Cassie Davis
- Michael & Susan Dell Center for Healthy Living, University of Texas Health Science Center at Houston (UTHealth) School of Public Health - Austin, Austin, TX, United States
| | | | - Megan Grayless
- Michael & Susan Dell Center for Healthy Living, University of Texas Health Science Center at Houston (UTHealth) School of Public Health - Austin, Austin, TX, United States
| | - Kathleen R Case
- Michael & Susan Dell Center for Healthy Living, University of Texas Health Science Center at Houston (UTHealth) School of Public Health - Austin, Austin, TX, United States
| | | | - Steven H Kelder
- Michael & Susan Dell Center for Healthy Living, University of Texas Health Science Center at Houston (UTHealth) School of Public Health - Austin, Austin, TX, United States
| |
Collapse
|
34
|
Mantey DS, Harrell MB, Case K, Crook B, Kelder SH, Perry CL. Corrigendum to "Subjective experiences at first use of cigarette, e-cigarettes, hookah, and cigar products among Texas adolescents" [Drug Alcohol Depend. 173/1 (2017) 10-16]. Drug Alcohol Depend 2018; 183:247. [PMID: 29306172 PMCID: PMC6956986 DOI: 10.1016/j.drugalcdep.2017.12.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Dale S. Mantey
- University of Texas School of Public Health, 1616 Guadalupe
St., Suite 6.300, Austin, TX 78701, USA
| | - Melissa B. Harrell
- University of Texas School of Public Health, 1616 Guadalupe
St., Suite 6.300, Austin, TX 78701, USA
| | - Kathleen Case
- University of Texas School of Public Health, 1616 Guadalupe St., Suite 6.300, Austin, TX 78701, USA.
| | - Brittani Crook
- Center for Health Communication Affiliated Fellow, Moody
College of Communication, University of Texas at Austin, 300 W. Dean Keeton St.,
Austin, TX 78712, USA
| | - Steven H. Kelder
- University of Texas School of Public Health, 1616 Guadalupe
St., Suite 6.300, Austin, TX 78701, USA
| | - Cheryl L. Perry
- University of Texas School of Public Health, 1616 Guadalupe
St., Suite 6.300, Austin, TX 78701, USA
| |
Collapse
|
35
|
Salahuddin M, Pérez A, Ranjit N, Kelder SH, Barlow SE, Pont SJ, Butte NF, Hoelscher DM. Predictors of Severe Obesity in Low-Income, Predominantly Hispanic/Latino Children: The Texas Childhood Obesity Research Demonstration Study. Prev Chronic Dis 2017; 14:E141. [PMID: 29283881 PMCID: PMC5757383 DOI: 10.5888/pcd14.170129] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION The objective of this study was to identify predictors of severe obesity in a low-income, predominantly Hispanic/Latino sample of children in Texas. METHODS This cross-sectional analysis examined baseline data on 517 children from the secondary prevention component of the Texas Childhood Obesity Research Demonstration (TX CORD) study; data were collected from September 2012 through February 2014. Self-administered surveys were used to collect data from parents of children who were aged 2 to 12 years, had a body mass index (BMI) in the 85th percentile or higher, and resided in Austin, Texas, or Houston, Texas. Multivariable logistic regression models adjusted for sociodemographic covariates were used to examine associations of children's early-life and maternal factors (large-for-gestational-age, exclusive breastfeeding for ≥4 months, maternal severe obesity [BMI ≥35.0 kg/m2]) and children's behavioral factors (fruit and vegetable consumption, physical activity, screen time) with severe obesity (BMI ≥120% of 95th percentile), by age group (2-5 y, 6-8 y, and 9-12 y). RESULTS Across all ages, 184 (35.6%) children had severe obesity. Among children aged 9 to 12 years, large-for-gestational-age at birth (odds ratio [OR] = 2.31; 95% confidence interval [CI], 1.13-4.73) was significantly associated with severe obesity. Maternal severe obesity was significantly associated with severe obesity among children aged 2 to 5 years (OR = 2.67; 95% CI, 1.10-6.47) and 9 to 12 years (OR = 4.12; 95% CI, 1.84-9.23). No significant association was observed between behavioral factors and severe obesity in any age group. CONCLUSION In this low-income, predominantly Hispanic/Latino sample of children, large-for-gestational-age and maternal severe obesity were risk factors for severe obesity among children in certain age groups. Promoting healthy lifestyle practices during preconception and prenatal periods could be an important intervention strategy for addressing childhood obesity.
