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Vanderloo LM, Tucker P. An objective assessment of toddlers' physical activity and sedentary levels: a cross-sectional study. BMC Public Health 2015; 15:969. [PMID: 26410376 PMCID: PMC4584128 DOI: 10.1186/s12889-015-2335-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Accepted: 09/23/2015] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Little evidence exists on the physical activity and sedentary time of Canadian toddlers; this study objectively measured such behaviors and compared participants' activity levels to national guidelines. Levels of screen-viewing among toddlers were also explored. METHODS Forty toddlers (mean age = 25.7 months) wore Actical accelerometers for seven consecutive days (15 s epoch). Parents/guardians completed a wear-time log and a demographic and screen-viewing questionnaire. Descriptive analyses were used to determine participants' levels of physical activity and sedentary time, to identify whether toddlers were meeting physical activity/sedentary guidelines, and to explore demographic variables. T-tests were used to assess whether toddlers' activity levels differed based on cut-points applied and various demographic and screen-related variables. Regression analyses were conducted to examine associations between toddlers' sedentary time and screen-viewing levels. RESULTS Toddlers engaged in 37.27 (SD = 3.79) to 49.40 (SD = 3.29) mins/hr of sedentary time, 9.79 (SD = 2.90) to 18.78 (SD = 3.22) mins/hr of light-intensity physical activity (LPA), 0.82 (SD = 0.72) to 3.95 (SD = 1.93) mins/hr of moderate- to vigorous-intensity physical activity (MVPA), and 10.60 (SD =3.29) to 22.73 (SD = 3.97) mins/hr of total physical activity (TPA), based on the Trost et al. and the Canadian Health Measures Survey (CHMS) cut-points respectively; these rates were significantly different (p <.001). On at least 1 day, 17.5 % (Trost et al. cut-points) and 97.5 % (CHMS cut-points) of the sample met or exceeded the Canadian physical activity guidelines. No statistically significant differences in sedentary time or physical activity (all intensities) based on sex were reported (p <.001); however, LPA (CHMS cut-points) did significantly differ based on childcare attendance (p <.05). Approximately 93.2 % of participants watched television, and 56.8 % utilized computers. Only 18.8 and 25.0 % of children under 2 years and 70.8 and 62.5 % of 2-3 years olds met the screen-use recommendation of the sedentary behavior guidelines on weekdays and weekend days, respectively. DISCUSSION AND CONCLUSION The implications of this work suggest that a greater understanding of toddlers' activity patterns is needed; additional mechanisms of promoting active behaviors among this group should be explored.
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Affiliation(s)
- Leigh M Vanderloo
- Health and Rehabilitation Sciences, Faculty of Health Sciences, Western University, 1201 Elborn College, Rm 2585, London, ON, N6G 1H1, Canada.
| | - Patricia Tucker
- School of Occupational Therapy, Faculty of Health Sciences, Western University, 1201 Elborn College, Rm 2547, London, ON, N6G 1H1, Canada.
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Vasudevan V, Rimmer JH, Kviz F. Development of the Barriers to Physical Activity Questionnaire for People with Mobility Impairments. Disabil Health J 2015; 8:547-56. [PMID: 26087721 DOI: 10.1016/j.dhjo.2015.04.007] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Revised: 04/29/2015] [Accepted: 04/30/2015] [Indexed: 11/24/2022]
Abstract
BACKGROUND Despite the widely known benefits of physical activity, people with disabilities are more likely to be inactive when compared to people without disabilities. Previous questionnaires that measure barriers physical activity for people with disabilities do not measure barriers from an ecological perspective. OBJECTIVE The purpose of this study was to develop the Barriers to Physical Activity Questionnaire for People with Mobility Impairments (BPAQ-MI) that measures barriers using an ecological framework. METHODS This study consisted of two phases. In Phase one, developed the content validity by (a) developing an item bank, (b) identifying missing items and combining items using a Delphi panel, and (c) refine item wording via cognitive interviews. In Phase two, people with mobility impairments took part in in-person interviews to establish test-retest reliability, internal consistency, and construct validity of the BPAQ-MI. RESULTS Exploratory factor analysis revealed the BPAQ-MI was comprised of eight subscales or factors: health; beliefs and attitudes; family; friends; fitness center built environment; staff and policy; community built environment; and safety. The BPAQ-MI demonstrated very good test-retest reliability. Cronbach's alpha ranged from 0.792 to 0.935. The BPAQ-MI showed significant negative correlations with exercise (minutes/week) and significant positive correlations between BPAQ-MI subscales and inactivity (hours/day). CONCLUSIONS The BPAQ-MI is the first questionnaire that places greater equity at measuring barriers to physical activity across the intrapersonal, interpersonal, organizational, and community domains. The BPAQ-MI has the potential to assist researchers in understanding the complex relationship between barriers and ultimately develop physical activity interventions that address these barriers.
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Affiliation(s)
- Vijay Vasudevan
- Institute on Disability and Human Development, University of Illinois at Chicago, 1640 W. Roosevelt Rd., M/C 626, Chicago, IL 60608, USA.
| | - James H Rimmer
- Lakeshore Foundation Endowed Chair in Health Promotion and Rehabilitation Sciences, 1705 University Blvd., School of Health Professions Building, University of Alabama at Birmingham, Birmingham, AL 35294-1212, USA
| | - Frederick Kviz
- School of Public Health, University of Illinois at Chicago, 1603 W. Taylor St. M/C 923, Chicago, IL 60612, USA
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Assah F, Mbanya JC, Ekelund U, Wareham N, Brage S. Patterns and correlates of objectively measured free-living physical activity in adults in rural and urban Cameroon. J Epidemiol Community Health 2015; 69:700-7. [PMID: 25841243 PMCID: PMC4484252 DOI: 10.1136/jech-2014-205154] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Accepted: 02/01/2015] [Indexed: 11/30/2022]
Abstract
Background Urbanisation in sub-Saharan Africa is changing lifestyles and raising non-communicable disease burden. Understanding the underlying pattern of physical activity and its correlates may inform preventive interventions. We examined correlates of objectively-measured physical activity in rural and urban Cameroon. Methods Participants were 544 adults resident in rural (W-156, M-89) or urban (W-189, M-110) regions. Physical activity was measured using individually-calibrated combined heart rate and movement sensing over seven continuous days. Sociodemographic data were collected by self-report. Independent associations of sociodemographic correlates with physical activity energy expenditure (PAEE) or moderate-to-vigorous physical activity (MVPA) were analysed in multivariate regression models. Results Rural dwellers were significantly more active than their urban counterparts (PAEE: 58.0 vs 42.9 kJ/kg/day; MVPA: 107 vs 62 min/day; MVPA of 150 min/week in >10 min bouts: 62 vs 39%) and less sedentary (923 vs 1026 min/day); p<0.001. There was no significant seasonal difference (dry vs rainy) in activity in urban dwellers whereas in rural dwellers activity was higher during dry seasons compared to rainy seasons (p<0.001). Age, obesity and education showed significant inverse associations with activity. Urban dwellers who considered themselves adequately active were only as active as rural dwellers who thought they were not adequately active. Conclusions This is the first study providing data on sociodemographic patterning of objectively-measured physical activity in rural and urban sub-Saharan Africa. Age, urban residence, obesity and higher educational level are important correlates of lower levels of physical activity. These suggest targets for public health interventions to improve physical activity in Cameroon.
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Affiliation(s)
- Felix Assah
- Department of Public Health, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Jean Claude Mbanya
- Department of Public Health, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - Ulf Ekelund
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | | | - Soren Brage
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
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Hall J, Mansfield L, Kay T, McConnell AK. The effect of a sit-stand workstation intervention on daily sitting, standing and physical activity: protocol for a 12 month workplace randomised control trial. BMC Public Health 2015; 15:152. [PMID: 25879905 PMCID: PMC4336471 DOI: 10.1186/s12889-015-1506-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Accepted: 02/05/2015] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND A lack of physical activity and excessive sitting can contribute to poor physical health and wellbeing. The high percentage of the UK adult population in employment, and the prolonged sitting associated with desk-based office-work, make these workplaces an appropriate setting for interventions to reduce sedentary behaviour and increase physical activity. This pilot study aims to determine the effect of an office-based sit-stand workstation intervention, compared with usual desk use, on daily sitting, standing and physical activity, and to examine the factors that underlie sitting, standing and physical activity, within and outside, the workplace. METHODS/DESIGN A randomised control trial (RCT) comparing the effects of a sit-stand workstation only and a multi-component sit-stand workstation intervention, with usual desk-based working practice (no sit-stand workstation) will be conducted with office workers across two organisations, over a 12 month period (N = 30). The multicomponent intervention will comprise organisational, environmental and individual elements. Objective data will be collected at baseline, and after 2-weeks, 3-months, 6-months and 12-months of the intervention. Objective measures of sitting, standing, and physical activity will be made concurrently (ActivPAL3™ and ActiGraph (GT3X+)). Activity diaries, ethnographic participant observation, and interviews with participants and key organisational personnel will be used to elicit understanding of the influence of organisational culture on sitting, standing and physical activity behaviour in the workplace. DISCUSSION This study will be the first long-term sit-stand workstation intervention study utilising an RCT design, and incorporating a comprehensive process evaluation. The study will generate an understanding of the factors that encourage and restrict successful implementation of sit-stand workstation interventions, and will help inform future occupational wellbeing policy and practice. Other strengths include the objective measurement of physical activity during both work and non-work hours. TRAIL REGISTRATION Clinicaltrials.gov identifier NCT02172599, 22nd June 2014.
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Affiliation(s)
- Jennifer Hall
- Division of Sport, Health and Exercise Sciences, Department of Life Sciences, Brunel University London, London, Middlesex, UB8 3PH, England, UK.
| | - Louise Mansfield
- Division of Sport, Health and Exercise Sciences, Department of Life Sciences, Brunel University London, London, Middlesex, UB8 3PH, England, UK. .,Social Sciences and Health Theme, Brunel University London, London, UK.
| | - Tess Kay
- Division of Sport, Health and Exercise Sciences, Department of Life Sciences, Brunel University London, London, Middlesex, UB8 3PH, England, UK. .,Social Sciences and Health Theme, Brunel University London, London, UK.
| | - Alison K McConnell
- Division of Sport, Health and Exercise Sciences, Department of Life Sciences, Brunel University London, London, Middlesex, UB8 3PH, England, UK.
