Breakout Session: Paths to Obtaining Funding for Community Engaged Research: One Successful Example

The purpose of this talk is (1) To describe important elements of a successful preliminary studies section, and (2) To share a recent example of leveraging a small pilot study and in-kind on the fly activities to inform a successful NIH grant application

The Social Context as a Determinant of Weight-Related Behaviors: Focus on Social Norms

Most research addressing social context as a determinant of weight-related behaviors has focused on social support and social networks, with limited research assessing social norms. Social norms for obesity are an important variable to understand given the pervasiveness of this condition in our society and the multiple life situations in which individuals are exposed to obesity-related behaviors. This presentation discusses a study that developed a measurement approach to assessing weight loss, dietary and physical activity social norms in the worksite and assessed the associations of these norms with behaviors

Breakout Session: Paths to Obtaining Funding for Community Engaged Research

Discusses the UMass CCTS Community Engagement & Research Section Pilot/Feasibility Grants Program and other potential sources of funding for community engaged research

Beverage Consumption Among Low-Income Hispanics with Uncontrolled Type 2 Diabetes

This study sought to describe beverage consumption, caloric contribution of beverages to total caloric intake, and associations between beverage consumption and metabolic factors among a sample of low-income Hispanics participating in a trial of a diabetes self-management intervention. Findings: Treatment strategies to improve glucose control and reduce diabetes complications among Hispanics are needed. There is a high consumption of calories from beverages, accounting for one-fifth of total caloric intake, among this high-risk Hispanic population. Milk, juices, fruit drinks and regular soda are particular sources of calories. Beverage consumption is associated with metabolic markers, including HbA1c, cholesterol, blood pressure, BMI and waist circumference, and may thus increase risk for diabetic and cardiovascular complications in this population. Beverage consumption among low-income Hispanics warrants further clinical and research attention, including development of interventions that target all liquid calories, not just sugar-sweetened beverages. Targeting beverage consumption through simple messages that are in line with the literacy challenges posed by this population may be feasible. The vast benefit of clarifying a single food group that can be modified to reduce risk factors of diabetes and obesity in this population cannot be overstated

Racial/Ethnic Disparities in Meeting 5-2-1-0 Recommendations among Adolescents in the United States

BACKGROUND: Obesity prevention has become a major focus of public health efforts in the United States. The Federal Government set forth national nutrition and physical activity recommendations to prevent obesity and promote well-being among children. A succinct message developed through a program in Maine “Let’s Go! 5-2-1-0” summarizes these obesity prevention behaviors including ≥5 fruit and vegetables, ≤2 hours of screen time, ≥1 hour of physical activity, and 0 sugar sweetened beverages daily. The study evaluates racial/ethnic disparities among adolescents meeting the 5-2-1-0 targets in a nationally representative sample. METHODS: The 2011-2012 NHANES dataset was used to conduct a cross sectional analysis of Hispanic (n=287), non-Hispanic Black (n=321), Asian (n=145) and non-Hispanic White (n=234) adolescents 12-19 years old. The 5-2-1-0 targets were evaluated using dietary recalls, Global Physical Activity Questionnaire, and questions about sedentary activities. Differences in the proportion of racial/ethnic groups meeting the 5-2-1-0 targets were compared using chi-square tests. Logistic models accounting for the complex sampling design were used to evaluate racial/ethnic disparities in meeting the 5-2-1-0 targets. RESULTS: There were no adolescents that met all four 5-2-1-0 targets. Meeting individual targets and meeting none of the targets differed by racial/ethnic group. The study found 28% of White, 39% of Hispanic, 44% of Black and 35% of Asian adolescents met zero 5-2-1-0 targets. Adolescents from different racial/ethnic groups had increased odds of meeting no 5-2-1-0 targets compared to their White peers (adjusted odds ratio [95% Confidence Interval] – Hispanic: 1.76 [1.04-2.98], Black: 1.82[1.04-3.17], Asian: 1.48[1.08-2.04]). CONCLUSION: Understanding the uptake of national nutrition and physical activity recommendations is necessary to reduce future obesity and health consequences in adulthood. Despite national initiatives, adolescents in the United States are far from meeting the 5-2-1-0 targets and there are racial/ethnic disparities in meeting the recommendations