Collapse
Affiliation(s)
- Meliha Salahuddin
- Michael & Susan Dell Center for Healthy Living, Austin, Texas
- The University of Texas Health Science Center at Houston School of Public Health in Austin,1616 Guadalupe St, Suite 6.300, Austin, TX 78701. ;
- Population Health, Office of Health Affairs, University of Texas System, Austin, Texas
| | - Adriana Pérez
- Michael & Susan Dell Center for Healthy Living, Austin, Texas
- The University of Texas Health Science Center at Houston School of Public Health in Austin, Austin, Texas
| | - Nalini Ranjit
- Michael & Susan Dell Center for Healthy Living, Austin, Texas
- The University of Texas Health Science Center at Houston School of Public Health in Austin, Austin, Texas
| | - Steven H Kelder
- Michael & Susan Dell Center for Healthy Living, Austin, Texas
- The University of Texas Health Science Center at Houston School of Public Health in Austin, Austin, Texas
| | - Sarah E Barlow
- Texas Children's Hospital, Baylor College of Medicine, Houston, Texas
| | - Stephen J Pont
- Texas Department of State Health Services, Office of Science and Population Health, Austin, Texas
- University of Texas at Austin Dell Medical School, Austin, Texas
| | - Nancy F Butte
- US Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Houston, Texas
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Deanna M Hoelscher
- Michael & Susan Dell Center for Healthy Living, Austin, Texas
- The University of Texas Health Science Center at Houston School of Public Health in Austin, Austin, Texas
| |
Collapse
|
36
|
Salahuddin M, Pérez A, Ranjit N, Hoelscher DM, Kelder SH. The associations of large-for-gestational-age and infant feeding practices with children's body mass index z-score trajectories: the Early Childhood Longitudinal Study, Birth Cohort. Clin Obes 2017; 7:307-315. [PMID: 28707388 DOI: 10.1111/cob.12201] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Revised: 05/03/2017] [Accepted: 05/23/2017] [Indexed: 12/15/2022]
Abstract
Very few studies have examined if high birth weight and infant feeding practices have implications for the trajectory of body mass index (BMI) growth across the early childhood period. The goal of this study was to assess if large-for-gestational-age (LGA) and infant feeding practices (exclusive breastfeeding for 6 months, and early introduction of complementary food prior to 4 months) are associated with BMI z-score trajectories over the early childhood period. Group-based trajectory modelling (GBTM) methods were employed to describe and classify developmental BMI z-score trajectories (the outcome of interest) in children from 9 months to 4 years of age (n = 4497) born to prenatal non-smoking mothers in the Early Childhood Longitudinal Study, Birth Cohort (2001-2005). Further analyses examined if the identified BMI z-score trajectories varied systematically with the exposures, LGA and specific infant feeding practices, after accounting for sociodemographic and other early-life factors. Two BMI z-score trajectory groups were identified: normal BMI z-score (56.2%) and high BMI z-score (43.8%). Children who were LGA infants had 2.3 times (risk ratio 95% confidence interval: 1.2, 4.5) greater risk of being in high BMI z-score group relative to normal BMI z-score group. BMI z-score trajectory groups did not differ by infant feeding practices, after controlling for LGA at birth. Membership in the high BMI z-score group was associated with LGA, but not with infant feeding practices. Healthcare professionals should provide early obesity counselling to parents of LGA infants so that parents can take appropriate obesity prevention measures for their children.
Collapse
Affiliation(s)
- M Salahuddin
- School of Public Health in Austin, University of Texas Health Science Center at Houston (UTHealth), Austin, TX, USA
- Population Health, Office of Health Affairs, UT System, Austin, TX, USA
| | - A Pérez
- School of Public Health in Austin, University of Texas Health Science Center at Houston (UTHealth), Austin, TX, USA
- Michael & Susan Dell Center for Healthy Living, UTHealth School of Public Health in Austin, Austin, TX, USA
| | - N Ranjit
- School of Public Health in Austin, University of Texas Health Science Center at Houston (UTHealth), Austin, TX, USA
- Michael & Susan Dell Center for Healthy Living, UTHealth School of Public Health in Austin, Austin, TX, USA
| | - D M Hoelscher
- School of Public Health in Austin, University of Texas Health Science Center at Houston (UTHealth), Austin, TX, USA
- Michael & Susan Dell Center for Healthy Living, UTHealth School of Public Health in Austin, Austin, TX, USA
| | - S H Kelder
- School of Public Health in Austin, University of Texas Health Science Center at Houston (UTHealth), Austin, TX, USA
- Michael & Susan Dell Center for Healthy Living, UTHealth School of Public Health in Austin, Austin, TX, USA
| |
Collapse
|
37
|
Hébert ET, Vandewater EA, Businelle MS, Harrell MB, Kelder SH, Perry CL. Feasibility and reliability of a mobile tool to evaluate exposure to tobacco product marketing and messages using ecological momentary assessment. Addict Behav 2017; 73:105-110. [PMID: 28500906 DOI: 10.1016/j.addbeh.2017.05.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 04/26/2017] [Accepted: 05/02/2017] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Existing measures of tobacco marketing and messaging exposure are limited, relying on recall, recognition, or proxy measures. This study aimed to determine the feasibility and reliability of a mobile application for the measurement of tobacco and e-cigarette marketing and message exposure using ecological momentary assessment (EMA). METHODS Young adults from Austin, TX (n=181, ages 18-29) were instructed to use a mobile application to record all sightings of marketing or social media related to tobacco (including e-cigarettes) in real-time for 28days (Event EMAs). Tobacco product use and recall of message encounters were assessed daily using an app-initiated EMA (Daily EMAs). RESULTS The mobile app was a feasible and acceptable method to measure exposure to tobacco messages. The majority of messages (45.0%) were seen on the Internet, and many were user-generated. Thirty-day recall of messages at baseline was poorly correlated with messages reported via Event EMA during the study period; however, the correlation between post-study 30-day recall and Event EMA was much stronger (r=0.603 for industry-sponsored messages, r=0.599 for user-generated messages). Correlations between Daily EMAs and 30-day recall of message exposure (baseline and post-study) were small (baseline: r=0.329-0.389) to large (post-study: r=0.656-0.766). CONCLUSIONS These findings suggest that EMA is a feasible and reliable method for measuring tobacco message exposure, especially given the prevalence of messages encountered online and on social media. Recall measures are limited in their ability to accurately represent marketing exposure, but might be improved by a period of priming or clearer response categories.
Collapse
|
38
|
Hébert ET, Case KR, Kelder SH, Delk J, Perry CL, Harrell MB. Exposure and Engagement With Tobacco- and E-Cigarette-Related Social Media. J Adolesc Health 2017; 61:371-377. [PMID: 28669801 PMCID: PMC5572318 DOI: 10.1016/j.jadohealth.2017.04.003] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [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: 10/07/2016] [Revised: 03/31/2017] [Accepted: 04/03/2017] [Indexed: 11/27/2022]
Abstract
PURPOSE Little is known about the nature and extent of adolescents' exposure to tobacco- and e-cigarette-related communications on social media. In this study, we describe the prevalence and correlates of youth exposure and engagement with tobacco- and e-cigarette-related social media. METHODS Data are from the baseline survey of the Texas Adolescent Tobacco and Marketing Surveillance system, a cross-sectional sample of sixth, eighth, and 10th graders (n = 3907, N = 461,097). Weighted logistic regression models were used to examine associations between demographic characteristics, sensation seeking, tobacco use, and exposure and engagement with tobacco-related social media. RESULTS Overall, 52.5% of students reported exposure to tobacco-related social media in the past month, whereas < 6% reported engagement. Exposure and some forms of engagement were more common among high school students, girls, those with friends who use tobacco, and high sensation seekers (p < .05). The odds of exposure were significantly higher among students susceptible to combustible tobacco (adjusted odds ratio [AOR] = 1.71, p < .05), e-cigarettes (AOR = 2.10, p < .01), and both combustible tobacco and e-cigarettes (AOR = 2.24, p < .001). The odds of engaging with social media was higher among those who were susceptible to, had ever, or currently use both combustible tobacco and e-cigarettes (AOR = 2.10-3.46, p < .05). CONCLUSIONS About 1 in every 2 adolescents in Texas are exposed to tobacco-related social media. Adolescents who are susceptible to or use e-cigarettes and/or combustible tobacco are exposed to and engage with tobacco-related social media more than their peers. Social media appears to be an important venue when targeting vulnerable youth in prevention campaigns.