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Li X, Cheng M, Zhang H, Ke T, Chen Y. Prevalence and determinations of physical inactivity among public hospital employees in Shanghai, China: a cross-sectional study. Front Med 2014; 9:100-7. [PMID: 25501883 DOI: 10.1007/s11684-014-0372-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Accepted: 08/25/2014] [Indexed: 01/12/2023]
Abstract
This study aims to explore the prevalence and determinations of physical inactivity among hospital employees in Shanghai, China. A cross-sectional study of 4612 employees aged 19 to 68 years was conducted through stratified cluster sampling from different classes of Shanghai hospitals in 2011. The total physical activity was evaluated using the metabolic equivalent according to the Global Physical Activity Questionnaire. Among the participants, 38.5%, 32.3%, and 64.6% of the employees are inactive at work, commuting, and taking leisure time, respectively. Up to 41.8% of the men and 37.8% of the women (P = 0.012) are physically inactive. When the age and educational level are adjusted, male doctors and medical technicians show a higher percentage of physical inactivity than male workers in logistics (P = 0.001). Among females, employees who are working in second- and third-class hospitals show a higher proportion of physical inactivity than those who are working in community health care centers. Logistic regression analyses show that the odds ratios (ORs) of leisure-time physical inactivity associated with the intensity of physical activity at work are 2.259, 2.897, and 4.266 for men (P < 0.001) and 2.456, 3.259, and 3.587 for women (P < 0.001), respectively. The time during commuting activities is significantly associated with leisure-time physical inactivity in either sex (OR = 2.116 for men and 2.173 for women, P < 0.001). Hospital employees, particularly doctors and medical technicians, show a higher proportion of physical inactivity than other inhabitants in Shanghai. The time and intensity of activity at work and commuting are associated with leisure-time activities.
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Affiliation(s)
- Xinjian Li
- Department of Cardiovascular Disease Prevention of Shanghai Municipal Center for Disease Control and Prevention, Shanghai, 200336, China,
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Albert BB, De Bock M, Derraik JGB, Brennan CM, Biggs JB, Hofman PL, Cutfield WS. Increasing parental age at childbirth is associated with greater insulin sensitivity and more favorable metabolic profile in overweight adult male offspring. Am J Hum Biol 2014; 27:380-6. [PMID: 25394335 DOI: 10.1002/ajhb.22654] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Revised: 09/16/2014] [Accepted: 10/15/2014] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVE To assess the effect of parental age at childbirth on insulin sensitivity and other metabolic outcomes in overweight middle-aged males. METHODS We studied 73 men aged 46.0±5.4 years, who were overweight (body mass index, BMI 25-30 kg/m(2) ) but otherwise healthy. Insulin sensitivity was assessed by the Matsuda method from an oral glucose tolerance test. Other assessments included dual-energy X-ray absorptiometry-derived body composition, lipid profile, 24-hour ambulatory blood pressure, and carotid intima-media thickness. Maternal and paternal ages were highly correlated (r = 0.71; P < 0.0001), and the main parameter of interest in this study was the mean parental age at childbirth (MPAC), calculated as the average of maternal and paternal ages. RESULTS Increasing MPAC was associated with a continuous increase in insulin sensitivity (β = 0.193; P = 0.008), as well as reductions in insulin resistance (HOMA-IR; β = -0.064; P = 0.011), fasting insulin (β = -0.221; P = 0.018) and fasting glucose (β = -0.030; P = 0.033) concentrations. Increasing MPAC was also associated with reductions in night time systolic (β = -0.500; P = 0.020) and diastolic (β = -0.325; P = 0.047) blood pressure, as well as with improved (greater) nocturnal diastolic blood pressure dipping (β = 0.413; P = 0.046). Subgroup analyses on participants of European descent (n = 64) showed that increasing MPAC was associated with reduced carotid intima-media thickness (β = -0.008; P = 0.018) and lower low-density lipoprotein cholesterol concentrations (β = -0.042; P = 0.028). CONCLUSIONS Increasing parental age at childbirth was associated with a more favorable metabolic phenotype in overweight middle-aged males. However, it is unknown whether the effect was maternal, paternal, or both. Future studies on the effects of parental age at childbirth on the metabolism of males and females across the BMI range are required.
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Drewnowski A, Rehm CD. Consumption of low-calorie sweeteners among U.S. adults is associated with higher Healthy Eating Index (HEI 2005) scores and more physical activity. Nutrients 2014; 6:4389-403. [PMID: 25329967 PMCID: PMC4210924 DOI: 10.3390/nu6104389] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Accepted: 09/26/2014] [Indexed: 01/13/2023] Open
Abstract
The possibility that low-calorie sweeteners (LCS) promote lower quality diets and, therefore, weight gain has been noted as a cause for concern. Data from a representative sample of 22,231 adults were obtained from five cycles of the National Health and Nutrition Examination Survey (1999–2008 NHANES). A single 24-hour recall was used to identify consumers of LCS beverages, foods and tabletop sweeteners. Diet quality was assessed using the Healthy Eating Index 2005 (HEI 2005) and its multiple subscores. Health behaviors of interest were physical activity, smoking and alcohol use. LCS consumers had higher HEI 2005 scores than did non-consumers, largely explained by better SoFAAS subscores (solid fats, added sugar and alcohol). LCS consumers had better HEI subscores for vegetables, whole grains and low-fat dairy, but worse subscores for saturated fat and sodium compared to non-consumers. Similar trends were observed for LCS beverages, tabletop LCS and LCS foods. Consumers of LCS were less likely to smoke and were more likely to engage in recreational physical activity. LCS use was associated with higher HEI 2005 scores, lower consumption of empty calories, less smoking and more physical activity.
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Affiliation(s)
- Adam Drewnowski
- Center for Public Health Nutrition, University of Washington, Box 353410.
| | - Colin D Rehm
- Center for Public Health Nutrition, University of Washington, Box 353410.
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Kumagai N, Ogura S. Persistence of physical activity in middle age: a nonlinear dynamic panel approach. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2014; 15:717-735. [PMID: 23860736 PMCID: PMC4145203 DOI: 10.1007/s10198-013-0518-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Accepted: 06/27/2013] [Indexed: 05/28/2023]
Abstract
No prior investigation has considered the effects of state dependence and unobserved heterogeneity on the relationship between regular physical activity (RPA) and latent health stock (LHS). Accounting for state dependence corrects the possible overestimation of the impact of socioeconomic factors. We estimated the degree of the state dependence of RPA and LHS among middle-aged Japanese workers. The 5 years' longitudinal data used in this study were taken from the Longitudinal Survey of Middle and Elderly Persons. Individual heterogeneity was found for both RPA and LHS, and the dynamic random-effects probit model provided the best specification. A smoking habit, low educational attainment, longer work hours, and longer commuting time had negative effects on RPA participation. RPA had positive effects on LHS, taking into consideration the possibility of confounding with other lifestyle variables. The degree of state dependence of LHS was positive and significant. Increasing the intensity of RPA had positive effects on LHS and caused individuals with RPA to exhibit greater persistence of LHS compared to individuals without RPA. This result implies that policy interventions that promote RPA, such as smoking cessation, have lasting consequences. We concluded that smoking cessation is an important health policy to increase both the participation in RPA and LHS.
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Affiliation(s)
- Narimasa Kumagai
- Faculty of Economics, Kinki University, 3-4-1 Kowakae Higashiosaka, Osaka, 577-8502 Japan
| | - Seiritsu Ogura
- Department of Economics, Hosei University, 4342 Aihara Machida, Tokyo, 194-0298 Japan
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Tannenbaum SL, Koru-Sengul T, Zhao W, Miao F, Byrne MM. Survival Disparities in Non–Small Cell Lung Cancer by Race, Ethnicity, and Socioeconomic Status. Cancer J 2014; 20:237-45. [DOI: 10.1097/ppo.0000000000000058] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Advani PS, Reitzel LR, Nguyen NT, Fisher FD, Savoy EJ, Cuevas AG, Wetter DW, McNeill LH. Financial strain and cancer risk behaviors among African Americans. Cancer Epidemiol Biomarkers Prev 2014; 23:967-75. [PMID: 24740200 PMCID: PMC4047153 DOI: 10.1158/1055-9965.epi-14-0016] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND African Americans suffer disproportionately from the adverse consequences of behavioral risk factors for cancer relative to other ethnic groups. Recent studies have assessed how financial strain might uniquely contribute to engagement in modifiable behavioral risk factors for cancer, but not among African Americans. The current study examined associations between financial strain and modifiable cancer risk factors (smoking, at-risk alcohol use, overweight/obesity, insufficient physical activity, inadequate fruit and vegetable intake, and multiple risk factors) among 1,278 African American adults (age, 46.5 ± 12.6 years; 77% female) and explored potential mediators (stress and depressive symptoms) of those associations. METHODS Logistic regression models were used to examine associations between financial strain and cancer risk factors. Analyses were adjusted for age, sex, partner status, income, educational level, and employment status. Analyses involving overweight/obesity status additionally controlled for fruit and vegetable intake and physical activity. Nonparametric bootstrapping procedures were used to assess mediation. RESULTS Greater financial strain was associated with greater odds of insufficient physical activity (P < 0.003) and smoking (P = 0.005) and was positively associated with the total number of cancer risk factors (P < 0.0001). There was a significant indirect effect of both stress and depressive symptoms on the relations of financial strain with physical inactivity and multiple risk factors, respectively. CONCLUSIONS Future interventions aimed at reducing cancer disparities should focus on African Americans experiencing higher financial strain while addressing their stress and depressive symptoms. IMPACT Longitudinal studies are needed to assess the temporal and causal relations between financial strain and modifiable behavioral cancer risk factors among African Americans.
