Failure to meet aerobic fitness standards among urban elementary students

The aim of this study was to explore the relationship of aerobic fitness with the elementary school environment and student characteristics among 4th and 5th grade children attending urban public schools in St. Louis, MO, USA. This cross-sectional study was conducted during 2012–2015 and included 2381 children (mean age 10.5 y) who completed the FITNESSGRAM® 20-m Progressive Aerobic Cardiovascular Endurance Run. Healthy Fitness Zone (HFZ) was defined according to FITNESSGRAM® aerobic capacity criteria. Other student-level variables included age, race, National School Lunch Program eligibility, BMI z-score, weight status, and daily pedometer steps. School environment variables included playground features and playground safety, physical education and recess practices, and school census tract data on vacant houses and median household income. Bivariate analyses with sex stratification were used to identify student-level and school-level predictors of failure to achieve the aerobic HFZ; predictors were then included in a multivariable logistic regression model. Failure to meet the aerobic HFZ was observed among 33% of boys and 57% of girls. School environment was not predictive, but higher age and fewer daily steps were: each additional year of age was associated with 41% higher odds of failing to meet the aerobic HFZ among boys and 100% higher odds among girls. Conversely, each additional 1000 daily steps was associated with 15% (boys) and 13% (girls) lower odds of failure. Obesity posed a 60% higher risk of failure to meet HFZ among girls. These results highlight the importance of childhood physical activity opportunities, especially for girls residing in low-resource areas. Keywords: Aerobic fitness, School, Environment, Student, Child, Urban, Low-resourc

Racial and ethnic heterogeneity in self-reported diabetes prevalence trends across Hispanic subgroups, National Health Interview Survey, 1997–2012

INTRODUCTION: We examined racial/ethnic heterogeneity in self-reported diabetes prevalence over 15 years. METHODS: We used National Health Interview Survey data for 1997 through 2012 on 452,845 adults aged 18 years or older. Annual self-reported diabetes prevalence was estimated by race/ethnicity and education. We tested for trends over time by education and race/ethnicity. We also analyzed racial/ethnic and education trends in average annual prevalence. RESULTS: During the 15 years studied, diabetes prevalence differed significantly by race/ethnicity (P < .001) and by Hispanic subgroup (P < .001). Among participants with less than a high school education, the 5-year trend in diabetes prevalence was highest among Cubans and Cuban Americans (β(5YR) = 4.8, P = .002), Puerto Ricans (β(5YR) = 2.2, P = .06), non-Hispanic blacks (β(5YR) = 2.2, P < .001), and non-Hispanic whites (β(5YR) = 2.1, P < .001). Among participants with more than a high school education, non-Hispanic blacks had the highest average annual prevalence (5.5%) and Puerto Ricans had the highest 5-year trend in annual diabetes prevalence (β(5YR) = 2.6, P = .001). CONCLUSIONS: In this representative sample of US adults, results show ethnic variations in diabetes prevalence. The prevalence of diabetes is higher among Hispanics than among non-Hispanic whites, unevenly distributed across Hispanic subgroups, and more pronounced over time and by education. Findings support disaggregation of data for racial/ethnic populations in the United States to monitor trends in diabetes disparities and the use of targeted, culturally appropriate interventions to prevent diabetes

A tale of two community networks program centers: Operationalizing and assessing CBPR principles and evaluating partnership outcomes