Collapse
Affiliation(s)
- Emily T. Hébert
- UT Health, UT Health Science Center at Houston, School of Public Health, Austin Campus, Austin, Texas,Oklahoma Tobacco Research Center, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Kathleen R. Case
- UT Health, UT Health Science Center at Houston, School of Public Health, Austin Campus, Austin, Texas
| | - Steven H. Kelder
- Department of Epidemiology, Human Genetics & Environmental Sciences, UT Health, UT Health Science Center at Houston, School of Public Health, Austin Campus, Austin, Texas
| | - Joanne Delk
- UT Health, UT Health Science Center at Houston, School of Public Health, Austin Campus, Austin, Texas
| | - Cheryl L. Perry
- Department of Health Promotion & Behavioral Sciences, UT Health, UT Health Science Center at Houston, School of Public Health, Austin Campus, Austin, Texas
| | - Melissa B. Harrell
- Department of Epidemiology, Human Genetics & Environmental Sciences, UT Health, UT Health Science Center at Houston, School of Public Health, Austin Campus, Austin, Texas,Address correspondence to: Melissa B. Harrell, Ph.D., M.P.H., UT Health, UT Health Science Center at Houston, School of Public Health, Austin Campus, 1616 Guadalupe Street, Suite 6.300, Austin, TX 78701. (M.B. Harrell)
| |
Collapse
|
39
|
Butte NF, Hoelscher DM, Barlow SE, Pont S, Durand C, Vandewater EA, Liu Y, Adolph AL, Pérez A, Wilson TA, Gonzalez A, Puyau MR, Sharma SV, Byrd-Williams C, Oluyomi A, Huang T, Finkelstein EA, Sacher PM, Kelder SH. Efficacy of a Community- Versus Primary Care-Centered Program for Childhood Obesity: TX CORD RCT. Obesity (Silver Spring) 2017; 25:1584-1593. [PMID: 28703504 DOI: 10.1002/oby.21929] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 06/03/2017] [Accepted: 06/06/2017] [Indexed: 12/27/2022]
Abstract
OBJECTIVE This randomized controlled trial was conducted to determine comparative efficacy of a 12-month community-centered weight management program (MEND2-5 for ages 2-5 or MEND/CATCH6-12 for ages 6-12) against a primary care-centered program (Next Steps) in low-income children. METHODS Five hundred forty-nine Hispanic and black children (BMI ≥ 85th percentile), stratified by age groups (2-5, 6-8, and 9-12 years), were randomly assigned to MEND2-5 (27 contact hours)/MEND/CATCH6-12 (121.5 contact hours) or Next Steps (8 contact hours). Primary (BMI value at the 95th percentile [%BMIp95 ]) and secondary outcomes were measured at baseline, 3 months (Intensive Phase), and 12 months (Transition Phase). RESULTS For age group 6-8, MEND/CATCH6-12 resulted in greater improvement in %BMIp95 than Next Steps during the Intensive Phase. Effect size (95% CI) was -1.94 (-3.88, -0.01) percentage points (P = 0.05). For age group 9-12, effect size was -1.38 (-2.87, 0.16) percentage points for %BMIp95 (P = 0.07). MEND2-5 did not differentially affect %BMIp95 . Attendance averaged 52% and 22% during the Intensive and Transition Phases. Intervention compliance was inversely correlated to change in %BMIp95 during the Intensive Phase (P < 0.05). In the Transition Phase, %BMIp95 was maintained or rebounded in both programs (P < 0.05). CONCLUSIONS MEND/CATCH6-12 was more efficacious for BMI reduction at 3 months but not 12 months compared to Next Steps in underserved children. Intervention compliance influenced outcomes, emphasizing the need for research in sustaining family engagement in low-income populations.
