Non-Traditional Predictors to Evaluate Dropout Rates

High attrition rates from community participatory research studies need to be explored more by non-traditional methods and participant profiles need to be developed to prevent high attrition rates. The purpose of this dissertation is to characterize compliance and drop out rates using the cardiovascular disease IQ quiz and the life priorities questionnaire. It is important to examine both compliance and dropouts in this context because both diabetes and cardiovascular disease are emerging as a major focus of public health efforts in the United States and abroad. These diseases are accelerating due to the current trends in obesity, which is a preventable, modifiable risk factor for diabetes and cardiovascular disease. Diabetes and cardiovascular disease continue to be the number seven and number one leading causes of death, respectively. We explore these concepts in a largely Hispanic border community in the Southwest, in the small town of Douglas, Arizona. The Hispanic population is increasing in the United States and is now the most populous minority group. Additionally, among this group are some of the highest rates of pre-diabetes, diabetes, and uncontrolled diabetes, all cardiovascular disease risk factors. We found that the cardiovascular disease IQ quiz was a much stronger predictor for compliance and drop out rates in this sample population than the life priorities questionnaire. Compliance did not seem to differ among the study participants who remained in the study. Interestingly, among the participants who were compliant, especially those who kept their eye check-up, were also those more likely to have health insurance and be employed. Though males only represented about 10% of the population sample, they tended to drop out more frequently than females. Dropouts tended to be younger, gainfully employed, and more educated. Qualitative analysis and logistic regression will further help explain the aforementioned associations

The role of fathers in child development from preconception to postnatal influences: Opportunities for the National Institutes of Health Environmental influences on Child Health Outcomes (ECHO) program

A growing body of literature highlights the important role of paternal health and socio-emotional characteristics in child development, from preconception through adolescence. Much of this research addresses the indirect effects of fathers, for instance their influence on maternal behaviors during the prenatal period or via the relationship with their partner. However, emerging evidence also recognizes the direct role of paternal health and behavior for child health and adjustment across development. This critical review presents evidence of biological and sociocultural influences of fathers on preconception, prenatal, and postnatal contributions to child development. The National Institutes of Health Environmental influences on Child Health Outcomes (ECHO) program incorporates in its central conceptualization the impact of fathers on family and child outcomes. This critical synthesis of the literature focuses on three specific child outcomes in the ECHO program: health outcomes (e.g., obesity), neurodevelopmental outcomes (e.g., emotional, behavioral, psychopathological development), and positive health. We highlight the unique insights gained from the literature to date and provide next steps for future studies on paternal influences

Understanding the Cellular and Molecular Mechanisms of Physical Activity-Induced Health Benefits.

The beneficial effects of physical activity (PA) are well documented, yet the mechanisms by which PA prevents disease and improves health outcomes are poorly understood. To identify major gaps in knowledge and potential strategies for catalyzing progress in the field, the NIH convened a workshop in late October 2014 entitled "Understanding the Cellular and Molecular Mechanisms of Physical Activity-Induced Health Benefits." Presentations and discussions emphasized the challenges imposed by the integrative and intermittent nature of PA, the tremendous discovery potential of applying "-omics" technologies to understand interorgan crosstalk and biological networking systems during PA, and the need to establish an infrastructure of clinical trial sites with sufficient expertise to incorporate mechanistic outcome measures into adequately sized human PA trials. Identification of the mechanisms that underlie the link between PA and improved health holds extraordinary promise for discovery of novel therapeutic targets and development of personalized exercise medicine

Understanding childhood obesity in the US: the NIH environmental influences on child health outcomes (ECHO) program

BACKGROUND: Few resources exist for prospective, longitudinal analysis of the relationships between early life environment and later obesity in large diverse samples of children in the United States (US). In 2016, the National Institutes of Health launched the Environmental influences on Child Health Outcomes (ECHO) program to investigate influences of environmental exposures on child health and development. We describe demographics and overweight and obesity prevalence in ECHO, and ECHO\u27s potential as a resource for understanding how early life environmental factors affect obesity risk. METHODS: In this cross-sectional study of 70 extant US and Puerto Rico cohorts, 2003-2017, we examined age, race/ethnicity, and sex in children with body mass index (BMI) data, including 28,507 full-term post-birth to38,332 aged 2-18 years. Main outcomes included high BMI for age \u3c2 \u3eyears, and at 2-18 years overweight (BMI 85th to \u3c95th \u3epercentile), obesity (BMI ≥ 95th percentile), and severe obesity (BMI ≥ 120% of 95th percentile). RESULTS: The study population had diverse race/ethnicity and maternal demographics. Each outcome was more common with increasing age and varied with race/ethnicity. High BMI prevalence (95% CI) was 4.7% (3.5, 6.0) \u3c1 \u3eyear, and 10.6% (7.4, 13.7) for 1 to \u3c2 \u3eyears; overweight prevalence increased from 13.9% (12.4, 15.9) at 2-3 years to 19.9% (11.7, 28.2) at 12 to\u27high\u27 BMI ranging from 1.2 to 2.2 for a wide range of exposure prevalences (1-50%) within each age group. CONCLUSIONS: ECHO is a powerful resource for understanding influences of chemical, biological, social, natural, and built environments on onset and trajectories of obesity in US children. The large sample size of ECHO cohorts adopting a standardized protocol for new data collection of varied exposures along with longitudinal assessments will allow refined analyses to identify drivers of childhood obesity

Understanding the Cellular and Molecular Mechanisms of Physical Activity-Induced Health Benefits

The beneficial effects of physical activity (PA) are well documented, yet the mechanisms by which PA prevents disease and improves health outcomes are poorly understood. To identify major gaps in knowledge and potential strategies for catalyzing progress in the field, the NIH convened a workshop in late October 2014 entitled “Understanding the Cellular and Molecular Mechanisms of Physical Activity-Induced Health Benefits.” Presentations and discussions emphasized the challenges imposed by the integrative and intermittent nature of PA, the tremendous discovery potential of applying “-omics” technologies to understand interorgan crosstalk and biological networking systems during PA, and the need to establish an infrastructure of clinical trial sites with sufficient expertise to incorporate mechanistic outcome measures into adequately sized human PA trials. Identification of the mechanisms that underlie the link between PA and improved health holds extraordinary promise for discovery of novel therapeutic targets and development of personalized exercise medicine