BACKGROUND: Community Networks Program (CNP) centers are required to use a community-based participatory research (CBPR) approach within their specific priority communities. Not all communities are the same and unique contextual factors and collaborators’ priorities shape each CBPR partnership. There are also established CBPR and community engagement (CE) principles shown to lead to quality CBPR in any community. However, operationalizing and assessing CBPR principles and partnership outcomes to understand the conditions and processes in CBPR that lead to achieving program and project level goals is relatively new in the science of CBPR. OBJECTIVES: We sought to describe the development of surveys on adherence to and implementation of CBPR/CE principles at two CNP centers and examine commonalities and differences in program- versus project-level CBPR evaluation. METHODS: A case study about the development and application of CBPR/CE principles for the Missouri CNP, Program for the Elimination of Cancer Disparities, and Minnesota CNP, Padres Informados/Jovenes Preparados, surveys was conducted to compare project versus program operationalization of principles. Survey participant demographics were provided by CNP. Specific domains found in CBPR/CE principles were identified and organized under an existing framework to establish a common ground. Operational definitions and the number of survey items were provided for each domain by CNP. CONCLUSION: There are distinct differences in operational definitions of CBPR/CE principles at the program and project levels of evaluation. However, commonalities support further research to develop standards for CBPR evaluation across partnerships and at the program and project levels

Legume Consumption and Severe Depressed Mood, the Modifying Roles of Gender and Menopausal Status

Objective: Legumes have been recommended as staple foods in the anticipation of disease prevention. However, the scientific evidence of their benefits, particularly on mental well-being, remains preliminary. We longitudinally assessed the association between legume consumption and the risk of severe depressed mood (SDM) among a national cohort. Design: The study included adults aged 25–74 years who were examined in 1971–1975 as a part of the National Health and Nutrition Examination Survey. Legume consumption at baseline was obtained from a 3-month FFQ and categorized as infrequent (/week), moderate (1–2 times/week) and frequent (≥3 times/week). SDM was defined as Center for Epidemiologic Studies Depression Scale score ≥22 or taking anti-depression medication after an average of 10•6 years of follow-up (from 8•0 to 12•5 years). Results: Among women, the proportion of individuals with SDM was 17•75 %. For premenopausal women (n 1778), a significant linear trend of deleterious effect from legume consumption was observed (P for trend = 0•0148). The relative risks (RR) for infrequent, moderate and frequent consumptions were 1 (reference), 1•24 (95 % CI = 0•91, 1•70) and 1•75 (1•12, 2•75), respectively. However, moderate consumption showed a significant protective effect (RR = 0•52 (0•27, 1•00)) among women undergoing the menopausal transition (n 454). No association was obtained from either postmenopausal women (n 601) or men (n 2036). Conclusions: These findings suggest that gender and menopausal status were effect modifiers of the association between legume consumption and SDM. Detrimental effects of frequent consumption of legumes may exist among premenopausal women; moderate consumption, however, may protect perimenopausal women against SDM

How Segregation Makes Us Fat: Food Behaviors and Food Environment as Mediators of the Relationship Between Residential Segregation and Individual Body Mass Index

ObjectivesRacial residential segregation affects food landscapes that dictate residents’ food environments and is associated with obesity risk factors, including individual dietary patterns and behaviors. We examine if food behaviors and environments mediate the association between segregation and body mass index (BMI).MethodsNon-Hispanic Whites and Blacks living in the St. Louis and Kansas City metro regions from 2012 to 2013 were surveyed on dietary behaviors, food environment, and BMI (n = 1,412). These data were combined with the CDC’s modified retail food environment index and 2012 American Community Survey data to calculate racial segregation using various evenness and exposure indices. Multi-level mediation analyses were conducted to determine if dietary behavior and food environment mediate the association between racial residential segregation and individual BMI.ResultsThe positive association between racial segregation and individual BMI is partially mediated by dietary behaviors and fully mediated by food environments.ConclusionRacial segregation (evenness and exposure) is associated with BMI, mediated by dietary behaviors and food environment. Elements of the food environment, which form the context for dietary behaviors, are potential targets for interventions to reduce obesity in residentially segregated areas

Dietary Protein and Protein-Rich Food in Relation to Severely Depressed Mood: A 10 Year Follow-Up of a National Cohort

