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Lucas AR, Kim Y, Lanoye A, Franco RL, Sutton AL, LaRose JG, Ross M, Sheppard VB. Longitudinal associations among physical activity and sitting with endocrine symptoms and quality of life in breast cancer survivors: A latent growth curve analysis. Cancer Med 2023; 12:20094-20105. [PMID: 37768040 PMCID: PMC10587924 DOI: 10.1002/cam4.6581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 08/24/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023] Open
Abstract
PURPOSE Adjuvant endocrine therapy (AET) often causes debilitating endocrine symptoms that compromise quality of life (QOL) in women diagnosed with hormone receptor positive breast cancer (BC). We examined whether greater levels of physical activity (PA) or prolonged sitting were associated with reduced side effects or worse side effects of AET, respectively. METHODS We used parallel process latent growth curve models to examine longitudinal patterns in PA and sitting behaviors, and their association with endocrine symptoms and QOL over 3 years of follow-up in 554 female BC survivors undergoing AET. RESULTS At baseline, women were a mean age of 59 years, mostly white (72%), with overweight/obesity (67%), and approximately 50% were within 1 year of diagnosis. Unconditional models showed significant increases in PA (p < 0.01) over time but no change in sitting. Endocrine symptoms, general and BC-specific QOL all significantly worsened over time (p < 0.01). Parallel process models showed no cross-sectional or longitudinal associations between PA and endocrine symptoms. Higher levels of baseline PA were associated with higher baseline QOL scores (p = 0.01) but changes in PA were not associated with changes in QOL. Conversely, more sitting at baseline was associated with worse endocrine symptoms, general and BC specific QOL (ps <0.01). At baseline, having better QOL scores was associated with increases in sitting (ps <0.01), while having worse endocrine symptoms was associated with a slower rate of increase in sitting (p < 0.01). Increases in sitting time were also associated with a slower rate of increase in endocrine symptoms (p = 0.017). Model fit statistics (x2, CFI, TLI, SRMR) were acceptable. CONCLUSION Both PA and sitting behaviors are important for the management of symptoms and in maintaining QOL in BC survivors. Women with already high symptom burden do not increase sitting time further but having better general and BC specific QOL to begin with means a greater decline over time.
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Affiliation(s)
- Alexander R. Lucas
- Department of Health Behavior and PolicyVirginia Commonwealth UniversityRichmondVirginiaUSA
- Department of Internal Medicine – CardiologyVirginia Commonwealth UniversityRichmondVirginiaUSA
| | - Youngdeok Kim
- Department of Kinesiology and Health SciencesVirginia Commonwealth University College of Humanities and SciencesRichmondVirginiaUSA
| | - Autumn Lanoye
- Department of Health Behavior and PolicyVirginia Commonwealth UniversityRichmondVirginiaUSA
- Massey Cancer CenterVirginia Commonwealth UniversityRichmondVirginiaUSA
| | - R. Lee Franco
- Department of Kinesiology and Health SciencesVirginia Commonwealth University College of Humanities and SciencesRichmondVirginiaUSA
| | - Arnethea L. Sutton
- Department of Health Behavior and PolicyVirginia Commonwealth UniversityRichmondVirginiaUSA
| | - Jessica G. LaRose
- Department of Health Behavior and PolicyVirginia Commonwealth UniversityRichmondVirginiaUSA
| | - Masey Ross
- Department of Internal Medicine‐ OncologyVirginia Commonwealth University Health SystemRichmondVirginiaUSA
| | - Vanessa B. Sheppard
- Department of Health Behavior and PolicyVirginia Commonwealth UniversityRichmondVirginiaUSA
- Office of Health Equity and Disparities Research, Massey Cancer CenterVirginia Commonwealth UniversityRichmondVirginiaUSA
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Kim Y, Lee Franco R, Lucas AR, Sutton AL, LaRose JG, Kenyon J, Via J, Cheng RK, D’Agostino RB, Sheppard VB, Hundley WG. Prevalence of Cardiovascular Diseases Among Breast Cancer Survivors: Findings From the NHANES 2003-2018. Am J Health Promot 2023; 37:233-238. [PMID: 35975972 PMCID: PMC10981503 DOI: 10.1177/08901171221120910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
PURPOSE To examine the prevalence of cardiovascular diseases (CVD) among breast cancer (BC) survivors. DESIGN Cross-sectional observational study using the data from the National Health and Nutrition Examination Survey (NHANES) 2003-2018. SETTING United States (US). SUBJECTS A nationally representative sample of US women with a history of BC. MEASURES Self-reported CVD status (i.e., coronary artery disease (CAD), heart failure, and stroke) and time of the CVD diagnosis were used to categorize BC survivors into three groups: No CVD, preexisting CVD, and post-acquired CVD after BC diagnosis. ANALYSIS The prevalence of CVD among BC survivors were estimated by demographic characteristics. Complex sampling design of the NHANES was accounted to estimate the population-level prevalence. RESULTS A total of 658 BC survivors were identified, representing 3.01% (≈3.4 million) of the US women aged ≥18 years old. Of those, ≈6% (≈.2 million) had preexisting CVD and ≈11% (≈.4 million) had at least one CVD diagnosed after BC diagnosis, with an average time elapsed ranging from ≈5 years for heart failure to ≈9 years for CAD and stroke. The prevalence of CVD among BC survivors differed by demographic characteristics including age, education, marital status, menopausal, and physical activity levels. CONCLUSION Our findings suggest that BC survivors are at risk of suffering from CVD and public health strategies for the long-term management of CVD risk factors in this vulnerable population group is recommended.