Differences in Blood Pressure Levels Among Children by Sociodemographic Status

INTRODUCTION: The American Academy of Pediatrics (AAP) updated its blood pressure (BP) screening guidelines in 2017 to emphasize body weight as a risk factor. We provide contemporary, nationally representative estimates of prevalence of elevated and hypertensive BP among US children and examine sociodemographic prevalence differences, accounting for the influence of weight. METHODS: We used cross-sectional data from children aged 8 to 17 years (N = 5,971; weighted N = 36,612,323) collected from 2011 through 2018 in 4 biennial cycles of the National Health and Nutrition Examination Survey (NHANES). Children\u27s BP was categorized as normal, elevated, or hypertensive. Sociodemographic characteristics included were sex, age, race/ethnicity, family income, and education. Log binomial regression, with and without adjustment for weight (dichotomized at the 85th body mass index percentile), determined prevalence estimates and differences for elevated and hypertensive BPs with 95% CIs. RESULTS: In NHANES data collected from 2011 through 2018, 7.2% (95% CI, 6.3%-8.3%) of US children had elevated BP, and 3.8% (95% CI, 3.3%-4.5%) had hypertensive BP according to 2017 AAP guidelines. Differences in prevalence of weight-adjusted elevated BP indicated higher prevalence among children aged 16 to 17 years compared with children aged 8 to 9 years (prevalence difference, +6.3%; 95% CI, 3.2%-9.4%), among males compared with females (+4.6%; 95% CI, 2.7%-6.4%), and among non-Latino Black children compared with non-Latino White children (+4.0%; 95% CI, 2.2%-5.8%). Crude hypertensive BP prevalence was highest among children aged 8 to 9 years, male children, and Mexican American children. The only difference remaining after weight adjustment was among children aged 8 to 9 years and 13 to 15 years. CONCLUSION: Elevated BP was most prevalent among US children who were older, male, or non-Latino Black. Factors beyond inequalities in body weight may contribute to disparities in elevated BP

Weight loss in persons with serious mental illness

Comment on A behavioral weight-loss intervention in persons with serious mental illness. [N Engl J Med. 2013

Association between food insecurity and CVD risk factors is moderated by intake of fruits and vegetables in Latinos

Background: Food insecurity has been consistently associated with CVD risk factors (i.e., obesity, type 2 diabetes, hypertension and hypercholesterolemia). Consumption of fruits and vegetables may reduce CVD risk factors among food insecure Latinos. Objective: To examine the potential moderating effect of fruit and vegetable intake in the association between food insecurity and CVD risk factors in a sample of Latino men and women in the northeast U.S. Methods: A representative community sample of Latino individuals was recruited from a community health center in Lawrence, MA. Food insecurity was measured with the 6-item USDA Household Food Security Scale. Fruit and vegetable intake, was measured with Block’s Fruit and Vegetable Screener. CVD risk factors examined included: obesity assessed by body mass index (BMI), and diagnoses of type 2 diabetes, hypertension and hyperlipidemia abstracted from electronic health records. Covariates considered included: age, gender, education and BMI (except in the obesity model). Statistical analyses included multivariable logistic regression testing for interaction between food insecurity and diet. Results: Overall, 51% of the sample were women and most self-identified as Dominicans (73%). Thirty-one percent of the sample experienced food insecurity and 79% consumed less than 5 servings of fruits and vegetables per day. Twenty percent of food secure participants and 23% of food insecure individuals consumed 5 servings or more of fruits and vegetables per day (p=0.439). In adjusted models, food insecurity was positively associated with type 2 diabetes in individuals consuming less than 5 servings of fruits and vegetables per day (OR=1.79; 95% CI=1.11–2.89) but not in individuals consuming 5 servings or more of fruits and vegetables per day. Interaction analyses showed that these estimates were significantly different from each other (p=0.04). Conclusion: Among those who were food insecure, low consumption of fruits and vegetables, was associated with type 2 diabetes in this Latino sample. Studies are needed to confirm our findings. Further, longitudinal studies are needed to understand a potential causal relationship. Interventions to increase availability of fruits and vegetables among food insecure Latinos may help alleviate diabetes disparities in this vulnerable group