Collapse
Affiliation(s)
- Nancy F Butte
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
| | - Deanna M Hoelscher
- Michael & Susan Dell Center for Healthy Living, The University of Texas Health Science Center-School of Public Health, Austin Regional Campus, Austin, Texas, USA
| | - Sarah E Barlow
- Children's Health, GI Practice, The University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Stephen Pont
- Texas Center for the Prevention and Treatment of Childhood Obesity, Dell Children's Medical Center, University of Texas at Austin Dell Medical School, Austin, Texas, USA
| | - Casey Durand
- Center for Systems and Community Design; Department of Community Health and Social Sciences; Graduate School of Public Health and Health Policy, City University of New York, New York, New York, USA
| | - Elizabeth A Vandewater
- Michael & Susan Dell Center for Healthy Living, The University of Texas Health Science Center-School of Public Health, Austin Regional Campus, Austin, Texas, USA
| | - Yan Liu
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
| | - Anne L Adolph
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
| | - Adriana Pérez
- Michael & Susan Dell Center for Healthy Living, The University of Texas Health Science Center-School of Public Health, Austin Regional Campus, Austin, Texas, USA
| | - Theresa A Wilson
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
| | - Alejandra Gonzalez
- Michael & Susan Dell Center for Healthy Living, The University of Texas Health Science Center-School of Public Health, Austin Regional Campus, Austin, Texas, USA
| | - Maurice R Puyau
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
| | - Shreela V Sharma
- Michael & Susan Dell Center for Healthy Living, The University of Texas Health Science Center-School of Public Health, Austin Regional Campus, Austin, Texas, USA
| | - Courtney Byrd-Williams
- Michael & Susan Dell Center for Healthy Living, The University of Texas Health Science Center-School of Public Health, Austin Regional Campus, Austin, Texas, USA
| | - Abiodun Oluyomi
- Michael & Susan Dell Center for Healthy Living, The University of Texas Health Science Center-School of Public Health, Austin Regional Campus, Austin, Texas, USA
| | - Terry Huang
- Center for Systems and Community Design; Department of Community Health and Social Sciences; Graduate School of Public Health and Health Policy, City University of New York, New York, New York, USA
| | - Eric A Finkelstein
- Duke University Global Health Institute, Durham, North Carolina, USA, and Duke-NUS Medical School, Singapore
| | - Paul M Sacher
- Childhood Nutrition Research Centre, University College-London, London, UK
| | - Steven H Kelder
- Michael & Susan Dell Center for Healthy Living, The University of Texas Health Science Center-School of Public Health, Austin Regional Campus, Austin, Texas, USA
| |
Collapse
|
40
|
Mantey DS, Harrell MB, Case K, Crook B, Kelder SH, Perry CL. Subjective experiences at first use of cigarette, e-cigarettes, hookah, and cigar products among Texas adolescents. Drug Alcohol Depend 2017; 173:10-16. [PMID: 28182981 PMCID: PMC5432196 DOI: 10.1016/j.drugalcdep.2016.12.010] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 12/06/2016] [Accepted: 12/10/2016] [Indexed: 01/20/2023]
Abstract
INTRODUCTION Subjective experiences ("SEs") at first cigarette use have been thoroughly examined; however, limited research has examined SEs at first use of non-cigarette products. This study addresses this gap in the literature. METHODS Cross-sectional data from 6th, 8th and 10th grade students in four metropolitan areas of Texas (n=3907/N=461,069). Nausea, coughing, relaxation, rush/buzz, and dizziness at first use were assessed for cigarettes, e-cigarettes, hookah, and cigar products. Chi-square analyses examined differences in the prevalence of first use SEs by product. Weighted multiple logistic regression analyses examined the association of SEs and current product use. Covariates were grade, gender, race/ethnicity, and current other tobacco product use. RESULTS Exploratory factor analysis of SEs determined differing factor structures across tobacco products. For example, the following items loaded onto the positive SE factor: 1) relaxation, rush, and dizziness for cigarettes, and 2) relaxation and rush for e-cigarettes, hookah, and cigar products. Prevalence of negative SEs (coughing and nausea) were higher for cigarette and cigar products compared to e-cigarettes and hookah. Positive SEs for cigarettes were associated with increased odds of current cigarette use (AOR=1.51); similarly positive SEs for cigars were associated with increased odds of current cigar use (AOR=2.11). Feeling nauseous at first use of cigars was associated with decreased odds of current cigar use (AOR=0.18). No SEs were associated with current e-cigarette or hookah use. CONCLUSIONS Subjective experiences at first use differ by tobacco product. Longitudinal studies are needed to examine temporal relationships between SEs at first use and sustained tobacco use.
Collapse
Affiliation(s)
- Dale S Mantey
- University of Texas School of Public Health, 1616 Guadalupe St., Suite 6.300, Austin, Texas 78701, USA.
| | - Melissa B Harrell
- University of Texas School of Public Health, 1616 Guadalupe St., Suite 6.300, Austin, Texas 78701, USA
| | - Kathleen Case
- University of Texas School of Public Health, 1616 Guadalupe St., Suite 6.300, Austin, Texas 78701, USA
| | - Brittani Crook
- Center for Health Communication Affiliated Fellow, Moody College of Communication, University of Texas at Austin,300 W. Dean Keeton St., Austin, TX 78712, USA
| | - Steven H Kelder
- University of Texas School of Public Health, 1616 Guadalupe St., Suite 6.300, Austin, Texas 78701, USA
| | - Cheryl L Perry
- University of Texas School of Public Health, 1616 Guadalupe St., Suite 6.300, Austin, Texas 78701, USA
| |
Collapse
|
41
|
Li L, Pérez A, Wu LT, Ranjit N, Brown HS, Kelder SH. Cardiometabolic Risk Factors among Severely Obese Children and Adolescents in the United States, 1999-2012. Child Obes 2016; 12:12-9. [PMID: 26785314 DOI: 10.1089/chi.2015.0136] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [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: 11/13/2022]
Abstract
BACKGROUND Severely obese children and adolescents are at high risk of suffering obesity-related comorbidities. This article is to examine the dose-response relationship between weight status and cardiometabolic risk factors among US adolescents. METHODS Youths aged 6-19 years participating in the National Health and Nutrition Examination Surveys (NHANES) 1999-2012 were included (N = 20,905). Severe obesity was defined as BMI ≥120% of 95th percentile of gender-specific BMI-for-age or BMI ≥35 kg/m(2). Obesity-related cardiometabolic risk factors included blood pressure (BP), high-density lipoprotein cholesterol (HDL), low-density lipoprotein cholesterol (LDL), total cholesterol (TC), triglycerides, and fasting glucose (FG). Weighted multiple logistic regression was used to assess whether severe obesity significantly changed the odds of having cardiometabolic risk factors. RESULTS The prevalence of high BP, high TC, low HDL, high triglycerides, high LDL, and high FG among severely obese adolescents was 9.9%, 16.5%, 40.0%, 30.0%, 13.0%, and 26.8%, respectively. Severely obese adolescents had at least twice the odds compared to normal weight adolescents of presenting high BP (OR = 5.3, 95% CI: 3.8-7.3); high TC (OR = 2.3, 95% CI: 1.8-3.0); low HDL (OR = 7.3, 95% CI: 6.1-8.8); high triglycerides (OR = 4.5, 95% CI: 3.4-5.9); high LDL (OR = 2.3, 95% CI: 1.5-3.5); and high FG (OR = 2.7, 95% CI: 1.8-4.0). Significant differences were also found between severely obese status and moderately obese status in the odds of having high BP (OR = 1.8, 95% CI: 1.7-2.2) and low HDL (OR = 1.9, 95% CI: 1.6-2.3). CONCLUSION Adolescents classified as severe status exhibit higher odds of having cardiometabolic risk factors compared to those with normal weight and moderately obese weight status.
