An assessment of the move your way program among hispanic adults in Las Vegas, Nevada

BACKGROUND

Physical activity (PA) is important because of its associated health benefits. However, many Americans remain inactive. The 2018 guidelines recognize that PA bouts of less than 10 min are beneficial. The U.S. Department of Health and Human Services' Office of Disease Prevention and Health Promotion created the Move Your Way® (MYW) campaign to provide PA resources for communities and healthcare providers. This study aims to describe the reach of the MYW campaign, and assess whether having seen, heard, or read (SHR) about MYW, or having seen the MYW logo, was associated with PA knowledge, self-efficacy, and behavior among Hispanics residing in the Las Vegas, Nevada area.

METHODS

Hispanics, aged 18-74, were surveyed at community events (n = 481) or via an online survey (n = 123). Respondents were asked if they had SHR of MYW, were aware of 2018 PA recommendations, and to report their personal PA behavior, PA knowledge, PA intentions, and demographics.

RESULTS

Respondents (71% female) completed a 38-42-item survey. Approximately (12.4%) had SHR of the MYW campaign and 16.1% had seen the MYW logo. Only 3.4% and 15% identified, "150 minutes per week" and "75 minutes per week" as the 2018 guidelines for moderate physical activity (MPA) and vigorous physical activity (VPA), respectively. Those who had SHR of the MYW campaign were more likely to correctly identify 150 min per week as the MPA guideline and had greater confidence in overcoming selected PA barriers. Regression analysis showed that those who had seen the MYW logo were more likely to meet strength guidelines, and that those who had SHR of MYW or saw the logo were more likely to know the recommended minutes of MPA.

CONCLUSIONS

Knowledge of the MYW program positively associates with some PA behaviors and PA correlates.

A Systematic Review of the Rationale for Vaccine Hesitancy among American Parents

INTRODUCTION: Vaccines are one of the most successful interventions in the history of public health. They are largely responsible for the near eradication of several diseases. However, some people are vaccination averse which can lead to vaccine hesitancy. Vaccine hesitant parents are those that refuse or delay getting their children vaccinated despite the availability of vaccination services. This phenomenon often occurs despite parent’s belief that vaccines are effective. The purpose of this review was to exam available literature to identify predictors of vaccine hesitancy among parents and parental rationale for vaccine hesitancy. METHODS: This literature review utilized the SCOPUS database to identify articles examining vaccine hesitancy among American parents, published from 1997 to 2020, inclusive. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology was utilized to select articles used in the final literature review. RESULTS: Fifty-one articles were included in the final review. Predictors of vaccine hesitancy included demographics (income, education, marital status, race/ethnicity), healthcare practices (provider relationship, use of complementary or alternative medicine), and social-cultural factors. Parental rationale for vaccine hesitancy included concerns about the safety of vaccinations, not fearing diseases covered by vaccinations, and the belief that vaccines were not necessary. The most consistent and prevalent theme of vaccination hesitancy was the strength of the influence that the medical provider has on the parents. CONCLUSION: Balanced communication with a trusted medical provider that addresses both the benefits and risk of vaccinations, along with parents’ concerns about safety are important factors to reduce vaccine hesitancy among parents.

The Impact of an Educational Intervention on Distracted Driving Knowledge, Attitudes, and Behaviors Among College Students

Distracted driving indiscriminately kills nearly 3500 people each year with young adults having greater risks associated with this phenomenon. Prevention programs targeting the distracted driving habits of young adults are necessary to ameliorate the high costs, both in dollars and in lives, associated with this behavior. Few health education and prevention programs have been assessed for their effectiveness in changing knowledge, attitudes, and behaviors related to distracted driving. This study explores a distracted driving intervention among undergraduate students enrolled in an introductory public health course. A quasi-experimental study design was used to compare the pre- and post-data of the group receiving 5-weeks of a distracted driving intervention to a control group. Questionnaires were administered to both groups prior to and 2 weeks following the intervention to assess changes in knowledge, attitudes, and behaviors related to distracted driving. A Difference-in-Difference technique showed significant changes in knowledge (β = 0.40, p = 0.03) and total scores (β = 2.48, p = 0.04) in the intervention (n = 97) compared to the control (n = 131). T-tests examining pre- and post-scores for individual behaviors showed the intervention group displayed positive changes for some behaviors (talking, texting, cellphone use, grooming) compared to the control. The results support the impact that a classroom-based distracted driving intervention can have on undergraduate college students. Implications for this type of health education program may lead to improvements in distracted driving attitudes and behavior among this age-group.