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Affiliation(s)
- Pragati S Advani
- Authors' Affiliations: Departments of Health Disparities Research and Biostatistics, The University of Texas MD Anderson Cancer Center; Department of Health Promotion and Behavioral Sciences, The University of Texas School of Public Health; Department of Educational Psychology, College of Education and Department of Psychology, College of Liberal Arts and Social Sciences, The University of Houston, Houston, Texas; and Department of Psychology, College of Liberal Arts & Sciences, The Portland State University, Portland, OregonAuthors' Affiliations: Departments of Health Disparities Research and Biostatistics, The University of Texas MD Anderson Cancer Center; Department of Health Promotion and Behavioral Sciences, The University of Texas School of Public Health; Department of Educational Psychology, College of Education and Department of Psychology, College of Liberal Arts and Social Sciences, The University of Houston, Houston, Texas; and Department of Psychology, College of Liberal Arts & Sciences, The Portland State University, Portland, Oregon
| | - Lorraine R Reitzel
- Authors' Affiliations: Departments of Health Disparities Research and Biostatistics, The University of Texas MD Anderson Cancer Center; Department of Health Promotion and Behavioral Sciences, The University of Texas School of Public Health; Department of Educational Psychology, College of Education and Department of Psychology, College of Liberal Arts and Social Sciences, The University of Houston, Houston, Texas; and Department of Psychology, College of Liberal Arts & Sciences, The Portland State University, Portland, Oregon
| | - Nga T Nguyen
- Authors' Affiliations: Departments of Health Disparities Research and Biostatistics, The University of Texas MD Anderson Cancer Center; Department of Health Promotion and Behavioral Sciences, The University of Texas School of Public Health; Department of Educational Psychology, College of Education and Department of Psychology, College of Liberal Arts and Social Sciences, The University of Houston, Houston, Texas; and Department of Psychology, College of Liberal Arts & Sciences, The Portland State University, Portland, Oregon
| | - Felicia D Fisher
- Authors' Affiliations: Departments of Health Disparities Research and Biostatistics, The University of Texas MD Anderson Cancer Center; Department of Health Promotion and Behavioral Sciences, The University of Texas School of Public Health; Department of Educational Psychology, College of Education and Department of Psychology, College of Liberal Arts and Social Sciences, The University of Houston, Houston, Texas; and Department of Psychology, College of Liberal Arts & Sciences, The Portland State University, Portland, Oregon
| | - Elaine J Savoy
- Authors' Affiliations: Departments of Health Disparities Research and Biostatistics, The University of Texas MD Anderson Cancer Center; Department of Health Promotion and Behavioral Sciences, The University of Texas School of Public Health; Department of Educational Psychology, College of Education and Department of Psychology, College of Liberal Arts and Social Sciences, The University of Houston, Houston, Texas; and Department of Psychology, College of Liberal Arts & Sciences, The Portland State University, Portland, Oregon
| | - Adolfo G Cuevas
- Authors' Affiliations: Departments of Health Disparities Research and Biostatistics, The University of Texas MD Anderson Cancer Center; Department of Health Promotion and Behavioral Sciences, The University of Texas School of Public Health; Department of Educational Psychology, College of Education and Department of Psychology, College of Liberal Arts and Social Sciences, The University of Houston, Houston, Texas; and Department of Psychology, College of Liberal Arts & Sciences, The Portland State University, Portland, Oregon
| | - David W Wetter
- Authors' Affiliations: Departments of Health Disparities Research and Biostatistics, The University of Texas MD Anderson Cancer Center; Department of Health Promotion and Behavioral Sciences, The University of Texas School of Public Health; Department of Educational Psychology, College of Education and Department of Psychology, College of Liberal Arts and Social Sciences, The University of Houston, Houston, Texas; and Department of Psychology, College of Liberal Arts & Sciences, The Portland State University, Portland, Oregon
| | - Lorna H McNeill
- Authors' Affiliations: Departments of Health Disparities Research and Biostatistics, The University of Texas MD Anderson Cancer Center; Department of Health Promotion and Behavioral Sciences, The University of Texas School of Public Health; Department of Educational Psychology, College of Education and Department of Psychology, College of Liberal Arts and Social Sciences, The University of Houston, Houston, Texas; and Department of Psychology, College of Liberal Arts & Sciences, The Portland State University, Portland, Oregon
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Kuo C, Cluver L, Casale M, Lane T. Cumulative effects of HIV illness and caring for children orphaned by AIDS on anxiety symptoms among adults caring for children in HIV-endemic South Africa. AIDS Patient Care STDS 2014; 28:318-26. [PMID: 24901465 DOI: 10.1089/apc.2013.0225] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Adults caring for children in HIV-endemic communities are at risk for poor psychological outcomes. However, we still have a limited understanding of how various HIV impacts--including caregiver's own HIV illness, responsibilities of caring for a child orphaned by AIDS, or both--affect psychological outcomes among caregivers. Furthermore, few studies have explored the relationship between stigma, HIV, and psychological outcomes among caregivers of children in HIV-endemic communities. A cross-sectional survey conducted from 2009 to 2010 assessed anxiety among 2477 caregivers of children in HIV-endemic South Africa. Chi-square tested differences in anxiety among caregivers living with HIV, caregivers of a child orphaned by AIDS, and caregivers affected with both conditions. Multivariate logistic regressions identified whether the relationship between HIV impacts and anxiety remained after controlling for socio-demographic co-factors. Mediation analysis tested the relationship between stigma, HIV, and anxiety. The odds of meeting threshold criteria for clinically relevant anxiety symptoms were two and a half times greater among caregivers living with HIV compared to nonaffected caregivers. The odds of meeting threshold criteria for clinically relevant anxiety symptoms were greatest among caregivers living with HIV and caring for a child orphaned by AIDS. Exposure to AIDS-related stigma partially mediated the relationship between HIV and anxiety. Interventions are needed to address caregiver psychological health, particularly among caregivers affected with both conditions of living with HIV and caring for a child orphaned by AIDS.
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Affiliation(s)
- Caroline Kuo
- Department of Behavioral and Social Sciences and Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, Rhode Island
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Lucie Cluver
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
- Department of Social Policy and Intervention, University of Oxford, Oxford, United Kingdom
- Health Economics and HIV/AIDS Research Division, University of KwaZulu-Natal, South Africa
| | - Marisa Casale
- Health Economics and HIV/AIDS Research Division, University of KwaZulu-Natal, South Africa
- Department of Psychology, University of Cape Town, Cape Town, South Africa
| | - Tyler Lane
- Department of Social Policy and Intervention, University of Oxford, Oxford, United Kingdom
- Health Economics and HIV/AIDS Research Division, University of KwaZulu-Natal, South Africa
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Reynolds KD, Dahmann N, Wolch J, Joassart-Marcelli P, Dunton G, Rudulph D, Newell J, Thayer J, Jerrett M. Factors predicting the capacity of Los Angeles city-region recreation programs to promote energy expenditure. Health Place 2014; 28:67-72. [PMID: 24755531 DOI: 10.1016/j.healthplace.2014.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2012] [Revised: 03/25/2014] [Accepted: 03/27/2014] [Indexed: 11/24/2022]
Abstract
An audit of recreation programs with moderate or higher levels of physical activity (PA) in Los Angeles area cities (N=82) was conducted using internet, telephone, and survey methods. Metabolic Equivalents (METs) were used to code programs׳ physical activity intensity. MET-hours per recreation program was associated with required age for enrollment, percent of residents >64 years of age, and fiscal capacity of cities. Capacity to promote energy expenditure may depend on targeted age groups, age of population, and municipal fiscal capacity. Cities with lower fiscal capacity might offer those higher MET-hour activities which require less specialized equipment and seek outside funding to offer higher MET programs.
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Affiliation(s)
- Kim D Reynolds
- Claremont Graduate University, School of Community and Global Health, 675 W. Foothill Blvd, Suite 310, Claremont, CA 91711, USA.
| | - Nicholas Dahmann
- University of Southern California, Department of American Studies & Ethnicity, 3620 S. Vermont Avenue, Kaprielian Hall 462, Los Angeles, CA 90089-2534, USA.
| | - Jennifer Wolch
- University of California, Berkeley, College of Environmental Design, 230 Wurster Hall #1820, Berkeley, CA 94720-1820, USA.
| | - Pascale Joassart-Marcelli
- San Diego State University, Department of Geography, 5500 Campanile Drive, San Diego, CA 92182, USA.
| | - Genevieve Dunton
- University of Southern California, Institute for Prevention Research, Health Sciences Campus, SSB 302E, M/C 9239, Los Angeles, CA 90089-9239, USA.
| | - Diana Rudulph
- Claremont Graduate University, School of Community and Global Health, 675 W. Foothill Blvd, Suite 310, Claremont, CA 91711, USA.
| | - Joshua Newell
- University of Michigan, School of Natural Resources & Environment, 1064 Dana Building, 440 Church Street, Ann Arbor, MI 48109-1041, USA.
| | - Jennifer Thayer
- Claremont Graduate University, School of Community and Global Health, 675 W. Foothill Blvd, Suite 310, Claremont, CA 91711, USA.
| | - Michael Jerrett
- University of California, Berkeley, School of Public Health, 50 University Hall #7360, Berkeley, CA 9472, USA.
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Impact of participant incentives and direct and snowball sampling on survey response rate in an ethnically diverse community: results from a pilot study of physical activity and the built environment. J Immigr Minor Health 2013; 15:207-14. [PMID: 21932003 DOI: 10.1007/s10903-011-9525-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Community-wide efforts to encourage healthy behaviours must respond to the needs of existing neighbourhoods, especially those where low physical activity (PA) is associated with social, economic, and cultural challenges. This study reports on the effect of direct and snowball sampling strategies and financial incentive levels on the response rates of a built environment and PA survey in a predominately urban, low-SES new-immigrant community. Women residing in the Jane-Finch neighbourhood of Toronto, Ontario were selected to participate by quasi-random sampling, yielding a response rate of 41.5%. The survey completion rate per contact attempt increased 2-fold when incentives were increased from $10 to $20 and a further threefold following the increase from $20 to $30. Snowball sampled respondents were older, less likely to have full-time employment, and had lower educational attainment than directly sampled participants. With appropriate incentives, face-to-face contact, and snowball sampling, survey-based research is feasible within a low-SES, high minority population.
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Sherpa LY, Deji, Stigum H, Chongsuvivatwong V, Nafstad P, Bjertness E. Prevalence of metabolic syndrome and common metabolic components in high altitude farmers and herdsmen at 3700 m in Tibet. High Alt Med Biol 2013; 14:37-44. [PMID: 23537259 DOI: 10.1089/ham.2012.1051] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES To estimate the prevalence of metabolic syndrome, its associated factors and components in 30-80-year-old Tibetans living at high altitude. METHOD Multistage sampling of 692 participants. We used IDF criteria for estimation of the metabolic syndrome, and a questionnaire based on the WHO MONICA protocol. RESULTS The prevalence of metabolic syndrome was 8.2% (Confidence interval (CI):6.1-10.2) while the common components were: fasting hyperglycemia 57.5% (53.8-61.1); abdominal obesity 46% (42.2-49.7); and high blood pressure 37% (33.4-40.5). Metabolic syndrome was significantly lower for males, those with higher education and physical activity >2000 Kcal/week. Self awareness, treatment and control were low for both diabetes and lipid abnormality. CONCLUSION The overall prevalence of metabolic syndrome in high altitude farmers and herdsmen in Tibet was lower compared to other high altitude natives, while its components (hyperglycemia, obesity, and high blood pressure) were higher than in other high altitude communities. Implications of the findings of high prevalence of smoking (among men), obesity, and hypertension and low rates of awareness, treatment, and control of the components of the metabolic syndrome among rural highlanders propels the need for health programs targeting risk factors.