Collapse
Affiliation(s)
- Linlin Li
- 1 Department of Psychiatry and Behavioral Sciences, School of Medicine, Duke University Medical Center , Durham, NC
| | - Adriana Pérez
- 2 Michael & Susan Dell Center for Healthy Living, The University of Texas School of Public Health , Austin, TX
| | - Li-Tzy Wu
- 1 Department of Psychiatry and Behavioral Sciences, School of Medicine, Duke University Medical Center , Durham, NC
| | - Nalini Ranjit
- 2 Michael & Susan Dell Center for Healthy Living, The University of Texas School of Public Health , Austin, TX
| | - Henry S Brown
- 2 Michael & Susan Dell Center for Healthy Living, The University of Texas School of Public Health , Austin, TX
| | - Steven H Kelder
- 2 Michael & Susan Dell Center for Healthy Living, The University of Texas School of Public Health , Austin, TX
| |
Collapse
|
42
|
Taber DR, Chriqui JF, Vuillaume R, Kelder SH, Chaloupka FJ. The association between state bans on soda only and adolescent substitution with other sugar-sweetened beverages: a cross-sectional study. Int J Behav Nutr Phys Act 2015; 12 Suppl 1:S7. [PMID: 26221969 PMCID: PMC4658713 DOI: 10.1186/1479-5868-12-s1-s7] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND Across the United States, many states have actively banned the sale of soda in high schools, and evidence suggests that students' in-school access to soda has declined as a result. However, schools may be substituting soda with other sugar-sweetened beverages (SSBs), and national trends indicate that adolescents are consuming more sports drinks and energy drinks. This study examined whether students consumed more non-soda SSBs in states that banned the sale of soda in school. METHODS Student data on consumption of various SSBs and in-school access to vending machines that sold SSBs were obtained from the National Youth Physical Activity and Nutrition Study (NYPANS), conducted in 2010. Student data were linked to state laws regarding the sale of soda in school in 2010. Students were cross-classified based on their access to vending machines and whether their state banned soda in school, creating 4 comparison groups. Zero-inflated negative binomial models were used to compare these 4 groups with respect to students’ self-reported consumption of diet soda, sports drinks, energy drinks, coffee/tea, or other SSBs. Students who had access to vending machines in a state that did not ban soda were the reference group. Models were adjusted for race/ethnicity, sex, grade, home food access, state median income, and U.S. Census region. RESULTS Students consumed more servings of sports drinks, energy drinks, coffee/tea, and other SSBs if they resided in a state that banned soda in school but attended a school with vending machines that sold other SSBs. Similar results were observed where schools did not have vending machines but the state allowed soda to be sold in school. Intake was generally not elevated where both states and schools limited SSB availability – i.e., states banned soda and schools did not have SSB vending machines. CONCLUSION State laws that ban soda but allow other SSBs may lead students to substitute other non-soda SSBs. Additional longitudinal research is needed to confirm this. Elevated SSB intake was not observed when both states and schools took steps to remove SSBs from school.
Collapse
Affiliation(s)
- Daniel R Taber
- Institute for Health Research and Policy, University of Illinois at Chicago,1747 West Roosevelt Road, Chicago, IL 60608 Chicago, IL, USA
- Michael & Susan Dell Center for Healthy Living, The University of Texas School of Public Health Austin Regional Campus, 1616 Guadalupe St. Austin, TX 78701, USA
| | - Jamie F Chriqui
- Institute for Health Research and Policy, University of Illinois at Chicago,1747 West Roosevelt Road, Chicago, IL 60608 Chicago, IL, USA
- Department of Health Policy and Administration, University of Illinois at Chicago, Chicago, IL, USA
| | - Renee Vuillaume
- Harvard University John F. Kennedy School of Government, 79 John F. Kennedy Street, Cambridge, MA 02138, USA
| | - Steven H Kelder
- Michael & Susan Dell Center for Healthy Living, The University of Texas School of Public Health Austin Regional Campus, 1616 Guadalupe St. Austin, TX 78701, USA
| | - Frank J Chaloupka
- Institute for Health Research and Policy, University of Illinois at Chicago,1747 West Roosevelt Road, Chicago, IL 60608 Chicago, IL, USA
- Department of Economics, University of Illinois at Chicago, Chicago, IL, 601 South Morgan UH725 M/C144, Chicago, IL 60607, USA
| |
Collapse
|
43
|
Springer AE, Li L, Ranjit N, Delk J, Mehta K, Kelder SH. School-level economic disadvantage and obesity in middle school children in central Texas, USA: a cross-sectional study. Int J Behav Nutr Phys Act 2015; 12 Suppl 1:S8. [PMID: 26222099 PMCID: PMC4518903 DOI: 10.1186/1479-5868-12-s1-s8] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Although children of lower socio-economic status (SES) in the United States have generally been found to be at greater risk for obesity, the SES-obesity association varies when stratified by racial/ethnic groups-with no consistent association found for African American and Hispanic children. Research on contextual and setting-related factors may provide further insights into ethnic and SES disparities in obesity. We examined whether obesity levels among central Texas 8th grade students (n=2682) vary by school-level economic disadvantage across individual-level family SES and racial/ethnicity groups. As a secondary aim, we compared the association of school-level economic disadvantage and obesity by language spoken with parents (English or Spanish) among Hispanic students. METHODS Multilevel regression models stratified by family SES and ethnicity were run using cross-sectional baseline data from five school districts participating in the Central Texas CATCH Middle School project. For family SES, independent multi-level logistic regression models were run for total sample and by gender for each family SES stratum (poor/near poor/just getting by, living comfortably, and very well off), adjusting for age, ethnicity, and gender. Similarly, multi-level regression models were run by race/ethnic group (African American, Hispanic, and White), adjusting for age, family SES, and gender. RESULTS Students attending highly economically disadvantaged (ED) schools were between 1.7 (95% CI: 1.1-2.6) and 2.4 (95% CI: 1.2-4.8) times more likely to be obese as students attending low ED schools across family SES groups (p<.05). African American (OR(Adj) =3.4, 95% CI: 1.1-11.4), Hispanic (OR(Adj)=1.8, 95% CI 1.1-3.0) and White (OR(Adj)=3.8, 95% CI: 1.6-8.9) students attending high ED schools were more likely to be obese as counterparts at low ED schools (p<.05). Gender-stratified findings were similar to findings for total sample, although fewer results reached significance. While no obesity differences across school ED categories were found for Hispanic Spanish-speaking students, Hispanic English-speaking students (HES) attending high ED schools were 2.4 times more likely to be obese as HES students at low ED schools (p=.003). CONCLUSION Findings support the need to prioritize economically disadvantaged schools for obesity prevention efforts and support further exploration of school SES context in shaping children’s physical activity and dietary behaviors.