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Affiliation(s)
- Youngdeok Kim
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, VA, USA
| | - R. Lee Franco
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, VA, USA
| | - Alexander R. Lucas
- Department of Health Behavior and Policy, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
- Pauley Heart Center, Virginia Commonwealth University, Richmond, VA, USA
| | - Arnethea L. Sutton
- Department of Health Behavior and Policy, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - Jessica G. LaRose
- Department of Health Behavior and Policy, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - Jonathan Kenyon
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, VA, USA
| | - Jeremy Via
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, VA, USA
| | - Richard K. Cheng
- Division of Cardiology, University of Washington, Seattle, WA, USA
| | - Ralph B. D’Agostino
- Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Vanessa B. Sheppard
- Department of Health Behavior and Policy, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
- Massey Cancer Center, Virginia Commonwealth University, Richmond, VA, USA
| | - W. Gregory Hundley
- Pauley Heart Center, Virginia Commonwealth University, Richmond, VA, USA
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Williams KDA, Adkins A, Kuo SIC, LaRose JG, Utsey SO, Guidry JPD, Dick D, Carlyle KE. Mental health disorder symptom prevalence and rates of help-seeking among University-Enrolled, emerging adults. J Am Coll Health 2023; 71:61-68. [PMID: 33735596 PMCID: PMC8448792 DOI: 10.1080/07448481.2021.1873791] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 12/14/2020] [Accepted: 01/03/2021] [Indexed: 06/12/2023]
Abstract
Objective. Examine mental health symptom prevalence and rates of campus services utilization among Black male, White male and Black female college students. Participants. 2500 students from an ongoing, student survey at a public university; launched in 2011. Methods. Measures included data for anxiety and depressive symptoms and utilization of campus health services (counseling center, health services, etc.). Descriptive analyses determined prevalence and utilization rates. Mann Whitney U tests compared prevalence. Chi-squared tests compared utilization rates. Results. Anxiety prevalence: greater than 60% of students from each ethnic group reported symptoms; reporting rates decreased significantly for Black men (49.6%); p < 0.001. Depression prevalence: greater than 80% reported symptoms; there were significant differences in reporting between Black men and Black women (72.7% vs. 87.1%, p < 0.001). Utilization: Black men utilized counseling services less than White men (20.4% vs. 37.8%, p = 0.024). Conclusion. Black men report depressive and anxiety symptoms but underutilize campus health resources.
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Affiliation(s)
- Kofoworola D. A. Williams
- Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Amy Adkins
- Department of Psychology, Virginia Commonwealth University College of Humanities & Sciences, Richmond, VA, USA
| | - Sally I-Chun Kuo
- Department of Psychology, Virginia Commonwealth University College of Humanities & Sciences, Richmond, VA, USA
| | - Jessica G. LaRose
- Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Shawn O. Utsey
- Department of African American Studies, Virginia Commonwealth University College of Humanities & Sciences, Richmond, VA, USA
| | - Jeanine P. D. Guidry
- Robertson School of Media and Culture, Virginia Commonwealth University College of Humanities & Sciences, Richmond, VA, USA
| | | | - Danielle Dick
- Department of Psychology, Virginia Commonwealth University College of Humanities & Sciences, Richmond, VA, USA
| | - Kellie E. Carlyle
- Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
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Valle CG, Diamond M, Pinto BM, LaRose JG, Nezami BT, Hales DP, Deal AM, Heiling H, Rini CM, Rosenstein DL, Tate DF. IMPACT: A Randomized Controlled Trial of an mHealth Physical Activity Intervention for Young Adult Cancer Survivors. Cancer Epidemiol Biomarkers Prev 2022. [PMID: 35775210 DOI: 10.1158/1055-9965.epi-22-0471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
PURPOSE The IMPACT trial evaluated a theory-based mobile physical activity (PA) intervention on total PA (primary) and moderate-to-vigorous (MVPA) at 6 months in a nationwide sample of young adult cancer survivors (YACS). METHODS YACS (N=280) were randomized to either an intervention group or a self-help (control) group. All participants received digital tools (activity tracker, smart scale, Facebook group) and an individual videochat session. Intervention participants also received a 6-month mHealth program with components to promote increased PA (behavioral lessons, adaptive goal-setting, tailored feedback, tailored text messages, Facebook group prompts). PA was assessed via accelerometry and online questionnaire (Godin Leisure Time Exercise Questionnaire) at baseline and 6 months. Using linear mixed models and an intention-to-treat approach, we tested for group differences in changes from baseline to 6 months, adjusting for education, time since diagnosis, age, and accelerometer wear time. RESULTS Of 280 YACS (M=33.4 (SD 4.8) yrs, 81.8% women, 23.2% racial/ethnic minority individuals), 92.9% completed 6-month measures. Device-measured total PA min/wk (i.e., sum of light, moderate, and vigorous PA) increased from a mean of 1974.3 (SD=673.9) to 2024.3 (686.7) at 6 months in the intervention group (p=.26) and from 1814.9 (704.5) to 1877.7 (758.2) in the control group (p=.43), with no difference between groups (p=.84). Both groups increased MVPA min/wk over 6 months; increases were 24.7 min/wk (95% CI: 14.8, 34.6; p<.0001) in the intervention versus 11.4 min/wk (95% CI: 1.4, 21.4; p=.02) in the control (p=.07 between groups). Increases in MVPA were 99.7% and 41.6% over baseline in the intervention and control groups, respectively. Increases in self-reported total PA were significant; 123.3 min/wk (95 CI%: 94.5, 152.1; p<.0001) in the intervention versus 83.40 (95% CI: 49.30, 117.50; p<.0001) in the control (p=.08 between groups). CONCLUSIONS While both groups increased total PA over 6 months, the intervention doubled the increase in MVPA min/wk relative to the control group, which is associated with important health benefits. Future research should examine moderators of effects to identify for whom, and under what conditions, the effectiveness varied.