Healthy Food Options at Dollar Discount Stores Are Equivalent in Quality and Lower in Price Compared to Grocery Stores: An Examination in Las Vegas, NV

Food deserts indicate limited access to and affordability of healthy foods. One potential mediator is the availability of healthy food in non-traditional outlets such as dollar-discount stores, stores selling produce at the fixed $1 price. The purpose of this study was to compare availability, quality, price differences in 'healthier' versus 'regular' food choices, price per each food item, and summary score in dollar-discount stores to grocery stores in Las Vegas using the NEMS-S; a protocol consisting of three subscores-availability, quality, price of healthier versus regular food, and a summary score. A 25% sample of grocery stores (n = 40) and all dollar-discount stores (n = 14) were evaluated. t-tests showed that dollar-discount stores were less likely to price healthy options lower than their unhealthy alternatives (mean (M) = 1.0 vs. M = 2.5; p < 0.001) and had reduced availability (M = 20.50 vs. M = 23.80; p < 0.001) compared to grocery stores. The quality of produce did not differ (M = 5.93 vs. M = 6.00; p = 0.34). Price comparisons revealed that 84.2% of produce and 89.5% of other food items were significantly less expensive at the dollar-discount stores, with only two items being more expensive. While dollar-discount stores did have lower availability, they provided quality fresh and healthy foods which were usually less expensive. Findings indicate that dollar discount stores may be an existing community asset, and considering them as such may aid in efforts to strengthen the overall food system. Practitioners should consider dollar discount stores when assessing the community food environment and designing and implementing outreach programs, as they may bridge some disparities in access.

An assessment of the relationship of physical activity, obesity, and chronic diseases/conditions between active/obese and sedentary/ normal weight American women in a national sample

OBJECTIVE

Obesity and physical inactivity are associated with increased rates of chronic diseases and conditions. However, the 'fit but fat' theory posits that cardiopulmonary fitness (or physical activity) can mitigate risks to health associated with obesity. The purpose of this study was to compare chronic diseases and conditions of highly active/obese women with inactive/normal weight women.

STUDY DESIGN

This was a cross-sectional study of the 2015 Behavioral Risk Factor Surveillance System data.

METHODS

Weighted descriptive statistics were performed to describe the demographic characteristics of the two groups. We calculated odds ratios and adjusted odds ratios for chronic diseases and conditions comparing highly active/obese women with inactive/normal weight women.

RESULTS

Highly active/obese women were more likely to report risk factors (hypertension, high cholesterol, and diabetes) for coronary heart disease (CHD) and cardiovascular disease (CVD) than inactive/normal weight women; however, they did not have increased rates of CVD, CHD, or heart attack and had decreased risk for stroke. Highly active/obese women had increased risk for asthma, arthritis, and depression, but not for cancer, kidney disease, or chronic obstructive pulmonary disease.

CONCLUSIONS

Highly active/obese women appear to be staving off the actual development of CHD and CVD; however, further research is needed to understand the long-term health benefits of physical activity among obese women.

The relationship among playground areas and physical activity levels in children

INTRODUCTION

Almost 20% of American children aged 6 to 11 years are obese. A decrease in physical activity has been associated with an increase in obesity. The school environment is one place where many children can be reached. This cross-sectional study determined which types of playground areas attract children and promote moderate to vigorous physical activity (MVPA) or sedentarism.

METHOD

Children on two urban elementary school playgrounds (one of which offered a jogging program called Jog and Walk Stars [JAWS]) were observed before school with use of the System for Observing Play and Leisure Activity in Youth and System for Observing Play and Recreation in Communities observational tools. Descriptive statistics, paired-samples t tests, and independent-samples t tests were used to analyze the data.

