Weight-related disparities in colorectal cancer prevention behaviors

Although Colorectal Cancer (CRC) is the 2nd leading cause of cancer mortality, it is estimated that as many as 90% of CRC cases could be prevented through screening and healthy lifestyle, such as engaging in regular physical activity. Obese women, who are at higher risk for CRC, may be less likely to engage in cancer prevention behaviors than normal weight women. The purpose of this research project was to understand how obesity affects CRC screening and physical activity behavior in order to design appropriate intervention messages for decreasing CRC risk among obese women. The dissertation followed three aims. For Aim 1, national data on CRC screening were analyzed to better understand the combined influence of gender, weight and race on CRC screening practices. We found that obese white women were 34% less likely to have had a colonoscopy in the past 10 years (p=0.001), but that there was no significant relationship between screening and weight in African American women. For Aim 2, focus groups were conducted with unscreened obese women to better understand how weight affects compliance with screening and physical activity guidelines. We found that knowledge of CRC prevention was low among obese women. While many of the barriers cited were similar to those found with non-obese women, obese women had more co-morbidities which they may prioritize over cancer screenings tests. Women also cited many weight-related barriers to physical activity. Aim III consisted of an online evaluation of weight-targeted CRC prevention messages. White women were stratified by weight (obese vs. non-obese) and randomized to receive either 10 weight-targeted messages developed based on focus group findings or 10 generic messages about CRC screening and physical activity. Women rated messages using the Elaboration Likelihood (ELM) Scale; there were no differences between ELM scores of women who read weight-targeted vs. generic messages, but obese women in both conditions reported higher elaboration (p=0.02) and felt that the messages were more personally relevant (p=0.005) and believable (p=0.047) than non-obese women did. Together, data from these three aims can be used to inform the development of future CRC prevention interventions targeted at obese women

Colorectal Cancer Screening and Physical Activity Promotion Among Obese Women: An Online Evaluation of Targeted Messages

Obese women are at higher risk for several cancers, but are less likely than normal weight women to engage in cancer prevention behaviors such as screening and physical activity. Targeted health messages may help increase healthy behaviors among vulnerable groups such as obese women. Using findings from focus groups with obese women, the authors created targeted messages to promote colorectal cancer screening and physical activity among obese women. The messages addressed psychosocial constructs, such as benefits and barriers to colorectal cancer screening and exercise, which were relevant to the target population. Messages were tested online with women age 50 years and older (N = 181). Participants were stratified by weight (obese vs. nonobese) and randomized to review either 10 targeted (intervention) or 10 generic (control) messages. Study outcomes included elaboration about the messages, message relevance and trustworthiness, and behavioral intentions. The authors used moderation and subgroup analyses to determine whether the intervention messages were better received by certain women. They found no differences in elaboration, behavioral intentions, relevance, or trustworthiness between intervention and control for either weight group. However, exercise intentions increased more (p=.06) among inactive obese women who received intervention messages (+2.9) compared with those who were in the control group (+1.2). Intervention messages also produced more elaboration among women who viewed their weight as a barrier to screening or exercise. Tailoring intervention messages for obese women on the basis of behavior and barriers may improve outcomes more than giving the same messages to all obese women

A Qualitative Study of Perceived Barriers to Fruit and Vegetable Consumption Among Low-Income Populations, North Carolina, 2011

IntroductionObesity is the leading preventable cause of illness and a major contributor to chronic disease. Eating fresh fruits and vegetables can help manage and prevent weight gain and reduce the risk of chronic diseases. Low-income communities often lack stores that sell fresh fruit and vegetables and have instead stores that sell foods low in nutritional value. The objective of this study was to understand perceived community-level barriers to fruit and vegetable consumption among low-income people.MethodsWe conducted 8 focus groups involving 68 low-income participants in 2 North Carolina counties, from May 2011 through August 2011. The socioecological model of health guided data analysis, and 2 trained researchers coded transcripts and summarized findings. Four focus groups were conducted in each county; 1 was all male, 5 all female, and 2 mixed sexes. Most participants were black (68%), most were women (69.1%), and most had a high school education or less (61.8%). Almost half received support from either the Supplemental Nutrition Assistance Program or another government assistance program.ResultsWe identified 6 major community-level barriers to access to fruits and vegetables: cost, transportation, quality, variety, changing food environment, and changing societal norms on food.ConclusionPolicymakers should consider supporting programs that decrease the cost and increase the supply of high-quality fruits and vegetables in low-income communities

Higher Right Hemisphere Gamma Band Lateralization and Suggestion of a Sensitive Period for Vocal Auditory Emotional Stimuli Recognition in Unilateral Cochlear Implant Children: An EEG Study