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Affiliation(s)
- Lhamo Y Sherpa
- Section for Preventive Medicine and Epidemiology, Department of Community Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway.
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Longitudinal associations between health behaviors and mental health in low-income adults. Transl Behav Med 2013; 3:104-13. [PMID: 23997836 DOI: 10.1007/s13142-012-0189-5] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
Although there are established relationships between physical and mental health, few studies have explored the relationship between health behaviors and mental health over time. To explore rates of health-compromising behaviors (HCBs) and the longitudinal relationship between HCBs and depression, anxiety, and stress, five waves of data were collected over 1 year from 482 patients at an urban public health clinic (47 % female, 68 % African-American, M age = 28). Smoking (61 %), binge drinking (52 %), illegal drug use (53 %), unprotected sex with non-primary partners (55 %), and fast food consumption (71 %) were common, while consumption of fruits or vegetables (30 %) and breakfast (17 %) were rare. Cross-lagged models identified within-time associations between HCBs and depression/anxiety and stress. Additionally, depression/anxiety and stress predicted later HCBs, but HCBs did not predict later mental health. Results suggest that targeting mental health may be important to promoting improvements across multiple health behaviors.
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66
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Cohen SS, Matthews CE, Signorello LB, Schlundt DG, Blot WJ, Buchowski MS. Sedentary and physically active behavior patterns among low-income African-American and white adults living in the southeastern United States. PLoS One 2013; 8:e59975. [PMID: 23573224 PMCID: PMC3616058 DOI: 10.1371/journal.pone.0059975] [Citation(s) in RCA: 131] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2012] [Accepted: 02/19/2013] [Indexed: 11/25/2022] Open
Abstract
Increased sedentary behavior and lack of physical activity are associated with increased risk for many chronic diseases. Differences in leisure-time physical activity between African American and white adults have been suggested to partially explain racial disparities in chronic disease outcomes, but expanding the definition of physical activity to include household and occupational activities may reduce or even eliminate racial differences in total physical activity. The objective of this study was to describe patterns of active and sedentary behaviors in black and white adults and to examine these behaviors across demographic measures. Sedentary and physically active behaviors were obtained from a validated physical activity questionnaire in 23,021 black men, 9,899 white men, 32,214 black women, and 15,425 white women (age 40–79) at enrollment into the Southern Community Cohort Study. Descriptive statistics for sedentary time; light, moderate, and vigorous household/occupational activity; sports/exercise; total activity; and meeting current physical activity recommendations via sports/exercise were examined for each race-sex group. Adjusted means were calculated using multiple linear regression models across demographic measures. Study participants spent approximately 60% of waking time in sedentary behaviors. Blacks reported more television viewing time than whites (45 minutes for females, 15 minutes for males), but when sitting time was expressed as a proportion of overall awake time, minimal racial differences were found. Patterns of light, moderate, and vigorous household/occupational activity were similar in all race/sex groups. 2008 Physical Activity Guidelines for Americans were followed by 16% of women and 25% of men independent of race. Overall, black and white men and women in this study spent the majority of their daily time in sedentary behaviors and less than one-fourth followed current guidelines for physical activity. These results indicate that public health campaigns should focus on both reducing sedentary behavior and increasing physical activity in all adult US populations.
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Affiliation(s)
- Sarah S Cohen
- International Epidemiology Institute, Rockville, Maryland, United States of America.
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67
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Siddiqi A, Kawachi I, Keating DP, Hertzman C. A Comparative Study of Population Health in the United States and Canada during the Neoliberal Era, 1980–2008. INTERNATIONAL JOURNAL OF HEALTH SERVICES 2013; 43:193-216. [DOI: 10.2190/hs.43.2.b] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This article draws on the vast evidence that suggests, on one hand, that socioeconomic inequalities in health are present in every society in which they have been measured and, on the other hand, that the size of inequalities varies substantially across societies. We conduct a comparative case study of the United States and Canada to explore the role of neoliberalism as a force that has created inequalities in socioeconomic resources (and thus in health) in both societies and the roles of other societal forces (political, economic, and social) that have provided a buffer, thereby lessening socioeconomic inequalities or their effects on health. Our findings suggest that, from 1980 to 2008, while both the United States and Canada underwent significant neoliberal reforms, Canada showed more resilience in terms of health inequalities as a result of differences in: ( a) the degree of income inequality, itself resulting from differences in features of the labor market and tax and transfer policies, ( b) equality in the provision of social goods such as health care and education, and ( c) the extent of social cohesiveness across race/ethnic- and class-based groups. Our study suggests that further attention must be given to both causes and buffers of health inequalities.
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Whitehorse LE, Manzano R, Baezconde-Garbanati LA, Hahn G. Culturally Tailoring a Physical Activity Program for Hispanic Women: Recruitment Successes of La Vida Buena's Salsa Aerobics. ACTA ACUST UNITED AC 2013. [DOI: 10.1080/10556699.1999.10603424] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
| | - Ruth Manzano
- a Community Health Promotion Department , Escondido Community Health Center , 401 E. Grand St., Suite 2D, Escondido , CA , 92025 , USA
| | - Lourdes A. Baezconde-Garbanati
- b Department of Preventive Medicine, Norris Comprehensive Cancer Center and Institute for Prevention Research , University of Southern California , USA
| | - Ginger Hahn
- c Latino Health Access , Santa Ana , CA , USA
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Finger JD, Tylleskär T, Lampert T, Mensink GBM. Physical activity patterns and socioeconomic position: the German National Health Interview and Examination Survey 1998 (GNHIES98). BMC Public Health 2012; 12:1079. [PMID: 23241280 PMCID: PMC3561273 DOI: 10.1186/1471-2458-12-1079] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2012] [Accepted: 12/14/2012] [Indexed: 11/30/2022] Open
Abstract
Background We investigated the associations between education and leisure-time, occupational, sedentary and total physical-activity levels based on data from the German National Health Interview and Examination Survey 1998 (GNHIES98). The roles of income level, occupational status and other mediating variables for these associations were also examined. Methods The total study sample of the GNHIES98 comprised 7,124 participants between the ages of 18 and 79. Complete information was available for 6,800 persons on leisure-time, sedentary and total physical-activity outcomes and for 3,809 persons in regular employment on occupational activity outcomes. The associations between educational level and physical activity (occupational, sedentary, leisure-time and total physical activity) were analysed separately for men and women using multivariate logistic regression analysis. Odds ratios (OR) of educational level on physical-activity outcomes were calculated and adjusted for age, region, occupation, income and other mediating variables. Results After adjusting for age and region, a higher education level was associated with more leisure-time activity – with an OR of 1.6 (95% CI, 1.3-2.0) for men with secondary education and 2.1 (1.7-2.7) for men with tertiary education compared to men with primary education. The corresponding ORs for women were 1.3 (1.1-1.6) and 1.7 (1.2-2.4), respectively. Higher education was associated with a lower level of vigorous work activity: an OR of 6.9 (4.6-10.3) for men with secondary education and 18.6 (12.0-27.3) for men with primary education compared to men with tertiary education. The corresponding ORs for women were 2.8 (2.0-4.0) and 5.8 (4.0-8.5), respectively. Higher education was also associated with a lower level of total activity: an OR of 2.9 (2.2-3.8) for men with secondary education and 4.3 (3.3-5.6) for men with tertiary education compared to men with primary education. The corresponding ORs for women were 1.6 (1.2-2.0) and 1.6 (1.2-2.1), respectively. Conclusions In Germany adults with a lower level of education are more physically active, both at work and overall, compared to adults with a higher education level, although they are less physically active in their leisure time. Higher work-related activity levels among adults with lower education may explain why they are less active in their leisure time.
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Affiliation(s)
- Jonas D Finger
- Department of Epidemiology and Health Reporting, Robert Koch Institute, General-Pape-Strasse, 62-66, Berlin, D-12101, Germany.
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Sebastião E, Gobbi S, Chodzko-Zajko W, Schwingel A, Papini CB, Nakamura PM, Netto AV, Kokubun E. The International Physical Activity Questionnaire-long form overestimates self-reported physical activity of Brazilian adults. Public Health 2012; 126:967-75. [PMID: 22944387 DOI: 10.1016/j.puhe.2012.07.004] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2011] [Revised: 04/04/2012] [Accepted: 07/20/2012] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To explore issues associated with measuring physical activity using the International Physical Activity Questionnaire (IPAQ)-long form in adults living in a mid-sized Brazilian city. METHODS A stratified random sampling procedure was used to select a representative sample of adults living in Rio Claro. This yielded 1572 participants who were interviewed using the IPAQ-long form. The data were analysed using standard statistical procedures. RESULTS Overall, 83% of men and 89% of women reported at least 150 min of combined moderate and/or vigorous physical activity per week. Reliable values of leisure and transportation-related physical activity were observed for both males and females. With regard to the household and work-related physical activity domains, both males and females reported unusually high levels of participation. CONCLUSION The IPAQ-long form appears to overestimate levels of physical activity for both males and females, suggesting that the instrument has problems in measuring levels of physical activity in Brazilian adults. Accordingly, caution is warranted before using IPAQ data to support public policy decisions related to physical activity.
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Affiliation(s)
- E Sebastião
- Aging and Diversity Laboratory, Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, 126 Louise Freer Hall, 906 S. Goodwin Ave., Urbana-Champaign, IL 61801, USA.
