172 research outputs found

    The Association between US Adolescents’ Weight Status, Weight Perception, Weight Satisfaction, and Their Physical Activity and Dietary Behaviors

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    Background: It remain unclear that the association between weight status, weight perception, weight satisfaction and the clustering of physical activity (PA) and dietary behaviors in adolescents. Method: A cross-sectional analysis of National Health and Nutrition Examination Survey and the US Department of Agriculture’s Food Patterns Equivalents 2007–2014 data from adolescents aged 12–17 years (n = 2965) was conducted. Multivariable logistic regression models adjusted for demographic characteristics examined the association between weight status, weight perception, weight satisfaction, and the four created lifestyle groups (healthier behaviors, healthier diet only, physically active only, unhealthier behaviors). Results: Males with obesity were more likely to be in the healthier diet only group than males with a normal weight (OR = 1.90, 95% CI: 1.02, 3.52). Similar patterns were found in males who perceived themselves as being overweight or having obesity (OR = 2.09, 95% CI: 1.09, 3.99) and males with obesity who perceived their weight status accurately (OR = 2.33, 95% CI: 1.12, 4.88). Female respondents who were satisfied with their weight were 59% less likely to be in the healthier diet only group than healthier behaviors group compared with females who were weight dissatisfied (OR = 0.41, 95% CI: 0.23, 0.75). This pattern was not observed in males. Conclusions: Clustering PA and dietary behaviors were associated with weight status and weight perception for males but not females. Weight satisfaction was associated with clustered PA and dietary behaviors for females. These findings are important for obesity prevention policies and programs to better address adolescents’ obesity and reduce health disparities in this population

    A “Swiss paradox” in the United States? Level of spatial aggregation changes the association between income inequality and morbidity for older Americans

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    Although a preponderance of research indicates that increased income inequality negatively impacts population health, several international studies found that a greater income inequality was associated with better population health when measured on a fine geographic level of aggregation. This finding is known as a “Swiss paradox”. To date, no studies have examined variability in the associations between income inequality and health outcomes by spatial aggregation level in the US. Therefore, this study examined associations between income inequality (Gini index, GI) and population health by geographic level using a large, nationally representative dataset of older adults. We geographically linked respondents’ county data from the 2012 Behavioral Risk Factor Surveillance System to 2012 American Community Survey data. Using generalized linear models, we estimated the association between GI decile on the state and county levels and five population health outcomes (diabetes, obesity, smoking, sedentary lifestyle and self-rated health), accounting for confounders and complex sampling. Although state-level GI was not significantly associated with obesity rates (b = − 0.245, 95% CI − 0.497, 0.008), there was a significant, negative association between county-level GI and obesity rates (b = − 0.416, 95% CI − 0.629, − 0.202). State-level GI also associated with an increased diabetes rate (b = 0.304, 95% CI 0.063, 0.546), but the association was not significant for county-level GI and diabetes rate (b = − 0.101, 95% CI − 0.305, 0.104). Associations between both county-level GI and state-level GI and current smoking status were also not significant. These findings show the associations between income inequality and health vary by spatial aggregation level and challenge the preponderance of evidence suggesting that income inequality is consistently associated with worse health. Further research is needed to understand the nuances behind these observed associations to design informed policies and programs designed to reduce socioeconomic health inequities among older adults

    Health-Related and Sociodemographic Correlates of Meeting the Muscle Strengthening Exercise Recommendations in Middle-Aged and Older Adults with and without Disabilities

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    ut disabilities Shirit Kamil-Rosenberg, Mary L. Greaney & Carol Ewing Garber Sport Sciences for Health (2020)Cite this article 51 Accesses 4 Altmetric Metricsdetails Abstract Purpose To identify sociodemographic and health correlates of meeting the muscle strengthening (MS) exercise recommendations in middle-aged and older adults by disability status. Methods Respondents from the 2011 Behavioral Risk Factor Surveillance System were stratified by disability status (with disability, without disability), age [ages 45–64 (middle-aged), 65 + years of age (older adults)] and whether they met MS recommendations (yes, no). Two logistic regression models were run to evaluate whether perceived health status and sociodemographic characteristics were associated with meeting the MS recommendations by disability status. Results The sample included 477,662. Middle-aged persons were 20% more likely than older adults to meet the MS recommendations. Persons with a disability were less likely to meet muscle strengthening recommendations compared with those without. Persons with a disability who reported having poor health were ~ 65% less likely to meet the MS recommendation than those reporting excellent health. Furthermore, those with a disability and with one or more chronic diseases were nearly 40% less likely to meet the MS recommendation than no disability. Among respondents without disability, being Black and being a healthy weight or underweight increased the odds of meeting the MS recommendations. Conclusion Several health and sociodemographic factors were associated with not meeting MS recommendations. Persons with disability and poor health, had the lowest likelihood of participation. Studies are needed to understand whether improving MS exercise behavior may attenuate functional limitations associated with chronic diseases and aging

    Community-based social determinants of three measures of mortality in Rhode Island cities and towns