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Williams KDA, Dougherty SE, Utsey SO, LaRose JG, Carlyle KE. “Could Be Even Worse in College”: Social Factors, Anxiety, and Depressive Symptoms Among Black Men on a College Campus. J Racial Ethn Health Disparities 2022; 10:1165-1177. [PMID: 35428951 DOI: 10.1007/s40615-022-01302-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 04/04/2022] [Accepted: 04/05/2022] [Indexed: 10/18/2022]
Abstract
Understanding mental health risks among Black men is a step forward in reducing health and educational disparities that are persistent in today's society. Semi-structured focus groups were conducted with 20 Black male undergraduate students from a college campus in the Southeast. The aim was to identify and understand the social and contextual factors impacting their risk of experiencing anxiety and depressive symptoms. A thematic analysis, theoretically grounded in the social-ecological model (SEM), was conducted, revealing three overarching themes: 1) what is known or felt about mental health 2) causes of stressors and 3) signs as symptoms. Discussions with men offered insight into their perspectives and personal experiences related to mental health issues and perceived risk factors. Themes suggest that the college transition, academic workload, perceived financial distress, and their desire and need to conform to ideals of masculinity were significant risk factors and stressors. Men offered descriptions of specific symptoms and health behaviors associated with such stress, including social isolation, anger, irritability, and changes in their own personal behaviors. Key findings paint a picture of college mental health experiences for some Black male college students. Moving forward, more research is needed to expand on this study's findings and improve mental health risk among this underserved population. Future directions are discussed alongside the results presented in this paper.
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Lanoye A, Evans RK, Leahey TM, LaRose JG. Using measured resting metabolic rate to derive calorie prescriptions in a behavioral weight loss program. Obes Sci Pract 2021; 7:335-338. [PMID: 34123400 PMCID: PMC8170564 DOI: 10.1002/osp4.489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 01/08/2021] [Accepted: 01/31/2021] [Indexed: 11/24/2022] Open
Abstract
Objective Within behavioral weight loss (BWL) programs, using measured resting metabolic rate (RMR) is a more accurate—yet costlier—alternative to the standard method of assigning calorie prescriptions using baseline weight. This investigation aimed to assess differences between calorie goals prescribed using each method including demographic predictors and associations with weight loss. Methods This is an ancillary study to a trial comparing approaches to motivational enhancement in a 6‐months BWL program designed for emerging adults age 18–25 (N = 308). RMR was measured at baseline and used to derive calorie prescriptions; standard calorie goals were retrospectively assigned for the purpose of these analyses. Results Standard calorie prescriptions were significantly higher than those derived from RMR. Sex and race were significant predictors of calorie prescription discrepancies: using the standard method, women and Black participants were assigned higher calorie goals than their RMR would indicate. Calorie goal discrepancy did not predict 6‐months weight change. Conclusions Differences in calorie prescriptions between approaches were significant; however, it remains to be determined whether measuring RMR is worth the cost, time, and participant burden. It may be the case that this consideration has greater impact for certain subgroups—namely, women and Black participants.