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Sacerdote C, Ricceri F, Rolandsson O, Baldi I, Chirlaque MD, Feskens E, Bendinelli B, Ardanaz E, Arriola L, Balkau B, Bergmann M, Beulens JWJ, Boeing H, Clavel-Chapelon F, Crowe F, de Lauzon-Guillain B, Forouhi N, Franks PW, Gallo V, Gonzalez C, Halkjær J, Illner AK, Kaaks R, Key T, Khaw KT, Navarro C, Nilsson PM, Dal Ton SO, Overvad K, Pala V, Palli D, Panico S, Polidoro S, Quirós JR, Romieu I, Sánchez MJ, Slimani N, Sluijs I, Spijkerman A, Teucher B, Tjønneland A, Tumino R, van der A D, Vergnaud AC, Wennberg P, Sharp S, Langenberg C, Riboli E, Vineis P, Wareham N. Lower educational level is a predictor of incident type 2 diabetes in European countries: the EPIC-InterAct study. Int J Epidemiol 2012; 41:1162-73. [PMID: 22736421 DOI: 10.1093/ije/dys091] [Citation(s) in RCA: 110] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) is one of the most common chronic diseases worldwide. In high-income countries, low socioeconomic status seems to be related to a high incidence of T2DM, but very little is known about the intermediate factors of this relationship. Method We performed a case-cohort study in eight Western European countries nested in the EPIC study (n = 340, 234, 3.99 million person-years of follow-up). A random sub-cohort of 16,835 individuals and a total of 12,403 incident cases of T2DM were identified. Crude and multivariate-adjusted hazard ratios (HR) were estimated for each country and pooled across countries using meta-analytical methods. Age-, gender- and country-specific relative indices of inequality (RII) were used as the measure of educational level and RII tertiles were analysed. RESULTS Compared with participants with a high educational level (RII tertile 1), participants with a low educational level (RII tertile 3) had a higher risk of T2DM [HR: 1.77, 95% confidence interval (CI): 1.69-1.85; P-trend < 0.01]. The HRs adjusted for physical activity, smoking status and propensity score according to macronutrient intake were very similar to the crude HR (adjusted HR: 1.67, 95% CI: 1.52-1.83 in men; HR: 1.88, 95% CI: 1.73-2.05 in women). The HRs were attenuated only when they were further adjusted for BMI (BMI-adjusted HR: 1.36, 95% CI: 1.23-1.51 in men; HR: 1.32, 95% CI: 1.20-1.45 in women). CONCLUSION This study demonstrates the inequalities in the risk of T2DM in Western European countries, with an inverse relationship between educational level and risk of T2DM that is only partially explained by variations in BMI.
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Warner ET, Wolin KY, Duncan DT, Heil DP, Askew S, Bennett GG. Differential accuracy of physical activity self-report by body mass index. Am J Health Behav 2012; 36:168-78. [PMID: 22370255 DOI: 10.5993/ajhb.36.2.3] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVES To examine whether agreement between self-reported and accelerometer-measured physical activity varies by BMI category in a low-income black sample. METHODS Participants completed a questionnaire and wore an accelerometer for 4-6 days. Using one- and 10-minute bouts, accelerometers measured light, moderate, and vigorous physical activity time. RESULTS Correlations varied by obesity (nonobese: one-minute r=0.41; 10-minute r=0.47; obese: one-minute r=0.21; 10-minute r=0 .14). Agreement was highest among nonobese persons (one-minute kappa = 0.48, 10-minute kappa = 0.023; obese: one-minute kappa = -0.024, 10- minute kappa = -0.020). CONCLUSIONS We found compromised questionnaire performance among obese participants.
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Affiliation(s)
- Erica T. Warner
- Department of Epidemiology, Human Development and Health, Harvard School of Public Health, Boston, MA, USA
| | - Kathleen Y. Wolin
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, Saint Louis, MO, USA.
| | - Dustin T. Duncan
- Department of Society, Human Development and Health, Harvard School of Public Health, Boston, MA, USA
| | - Daniel P. Heil
- Health and Human Performance, Montana State University, Bozeman, MT, USA
| | - Sandy Askew
- Senior Data Technician, Global Health Institute, Duke University, Department Psychology and Neuroscience, Durham, NC, USA
| | - Gary G. Bennett
- Duke University, Department Psychology and Neuroscience, Durham, NC, USA
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Baernholdt M, Yan G, Hinton I, Rose K, Mattos M. Quality of life in rural and urban adults 65 years and older: findings from the National Health and Nutrition Examination survey. J Rural Health 2012; 28:339-47. [PMID: 23083080 PMCID: PMC3615459 DOI: 10.1111/j.1748-0361.2011.00403.x] [Citation(s) in RCA: 95] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE The proportion of people over 65 years of age is higher in rural areas than in urban areas, and their numbers are expected to increase in the next decade. This study used Andersen's behavioral model to examine quality of life (QOL) in a nationally representative sample of community-dwelling adults 65 years and older according to geographic location. Specifically, associations between 3 dimensions of QOL (health-related QOL [HQOL], social functioning, and emotional well-being) and needs and health behaviors were examined. METHODS The 2005-2006 National Health and Nutrition Examination survey was linked with the 2007 Area Resources File via the National Center for Health Statistics' remote access system. Frequencies and distribution patterns were assessed according to rural, adjacent, and urban locations. FINDINGS Older adults reported high levels of QOL; however, rural older adults had lower social functioning than their urban counterparts. Older blacks and Hispanics had lower scores than whites on 2 dimensions of QOL. Associations between QOL and needs and health behaviors varied. Although activities of daily living were associated with all 3 dimensions, others were associated with 1 or 2 dimensions. CONCLUSIONS The lower scores on social functioning in rural areas suggest that rural older adults may be socially isolated. Older rural adults may need interventions to maintain physical and mental health, strengthen social relationships and support, and increase their participation in the community to promote QOL. In addition, older blacks and Hispanics seem more vulnerable than whites and may need more assistance.
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Affiliation(s)
- Marianne Baernholdt
- School of Nursing, University of Virginia, Charlottesville, Virginia 22903, USA.
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Merom D, Sinnreich R, Aboudi V, Kark JD, Nassar H. Lifestyle physical activity among urban Palestinians and Israelis: a cross-sectional comparison in the Palestinian-Israeli Jerusalem risk factor study. BMC Public Health 2012; 12:90. [PMID: 22289260 PMCID: PMC3311574 DOI: 10.1186/1471-2458-12-90] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2011] [Accepted: 01/30/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Urban Palestinians have a high incidence of coronary heart disease, and alarming prevalences of obesity (particularly among women) and diabetes. An active lifestyle can help prevent these conditions. Little is known about the physical activity (PA) behavior of Palestinians. This study aimed to determine the prevalence of insufficient PA and its socio-demographic correlates among urban Palestinians in comparison with Israelis. METHODS An age-sex stratified random sample of Palestinians and Israelis aged 25-74 years living in east and west Jerusalem was drawn from the Israel National Population Registry: 970 Palestinians and 712 Israelis participated. PA in a typical week was assessed by the Multi-Ethnic Study of Atherosclerosis (MESA) questionnaire. Energy expenditure (EE), calculated in metabolic equivalents (METs), was compared between groups for moderate to vigorous-intensity physical activity (MVPA), using the Wilcoxon rank-sum test, and for domain-specific prevalence rates of meeting public health guidelines and all-domain insufficient PA. Correlates of insufficient PA were assessed by multivariable logistic modeling. RESULTS Palestinian men had the highest median of MVPA (4740 METs-min*wk-1) compared to Israeli men (2,205 METs-min*wk-1 p < 0.0001), or to Palestinian and Israeli women, who had similar medians (2776 METs-min*wk-1). Two thirds (65%) of the total MVPA reported by Palestinian women were derived from domestic chores compared to 36% in Israeli women and 25% among Palestinian and Israeli men. A high proportion (63%) of Palestinian men met the PA recommendations by occupation/domestic activity, compared to 39% of Palestinian women and 37% of the Israelis. No leisure time PA was reported by 42% and 39% of Palestinian and Israeli men (p = 0.337) and 53% and 28% of Palestinian and Israeli women (p < 0.0001). Palestinian women reported the lowest level of walking. Considering all domains, 26% of Palestinian women were classified as insufficiently active versus 13% of Palestinian men (p < 0.0001) who did not differ from the Israeli sample (14%). Middle-aged and elderly and less educated Palestinian women, and unemployed and pensioned Palestinian men were at particularly high risk of inactivity. Socio-economic indicators only partially explained the ethnic disparity. CONCLUSIONS Substantial proportions of Palestinian women, and subgroups of Palestinian men, are insufficiently active. Culturally appropriate intervention strategies are warranted, particularly for this vulnerable population.
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Affiliation(s)
- Dafna Merom
- School of Science and Health, University of Western Sydney, Locked Bag 1797, Penrith NSW 2571, Australia
| | - Ronit Sinnreich
- Epidemiology Unit, Hebrew University-Hadassah School of Public Health and Community Medicine, Jerusalem, Israel
| | - Vartohi Aboudi
- St Joseph Hospital, East Jerusalem, Jerusalem, Israel
- IVF Department, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Jeremy D Kark
- Epidemiology Unit, Hebrew University-Hadassah School of Public Health and Community Medicine, Jerusalem, Israel
| | - Hisham Nassar
- Cardiology Department, Hadassah-Hebrew University Medical Center and Cardiology Consultant, St Joseph Hospital, East Jerusalem, Jerusalem, Israel
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Yang Y, Diez Roux AV, Auchincloss AH, Rodriguez DA, Brown DG. Exploring walking differences by socioeconomic status using a spatial agent-based model. Health Place 2012; 18:96-9. [PMID: 22243911 PMCID: PMC3345574 DOI: 10.1016/j.healthplace.2011.08.010] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2011] [Revised: 07/11/2011] [Accepted: 08/24/2011] [Indexed: 11/23/2022]
Abstract
We use an exploratory agent-based model of adults' walking behavior within a city to examine the possible impact of interventions on socioeconomic differences in walking. Simulated results show that for persons of low socioeconomic status, increases in walking resulting from increases in their positive attitude towards walking may diminish over time if other features of the environment are not conducive to walking. Similarly, improving the safety level for the lower SES neighborhoods may be effective in increasing walking, however, the magnitude of its effectiveness varies by levels of land use mix, such that effects of safety are greatest when persons live in areas with a large mix of uses.
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Affiliation(s)
- Yong Yang
- Department of Epidemiology, Center for Social Epidemiology and Population Health, University of Michigan, Ann Arbor, Michigan 48109, USA.
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Kuo C, Operario D, Cluver L. Depression among carers of AIDS-orphaned and other-orphaned children in Umlazi Township, South Africa. Glob Public Health 2011; 7:253-69. [PMID: 22081931 PMCID: PMC3273578 DOI: 10.1080/17441692.2011.626436] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
South Africa faces the challenge of supporting the well-being of adults caring for growing numbers of AIDS-orphaned children. These adults play a critical role in responses to the epidemic, but little information exists in regard to their mental health needs. This paper reports on findings from n=1599 adults, recruited through representative household sampling, who serve as primary carers for children in Umlazi Township, an HIV-endemic community. Overall, 22% of participants were carers of AIDS-orphaned children, 11% were carers of other-orphaned children and 67% were carers of non-orphaned children. Prevalence of depression was 30.3%. Orphan carers, regardless of whether they cared for AIDS-orphaned or other-orphaned children, were significantly more likely than carers of non-orphaned children to meet the clinical threshold for depression (35.2% vs. 27.9%, p < 0.01). In multivariate logistic regressions, food insecurity and being a female carer were identified as additional risk factors for greater depression. In contrast, households with access to running water and households dependent on salaries as the main source of income were identified as protective factors for disparities in depression. Mental health interventions are urgently needed to address an increased risk for depression among all orphan carers, not just those caring for AIDS-orphaned children.