RESULTS

The highest populated areas for schools K and B on non-JAWS days were the general blacktop areas; however, approximately 50% of the children in these areas were sedentary. At school B on days when the JAWS program was offered, the highest populated area was the JAWS track, and 99% of those children participated in MVPA. There was a significant difference in counts for average total sedentary children per square foot between school K (M = 216.70) and school B on JAWS days: M = 80.38, t (22.02) = 2.24, p < .5, two-tailed.

DISCUSSION

A playground environment assessment to identify areas that promote MVPA, such as offering a JAWS program, may be one avenue to address the need for increasing MVPA levels in children in general, in addition to physical education class, and help them obtain the recommended 60 minutes of daily MVPA.

The impact of follow-up type and missed deaths on population-based cancer survival studies for Hispanics and Asians

BACKGROUND

The accuracy of cancer survival statistics relies on the quality of death linkages and follow-up information collected by population-based cancer registries. Methodological issues on survival data by race-ethnicity in the United States, in particular for Hispanics and Asians, have not been well studied and may undermine our understanding of survival disparities.

METHODS

Based on Surveillance, Epidemiology, and End Results (SEER)-18 data, we analyzed existing biases in survival statistics when comparing the four largest racial-ethnic groups in the United States, whites, blacks, Hispanics and Asians. We compared the "reported alive" method for calculation of survival, which is appropriate when date of last alive contact is available for all cases, with the "presumed alive" method used when dates of last contact are unavailable. Cox regression was applied to calculate the likelihood of incomplete follow-up (those with less than 5 years of vital status information) according to racial-ethnic group and stage of diagnosis. Finally, potentially missed deaths were estimated based on the numbers of cases with incomplete follow-up for highly fatal cancers.

RESULTS

The presumed alive method overestimated survival compared with the reported alive method by as much as 0.9-6.2 percentage points depending on the cancer site among Hispanics and by 0.4-2.7 percentage points among Asians. In SEER data, Hispanics and Asians are more likely to have incomplete follow-up than whites or blacks. The assumption of random censoring across race-ethnicity is not met, as among non-white cases, those who have a worse prognosis are more likely to have incomplete follow-up than those with a better prognosis (P < .05). Moreover, death ascertainment is not equal across racial-ethnic groups. Overall, 3% of cancer deaths were missed among Hispanics and Asians compared with less than 0.5% among blacks and whites.

CONCLUSIONS

Cancer survival studies involving Hispanics and Asians should be interpreted with caution because the current available data overtly inflates survival in these populations. Censoring is clearly nonrandom across race-ethnicity meaning that findings of Hispanic and Asian survival advantages may be biased. Problematic death linkages among Hispanics and Asians contribute to missing deaths and overestimated survival. More complete follow-up with at least 5 years of information on vital status as well as improved death linkages will decisively increase the validity of survival estimates for these growing populations.

Limitations in the imputation strategy to handle missing nativity data in the Surveillance, Epidemiology, and End Results program

The proposed multiple imputation strategy for handling missing nativity data is affected by well established associations between stage at diagnosis, specified ethnicity, known birthplace, and survival.

Awareness and beliefs regarding intimate partner violence among first-year dental students

Intimate partner violence (IPV) may affect one to four million individuals per year in the United States, with women accounting for the majority of both reported and unreported cases. Dental professionals are in a unique position to identify many types of IPV because injuries to the head and neck may be indicators or predictors of IPV abuse. Fewer than half of dental programs surveyed have reported having IPV-specific curricula, and most dental students surveyed have reported having little experience or training to recognize IPV. Based on this information, this pilot study sought to assess the awareness and beliefs regarding IPV among first-year dental students at the University of Nevada, Las Vegas. Using a voluntary survey, followed by a one-hour educational seminar facilitated by an experienced IPV/domestic violence advocate, a post-seminar survey was administered to assess changes in student perceptions and beliefs and to determine the magnitude and direction of any changes. The survey had an 81.25 percent response rate (65/80). The results demonstrated that more than two-thirds of the students had no previous IPV-specific education. In addition, approximately half of these students began the educational session reporting they did not believe IPV was a health care issue, although the overwhelming majority had decided it was when surveyed after the seminar. Moreover, their perceptions and beliefs about the responsibilities of the dental professional, as well as knowledge about resources and available support services, were significantly changed. These results suggest that targeted, information-specific seminars may be sufficient to provide dental students with an understanding of the key issues regarding IPV. With this knowledge, they can better provide specific information about resources and referrals for services to their patients who have experienced IPV. Recommendations based on these findings are being used to develop and refine IPV-specific curricula at this institution, which may be of significant value to other dental schools with plans to develop and integrate this material into their programs.