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Affiliation(s)
- Autumn Lanoye
- Department of Health Behavior and Policy Virginia Commonwealth University School of Medicine Richmond Virginia USA.,Massey Cancer Center Richmond Virginia USA
| | - Ronald K Evans
- Department of Kinesiology and Health Sciences Virginia Commonwealth University College of Humanities and Sciences Richmond Virginia USA
| | - Tricia M Leahey
- Institute for Collaboration on Health, Intervention, and Policy University of Connecticut Storrs Connecticut USA
| | - Jessica G LaRose
- Department of Health Behavior and Policy Virginia Commonwealth University School of Medicine Richmond Virginia USA
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7
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Williams KDA, Adkins AE, Kuo SIC, LaRose JG, Utsey SO, Guidry JPD, Dick D, Carlyle KE. Risk, Protective, and Associated Factors of Anxiety and Depressive Symptoms and Campus Health Services Utilization Among Black Men on a College Campus. J Racial Ethn Health Disparities 2021; 9:505-518. [PMID: 33686626 DOI: 10.1007/s40615-021-00981-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 01/21/2021] [Accepted: 01/27/2021] [Indexed: 01/10/2023]
Abstract
OBJECTIVE The aim of this study is to analyze relationships among social and environmental determinants serving as risk, protective, and important covariate factors for mental health risk and help-seeking among Black men on a college campus. METHODS A secondary data analysis was conducted utilizing an ongoing, campus-wide survey at a large, urban, public university. Measures included depressive and anxiety symptoms; campus service utilization; risk factors (e.g., financial status); protective factors (social support/religiosity); and additional covariates (substance use/GPA). Multiple linear regressions were conducted to examine relationships between these factors, symptoms and help-seeking. RESULTS Data is included for 681 students. Findings indicated that stressful life events were associated with higher levels of anxiety symptoms (B = 0.39, p < 0.001) and depressive symptoms (B = 0.33, p = 0.013). Cannabis use (B = 1.14, p = .020) was also associated with higher levels of depressive symptoms. We found that financial status (B = 0.21, p = 0.041) was positively associated with higher levels of depressive symptoms and endorsement of religiosity was associated with lower levels anxiety (B = - 0.23, p = 0.019) and depressive symptoms (B = - 0.32, p = 0.035). Religiosity predicted lower utilization of campus health services. CONCLUSIONS The key findings indicated that Black men's mental health is negatively influenced by stressful live events and cannabis use. As religiosity was associated with lower levels of symptoms and utilization, it may be beneficial to assess this in future work. Further research is needed to address and improve mental health and help-seeking among these men.
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Affiliation(s)
- Kofoworola D A Williams
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, 750 N. Lake Shore Drive, 10th Floor, Chicago, IL, 60611, USA.
| | - Amy E Adkins
- Department of Psychology, Virginia Commonwealth University College of Humanities & Sciences, Richmond, VA, USA
| | - Sally I-Chun Kuo
- Department of Psychology, Virginia Commonwealth University College of Humanities & Sciences, Richmond, VA, USA
| | - Jessica G LaRose
- Department of Health Behavior and Policy, Virginia Commonwealth School of Medicine, Richmond, VA, USA
| | - Shawn O Utsey
- Department of African American Studies, Virginia Commonwealth University College of Humanities & Sciences, Richmond, VA, USA
| | - Jeanine P D Guidry
- Robertson School of Media and Culture, Virginia Commonwealth University College of Humanities & Sciences, Richmond, VA, USA
| | | | - Danielle Dick
- Department of Psychology, Virginia Commonwealth University College of Humanities & Sciences, Richmond, VA, USA
| | - Kellie E Carlyle
- Department of Health Behavior and Policy, Virginia Commonwealth School of Medicine, Richmond, VA, USA
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Pool AC, Coffman DL, Sarwer DB, LaRose JG, Hart CN. Associations between weight misperception, contextual factors, and weight loss behaviours in young adult men with overweight/obesity. Obes Sci Pract 2020; 6:39-46. [PMID: 32128241 PMCID: PMC7042023 DOI: 10.1002/osp4.382] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 10/14/2019] [Accepted: 10/16/2019] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Young men are less likely to engage in weight loss behaviours than their female counterparts. This may be because of an increased likelihood for young men, particularly young black men, with overweight/obesity to misperceive their weight status. This study examined racial differences in weight status perception accuracy and associations between this perception and weight loss behaviours among young men. Associations between weight loss behaviours and contextual factors were also explored. METHODS Data from 1417 young adult (YA) men with overweight/obesity from the 2007 to 2014 National Health and Nutrition Examination Survey (NHANES) were analysed. Associations between weight status perception accuracy, contextual factors, and weight loss attempts and behaviours were examined with logistic regression. RESULTS YA men with overweight/obesity were more likely to report weight loss attempts and behaviours if they perceived themselves as being overweight (OR = 3.10; 95% CI, 2.18-4.41; P < .01; OR = 3.20, 95% CI, 2.16-4.72, P < .01, respectively). Greater education and income were associated with a greater likelihood of reporting weight loss attempts and healthy weight loss behaviours. Greater reported depressive symptoms were associated with reported weight loss attempts but not healthy weight loss behaviours. There were no differences by race for reported weight loss attempts or behaviours. CONCLUSION Among YA men with overweight/obesity, perceiving oneself as overweight was associated with reporting weight loss attempts and healthy weight loss behaviours. Future research should consider how weight status perception accuracy affects weight loss attempts among YA men and what additional factors may account for racial differences.