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Affiliation(s)
- Caroline Kuo
- Department of Psychiatry, Rhode Island Hospital and Alpert Medical School, Brown University, Box G-S121-Floor 4, Providence, Rhode Island 02903, USA, Phone: +1 401 863 6630, Fax: +1 401 863 6647
| | - Don Operario
- Department of Community Health and Center for Alcohol and Addiction Studies, Brown University, Box G-S121-Floor 5, Providence, Rhode Island 02903, USA, Phone: +1 401 863 6657, Fax: +1 401 863 6697
| | - Lucie Cluver
- Department of Social Policy and Social Work, Oxford University, 32 Wellington Square, Oxford OX1 2ER, England, Phone: +44 01865 270325, Fax: +44 01865 270324
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Dahl-Petersen IK, Jørgensen ME, Bjerregaard P. Physical activity patterns in Greenland: A country in transition. Scand J Public Health 2011; 39:678-86. [DOI: 10.1177/1403494811420486] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Aims: To examine differences in physical activity patterns among Inuit in Greenland in relation to social transition. The Inuit in Greenland are an indigenous population in the circumpolar north who are experiencing rapid social transition. Methods: Physical activity patterns were assessed by the International Physical Activity Questionnaire (long version). The population was divided into six groups according to different stages of social change, measured on the basis of education, current residence and occupation. Data were collected in a country-wide cross-sectional population survey among adult Inuit in Greenland from 2005 to 2009. Results: Men with long vocational or academic education living in towns (latest stage of social change) spent significantly less time on occupational physical activity (p = 0.001) compared with hunters and fishermen in villages (earliest stage of social change) (trend test p = 0.01). Women in the latest stage of change spent significantly less time on domestic physical activity (p < 0.001) (trend test p = 0.06) compared with women in the earliest stage of social change. This was also found for physical activity during transportation (p = 0.02 and p = 0.01 for men and women, respectively). No significant difference was found for leisuretime physical activity. Men and women in the latest stage of social change spent more time on sedentary activity (p < 0.001). Conclusions: Differences in physical activity patterns among Inuit in Greenland included decreasing time spent on domestic and occupational physical activity and increasing time spent on sedentary activities along with social change. Knowledge of changes in physical activity patterns in relation to social transition is important in prevention of obesity, type 2 diabetes and lifestyle diseases.
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Affiliation(s)
- Inger K. Dahl-Petersen
- Centre for Health Research in Greenland, National Institute of Public Health, University of Southern Denmark, Denmark,
| | | | - Peter Bjerregaard
- Centre for Health Research in Greenland, National Institute of Public Health, University of Southern Denmark, Denmark
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78
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Kellar I, Mann E, Kinmonth A, Prevost A, Sutton S, Marteau T. Can informed choice invitations lead to inequities in intentions to make lifestyle changes among participants in a primary care diabetes screening programme? Evidence from a randomized trial. Public Health 2011; 125:645-52. [DOI: 10.1016/j.puhe.2011.05.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2010] [Revised: 02/28/2011] [Accepted: 05/26/2011] [Indexed: 11/28/2022]
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Sherpa LY, Deji, Stigum H, Chongsuvivatwong V, Luobu O, Thelle DS, Nafstad P, Bjertness E. Lipid profile and its association with risk factors for coronary heart disease in the highlanders of Lhasa, Tibet. High Alt Med Biol 2011; 12:57-63. [PMID: 21452966 DOI: 10.1089/ham.2010.1050] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The aim of this study was to determine the prevalence of abnormal lipid levels and its association with selected coronary heart disease (CHD) risk factors in the Tibetan population living at 3660 meters above sea level in Lhasa, Tibet. Three hundred seventy one randomly selected male and female, aged 30 to 70 yr took part in the study. Based on the National Cholesterol Education Programme (NCED) adult treatment panel ATP-III 2004 criteria, the age-adjusted prevalence of hypertriglyceridemia was 12.0%; high triglycerides (TG), 33.4%; high low-density lipoprotein cholesterol (LDL-C), 4.8%; and low high-density lipoprotein cholesterol (HDL-C); 24.3%. After adjusting for age, sex, smoking, alcohol, physical activity, diet, hemoglobin (Hb) concentration, and systolic and diastolic blood pressure (BP), an increase in waist-to-hip ratio (WHR) by 0.1 unit was associated with a statistically significant increase in TG, total cholesterol (TC) and LDL-C by 0.25 mmol/L, 0.24 mmol/L, and 0.18 mmol/L, respectively. Female gender increased HDL-C by 0.18 mmol/L when compared with males. Age-adjusted prevalences of Framingham CHD risk score for males and females were 16.3% and 0.6%, respectively. This study demonstrated a high prevalence of hypertriglyceridemia in males, a higher prevalence of low HDL-C in females, and a high hypercholesterolemia prevalence in both genders. However, further longitudinal studies assessing CHD risk factors in high altitude natives are required.
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Affiliation(s)
- Lhamo Y Sherpa
- Section for Preventive Medicine and Epidemiology, Institute of Health and Society, University of Oslo, Oslo, Norway.
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80
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Baernholdt M, Hinton I, Yan G, Rose K, Mattos M. Factors associated with quality of life in older adults in the United States. Qual Life Res 2011; 21:527-34. [PMID: 21706127 DOI: 10.1007/s11136-011-9954-z] [Citation(s) in RCA: 99] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2011] [Indexed: 12/21/2022]
Abstract
PURPOSE According to the World Health Organization, quality of life (QOL) includes physical and mental health, emotional well-being, and social functioning. Using an adaptation of Andersen's behavioral model, we examined the associations between the three dimensions of QOL and needs and health behaviors in a nationally representative sample of adults 65 years and older. METHODS A representative sample from the 2005-2006 National Health and Nutrition Examination Survey (NHANES) was used. NHANES over-samples persons 60 years and older, African Americans, and Hispanics. Frequencies and distribution patterns were assessed, followed by bivariate and multiple regression analyses. RESULTS These older adults reported high levels of QOL. However, associations between needs and health behaviors and QOL varied across dimensions. Activities of daily living (ADL) were associated with all three dimensions. Depression was associated with two dimensions and memory problems with one dimension. Physical activity was linked to social functioning, and health care utilization was linked to emotional well-being. CONCLUSIONS The differences in associations with different dimensions of QOL confirm that this is a multidimensional concept. Since depression, memory problems, and ADL function were all associated with some dimension of QOL, future interventions to improve QOL in older adults should include screening and treatment for these problems.
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Affiliation(s)
- Marianne Baernholdt
- School of Nursing and Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA.
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81
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Does dog-ownership influence seasonal patterns of neighbourhood-based walking among adults? A longitudinal study. BMC Public Health 2011; 11:148. [PMID: 21375754 PMCID: PMC3087680 DOI: 10.1186/1471-2458-11-148] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2010] [Accepted: 03/04/2011] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND In general dog-owners are more physically active than non-owners, however; it is not known whether dog-ownership can influence seasonal fluctuations in physical activity. This study examines whether dog-ownership influences summer and winter patterns of neighbourhood-based walking among adults living in Calgary, Canada. METHODS A cohort of adults, randomly sampled from the Calgary metropolitan area, completed postal surveys in winter and summer 2008. Both winter and summer versions of the survey included questions on dog-ownership, walking for recreation, and walking for transportation in residential neighbourhoods. Participation in neighbourhood-based walking was compared, among dog-owners and non-owners, and in summer and winter, using general linear modeling. Stability of participation in neighbourhood-based walking across summer and winter among dog-owners and non-owners was also assessed, using logistic regression. RESULTS A total of 428 participants participated in the study, of whom 115 indicated owning dogs at the time of both surveys. Dog-owners reported more walking for recreation in their neighbourhoods than did non-owners, both in summer and in winter. Dog-owners were also more likely than non-owners to report participation in walking for recreation in their neighbourhoods, in summer as well as in winter. Dog-owners and non-owners did not differ in the amount of walking that they reported for transportation, either in summer or in winter. CONCLUSIONS By acting as cues for physical activity, dogs may help their owners remain active across seasons. Policies and programs related to dog-ownership and dog-walking, such as dog-supportive housing and dog-supportive parks, may assist in enhancing population health by promoting physical activity.
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82
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Oliveira CSD, Stefane CA, Liziero L, Gabilan JG, Paranhos Filho AC, Guimarães FKDO. A prática de atividade física na cidade universitária da Universidade Federal de Mato Grosso do Sul (UFMS). CIENCIA & SAUDE COLETIVA 2011; 16 Suppl 1:1489-96. [DOI: 10.1590/s1413-81232011000700084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2008] [Accepted: 10/28/2008] [Indexed: 11/22/2022] Open
Abstract
A implementação e o fortalecimento de iniciativas na atividade física e saúde são necessárias para orientar e propor práticas corporais de forma consciente e autônoma. Diante da relevância de levantamento de locais para prática de atividade física na elaboração de políticas públicas e práticas de intervenção, se faz necessário o conhecimento sobre onde e como esta atividade é desenvolvida, além das características de quem a busca. Este estudo teve por objetivos caracterizar os praticantes de atividade física na Cidade Universitária da Universidade Federal de Mato Grosso do Sul (UFMS), identificar as modalidades e motivos que os levavam a procurar aquele espaço e a importância de orientação profissional para esta prática. A coleta ocorreu por observação e entrevista com 75 indivíduos, em novembro de 2006. Os resultados indicaram que a maior parte eram homens, adultos, praticantes de caminhada e não tinham orientação profissional. Espera-se que estudos sejam realizados, pois estas informações podem colaborar para intervenções e iniciativas de políticas públicas fundamentadas, além de direcionar a elaboração de programas de incentivo à atividade física, como o Atlas do Esporte em âmbito municipal (em operacionalização).
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Abstract
OBJECTIVE Type 2 diabetes is a common disease, afflicting more than 20 million Americans. Psychiatric disorders, particularly depression, have been previously correlated with diabetes. METHODS The objectives of this study were to determine the frequency of psychiatric illnesses in a type 2 pediatric diabetic cohort and to examine if there were any significant demographic differences between diabetic children with psychiatric disorders and diabetic children without psychiatric disorders. A retrospective chart review was performed on patients from two southeastern children's hospitals. RESULTS In our study, 26.2% (67 of 256) of diabetic patients were diagnosed with neuropsychiatric disorders (NPD). A comparison between gender frequencies of affected and unaffected patients suggested a statistical difference (P = 0.009). It appears that pediatric diabetic males are affected with NPD to a greater extent than females. Patients diagnosed with neurological disorders showed a body mass index average of 39.03, which was statistically different from non-diagnosed NPD patients (P = 0.0313). CONCLUSIONS To our knowledge, this is the first report to demonstrate the frequency of psychiatric disorders in a cohort of pediatric type 2 diabetics in the southeastern US. This study provides information regarding children afflicted with type 2 diabetes mellitus and the frequency of neuropsychiatric morbidities. This information may be useful for crafting future health policies and quality improvement interventions.