In deaf children, huge emphasis was given to language; however, emotional cues decoding and production appear of pivotal importance for communication capabilities. Concerning neurophysiological correlates of emotional processing, the gamma band activity appears a useful tool adopted for emotion classification and related to the conscious elaboration of emotions. Starting from these considerations, the following items have been investigated: (i) whether emotional auditory stimuli processing differs between normal-hearing (NH) children and children using a cochlear implant (CI), given the non-physiological development of the auditory system in the latter group; (ii) whether the age at CI surgery influences emotion recognition capabilities; and (iii) in light of the right hemisphere hypothesis for emotional processing, whether the CI side influences the processing of emotional cues in unilateral CI (UCI) children. To answer these matters, 9 UCI (9.47 ± 2.33 years old) and 10 NH (10.95 ± 2.11 years old) children were asked to recognize nonverbal vocalizations belonging to three emotional states: positive (achievement, amusement, contentment, relief), negative (anger, disgust, fear, sadness), and neutral (neutral, surprise). Results showed better performances in NH than UCI children in emotional states recognition. The UCI group showed increased gamma activity lateralization index (LI) (relative higher right hemisphere activity) in comparison to the NH group in response to emotional auditory cues. Moreover, LI gamma values were negatively correlated with the percentage of correct responses in emotion recognition. Such observations could be explained by a deficit in UCI children in engaging the left hemisphere for more demanding emotional task, or alternatively by a higher conscious elaboration in UCI than NH children. Additionally, for the UCI group, there was no difference between the CI side and the contralateral side in gamma activity, but a higher gamma activity in the right in comparison to the left hemisphere was found. Therefore, the CI side did not appear to influence the physiologic hemispheric lateralization of emotional processing. Finally, a negative correlation was shown between the age at the CI surgery and the percentage of correct responses in emotion recognition and then suggesting the occurrence of a sensitive period for CI surgery for best emotion recognition skills development

Race moderates the relationship between obesity and colorectal cancer screening in women

To determine if the relationship between obesity and usage of colorectal cancer (CRC) screening in women varies when stratifying by race

Cancer Screening Patterns by Weight Group and Gender for Urban African American Church Members

Obese white women have lower rates of cancer screening compared to non-obese women. This study will determine if a relationship exists between weight and adherence to cancer screening guidelines among African Americans

Using implementation mapping to refine strategies to improve implementation of an evidence-based mobile market intervention: a study protocol

Objectives The Veggie Van model is a mobile market model that is efficacious in increasing fruit and vegetable consumption for lower-income participants. The model is currently being evaluated for its effectiveness in a multi-state trial. Preliminary implementation data, collected through process measures surveys and implementation interviews, indicate that there are several barriers to implementation among partner organizations and implementation fidelity to the Veggie Van model was low. Consideration and planning for implementation ought to occur early and often throughout the research process order to ensure Veggie Van model effectiveness. This paper describes the step-by-step process for creating strategies to enhance implementation of Veggie Van model components. Methods Implementation mapping is a systematic process to develop implementation strategies through engagement with key stakeholders. We conducted a series of interviews (n = 31 representatives) with partner organizations (n = 8) to identify facilitators and barriers to Veggie Van model implementation. We then applied interview findings to an Implementation Mapping process to develop theory and practice-driven strategies to be integrated into existing implementation tools and technical assistance. Results We identified implementation outcomes (e.g., staff implement the Veggie Van model component of nutrition education with fidelity) and performance objectives (e.g., offer nutrition education, in the form of food lessons and/or food demonstrations, at least bi-weekly) to achieve them. We conducted a secondary qualitative analysis of the findings from implementation interviews with partner organizations to identify behavioral determinants (e.g., attitudinal beliefs, social support) which were combined with the performance objectives to generate change objectives (e.g., view the Veggie Van model as advantageous to an organization and communities served). To achieve the change objectives, we developed implementation strategies that would be integrated into existing Veggie Van training resources including an online toolkit, webinars and trainings, an annual mobile market conference, and technical assistance. Conclusion The development of theory and practice-driven implementation strategies will enable us to improve our implementation tools, thereby improving fidelity to the Veggie Van model among organizations and increasing the likelihood of its effectiveness. Detailing the design of a multifaceted implementation strategy using Implementation Mapping also provides a model to design similar strategies for other community-based interventions

Study of the a_0(980) meson via the radiative decay phi->eta pi^0 gamma with the KLOE detector

We have studied the phi->a_0(980) gamma process with the KLOE detector at the Frascati phi-factory DAPhNE by detecting the phi->eta pi^0 gamma decays in the final states with eta->gamma gamma and eta->pi^+ pi^- pi^0. We have measured the branching ratios for both final states: Br(phi->eta pi^0 gamma)=(7.01 +/- 0.10 +/- 0.20)x10^-5 and (7.12 +/- 0.13 +/- 0.22)x10^-5 respectively. We have also extracted the a_0(980) mass and its couplings to eta pi^0, K^+ K^-, and to the phi meson from the fit of the eta pi^0 invariant mass distributions using different phenomenological models.Comment: 17 pages, 6 figures, submitted to Physics Letters B. Corrected typos in eq.

Study of the process e+e- -> omega pi0 in the phi-meson mass region with the KLOE detector

We have studied the e+e- -> omegapi0 cross section in the sqrt(s) interval 1000-1030 MeV using the pi+pi-pi0pi0 and pi0pi0gamma final states with a sample of ~600 pb^-1 collected with the KLOE detector at DAFNE. By fitting the observed interference pattern around M_phi for both final states, we extract the ratio of the decay widths Gamma(omega->pi0gamma)/Gamma(omega->pi+pi-pi0) = 0.0897 +- 0.0016 and derive the branching fractions BR(omega -> pi+pi-pi0)= (90.24 +- 0.19)%, BR(omega -> pi0gamma) = (8.09 +- 0.14)%. The parameters describing the e+e- -> omegapi0 reaction around M_\phi are also used to extract the branching fraction for the OZI and G-parity violating phi -> omegapi0 decay: BR(phi->omegapi0) = (4.4 +- 0.6)x10^-5.Comment: 12 Pages, 4 figures, submitted to Physics Letter