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Affiliation(s)
- Andrew C. Pool
- Center for Parent and Teen CommunicationCraig‐Dalsimer Division of Adolescent Medicine, Children's Hospital of PhiladelphiaPhiladelphiaPennsylvania
| | - Donna L. Coffman
- Department of Epidemiology and BiostatisticsTemple UniversityPhiladelphiaPennsylvania
| | - David B. Sarwer
- Center for Obesity Research and EducationTemple UniversityPhiladelphiaPennsylvania
- Department of Social and Behavioral SciencesTemple UniversityPhiladelphiaPennsylvania
| | - Jessica G. LaRose
- Department of Health Behavior and PolicyVirginia Commonwealth University School of MedicineRichmondVirginia
| | - Chantelle N. Hart
- Center for Obesity Research and EducationTemple UniversityPhiladelphiaPennsylvania
- Department of Social and Behavioral SciencesTemple UniversityPhiladelphiaPennsylvania
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Bihuniak JD, Bryant T, Kleiman J, Rotondo M, Decoteau J, Haisley S, Monserrate D, Cunningham M, MacKenzie A, Dauz S, Ippolito R, Fernandes N, LaRose JG, Leahey TM. Behavioural weight loss treatment preferences of college students with overweight and obesity. Clin Obes 2020; 10:e12343. [PMID: 31613059 DOI: 10.1111/cob.12343] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 09/04/2019] [Accepted: 09/11/2019] [Indexed: 01/08/2023]
Abstract
The college environment increases risk of weight gain in young adults with overweight/obesity. Behavioural weight loss interventions are proven effective, however, young adults' adherence to such programs is poor. The purpose of the study was to determine weight loss treatment preferences of 2- and 4-year college students for the development of population-specific interventions. Students with a BMI ≥25, between 18 and 24 years of age, and enrolled in one of four institutions were recruited. A questionnaire was developed to assess students' preferences and was administered via Qualtrics. BMI was calculated from objectively assessed height and weight measurements. Descriptive analyses, chi-square, Fisher's Exact Test, Mann-Whitney U test and Cramer's V were performed. Participants (n = 133, age = 20.2 ± 1.8) predominately identified as female (70%), non-Hispanic (68%) and Black/African American (32%) or White (32%). Fifty-five percent met criteria for obesity. Most students preferred session length of ≤1 hour (78%), for meetings to be held on a weekday (70%) and for both a peer and a professional to co-facilitate meetings (61%). Preferences for health outcomes and physical activity monitoring, type of physical activity, frequency of dietary monitoring, physical activity tracking method and interest in financial incentives to promote core treatment components differed between institutions. Heterogeneity in program preferences by college environment should be considered when designing weight loss interventions.
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Affiliation(s)
- Jessica D Bihuniak
- Department of Nutrition and Food Studies, Steinhardt School of Culture, Education, and Human Development, New York University, New York, New York
| | - Tiffany Bryant
- Department of Nutrition and Food Studies, Steinhardt School of Culture, Education, and Human Development, New York University, New York, New York
| | - Jennifer Kleiman
- Department of Nutrition and Food Studies, Steinhardt School of Culture, Education, and Human Development, New York University, New York, New York
| | - Megan Rotondo
- Department of Allied Health Sciences, University of Connecticut, Storrs, Connecticut
| | - Jessica Decoteau
- Department of Allied Health Sciences, University of Connecticut, Storrs, Connecticut
| | - Samantha Haisley
- Department of Nutrition and Food Studies, Steinhardt School of Culture, Education, and Human Development, New York University, New York, New York
- Health Sciences Department, LaGuardia Community College, Long Island City, New York
| | - David Monserrate
- Health and Exercise Science Program, Manchester Community College, Manchester, Connecticut
| | - Michael Cunningham
- Health and Exercise Science Program, Manchester Community College, Manchester, Connecticut
| | - Allison MacKenzie
- Health and Exercise Science Program, Manchester Community College, Manchester, Connecticut
| | - Steve Dauz
- Health Sciences Department, LaGuardia Community College, Long Island City, New York
| | - Rosann Ippolito
- Health Sciences Department, LaGuardia Community College, Long Island City, New York
| | - Nicolle Fernandes
- Health Sciences Department, LaGuardia Community College, Long Island City, New York
| | - Jessica G LaRose
- Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, Richmond, Virginia
| | - Tricia M Leahey
- Department of Allied Health Sciences, University of Connecticut, Storrs, Connecticut
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Guidry JPD, Carlyle KE, Perrin PB, LaRose JG, Ryan M, Messner M. A path model of psychosocial constructs predicting future Zika vaccine uptake intent. Vaccine 2019; 37:5233-5241. [PMID: 31375439 DOI: 10.1016/j.vaccine.2019.07.064] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 06/30/2019] [Accepted: 07/18/2019] [Indexed: 01/21/2023]
Abstract
OBJECTIVE The recent Zika virus outbreak, while no longer an international public health emergency, is still a serious threat, particularly to pregnant women and babies born to pregnant women infected with the virus. This study examined the predictive effects of psychosocial constructs on self-reported intent to get a future Zika vaccine among women of reproductive age. METHODS Data were collected using an online survey with a representative sample of 339 women ages 18-49 from the continental United States. The survey addressed variables originating with the Extended Parallel Processing Model (EPPM) as related to future Zika vaccine uptake intent. RESULTS Three quarters of all respondents reported intention to get a future Zika vaccine. Path modeling revealed a direct effect of perceived susceptibility, self-efficacy, and response efficacy on future Zika vaccine uptake intent, as well as an indirect effect of perceived susceptibility through both self-efficacy and response efficacy. In addition, the final model showed an indirect effect of perceived severity on Zika vaccine uptake intent through self-efficacy and response efficacy and accounted for 54.6% of the variance in vaccination intent. CONCLUSIONS These findings have implications for future Zika vaccine promotion campaigns. This study confirms the importance of perceived susceptibility, self-efficacy, and response efficacy for use in Zika vaccine uptake campaigns; in addition, when using perceived severity, both self-efficacy and response efficacy should be considered in message design.