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84
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Devís-Devís J, Peiró-Velert C, Beltrán-Carrillo VJ, Tomás JM. Brief report: Association between socio-demographic factors, screen media usage and physical activity by type of day in Spanish adolescents. J Adolesc 2010; 35:213-8. [PMID: 21145102 DOI: 10.1016/j.adolescence.2010.11.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2009] [Revised: 09/03/2010] [Accepted: 11/14/2010] [Indexed: 10/18/2022]
Abstract
This study examined the relationship between socio-demographic factors, screen media time usage, and light, moderate and vigorous activities on weekdays and weekends. Cross-sectional data was collected from 323 Spanish adolescents (mean age 13.59 years) who completed an interview administered recall questionnaire. Structural equation models indicated that male and younger adolescents spent more time on vigorous activities at the weekend, while females and older adolescents showed a greater involvement in light activities both on weekdays and weekends. State school students reported engaging in light and vigorous activities for longer periods than private school students on weekends. TV viewing was negatively linked to vigorous activities during weekdays and to light and moderate activities on weekends. The amount of mobile phone usage, however, was positively linked to light activities during weekdays, but negatively on weekends. The negative relationship between adolescents' use of screen media (TV and mobile phone) and physical activity and its possible displacement, depending on the type of day, added useful comparable knowledge for policies promoting an active lifestyle. Further research is required to provide evidence of the causality in the observed relationships.
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Affiliation(s)
- José Devís-Devís
- Universitat de València, Facultad de Ciencias de la Actividad Física y el Deporte, Valencia, Spain.
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85
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Willey JZ, Paik MC, Sacco R, Elkind MSV, Boden-Albala B. Social determinants of physical inactivity in the Northern Manhattan Study (NOMAS). J Community Health 2010; 35:602-8. [PMID: 20574777 PMCID: PMC2946979 DOI: 10.1007/s10900-010-9249-2] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Physical inactivity is an important and modifiable cardiovascular disease risk factor. Little is known about the social determinants of physical inactivity in older, urban-dwelling populations. We collected socio-demographic and medical risk factor information and physical activity questionnaires in the Northern Manhattan Study. Logistic regression models were constructed to examine whether measures of social isolation, race-ethnicity, and sex were associated with physical inactivity. Physical inactivity was present in 40.5% of the cohort. In multivariable models adjusted for medical comorbidities, Hispanic race-ethnicity (compared to non-Hispanic white) was associated with higher odds of physical inactivity (OR 2.18, 95% CI 1.78, 2.67), while women were more likely to be inactive than men (OR 1.33, 95% CI 1.15, 1.54). Having Medicaid/being uninsured (OR 1.20, 95% CI 1.02, 1.42), and having fewer than 3 friends (1.41, 95% CI 1.15, 1.72) were also associated with physical inactivity. Physical inactivity is common, particularly in Hispanics, women, and those who are socially isolated. Public health interventions aimed at increasing physical activity in these more sedentary groups are required.
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Affiliation(s)
- Joshua Z Willey
- Department of Neurology, Neurological Institute, Columbia University, 710 West 168th Street, New York, NY 10032, USA.
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86
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Comparing physical activity patterns of hypertensive and nonhypertensive US adults. Am J Hypertens 2010; 23:987-93. [PMID: 20431526 DOI: 10.1038/ajh.2010.88] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Nonpharmacologic management of hypertension is an important strategy in treating people with hypertension, but little is known about patterns of physical activity among such people. We compared patterns of physical activity of adults with and without hypertension in the United States using the most recent guidelines for physical activity. METHODS We used data from 391,017 adults aged > or =18 years from the 2007 Behavioral Risk Factor Surveillance System (BRFSS) and physical activity categories based on 2008 Department of Health and Human Services (DHHS) guidelines. All information was self-reported. RESULTS The age-adjusted prevalence of hypertension was 27.2%, whereas the age-adjusted prevalence of meeting DHHS recommendations was 60.2% among participants with hypertension and 66.9% among participants without hypertension. After adjusting for age, gender, race or ethnicity, education, body mass index (BMI), smoking status, and histories of diabetes and cardiovascular disease (CVD), the odds ratio (OR) for meeting DHHS recommendations among participants with hypertension was 0.85 (95% confidence interval (CI) 0.82, 0.88) compared with those who did not have hypertension. CONCLUSIONS Although the majority of adults with hypertension are currently meeting national guidelines for physical activity, they are less active overall than adults who do not have hypertension.
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87
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Phillips JE, Klein WMP. Socioeconomic Status and Coronary Heart Disease Risk: The Role of Social Cognitive Factors. SOCIAL AND PERSONALITY PSYCHOLOGY COMPASS 2010; 4:704-727. [PMID: 21785652 PMCID: PMC3140045 DOI: 10.1111/j.1751-9004.2010.00295.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The aim of this study is to examine existing research on social cognitive factors that may, in part, mediate the relationship between socioeconomic status (SES) and coronary heart disease (CHD). We focus on how social status is 'carried' in the mental systems of individuals, and how these systems differentially affect CHD risk and associated behaviors. To this end, literatures documenting the association of various social cognitive factors (e.g., social comparison, perceived discrimination, and self-efficacy) with cardiovascular disease are reviewed as are literatures regarding the relationship of these factors to SES. Possible mechanisms through which social cognitions may affect health are addressed. In addition, directions for future research are discussed, and a model identifying the possible associations between social cognitive factors, SES, and coronary disease is provided.
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88
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Walker AR. Epidemiology and health implications of obesity, with special reference to African populations. Ecol Food Nutr 2010. [DOI: 10.1080/03670244.1998.9991536] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Puterman E, Lin J, Blackburn E, O'Donovan A, Adler N, Epel E. The power of exercise: buffering the effect of chronic stress on telomere length. PLoS One 2010; 5:e10837. [PMID: 20520771 PMCID: PMC2877102 DOI: 10.1371/journal.pone.0010837] [Citation(s) in RCA: 221] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2010] [Accepted: 04/30/2010] [Indexed: 12/16/2022] Open
Abstract
Background Chronic psychological stress is associated with detrimental effects on physical health, and may operate in part through accelerated cell aging, as indexed by shorter telomeres at the ends of chromosomes. However, not all people under stress have distinctly short telomeres, and we examined whether exercise can serve a stress-buffering function. We predicted that chronic stress would be related to short telomere length (TL) in sedentary individuals, whereas in those who exercise, stress would not have measurable effects on telomere shortening. Methodology and Principal Findings 63 healthy post-menopausal women underwent a fasting morning blood draw for whole blood TL analysis by a quantitative polymerase chain reaction method. Participants completed the Perceived Stress Scale (Cohen et al., 1983), and for three successive days reported daily minutes of vigorous activity. Participants were categorized into two groups-sedentary and active (those getting Centers for Disease Control-recommended daily amount of activity). The likelihood of having short versus long telomeres was calculated as a function of stress and exercise group, covarying age, BMI and education. Logistic regression analyses revealed a significant moderating effect of exercise. As predicted, among non-exercisers a one unit increase in the Perceived Stress Scale was related to a 15-fold increase in the odds of having short telomeres (p<.05), whereas in exercisers, perceived stress appears to be unrelated to TL (B = −.59, SE = .78, p = .45). Discussion Vigorous physical activity appears to protect those experiencing high stress by buffering its relationship with TL. We propose pathways through which physical activity acts to buffer stress effects.
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Affiliation(s)
- Eli Puterman
- Department of Psychiatry, University of California San Francisco, San Francisco, California, USA.
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90
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The relationship between physical activity and mental health varies across activity intensity levels and dimensions of mental health among women and men. Public Health Nutr 2009; 13:1207-14. [PMID: 20018121 DOI: 10.1017/s1368980009992825] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To explore gender-specific variations related to activity intensity in the relationship between physical activity (PA) and mental health (MH). Evaluating whether psychological well-being enhances with increases in PA at recommended levels and above, in the general population. DESIGN Cross-sectional. SETTING Population-based, representative for Belgium. SUBJECTS A total of 6803 adults aged 25-64 years from the Belgian National Health Interview Survey. RESULTS Multiple logistic regression analyses showed that clearly different intensity levels characterised the PA that associated with MH in women and men. In men, inverse associations existed between participation in vigorous-intensity PA and feelings of depression (OR = 0.580; 95 % CI 0.405, 0.830), anxiety (OR = 0.547; 95 % CI 0.364, 0.821) and symptoms of somatisation (OR = 0.590; 95 % CI 0.398, 0.874). In women, positive associations existed between walking and emotional well-being (OR = 1.202; 95 % CI 1.038, 1.394) and inverse associations between participation in moderate-intensity PA and symptoms of somatisation (OR = 0.737; 95 % CI 0.556, 0.977). Secondary analyses confirmed that differences in psychological complaints were significant for vigorous PA in men, and for moderate PA in women, whereas differences in emotional well-being were significant for walking exclusively in women. CONCLUSIONS In the general population, the PA-MH relationship is always positive, regardless of activity intensity. In men, it addresses complaints (symptoms, palpable discomfort) and the optimal PA intensity is high. In women, it addresses complaints, but also distress (lowered mood, disturbing anxiety, altered well-being) and the PA intensity is mild.
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91
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Abstract
SummaryOver the past century, the population of Korea has aged rapidly as a result of decreasing fertility and mortality. Furthermore, the percentage of the population aged 65 and older is expected to double from 7% to 14% within 18 years, a much shorter doubling period than in most other developed countries. As Korean society ages, interest in healthy and successful ageing has increased. However, although previous studies have examined various determinants of successful ageing, such as socioeconomic status, gender differences have been neglected. This study investigated gender differences as factors in successful ageing among elderly men and women. Successful ageing has been defined as having high levels of physical and social functioning. Physical functioning includes having no difficulties with activities of daily living (ADL) or instrumental activities of daily living (IADL). Social functioning is defined as participation in at least one of the following social activities: paid work, religious gatherings or volunteer service. Data for this study were obtained from a representative sample of 761 community-living individuals aged 65–84 years (340 males, 421 females); the respondents were interviewed face-to-face as part of the third wave of the Hallym Ageing Study (2007). Socioeconomic status appears to have a greater gender-specific effect on physical functioning than on social functioning. Especially for elderly men, a higher monthly individual income was significantly related to a higher level of physical functioning. Among elderly women, a higher level of education was associated with a higher level of physical functioning. In a major metropolis, elderly men had low social functioning and elderly women had low physical functioning. As Korea's population ages, successful ageing has received much attention. This study shows that policies promoting successful ageing must consider gender differences and associated socioeconomic factors.