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    Background: Efforts to understand and address the causes of place-based health disparities have focused primarily on understanding the social determinants of health on a large geographic level, such as the region, state, or county. However, there is a growing need to assess and understand how place-based characteristics at smaller geographic areas relate to of local place-based neighborhood characteristics on population health. Therefore, the objective of this study was to evaluate the magnitude of the associations between social determinants of health and life expectancy (LE) and related measures on the community level. Methods: LE at birth (LE0), remaining LE at age 65 (LE65), and age-specific mortality rates (ASMR) were calculated from mortality data (2009–2011) collected by the Rhode Island Department of Health (RIDoH) using abridged life table methods for each RI city/town. The city/town-specific LE and ASMR were linked to data collected by the US Census, RIDoH, the Federal Bureau of Investigation, and other databases that include information about multiple social, environmental, and demographic determinants of health. Bivariate correlations between city/town-level LE0, LE65, and ASMR and social determinants: demographics, household composition, income and poverty, education, environment, food insecurity, crime, transportation, and rural-urban status were examined. Results: LE0 (range: 75.9–83.3 years) was strongly associated with the percent of the population with a graduate/professional degree (r = 0.687, p \u3c  0.001), violent crime rate (r = − 0.598, p \u3c  0.001), and per capita income (r = 0.553, p \u3c  0.001). Similar results were observed for ASMR: ASMR was associated with the percent of the population with a graduate/professional degree (r = − 0.596, p \u3c  0.001), violent crime rate (r = 0.450, p = 0.005), and per capita income (r = − 0.533, p \u3c 0.001). The associations between LE65 and social determinants were more attenuated. Of note, none of the measures (LE0, LE65, or ASMR) were associated with any of the race/ethnicity variables. Conclusions: There are several important place-based characteristics associated with mortality (LE and ASMR) among RI cities/towns. Additionally, some communities had unexpectedly high LE and low ASMR, despite poor social indicators

    Perspectives of WIC Staff Regarding Physical Activity Levels and Behaviors of Latino Preschool Children

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    Background: Racial and ethnic disparities in physical activity (PA) are evident, with non-Hispanic Black and Mexican American children engaging in less vigorous activity than non-Hispanic White children. Collaborating with public health programs serving at-risk populations, such as the WIC program may be an effective way to promote the development of healthful PA behaviors among low-income preschool children and families. This paper explores WIC staff perceptions, attitudes, barriers, and facilitators related to PA levels and behaviors among low-income Latino preschool children and families, as well as the role the WIC program may play in promoting PA among low-income populations. Methods: A qualitative study was conducted with a sample of WIC staff in the State of Rhode Island (RI), Northeast United States. Individual, semi-structured interviews were carried out with 21 WIC staff working directly with Latino clients enrolled in the WIC program. Thematic content analysis was used. Results: The majority of WIC staff reported their Latino clients facing many barriers that limit their ability to be physically active, including busy and multiple shift schedules, lack of access to safe outdoor spaces, financial constraints to attending programs and recreational facilities, lack of transportation getting to safe outdoor spaces and facilities, etc. WIC staff identified several ways that the WIC program could increase the promotion PA among Latino families including partnering with local organizations such as the YMCA, Boys and Girls Club to provide increased access and opportunities for PA among low-income, Latino families. Conclusions: Study findings add to the existing literature suggesting that the WIC program is an important venue for educating low-income, Latino children and families about the importance of establishing early healthy PA habits within the context of overall health and development. Findings also highlight the need for a continuing effort to integrate the promotion of PA as part of the WIC program. In addition, findings highlight WIC staff desire for additional training and resources in promotion of PA

    Exploring Changes in Caregiver Burden and Caregiving Intensity due to COVID-19

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    This study explored self-reported changes in caregiving intensity (CI) and caregiver burden (CB) among informal caregivers due to the COVID-19 pandemic overall and by gender. Informal caregivers for someone age 50+ completed a survey via Amazon’s MTurk in June 2020. Participants reported changes in CI and CB due to COVID-19 and provided demographic information. Multinomial logistic regression models assessed changes in CI and CB attributed to the COVID-19 pandemic overall and by gender. The sample (n = 835) was 68.5% male and had an average age of 34 years (SD 9.8); 55.7% had increased CI, and 53.1% had increased CB attributed to the pandemic. Increased CB due to COVID-19 was associated with increased CI (OR 5.67, 95% CI 3.92–8.00). Male caregivers with decreased CI due to COVID-19 were nearly seven times as likely as those with no change in CI to have reduced CB due to COVID-19 (OR 6.91, 95% CI 3.29–14.52). Women with decreased CI due to COVID-19 were over eight times as likely to have reduced CB due to COVID (OR 8.30, 95% CI 2.66–25.91). Results indicate that many caregivers experienced increases in CI and CB since the start of the COVID-19 pandemic, and that these changes are complex and vary by gender

    A qualitative study conducted in the USA exploring Latino fathers’ beliefs, attitudes and practices related to their young children’s eating, physical activity and sedentary behaviours