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Affiliation(s)
| | | | | | | | - Mark Ryan
- Virginia Commonwealth University, Richmond, VA, USA
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11
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Guidry JPD, Carlyle KE, LaRose JG, Perrin P, Messner M, Ryan M. Using the Health Belief Model to Analyze Instagram Posts about Zika for Public Health Communications. Emerg Infect Dis 2019; 25:179-180. [PMID: 30561302 PMCID: PMC6302587 DOI: 10.3201/eid2501.180824] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
We analyzed Instagram posts about Zika by using the Health Belief Model. We found a high presence of threat messages, yet little engagement with these posts. Public health professionals should focus on posting messages to increase self-efficacy and benefits of protective behavior, especially when a vaccine becomes available.
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Caccavale LJ, Corona R, LaRose JG, Mazzeo SE, Sova AR, Bean MK. Exploring the role of motivational interviewing in adolescent patient-provider communication about type 1 diabetes. Pediatr Diabetes 2019; 20:217-225. [PMID: 30575237 PMCID: PMC7196323 DOI: 10.1111/pedi.12810] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 12/04/2018] [Accepted: 12/10/2018] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE Adolescents with type 1 diabetes (T1D) frequently experience deterioration in glycemic control. Providers have unique opportunities to address diabetes self-management, yet little is known about the most effective way to communicate with adolescents. This investigation used a motivational interviewing (MI) framework to characterize naturally-occurring adolescent patient-provider communication in medical encounters and examined relations between adolescent patient-provider communication and (a) T1D self-management and (b) glycemic control (hemoglobin A1c [HbA1c]). METHODS Medical encounters between pediatric endocrine providers and 55 adolescents with T1D (49% female; M age = 14.8 years; M baseline HbA1c = 8.6%) were audio recorded and coded using standardized rating instruments. Patients and parents completed measures assessing T1D care behaviors and self-efficacy. Assessments were completed at routine endocrinology visits (baseline) and 1 and 3-month post-baseline; HbA1c was obtained from medical records at baseline and 3-month. RESULTS Hierarchical multiple regressions showed that greater provider use of MI non-adherent behaviors (eg, confronting, persuading) was associated with (a) poorer 3-month HbA1c, P < 0.001; (b) worse 1-month adolescent diabetes adherence P < 0.001, and (c) lower diabetes self-efficacy at 1-month (P < 0.001) follow-up. Lower patient self-efficacy for diabetes self-management mediated the relation between provider use of MI non-adherent language and lower diabetes adherence (P = 0.020). CONCLUSION Providers' use of persuasion and confrontation regarding risks of non-adherence was associated with poorer glycemic control and adherence. Communication training for providers that targets reductions in MI-inconsistent language may have the potential to improve diabetes self-care in this vulnerable population.
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Affiliation(s)
- Laura J Caccavale
- Department of Pediatrics, Children's Hospital of Richmond at Virginia Commonwealth University, Richmond, Virginia
| | - Rosalie Corona
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia
| | - Jessica G LaRose
- Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, Richmond, Virginia
| | - Suzanne E Mazzeo
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia
| | - Alexandra R Sova
- Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, Richmond, Virginia
| | - Melanie K Bean
- Department of Pediatrics, Children's Hospital of Richmond at Virginia Commonwealth University, Richmond, Virginia
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13
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Guidry JPD, Carlyle KE, LaRose JG, Perrin P, Ryan M, Messner M, Adams J. Framing and visual type: Effect on future Zika vaccine uptake intent. J Public Health Res 2018; 7:1162. [PMID: 29780762 PMCID: PMC5941253 DOI: 10.4081/jphr.2018.1162] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Accepted: 04/17/2018] [Indexed: 11/22/2022] Open
Abstract
Introduction The Zika virus is associated with the birth defect microcephaly, and while a vaccine was not available in early- 2017, several were under development. This study's purpose was to identify effective communication strategies to promote uptake of a new vaccine, particularly among women of reproductive age. Design and methods In order to study the effects of Zika message framing (gain vs. loss) and visual type (photo vs. infographic) on future Zika vaccine uptake intent, a 2×2 between-subjects experiment was performed via an online survey in 2017 among 339 U.S. women of reproductive age (18-49 years). Participants were exposed to one of four messages, all resembling Instagram posts: gain-framed vs. loss-framed infographic, and gain-framed vs. loss-framed photo. These messages were followed by questions about Zika vaccine uptake intent as well as intermediate psychosocial variables that could lead to intent. Results There was no interaction between framing and visual type (P=0.116), and there was no effect for framing (P=0.185) or visual type (P=0.724) on future Zika vaccine uptake intent, which is likely indicative of insufficient dosage of the intervention. However, when focusing on intermediate psychosocial constructs that are known to influence behavior and intent, gain-framed messages were more effective in increasing subjective norms (P=0.005) as related to a future Zika vaccine, as well as perceived benefits (P=0.016) and self-efficacy (P=0.032). Conclusions Gain-framed messages seem to be more effective than loss-framed messages to increase several constructs that could, in turn, affect future Zika vaccine uptake intent. This is a novel finding since, traditionally, loss-framed messages are considered more beneficial in promoting vaccine-related health behaviors.