The Impact of Unemployment on Mental and Physical Health, Access to Health Care and Health Risk Behaviors

The purpose of this study was to examine the impact of employment status and unemployment duration on perceived health, access to health care, and health risk behaviors. Data from Nevada's 2009 Behavioral Risk Factor Surveillance System (BRFSS) were analyzed. We compared participants who were unemployed (greater than and less than one year) to those who were employed and those who were voluntarily out of the labor force (OLF). Unemployed participants had significantly worse perceived mental health profiles, were more likely to delay health care services due to cost, and were less likely to have access to health care than employed participants and OLF participants. OLF participants were not significantly different from employed participants. Contrary to previous findings, unemployed participants in this study were not more likely to binge drink, smoke, or be physically inactive. Findings from this study suggest that the impetus for unemployment, be it voluntary or involuntary, may significantly impact a person's mental health.

Mortality and longevity of elite athletes

The health benefits of leisure-time physical activity are well known, however the effects of engaging in competitive sports on health are uncertain. This literature review examines mortality and longevity of elite athletes and attempts to understand the association between long-term vigorous exercise training and survival rates. Fourteen articles of epidemiological studies were identified and classified by type of sport. Life expectancy, standardised mortality ratio, standardised proportionate mortality ratio, mortality rate, and mortality odds ratio for all causes of death were used to analyse mortality and longevity of elite athletes. It appears that elite endurance (aerobic) athletes and mixed-sports (aerobic and anaerobic) athletes survive longer than the general population, as indicated by lower mortality and higher longevity. Lower cardiovascular disease mortality is likely the primary reason for their better survival rates. On the other hand, there are inconsistent results among studies of power (anaerobic) athletes. When elite athletes engaging in various sports are analysed together, their mortality is lower than that of the general population. In conclusion, long-term vigorous exercise training is associated with increased survival rates of specific groups of athletes.

Prevalence and correlates of walking and biking to school among adolescents

Increasing the rates that our adolescents walk and bicycle to school, also called active transport to school (ATS), could increase the physical activity (PA) levels of that age group. This type of activity has been identified as a missed opportunity for PA. It is currently estimated that 15% of American youth walk or bicycle to school. These rates of ATS are lower than those of European and Asian youth. Efforts to enhance levels of non-motorized transport to school could aid in reducing obesity rates among American youth, decrease traffic congestion and attenuate emission of greenhouse gasses. The objective was to identify demographic, environmental and psychosocial predictors of ATS. A 30-questionnaire was completed by 2,692 students. Logistic regression was used to identify psychosocial, demographic and environmental predictors of ATS. Only 4.6% of students used ATS. Predictors of ATS were street connectedness (density of street intersections) and gender, (boys had higher ATS rates). Public health officials should be alert for opportunities to select sites for new schools that are in neighborhoods with well connected street systems. Interventions promoting ATS will need to target male and female students and there appears to be an opportunity to increase rates that students bicycle to school.

Modes and locales of physical activity

Older adults are important from a public health standpoint as the number and proportion of elderly in our population is increasing. Further, this segment of the population is characterized by low physical activity involvement and suffers from hypokinetic diseases at high rates. Thus, health promoters should be aware of the types of PA that older adults engage in, and where that PA occurs. The purpose of this study was to describe the modes of PA in which middle-aged and older adults engage in and locales of where that PA occurs. An additional purpose was to identify predictors of meeting PA guidelines that have been created by experts. We also sought to determine if participation in social activities predicted meeting PA guidelines, as both are important aspects of aging. Knowledge of such information could be valuable in designing PA interventions. Methods: The study design was cross-sectional and all data was collected via a telephone interview. A racially mixed sample of 350 females and 199 males completed a 52-item survey that included measures of PA behavior and neighborhood characteristics. Twenty participants failed to report their gender and were excluded from the analysis. Logistic regression was used to identify predictors of meeting PA guidelines. Results: Participant ages ranged from 45-89 years (M = 60.8). The most frequently cited mode of PA was walking, by 53.7% of the sample, most of which occurred near residences (63.6%). Only 11.2% of participants met PA guidelines by doing either moderately or vigorously intense PA. Predictors of meeting PA guidelines included doing PA in a community facility or fitness club, and participation in social activities, which approached significance. Public health personnel should recommend activities, especially walking, to older adults that can be done near their homes, and future research should assess neighborhood characteristics that are supportive of, or hinder the PA of older adults.