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    Objective: Increasing evidence documents fathers’ influential role in their children’s eating, physical activity (PA) and sedentary behaviours (SB). We aimed to expand limited existing research examining fathers’ influence in these areas by exploring Latino fathers’ beliefs, attitudes and practices related to eating, PA and SB of their young children. Designs: Seven focus group discussions were conducted in Spanish with Latino fathers (n 28) of children aged 2–8 years. Audio recordings were transcribed and translated verbatim without identifiers. Data were analysed using thematic analysis to identify key concepts and themes using NVivo 11 software. Results: Fathers expressed positive beliefs and attitudes about the importance of healthy eating for their young children, themselves and their families. Nevertheless, the majority reported familial practices including eating out, getting take-out, etc. that have been linked to increased obesity risk among Latino children. Fathers were more involved and engaged in children’s PA than eating and feeding. However, several fathers reported engaging predominantly in sedentary activities with their children, appeared permissive of children’s sedentary habits and struggled to set limits on children’s screen-time. Conclusions: We provide new information on Latino fathers’ beliefs and child feeding and PA practices that may provide important targets for interventions aimed at promoting healthful eating and PA behaviours of Latino children. Future research should further quantify the influence of Latino fathers’ parenting styles and practices on development of children’s eating, PA and SB. This information is needed to identify risk factors amenable to interventions and to design culturally appropriate parenting and family-based interventions targeting Latino children’s home environment and designed to meet this ethnic group’s specific needs

    Factors Affecting Surgical Decisions in Newly Diagnosed Young Women with Early-Stage Breast Cancer

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    Given that young women with breast cancer often have concerns and priorities attributable to their life stage, we conducted a series of interviews to better understanding the surgical decision-making experience among women diagnosed at age ≤40. Women spoke of how the potential effect of an extended recovery was affecting their decision and, in some cases, contributing to decisional conflict. Several women described their worry of leaving cancer cells behind; others cited the need for continued surveillance as a consideration. Attention to situational anxiety and concerns about recurrence are warranted to ensure that decisions are made in a supportive and patient-centered setting

    Non-Responsive Feeding Practices, Unhealthy Eating Behaviors, and Risk of Child Overweight and Obesity in Southeast Asia: A Systematic Review

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    Childhood obesity is increasing dramatically in many Southeast Asian countries, and becoming a significant public health concern. This review summarizes the evidence on associations between parental feeding practices, child eating behaviors, and the risk of overweight and obesity in Southeast Asian children 2–12 years old. We systematically searched five electronic academic/research (PubMed, PsycINFO, ProQuest Nursing, Medline, and CINAHL) databases using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement for peer-reviewed studies published in English between January 2000 and December 2016. Fourteen observational studies met the inclusion criteria and were reviewed. Reviewed studies were examined separately for preschool- and school-aged children and revealed that non-responsive parental feeding practices and unhealthy child eating behaviors were associated with a risk of child overweight and obesity in several Southeast Asian countries. Nonetheless, due to the small number of identified studies (n= 14) and because only about half of the Southeast Asian countries (Thailand, Vietnam, Singapore, the Philippines, and Malaysia) were represented (5/11) in the examined studies, additional research is needed to further understand the factors associated with childhood obesity among children in Southeast Asia to develop interventions that are tailored to the specific needs of Southeast Asian countries and designed to address practices and behaviors that may promote childhood obesity

    Age-specific trends in health-related quality of life among US adults: Findings from National Health and Nutrition Examination Survey, 2001-2016

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    Purpose Health-related quality of life (HRQoL) is an important indicator of population health, yet no age-specific trend analyses in HRQoL have been conducted with a nationally representative sample since 2004. Therefore, to address this gap, an age-specific trend analysis of HRQoL was conducted using National Health and Nutrition Examination Surveys (NHANES) data. Methods NHANES 2001–2016 data (8 cycles) were examined to evaluate trends in HRQoL by age group (young adults: 21–39, middle-aged: 40–64, older adults: 65+). HRQoL was assessed by self-reported health (SRH) and number of physically unhealthy, mentally unhealthy, and inactive days to due to physical or mental health in the past 30 days. Multiple linear or logistic regression analyses explored trends in HRQoL by age group, adjusting for demographics over time. Results Analysis revealed increasing fair/poor SRH over time for the entire sample (β = 0.34, 95% CI 0.08, 0.60, p = 0.011). However, age-specific analysis identified a bi-annual increase in fair/poor SRH only among young adults (β = 0.49, 95% CI 0.22, 0.76, p \u3c 0.001) and a decrease among older adults (β = − 0.60, 95% CI − 1.14, − 0.06, p = 0.03). Closer inspection revealed increasing fair/poor SRH increased among young women (β = 0.52, 95% CI 0.11, 0.93, p = 0.013) and young men (β = 0.46, 95% CI 0.04, 0.88, p = 0.03) but decreased among older women (β = − 0.81, 95% CI − 1.59, − 0.03, p = 0.042) over time. Analyses also determined that there was a trend for a decreasing number of physically unhealthy days among young adults (p \u3c 0.001), although no trends were observed for the other HRQoL items. Conclusions Although there was a significant trend over time for increasing fair/poor SRH when considering the entire sample, this trend was not consistent between age groups or sexes. Given increasing fair/poor SRH among young adults, there is a need to understand and address factors relating to HRQoL among this age group
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