Collapse
Affiliation(s)
- Andrew E Springer
- Michael & Susan Dell Center for Advancement of Healthy Living, University of Texas School of Public Health-Austin Regional Campus, TX, USA
| | - Linlin Li
- Michael & Susan Dell Center for Advancement of Healthy Living, University of Texas School of Public Health-Austin Regional Campus, TX, USA
| | - Nalini Ranjit
- Michael & Susan Dell Center for Advancement of Healthy Living, University of Texas School of Public Health-Austin Regional Campus, TX, USA
| | - Joanne Delk
- Texas Department of State Health Services, Austin, TX, 78756, USA
| | - Kajal Mehta
- UT Southwestern Medical Center, Dallas, TX, USA
| | - Steven H Kelder
- Michael & Susan Dell Center for Advancement of Healthy Living, University of Texas School of Public Health-Austin Regional Campus, TX, USA
| |
Collapse
|
44
|
Oluyomi AO, Byars A, Byrd-Williams C, Sharma SV, Durand C, Hoelscher DM, Butte NF, Kelder SH. The utility of Geographical Information Systems (GIS) in systems-oriented obesity intervention projects: the selection of comparable study sites for a quasi-experimental intervention design--TX CORD. Child Obes 2015; 11:58-70. [PMID: 25587670 PMCID: PMC4696445 DOI: 10.1089/chi.2014.0054] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [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: 11/13/2022]
Abstract
BACKGROUND The Texas Childhood Obesity Research Demonstration project (TX CORD) uses a systems-oriented approach to address obesity that includes individual and family interventions, community-level action, as well as environmental and policy initiatives. Given that randomization is seldom possible in community-level intervention studies, TX CORD uses a quasi-experimental design. Comparable intervention and comparison study sites are needed to address internal validity bias. METHODS TX CORD was designed to be implemented in low-income, ethnically diverse communities in Austin and Houston, Texas. A three-stage Geographical Information System (GIS) methodology was used to establish and ascertain the comparability of the intervention and comparison study sites. Census tract (stage 1) and school (stage 2) data were used to identify spatially exclusive geographic areas that were comparable. In stage 3, study sites were compared on demographic characteristics, socioeconomic status (SES), food assets, and physical activity (PA) assets. Student's t-test was used to examine significant differences between the selected sites. RESULTS The methodology that was used resulted in the selection of catchment areas with demographic and socioeconomic characteristics that fit the target population: ethnically diverse population; lower-median household income; and lower home ownership rates. Additionally, the intervention and comparison sites were statistically comparable on demographic and SES variables, as well as food assets and PA assets. CONCLUSIONS This GIS approach can provide researchers, program evaluators, and policy makers with useful tools for both research and practice. Area-level information that allows for robust understanding of communities can enhance analytical procedures in community health research and offer significant contributions in terms of community assessment and engagement.
Collapse
Affiliation(s)
- Abiodun O. Oluyomi
- Michael & Susan Dell Center for Healthy Living, University of Texas School of Public Health, Austin, TX
| | - Allison Byars
- Michael & Susan Dell Center for Healthy Living, University of Texas School of Public Health, Austin, TX
| | - Courtney Byrd-Williams
- Michael & Susan Dell Center for Healthy Living, University of Texas School of Public Health, Austin, TX
| | - Shreela V. Sharma
- Michael & Susan Dell Center for Healthy Living, University of Texas School of Public Health, Austin, TX
| | - Casey Durand
- Michael & Susan Dell Center for Healthy Living, University of Texas School of Public Health, Austin, TX
| | - Deanna M. Hoelscher
- Michael & Susan Dell Center for Healthy Living, University of Texas School of Public Health, Austin, TX
| | - Nancy F. Butte
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX
| | - Steven H. Kelder
- Michael & Susan Dell Center for Healthy Living, University of Texas School of Public Health, Austin, TX
| |
Collapse
|
45
|
Hoelscher DM, Butte NF, Barlow S, Vandewater EA, Sharma SV, Huang T, Finkelstein E, Pont S, Sacher P, Byrd-Williams C, Oluyomi AO, Durand C, Li L, Kelder SH. Incorporating primary and secondary prevention approaches to address childhood obesity prevention and treatment in a low-income, ethnically diverse population: study design and demographic data from the Texas Childhood Obesity Research Demonstration (TX CORD) study. Child Obes 2015; 11:71-91. [PMID: 25555188 PMCID: PMC4696423 DOI: 10.1089/chi.2014.0084] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [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: 11/13/2022]
Abstract
BACKGROUND There is consensus that development and evaluation of a systems-oriented approach for child obesity prevention and treatment that includes both primary and secondary prevention efforts is needed. This article describes the study design and baseline data from the Texas Childhood Obesity Research Demonstration (TX CORD) project, which addresses child obesity among low-income, ethnically diverse overweight and obese children, ages 2-12 years; a two-tiered systems-oriented approach is hypothesized to reduce BMI z-scores, compared to primary prevention alone. METHODS Our study aims are to: (1) implement and evaluate a primary obesity prevention program; (2) implement and evaluate efficacy of a 12-month family-centered secondary obesity prevention program embedded within primary prevention; and (3) quantify the incremental cost-effectiveness of the secondary prevention program. Baseline demographic and behavioral data for the primary prevention community areas are presented. RESULTS Baseline data from preschool centers, elementary schools, and clinics indicate that most demographic variables are similar between intervention and comparison communities. Most families are low income (≤$25,000) and Hispanic/Latino (73.3-83.8%). The majority of parents were born outside of the United States. Child obesity rates exceed national values, ranging from 19.0% in preschool to 35.2% in fifth-grade children. Most parents report that their children consume sugary beverages, have a television in the bedroom, and do not consume adequate amounts of fruits and vegetables. CONCLUSIONS Interventions to address childhood obesity are warranted in low-income, ethnically diverse communities. Integrating primary and secondary approaches is anticipated to provide sufficient exposure that will lead to significant decreases in childhood obesity.