The association of distraction and caution displayed by pedestrians at a lighted crosswalk

The rates of deaths and injuries among pedestrians have fallen in recent years, but still remain public health problems as about 5000 pedestrians die each year. Because pedestrians have been shown to be responsible or partially responsible for many of the crashes in which they are involved, we sought to assess the relationship of distracted walking and performing routine cautionary behaviors of pedestrians crossing a busy street in a southwestern city at an intersection, adjacent a university. The behavior of 866 individuals was recorded by trained observers as pedestrians walked across a 105-foot wide street served by a stop light and zebra painted crosswalk. We defined distracted pedestrians as those wearing headphones, talking on a cell phone, eating, drinking, smoking or talking as they crossed the street. Caution was measured by looking left and right, and entering the crosswalk only when the white proceed light was illuminated. We found that only 13.5% of walkers looked left and right and entered the crosswalk while the white light was flashing. Approximately 20% of walkers were distracted as they crossed the street. Regression analysis indicated that distraction was negatively, but weakly associated with displaying cautious pedestrian behaviors. Because traffic lights were routinely ignored and lack of caution was predicted by distraction, we suggest that inexpensive education efforts target pedestrians near college campuses.

Public Posting as a Strategy to Increase Walking

Because most American adults do not meet recommended physical activity guidelines, the need for new and innovative strategies is apparent. The current study employed public posting in an attempt to increase walking behavior in a worksite setting. Pedometer generated data was publicly posted in a prominent location in the worksite. In our study that utilized a pre-experimental design, we found that walking steps were statistically higher during the intervention and in a post intervention period as compared to the baseline data. We conclude that the public posting of physical activity data has the potential to increase walking behavior.

American adults' knowledge of exercise recommendations

Physical inactivity is a major risk factor for cardiovascular disease, stroke, hypertension, diabetes, obesity, osteoporosis, and some cancers. Approximately 950,000 Americans die annually from cardiovascular diseases. The purpose of this study was to determine whether American adults know which traditional and lifestyle physical activities affect health and how they should be physically active to achieve a health benefit. Secondary purposes were to determine whether this knowledge is a function of gender, ethnicity, education, or age and if those who are sufficiently active for a health benefit possess different knowledge levels than those not sufficiently active for a health benefit. Items based on the Centers for Disease Control and Prevention/American College of Sports Medicine principles included knowledge of exercise guidelines and traditional and lifestyle physical activities. This information was obtained from 20 questions that were part of a national random telephone survey of 2,002 American households in the 48 contiguous states and the District of Columbia. Respondents were most aware of traditional physical activities (M = 94%) that provide a health benefit and less aware of specific exercise guidelines (M = 68%) and lifestyle physical activities (M = 71%) that can result in a health benefit. Knowledge was not related to physical activity behavior sufficient for a health benefit and only slightly related to ethnicity, education, and age. These data suggest that physical activity knowledge alone is not sufficient to elicit a behavior; however, it provides educators with an understanding of the public's physical activity knowledge that could be helpful in developing health promotion and physical activity interventions.

Benefits of Breastfeeding

Currently 16% of Americans breastfeed their children for at least 12 months as recommended by the AAP, which is well below the HP 2010 goal of 25%. Breastfed infants receive benefits that can improve their health throughout their lives. The benefits of breastfeeding for children include increased resistance to infectious diseases, such as gastroenteritis, respiratory tract infections, and ear infections. Breastfed children also display lower rates of chronic diseases including diabetes, obesity, asthma, and leukemia. The choice to breastfeed results in economic benefits from lower health care costs and from reduced spending on infant formula. The Healthy People 2010 targets are reviewed along with several studies of interventions to increase breastfeeding rates. Health educators must work to increase breastfeeding rates.