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Affiliation(s)
| | | | | | | | - Mark Ryan
- Department of Family Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | | | - Jay Adams
- Robertson School of Media and Culture
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14
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Abstract
PURPOSE OF REVIEW Emerging adulthood (age 18-25) represents a critical period for weight control: rate of weight gain is greatest during these years and the prevalence of overweight and obesity is estimated to be at least 40% among emerging adults. Unique behavioral, psychosocial, and cognitive risk factors among this population must be specifically addressed within weight management programs. We review extant treatment approaches, including lessons learned from the nascent literature specifically targeting this population. Lastly, we provide suggestions to inform future work in this area. RECENT FINDINGS The EARLY consortium comprises seven clinical trials targeting weight control in young adults age 18-35. Though these studies encompass a broader age range, two of the trials enrolled large numbers of 18-25-year-olds. Results from these trials and other recent pilot trials provide a foundation for next steps with respect to developing weight management interventions for emerging adults. The design of targeted weight control approaches for emerging and young adults has contributed to improved outcomes for this high-risk population. However, suboptimal engagement and variability in response pose challenges. Identifying and intervening on individual-level behavioral and psychological variables may enhance the effects of these adapted treatments.
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Affiliation(s)
- Autumn Lanoye
- Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, 830 East Main Street, Richmond, VA, 23219, USA
- Department of Psychology, Virginia Commonwealth University, 806 West Franklin Street Box 842018, Richmond, VA, 23284, USA
| | - Kristal L Brown
- Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, 830 East Main Street, Richmond, VA, 23219, USA
| | - Jessica G LaRose
- Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, 830 East Main Street, Richmond, VA, 23219, USA.
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15
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LaRose JG, Guthrie KM, Lanoye A, Tate DF, Robichaud E, Caccavale LJ, Wing RR. A mixed methods approach to improving recruitment and engagement of emerging adults in behavioural weight loss programs. Obes Sci Pract 2016; 2:341-354. [PMID: 28090339 PMCID: PMC5192532 DOI: 10.1002/osp4.71] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Revised: 08/25/2016] [Accepted: 08/26/2016] [Indexed: 11/23/2022] Open
Abstract
Objective Emerging adults ages 18–25 are at high risk for obesity, but are markedly underrepresented in behavioural weight loss (BWL) programs and experience lower engagement and retention relative to older adults. Purpose To utilize a mixed methods approach to inform future efforts to effectively recruit and engage this high‐risk population in BWL programs. Methods We used a convergent parallel design in which quantitative and qualitative data were given equal priority. Study 1 (N = 137, age = 21.8 + 2.2, BMI = 30.1 + 4.7) was a quantitative survey, conducted online to reduce known barriers and minimize bias. Study 2 (N = 7 groups, age = 22.3 + 2.2, BMI = 31.5 + 4.6) was a qualitative study, consisting of in person focus groups to gain greater depth and identify contextual factors unable to be captured in Study 1. Results Weight loss was of interest, but weight itself was not a central motivation; an emphasis on overall lifestyle, self‐improvement and fitness emerged as driving factors. Key barriers were time, motivation and money. Recruitment processes should be primarily online with messages tailored specifically to motivations and preferences of this age group. Preferences for a program were reduced intensity and brief, hybrid format with some in‐person contact, individual level coaching, experiential learning and peer support. Key methods of promoting engagement and retention were autonomy and choice, money and creating an optimal default. Conclusions An individually tailored lifestyle intervention that addresses a spectrum of health behaviours, promotes autonomy and emphasizes activity and fitness may facilitate recruitment and engagement in this population better than traditional BWL protocols.