Collapse
Affiliation(s)
- Deanna M. Hoelscher
- Michael & Susan Dell Center for Healthy Living, The University of Texas School of Public Health, Austin, TX
| | - Nancy F. Butte
- Department of Pediatrics, USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX
| | - Sarah Barlow
- Department of Pediatric Medicine, GI, Hepatology and Nutrition, Texas Children's Hospital, Baylor College of Medicine, Houston, TX
| | - Elizabeth A. Vandewater
- Michael & Susan Dell Center for Healthy Living, The University of Texas School of Public Health, Austin, TX
| | - Shreela V. Sharma
- Michael & Susan Dell Center for Healthy Living, The University of Texas School of Public Health, Houston, TX
| | - Terry Huang
- Department of Health Promotion, University of Nebraska Medical Center, Omaha, NE
| | - Eric Finkelstein
- Program in Health Services Systems Research, Duke University Global Health Institute, Singapore
| | - Stephen Pont
- Texas Center for the Prevention and Treatment of Childhood Obesity, Dell Children's Medical Center, University of Texas Southwestern–Austin, Austin, TX
| | - Paul Sacher
- Childhood Nutrition Research Center, University College, London, United Kingdom
| | - Courtney Byrd-Williams
- Michael & Susan Dell Center for Healthy Living, The University of Texas School of Public Health, Austin, TX
| | - Abiodun O. Oluyomi
- Michael & Susan Dell Center for Healthy Living, The University of Texas School of Public Health, Austin, TX
| | - Casey Durand
- Michael & Susan Dell Center for Healthy Living, The University of Texas School of Public Health, Houston, TX
| | - Linlin Li
- Michael & Susan Dell Center for Healthy Living, The University of Texas School of Public Health, Austin, TX
| | - Steven H. Kelder
- Michael & Susan Dell Center for Healthy Living, The University of Texas School of Public Health, Austin, TX
| |
Collapse
|
46
|
Delk J, Springer AE, Kelder SH, Grayless M. Promoting teacher adoption of physical activity breaks in the classroom: findings of the Central Texas CATCH Middle School Project. J Sch Health 2014; 84:722-730. [PMID: 25274172 DOI: 10.1111/josh.12203] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [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: 08/22/2013] [Revised: 03/03/2014] [Accepted: 05/11/2014] [Indexed: 06/03/2023]
Abstract
BACKGROUND Research suggests that physical activity breaks (ABs) during class increase students' physical activity levels and provide an academic benefit. This study evaluates a 3-year intervention aimed at encouraging teacher AB use. METHODS Thirty central Texas middle schools were assigned to 1 of 3 conditions: training-only (Basic), training plus facilitator support (Basic Plus), and training/facilitator support and a social marketing campaign (Basic Plus SM). Teachers completed surveys at end of years 2 (N = 1039) and 3 (N = 831) to assess exposure to program, self-efficacy, and frequency of AB use. RESULTS At end of year 3, teachers in facilitator-supported conditions reported increased exposure, self-efficacy, and use compared to Basic condition. Only 43.2% of teachers in the Basic condition reported receiving training in ABs compared to 84.2% and 90.6% in the Basic Plus and Basic Plus SM conditions, respectively. Additionally, a greater percentage of teachers in the facilitator-support conditions reported conducting ABs weekly (Basic = 23.3%, Basic Plus = 34.4%, Basic Plus SM = 38.7%, at year 3; p < .001). CONCLUSIONS Despite perceived barriers, including fear that ABs will detract from instructional time, the intervention was successful in having a core group of teachers implement them weekly. More research is needed to increase the percentage of teachers implementing ABs regularly.
Collapse
Affiliation(s)
- Joanne Delk
- University of Texas School of Public Health, Austin Regional Campus, Michael & Susan Dell Center for Healthy Living, 1616 Guadalupe St. Suite 6.300, Austin, TX 78701.
| | | | | | | |
Collapse
|
47
|
Janak JC, Gabriel KP, Oluyomi AO, Peréz A, Kohl HW, Kelder SH. The association between physical fitness and academic achievement in Texas state house legislative districts: an ecologic study. J Sch Health 2014; 84:533-542. [PMID: 25040122 DOI: 10.1111/josh.12176] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [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: 01/30/2013] [Revised: 11/06/2013] [Accepted: 01/18/2014] [Indexed: 06/03/2023]
Abstract
BACKGROUND The association of physical fitness with cognitive function in children and adolescents is unclear. The purpose of this ecological study was to describe the association between academic achievement, body mass index (BMI), and cardiovascular fitness (CVF) in a large sample of elementary, middle, and high school students in Texas. METHODS FITNESSGRAM(®) results for 2,550,144 students were matched with standardized composite academic test (TAKS) results from 2008 to 2009. Analyses were conducted on the percent of students meeting TAKS standards by BMI and CVF quintiles. Analyses of variance with Tukey adjustment examined differences between the most favorable 5th quintile (referent) and all other quintiles. RESULTS The prevalence of students meeting the TAKS standard was significantly higher in the highest fitness category for BMI and CVF compared to all other categories, regardless of sex or grade category (p < .05). Linear modeling suggested a 5% increase in the prevalence of students meeting healthy BMI and CVF standards would result in a 2.25% and 0.65% increase in the prevalence of students meeting the TAKS standard (both p < .05). CONCLUSION Findings suggest a healthy BMI and CVF are associated with higher academic achievement, and the need for additional research examining the role of potential confounders and/or effect modifiers longitudinally.