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92
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Sabanayagam C, Shankar A, Saw SM, Tai ES, Wong TY. The association between socioeconomic status and overweight/obesity in a Malay population in Singapore. Asia Pac J Public Health 2009; 21:487-96. [PMID: 19661104 DOI: 10.1177/1010539509343957] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In developed countries in the West, lower socioeconomic status (SES) is associated with a higher prevalence of overweight/obesity. The authors examined the association between SES defined by education and income and overweight/obesity in a population-based cohort of 2807 individuals of Malay ethnicity (age 40-80 years, 51% women) in Singapore. The prevalence of overweight/ obesity (body mass index > or =25 kg/m(2)) in men and women was 50.4% and 65.1%, respectively. In women, the prevalence of overweight/obesity increased with lower levels of education and income. Compared with the higher categories of SES, the odds ratio (95% confidence interval) of overweight/obesity in women was 1.42 (1.06-1.89) for education and 2.08 (1.33-3.26) for income. In contrast, in men, the prevalence of overweight/obesity decreased with lower levels of education and income (P interaction by gender <.05 for all SES variables). Lower SES was positively associated with overweight/obesity in Malay women, and the association was in the opposite direction in Malay men.
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Affiliation(s)
- Charumathi Sabanayagam
- Department of Community, Occupational, and Family Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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93
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Chung S, Domino ME, Stearns SC, Popkin BM. Retirement and physical activity: analyses by occupation and wealth. Am J Prev Med 2009; 36:422-8. [PMID: 19269129 DOI: 10.1016/j.amepre.2009.01.026] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2008] [Revised: 01/06/2009] [Accepted: 01/12/2009] [Indexed: 10/21/2022]
Abstract
BACKGROUND Older adults close to retirement age show the lowest level of physical activity. Changes in lifestyle with retirement may alter physical activity levels. This study investigated whether retirement changes physical activity and how the effect differs by occupation type and wealth level. METHODS This longitudinal study used the Health and Retirement Study (1996-2002), U.S. population-based data. Analyses were conducted in 2007 and 2008. Physical activity was measured by a composite indicator of participation in either work-related or leisure-time physical activity. Fixed-effects regression models were used to account for confounders and unobserved heterogeneity. The dependent variable was a composite indicator of participation in regular physical activity either at work or during nonworking hours. RESULTS Physical activity decreased with retirement from a physically demanding job but increased with retirement from a sedentary job. Occupation type interacted with wealth level, with the negative impact on physical activity of retirement exacerbated by lack of wealth and the positive effect of retirement on physical activity enhanced by wealth. CONCLUSIONS Substantial differences in the effect of retirement on physical activity occurred across subgroups. As the number of people approaching retirement age rapidly increases, findings suggest that a growing segment of the nation's population may not sustain an adequate level of physical activity.
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Affiliation(s)
- Sukyung Chung
- Palo Alto Medical Foundation Research Institute and Phillip R. Lee Institute for Health Policy Studies, University of California, San Francisco, CA, USA.
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94
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Walton E, Takeuchi DT, Herting JR, Alegría M. Does place of education matter? Contextualizing the education and health status association among Asian Americans. BIODEMOGRAPHY AND SOCIAL BIOLOGY 2009; 55:30-51. [PMID: 19835099 PMCID: PMC2810406 DOI: 10.1080/19485560903054648] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
The educational gradient in health is one of the most robust associations in social science research. Results of the current study indicate that, like the pattern observed among other racial and ethnic minority groups, the well-established educational gradient in health is attenuated among Asian Americans. We also show that the gradient association between educational attainment and self-rated health among Asian Americans depends on whether they receive the bulk of their education in the United States or abroad. Compared to the schooling received in the United States, being educated in a foreign country does not result in the same health payoffs for increasing educational attainment. Analysis of an extensive set of mediators indicates that a foreign education restricts economic opportunities, limits positive social interaction, and inhibits English language proficiency. We discuss the implications for Asian Americans, a group composed largely of immigrants who received their education outside the United States.
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Affiliation(s)
- Emily Walton
- Department of Sociology, University of Washington, Box 353340, Seattle, WA 98195, USA.
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95
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Chipperfield JG, Newall NE, Chuchmach LP, Swift AU, Haynes TL. Differential determinants of men's and women's everyday physical activity in later life. J Gerontol B Psychol Sci Soc Sci 2008; 63:S211-S218. [PMID: 18689770 PMCID: PMC3874240 DOI: 10.1093/geronb/63.4.s211] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES The present study of a representative sample of older adults quantified everyday physical activity (EPA) by having participants wear actigraphs. Our objectives were to examine whether poor health may partly explain why older adults become less physically active with advancing age and whether gender might moderate the extent to which health status predicts EPA. METHODS We performed multiple regression analyses on a sample of older, community-dwelling adults (aged 80-98 years, N = 198; women = 63.1%). RESULTS The results imply that age-related declines in EPA may be partially accounted for by health (in men) and by living arrangements (in women). DISCUSSION We consider reasons why poorer health might erode EPA for men (but not women) and why living alone might erode EPA for women (but not men).
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Affiliation(s)
- Judith G Chipperfield
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada, R3T 2N2.
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Tseng TS, Lin HY. Gender and age disparity in health-related behaviors and behavioral patterns based on a National Survey of Taiwan. Int J Behav Med 2008; 15:14-20. [PMID: 18444016 DOI: 10.1007/bf03003069] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND This is a population-based study based on the 2002 National Survey of Taiwan on Knowledge, Attitude, and Practice of Health Promotion. PURPOSE The objective of this study is to examine health-related behaviors and behavioral patterns among different gender and age groups. METHOD A total of 26,755 participants were interviewed, resulting in a response rate of 81.9%. Factor analysis with orthogonal rotation was applied to identify the underlying factor structure for the health-related behaviors, including cigarette smoking, betel nut chewing, alcohol drinking, intake of fruits or vegetables, prevention service utilization, physical activity, and tooth brushing. RESULTS Protective and risk behavioral patterns were selected consistently among various gender and age subgroups. These two behavior patterns were negatively associated with each other. In younger age groups (age < 55), a risk behavioral pattern was more dominant than a protective behavioral pattern. In the older age group (age >or= 55), the pattern order was reversed. CONCLUSION An effective health intervention program should be based on behavioral patterns instead of an individual behavior. Gender and age play an important role in the behavioral patterns and need to be taken into consideration when designing intervention programs.
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Affiliation(s)
- Tung-Sung Tseng
- Division of Preventive Medicine, School of Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA.
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97
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Peiró-Velert C, Devís-Devís J, Beltrán-Carrillo VJ, Fox KR. Variability of Spanish adolescents’ physical activity patterns by seasonality, day of the week and demographic factors. Eur J Sport Sci 2008. [DOI: 10.1080/17461390802020868] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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98
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Marcondelli P, Costa THMD, Schmitz BDAS. Nível de atividade física e hábitos alimentares de universitários do 3º ao 5º semestres da área da saúde. REV NUTR 2008. [DOI: 10.1590/s1415-52732008000100005] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJETIVO: Este trabalho teve como objetivo verificar o nível de atividade física e os hábitos alimentares de universitários da área de saúde visto serem, no futuro, os disseminadores dessas informações. MÉTODOS: Estudo transversal, realizado em 281 estudantes da área da saúde da Universidade de Brasília. Foram avaliadas variáveis antropométricas, de consumo alimentar e de nível de atividade física. RESULTADOS: Observou-se alto nível de sedentarismo nos estudantes da área de saúde, exceto nos alunos de educação física, que praticam atividade física como parte da própria grade curricular. Verificou-se tendência de menor nível de atividade física nos estudantes de menor estrato socioeconômico. A alimentação foi considerada inadequada para a maioria dos estudantes (79,7%). Os menores percentuais relativos a uma alimentação adequada foram observados para o grupo de leite e derivados (23,0%), frutas e vegetais (24,9%) e carboidratos complexos (25,9%). Verificou-se um alto percentual de consumo inadequado de refrigerantes e doces (74,0%). O sexo foi associado significantemente ao índice de massa corporal, tendo os homens um índice de massa corporal maior que o das mulheres (p<0,001). CONCLUSÃO: Apesar de a amostra ser composta por estudantes da área da saúde, que, em princípio, são possuidores de maior conhecimento sobre práticas de vida saudáveis, observou-se um alto percentual de sedentarismo e de inadequação nos hábitos alimentares. Verifica-se a necessidade do repensar sobre a associação entre o conhecimento teórico e a mudança real no estilo de vida, visando à promoção da saúde do indivíduo.
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99
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Kim YM, Kim MH. [Health inequalities in Korea: current conditions and implications]. J Prev Med Public Health 2008; 40:431-8. [PMID: 18063897 DOI: 10.3961/jpmph.2007.40.6.431] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES The aim of this study is to summarize the current conditions and implications of health inequalities in South Korea. METHODS Through a literature review of empirical studies and supplementary analysis of the data presented in the 1998, 2001, and 2005 KNHANEs, we evaluated the extent and trends of socioeconomic inequalities in both health risk factors, such as smoking, physical activity, and obesity, and outcomes, such as total mortality, subjective poor health status by self-reports and metabolic syndrome. Relative risks and odds ratios were used to measure differences across socioeconomic groups, and the relative index of inequality was used to evaluate the changes in inequalities over time. RESULTS We found clear inequalities to various degrees in most health indicators. While little change was observed in mortality differences over time, the socioeconomic gaps in risk factors and morbidity have been widening, with much larger differences among the younger population. CONCLUSIONS Socioeconomic inequalities are pervasive across various health indicators, and some of them are increasing. The trends in socioeconomic inequalities in health should be carefully monitored, and comprehensive measures to alleviate health inequalities are needed, especially for young populations.
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Affiliation(s)
- Yu-Mi Kim
- Department of Preventive Medicine, Hanyang University College of Medicine
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100
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Bourdeaudhuij ID, Oost PV. Family characteristics and health behaviours of adolescents and families. Psychol Health 2007. [DOI: 10.1080/08870449808407432] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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