Association between food insecurity and CVD risk factors is moderated by intake of fruits and vegetables in Latinos

Background: Food insecurity has been consistently associated with CVD risk factors (i.e., obesity, type 2 diabetes, hypertension and hypercholesterolemia). Consumption of fruits and vegetables may reduce CVD risk factors among food insecure Latinos. Objective: To examine the potential moderating effect of fruit and vegetable intake in the association between food insecurity and CVD risk factors in a sample of Latino men and women in the northeast U.S. Methods: A representative community sample of Latino individuals was recruited from a community health center in Lawrence, MA. Food insecurity was measured with the 6-item USDA Household Food Security Scale. Fruit and vegetable intake, was measured with Block’s Fruit and Vegetable Screener. CVD risk factors examined included: obesity assessed by body mass index (BMI), and diagnoses of type 2 diabetes, hypertension and hyperlipidemia abstracted from electronic health records. Covariates considered included: age, gender, education and BMI (except in the obesity model). Statistical analyses included multivariable logistic regression testing for interaction between food insecurity and diet. Results: Overall, 51% of the sample were women and most self-identified as Dominicans (73%). Thirty-one percent of the sample experienced food insecurity and 79% consumed less than 5 servings of fruits and vegetables per day. Twenty percent of food secure participants and 23% of food insecure individuals consumed 5 servings or more of fruits and vegetables per day (p=0.439). In adjusted models, food insecurity was positively associated with type 2 diabetes in individuals consuming less than 5 servings of fruits and vegetables per day (OR=1.79; 95% CI=1.11–2.89) but not in individuals consuming 5 servings or more of fruits and vegetables per day. Interaction analyses showed that these estimates were significantly different from each other (p=0.04). Conclusion: Among those who were food insecure, low consumption of fruits and vegetables, was associated with type 2 diabetes in this Latino sample. Studies are needed to confirm our findings. Further, longitudinal studies are needed to understand a potential causal relationship. Interventions to increase availability of fruits and vegetables among food insecure Latinos may help alleviate diabetes disparities in this vulnerable group

Preventive healthcare use, smoking, and alcohol use among Rhode Island women experiencing intimate partner violence

OBJECTIVE: Intimate partner violence (IPV) poses major health threats to women, including increased risk for several chronic health conditions. The impact of IPV on use of preventive health services is not well understood. Although several studies indicate that female victims of IPV have higher rates of alcohol abuse, this has not been replicated in population-based studies. The association of IPV with smoking has not been a major research focus. The purpose of this study was to examine the association between physical and psychological IPV in the past 12 months and preventive healthcare use, smoking, and alcohol use among women. METHODS: Data on 1643 women aged 18-54 from the 1999 Rhode Island Behavioral Risk Factor Surveillance System were analyzed. Logistic regression, controlling for age, race, marital status, education, insurance status, and functional disability, was used to model the associations of IPV with (1) checkups, (2) clinical breast examinations (CBEs), (3) Pap smear screening, (4) cigarette smoking, and (5) high-risk alcohol use. RESULTS: Prevalence of physical IPV was 4.1%. The prevalence of psychological IPV, in the absence of physical IPV was 4.5%. Physical IPV was associated with receiving regular Pap smears odds ratio ([OR] = 2.39, 95% confidence interval [CI] 1.01-5.70), current smoking (OR = 2.07, 95% CI 1.03-4.18), and high-risk alcohol use (OR = 4.85, 95% CI 2.02-11.60). Psychological IPV was associated with high-risk alcohol use (OR = 3.22, 95% CI 1.46-7.09). CONCLUSIONS: Women experiencing IPV regularly access preventive healthcare, providing healthcare providers with opportunities to assess and counsel women for IPV in addition to smoking and high-risk alcohol use