Benefits of Breastfeeding

Currently 16% of Americans breastfeed their children for at least 12 months as recommended by the AAP, which is well below the HP 2010 goal of 25%. Breastfed infants receive benefits that can improve their health throughout their lives. The benefits of breastfeeding for children include increased resistance to infectious diseases, such as gastroenteritis, respiratory tract infections, and ear infections. Breastfed children also display lower rates of chronic diseases including diabetes, obesity, asthma, and leukemia. The choice to breastfeed results in economic benefits from lower health care costs and from reduced spending on infant formula. The Healthy People 2010 targets are reviewed along with several studies of interventions to increase breastfeeding rates. Health educators must work to increase breastfeeding rates.

Predictors of bicycle helmet usage among seniors

This study identified predictors of bicycle helmet usage in a sample of seniors in Mesa, Arizona. Participants reported: days/week bicycling, usual duration, where biking occurred, helmet ownership, bicycle accidents, injuries, and age and gender. Descriptive, non-parametric statistics, and regression analysis were utilized. Seventy-four females and 123 males completed the survey. The mean age was 70.7(7.2) years. Respondents biked a mean of 4.9(2.3) days per week and averaged 40.5 (32.5) minutes of riding per day. Eighty-two participants (41.6%) owned bicycle helmets and 55 (27.9%) were observed wearing helmets. Eighty-seven (44.2%) participants biked outside their retirement community and 25 (12.7%) reported an accident within the past year. Chi-square (2, N = 197) = 0.66, p = .72) indicated no differences in of male or female helmet usage. Those who rode outside the retirement communities (chi2(2, 197) = 22.6, p = .001) were more likely to wear helmets than counterparts. Logistic regression found age to be a predictor of bicycle helmet usage.

Exercise during pregnancy and type of delivery in nulliparae

OBJECTIVE

To assess the association between participation in aerobic exercise during the first two trimesters of pregnancy and type of delivery in nulliparous women.

DESIGN

Nonexperimental, retrospective.

SETTING

A large metropolitan area in the southwestern United States.

PARTICIPANTS

137 nulliparous women.

OUTCOME MEASURES

Method of delivery.

RESULTS

An unadjusted odds ratio showed that sedentary women (n = 93) were 2.05 times more likely to deliver via cesarean section than active women (n = 44), but this relationship was not statistically significant. Through logistic regression analysis with control for the mother's prepregnancy exercise program, age, use of epidural anesthesia, change in prepregnancy to delivery body mass index, labor length, whether labor was induced, and the hospital of birth, the odds of cesarean delivery were found to be 4.5 times greater for sedentary women than for active women.

CONCLUSION

Regular participation in physical activity during the first two trimesters of pregnancy may be associated with reduced risk for cesarean delivery in nulliparous women.

Determinants of physical activity among female adolescents

INTRODUCTION

Women, and particularly African-American women, may be less physically active than what is ideal. Knowledge of factors that influence physical activity is valuable information to those planning and administering exercise promoting interventions.

METHODS

The associations of 25 variables with current global physical activity were assessed via regression analysis. Eight hundred and fifty-two young women, 14-18 years of age, were sampled. Each completed a 7-day recall of physical activity and an 83-item survey. The sample was further subdivided by ethnic group, and then ethnic group and age to ascertain whether determinants of physical activity differ across these groups.

RESULTS

Ethnic group (Caucasians more active) and age (younger more active) were significant influences on physical activity. Overall, nurture from biological fathers and participation in organized sports associated with physical activity. Viewing two or more hours of television per night negatively influenced physical activity. Among African-American girls (n = 626), participation in organized sports, friend support, and nurture from biological fathers significantly associated with physical activity. However, following sports through the media negatively influenced physical activity. Among Caucasians (n = 226), attitudes were the sole significant correlate of physical activity.

CONCLUSIONS

Those planning interventions targeting female adolescents should consider employing distinct strategies for specific ethnic group and age subgroups. Opportunities for physicians to have an impact on the physical activity of female adolescents includes using their community standing to influence school policies and to counsel female patients individually during office visits.