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Affiliation(s)
- J G LaRose
- Virginia Commonwealth University School of Medicine Richmond VA USA; Weight Control and Diabetes Research Center The Miriam Hospital Providence RI USA; Alpert Medical School of Brown University Providence RI USA
| | - K M Guthrie
- Alpert Medical School of Brown University Providence RI USA; Centers for Behavioral and Preventive Medicine The Miriam Hospital Providence RI USA
| | - A Lanoye
- Virginia Commonwealth University School of Medicine Richmond VA USA
| | - D F Tate
- Gillings Global School of Public Health University of North Carolina at Chapel Hill Chapel Hill NC USA; Lineberger Comprehensive Cancer Center University of North Carolina at Chapel Hill Chapel Hill NC USA
| | - E Robichaud
- Weight Control and Diabetes Research Center The Miriam Hospital Providence RI USA
| | - L J Caccavale
- Virginia Commonwealth University School of Medicine Richmond VA USA
| | - R R Wing
- Weight Control and Diabetes Research Center The Miriam Hospital Providence RI USA; Alpert Medical School of Brown University Providence RI USA
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16
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LaRose JG, Lanoye A, Tate DF, Wing RR. Frequency of self-weighing and weight loss outcomes within a brief lifestyle intervention targeting emerging adults. Obes Sci Pract 2016; 2:88-92. [PMID: 27668087 PMCID: PMC5021162 DOI: 10.1002/osp4.24] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Revised: 12/04/2015] [Accepted: 12/09/2015] [Indexed: 01/16/2023] Open
Abstract
Background Frequent self‐weighing is associated with better weight loss and maintenance among adults. Emerging adults ages 18–25 rarely enroll in behavioural weight loss trials, and thus, little is known about their willingness to engage in frequent self‐weighing and its association with weight loss in this age group. Purpose The purpose of this study is to examine the frequency of self‐weighing among 18–25‐year‐old over the course of a brief lifestyle intervention and to determine the association between frequent self‐weighing and weight loss. Methods Emerging adults (EA) ages 18–25 [N = 52, 54% racial/ethnic minority, 79% female, BMI = 34.2 (5.4)] enrolled in a 3‐month lifestyle intervention with structure and content modified for EA. Benefits of frequent self‐weighing were presented; participants were encouraged to weigh themselves at least weekly and no more than daily. Assessments occurred at baseline and post‐treatment (3 months). Results At baseline, a majority of participants (63.5%) reported self‐weighing less than once a week. Frequency of self‐weighing increased over treatment (p < 0.001), with 42.9% weighing weekly and 38.2% weighing several times per week or more (i.e. frequent self‐weighing) at 3 months. Frequent self‐weighing was associated with greater weight loss (p = 0.03) and greater likelihood of achieving 5% weight loss (p = 0.01) at post‐treatment. Conclusions Frequent self‐weighing may be a viable approach to promoting self‐regulation during the high‐risk developmental period of emerging adulthood. Consistent with findings among other adult samples, frequent self‐weighing was associated with greater weight losses.
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Affiliation(s)
- J G LaRose
- Department of Health Behavior and Policy Virginia Commonwealth University School of Medicine Richmond VA USA
| | - A Lanoye
- Department of Health Behavior and Policy Virginia Commonwealth University School of Medicine Richmond VA USA; Department of Psychology Virginia Commonwealth University Richmond VA USA
| | - D F Tate
- Gillings Global School of Public Health University of North Carolina at Chapel Hill Chapel Hill NC USA; Lineberger Comprehensive Cancer Center Chapel Hill NC USA
| | - R R Wing
- Alpert Medical School of Brown University Providence RI USA; Weight Control and Diabetes Center the Miriam Hospital Providence RI USA
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17
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Tate DF, LaRose JG, Griffin LP, Erickson KE, Robichaud EF, Perdue L, Espeland MA, Wing RR. Recruitment of young adults into a randomized controlled trial of weight gain prevention: message development, methods, and cost. Trials 2014; 15:326. [PMID: 25128185 PMCID: PMC4150977 DOI: 10.1186/1745-6215-15-326] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Accepted: 07/30/2014] [Indexed: 11/23/2022] Open
Abstract
Background Young adulthood (age 18 to 35) is a high-risk period for unhealthy weight gain. Few studies have recruited for prevention of weight gain, particularly in young adults. This paper describes the recruitment protocol used in the Study of Novel Approaches to Prevention (SNAP). Methods We conducted extensive formative work to inform recruitment methods and message development. We worked with a professional marketing firm to synthesize major themes and subsequently develop age-appropriate messages for recruitment. A variety of approaches and channels were used across two clinical centers to recruit young adults who were normal or overweight (body mass index (BMI) 21 to 30 kg/m2) for a 3-year intervention designed to prevent weight gain. We tracked recruitment methods, yields, and costs by method. Logistic regression was used to identify recruitment methods that had the highest relative yield for subgroups of interest with covariate adjustments for clinic. Results The final sample of 599 participants (27% minority, 22% male) was recruited over a 19-month period of sustained efforts. About 10% of those who initially expressed interest via a screening website were randomized. The most common reason for ineligibility was already being obese (BMI >30 kg/m2). The top two methods for recruitment were mass mailing followed by email; together they were cited by 62% of those recruited. Television, radio, paid print advertising, flyers and community events each yielded fewer than 10% of study participants. Email was the most cost-effective method per study participant recruited. Conclusions These findings can guide future efforts to recruit young adults and for trials targeting weight gain prevention. Trial registration ClinicalTrials.gov
NCT01183689 (registered 13 August 2010).
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Affiliation(s)
- Deborah F Tate
- The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
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