High-protein diets are advocated to facilitate weight loss, and improve cardiovascular risk factors, but data on psychiatric effects are lacking. We analyzed data from 1947 men and 2909 women aged 25–74 years when examined in 1971–1975 as the baseline of the National Health and Nutrition Examination Follow-Up Study. The amounts of macronutrients were obtained from a 24-hour recall, and frequencies of eating protein-rich foods were estimated using a 3-month food frequency questionnaire. Severely depressed mood (SDM) was defined as Center for Epidemiologic Studies Depression Scale score ≥ 22 or taking anti-depression medication after an average of 10.6 years of follow-up. A significant gender difference was observed in the prevalence of SDM and its association with protein intake. The weighted prevalence of SDM was 11.45 (SE = 0.96) % and 17.45(1.05) % respectively among men and women. Among men, the relative risk (RRs) of SDM were 1.00, 0.46 (95% CI = 0.22–0.99) and 0.38 (0.16–0.92) respectively for the lowest, middle and highest third protein intake (p for trend = 0.0347). Among women, the RRs were 1.00, 1.93 (1.23–3.08) and 2.47 (1.24–4.90) respectively with lowest, middle and the highest third intakes (p for trend = 0.0023). These estimates were adjusted for cigarette smoking, alcohol consumption, BMI, socioeconomic status at baseline, and the history of cancer, stroke, heart attack and diabetes assessed at follow-up interview. The authors concluded that increased intake of protein demonstrated a protective effect among men but a deleterious effect among women

Body Mass Index and Death Rate of Colorectal Cancer among a National Cohort of U.S. Adults

Substantial evidence suggests that increasing adiposity is associated with an increased death rate of colorectal cancer, but no studies were conducted among national representative populations in the United States. The current study examined the death rate across BMI levels in 7,016 adults who participated in the National Health and Nutrition Examination Survey in 1971–1975. BMI categories were defined as normal (18.5–24.9 kg/m2), overweight (25–29.9), and obese (≥30). A total of 519 cancer deaths were identified during a 17-yr follow-up with 118,998 person-years. No significantly increased death rates of total cancers, lung, breast, and prostate cancer were observed among participants with an increased BMI. However, colorectal cancer death rates were 0.39, 0.68, and 0.96/1,000 person-years, respectively, for normal weight, overweight, and obese (P value for log-rank trend test \u3c 0.001), and the corresponding adjusted hazard ratios [95% confidence intervals (CI)] were 1.00 (reference), 1.25 (95% CI = 0.72–2.19), and 2.04 (1.08–3.83), respectively. No gender difference of the association was identified. The authors conclude that a significantly increased death rate of colorectal cancer was associated with excess body weight. The current study is an addition to the expanding body of literature indicating an increased risk of colorectal cancer development among the obese

Evaluation of a Multi-Site Asthma Program Initiative: Linking Program Activities with Distal Outcomes to Demonstrate Systems Change

Five unique community interventions to reduce childhood asthma morbidity and to facilitate healthcare and community systems level changes were developed and privately funded in GA. In an effort to document these outcomes and facilitate a multi site level of understanding, the funder also contracted with our university-based evaluation team. Our team worked with program staff and developed a plan to document both program level evaluation and cross site measures (process, impact and outcome). The funded projects were charged with increasing enrollment of children and the management of their asthma. They used best practice interventions and planned to document that systems changes did indeed improve care as measured by emergency room visit reductions, hospitalization reductions, reduced school absences, increase quality of life and/or reduction of acute care primary care visits. The evaluation team worked to support the program leaders in their efforts to link the program activities and objectives with the more distal outcomes they hoped to achieve, such as reduced ER use, reduced hospitalization or reduced school absenteeism. This presentation will document the processes the evaluation team used to support the linking of the systems objectives to the distal outcomes through more short term or intermediate outcomes such as changes in timely use of appropriate medications or reduction in triggers for asthma. The need to produce a clear link between the program activities, systems changes and outcomes through evaluation evidence is critical when calling for policy change