Collapse
Affiliation(s)
- Jud C Janak
- Postdoctoral Research Fellow, , 1616 Guadalupe Street, Suite 6.300, Austin, TX 78701
| | | | | | | | | | | |
Collapse
|
48
|
Poulos NS, Pasch KE, Springer AE, Hoelscher DM, Kelder SH. Is frequency of family meals associated with parental encouragement of healthy eating among ethnically diverse eighth graders? Public Health Nutr 2014; 17:998-1003. [PMID: 23651952 PMCID: PMC10282384 DOI: 10.1017/s1368980013001092] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [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: 05/15/2012] [Revised: 12/18/2012] [Accepted: 01/23/2013] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The purpose of the present study was to explore the relationship between family meals and parental encouragement of healthy eating overall and by ethnicity. DESIGN Family meal frequency was measured with one item asking how many times in the past 7 d all or most of the family ate a meal together, which was then categorized to represent three levels of family meals (≤2 times, 3-6 times and ≥7 times). Parental encouragement of healthy eating assessed how often parents encouraged the student to eat fruits and vegetables, drink water, eat wholegrain bread, eat breakfast and drink low-fat milk (never to always). An overall scale of parental encouragement of healthy eating was created. Mixed-effect regression analyses were run controlling for gender, ethnicity, age and socio-economic status. Moderation by ethnicity was explored. SETTING Middle schools. SUBJECTS Participants included 2895 US eighth grade students participating in the Central Texas CATCH (Coordinated Approach To Child Health) Middle School Project (mean age 13·9 years; 24·5 % White, 52·7 % Hispanic, 13·0 % African-American, 9·8 % Other; 51·6 % female). RESULTS Eating more family meals was significantly associated with having parents who encouraged healthy eating behaviours (P for trend <0·001). The number of family meals was positively associated with encouragement of each of the healthy eating behaviours (P for trend <0·0001). There were no differences in the relationships by ethnicity of the students. CONCLUSIONS Families who eat together are more likely to encourage healthy eating in general. Interventions which promote family meals may include tips for parents to increase discussions about healthy eating.
Collapse
Affiliation(s)
- Natalie S Poulos
- Department of Kinesiology and Health Education, University of Texas, 1 University Station, D3700, Austin, TX 78712, USA
| | - Keryn E Pasch
- Department of Kinesiology and Health Education, University of Texas, 1 University Station, D3700, Austin, TX 78712, USA
| | - Andrew E Springer
- Michael & Susan Dell Center for Healthy Living, University of Texas School of Public Health, Austin, TX, USA
| | - Deanna M Hoelscher
- Michael & Susan Dell Center for Healthy Living, University of Texas School of Public Health, Austin, TX, USA
| | - Steven H Kelder
- Michael & Susan Dell Center for Healthy Living, University of Texas School of Public Health, Austin, TX, USA
| |
Collapse
|
49
|
Abstract
The Minnesota Heart Health Program (MHHP) is a population-wide research and demonstration project designed to reduce cardiovascular disease in three educated communities (1980-1993) compared to three matched reference communities. The Class of 1989 Study, a substudy of the MHHP, collected self-reported data in one educated and one matched reference community. All sixth graders enrolled in both communities were invited to participate in a baseline survey in 1983, and that grade cohort was surveyed annually throughout junior high and high school until 1989. Students received interventions designed to favorably influence their smoking, physical activity levels, and eating behavior each year from 1983 to 1987. As part of this five-year intervention, a program addressing smoking, alcohol use, drinking and driving behavior, and marijuana use was implemented during the school year of 1985-1986, when students were in ninth grade.Using the school as the unit of analysis, we found that students in the intervention community in 1986 reported fewer occasions on which they had been drinking alcohol in the past 30 days than did students in the reference community. Furthermore, students in the intervention community reported less problem drinking in the previous two weeks and less driving after drinking than did students in the reference community. These positive intervention effects were not maintained through twelfth grade.
Collapse
|
50
|
Ford KH, Oladapo AO, Sterling KL, Diamond PM, Kelder SH, McAlister A. Assessing the psychometric properties of smoking-related attitudes, self-efficacy, and intention among a diverse population of middle school students. Addict Behav 2013; 38:2378-83. [PMID: 23639848 DOI: 10.1016/j.addbeh.2013.03.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2012] [Revised: 02/27/2013] [Accepted: 03/27/2013] [Indexed: 11/26/2022]
Abstract
Large-scale surveys frequently assess smoking-related attitudes, self-efficacy and intention to understand differences in smoking behavior. However, a critical assumption is that measures of these determinants should be equivalent across different subgroups of a target population. The current study examined the factorial invariance of measures of smoking-related attitudes, self-efficacy, and intention with a large sample (N=13,733) of middle school students from 25 schools in Texas. We examined five levels of factorial invariance using a sequential process, in which increasingly constrained models assess the equivalence of a measure across subgroups. Strong factorial invariance provided a good fit for the model across all of the subgroups: race/ethnicity (CFI=.93), gender (CFI=.96), age (CFI=.95), and grade level (CFI=.95). Invariance results provide strong empirical support for the validity of smoking-related attitudes, self-efficacy, and intention measures across race/ethnicity, gender, age, and grade level for middle school students.
Collapse
|