Solving the Obesity Epidemic in African American and Hispanic Communities: Voices from the Community

Purpose: Science & Community: Ending Obesity Improving Health (Science & Community) aimed at reducing obesity in Houston by developing partnerships and collaborating with community organizations to identify community research priorities and develop an obesity reduction program. Method: Partnership members were recruited from Science & Community events and invited to participate in in-depth interviews to gain insight on obesity prevalence, causes, and solutions. Partnership and community members (N=22) completed a 60-90 minute in-depth interview with a trained Science & Community team member. The interview guide consisted of 30 questions about pressing health problems in the community, potential solutions to health problems and obesity, and how the environment has impacted obesity and health behaviors in the community. Interviews were led by trained researchers and were transcribed by an external medical transcription company. Transcribed interviews were coded independently by two coders in ATLAS.ti version 6.2. Results: Interviewees (n=12 women and 10 men) were mostly Hispanic or Latino (n=9) and African American (n=7). Common problems identified by interviewees were childhood obesity, balancing a healthy diet, and physical inactivity. Interviewees identified obesity as a major problem in their communities and cited access to quality food and physical activity resources as both the problem and a solution. Additional emergent themes focused on solutions and included increasing awareness and education, coordinated efforts among organizations and using an ecologic approach to combat obesity. Conclusions: Community insight gleaned from this study be used to enhance relevance and sustainability of programs developed to reduce obesity and suggests possible avenues for participatory research and intervention

Us adolescent Rest-Activity Patterns: insights From Functional Principal Component analysis (Nhanes 2011-2014)

BACKGROUND: Suboptimal rest-activity patterns in adolescence are associated with worse health outcomes in adulthood. Understanding sociodemographic factors associated with rest-activity rhythms may help identify subgroups who may benefit from interventions. This study aimed to investigate the association of rest-activity rhythm with demographic and socioeconomic characteristics in adolescents. METHODS: Using cross-sectional data from the nationally representative National Health and Nutrition Examination Survey (NHANES) 2011-2014 adolescents (N = 1814), this study derived rest-activity profiles from 7-day 24-hour accelerometer data using functional principal component analysis. Multiple linear regression was used to assess the association between participant characteristics and rest-activity profiles. Weekday and weekend specific analyses were performed in addition to the overall analysis. RESULTS: Four rest-activity rhythm profiles were identified, which explained a total of 82.7% of variance in the study sample, including (1) High amplitude profile; (2) Early activity window profile; (3) Early activity peak profile; and (4) Prolonged activity/reduced rest window profile. The rest-activity profiles were associated with subgroups of age, sex, race/ethnicity, and household income. On average, older age was associated with a lower value for the high amplitude and early activity window profiles, but a higher value for the early activity peak and prolonged activity/reduced rest window profiles. Compared to boys, girls had a higher value for the prolonged activity/reduced rest window profiles. When compared to Non-Hispanic White adolescents, Asian showed a lower value for the high amplitude profile, Mexican American group showed a higher value for the early activity window profile, and the Non-Hispanic Black group showed a higher value for the prolonged activity/reduced rest window profiles. Adolescents reported the lowest household income had the lowest average value for the early activity window profile. CONCLUSIONS: This study characterized main rest-activity profiles among the US adolescents, and demonstrated that demographic and socioeconomic status factors may shape rest-activity behaviors in this population

Using the RE-AIM framework to evaluate physical activity public health programs in México

Background: Physical activity (PA) public health programming has been widely used in Mexico; however, few studies have documented individual and organizational factors that might be used to evaluate their public health impact. The RE-AIM framework is an evaluation tool that examines individual and organizational factors of public health programs. The purpose of this study was to use the RE-AIM framework to determine the degree to which PA programs in Mexico reported individual and organizational factors and to investigate whether reporting differed by the program's funding source. Methods: Public health programs promoting PA were systematically identified during 2008-2013 and had to have an active program website. Initial searches produced 23 possible programs with 12 meeting inclusion criteria. A coding sheet was developed to capture behavioral, outcome and RE-AIM indicators from program websites. Results: In addition to targeting PA, five (42%) programs also targeted dietary habits and the most commonly reported outcome was change in body composition (58%). Programs reported an average of 11.1 (±3.9) RE-AIM indicator items (out of 27 total). On average, 45% reported reach indicators, 34% reported efficacy/effectiveness indicators, 60% reported adoption indicators, 40% reported implementation indicators, and 35% reported maintenance indicators. The proportion of RE-AIM indicators reported did not differ significantly for programs that were government supported (M∈=∈10, SD∈=∈3.1) and programs that were partially or wholly privately or corporately supported (M∈=∈12.0, SD∈=∈4.4). Conclusion: While reach and adoption of these programs were most commonly reported, there is a need for stronger evaluation of behavioral and health outcomes before the public health impact of these programs can be established. © 2015 Jauregui et al.; licensee BioMed Central

The impact of religiosity on dietary habits and physical activity in minority women participating in the Health is Power (HIP) study

African American (AA) and Hispanic/Latina (HL) women report lower rates of physical activity (PA) and poorer dietary habits compared to their white counterparts. Religiosity can act as a protective factor for health; however, the relationship between religiosity, PA, and diet is unclear. This study aimed to investigate the influence of religiosity on PA and fruit and vegetable (FV) and fat consumption in minority women. Health is Power (HIP) was a 6-month intervention where participants (AA: 63%; HL: 37%) were randomized to a PA or FV group. Questionnaires assessed religiosity at baseline and PA, FV and fat consumption at baseline and post-intervention. Hierarchical linear regression models were used to investigate religiosity as a predictor of change in PA, FV and fat, while controlling for demographics. AA women had significantly higher religiosity scores (M = 44.15, SD = 10.66) compared to H/L women (M = 35.11, SD = 12.82; t(251) = 5.86, p < 0.001). Across both groups, PA increased by 15%, FV intake increased by 27%, and consumption of calories by fat decreased by 5%. Religiosity was not a significant predictor of PA or diet (p < 0.05). The results of this study found no association between religiosity and change in PA and diet. More longitudinal studies are needed to explore the role of religiosity in the health of minority women

Associations between objective and self-report measures of traffic and crime safety in Latino parents of preschool children

Differences in subjective and objective safety may be explained by moderators that shape parental perceptions of the environment. This study examined associations between subjective and objective measures of traffic and crime safety in preschool parents (N = 240) and potential moderators. Community cohesion, social control, and physical activity parenting practices were measured. Objective measures of crime and traffic were measured at the block-group level. Linear models revealed perceived traffic was negatively associated with the traffic hazards (b = −0.03; 95 % CI: −0.05, −0.01; p = .041). Acculturation moderated the relationship between perceptions of disorder and crime (b = 0.001; 95 % CI: 0.000, 0.003; p = .044). Poor community cohesion moderated the relationship between perceptions of disorder and crime (b = 0.0015; 95 % CI: 0.0002, 0.0028; p = .028). Perceived traffic safety was associated with the traffic hazard index in parents of boys (b = −0.04; 95 % CI: −0.07, −0.01; p = .027). Acculturation and community cohesion can be used to align misperceptions of safety to actual safety to promote outdoor play

Technology-Based Obesity Prevention Interventions Among Hispanic Adolescents in the United States: Scoping Review

BackgroundGiven that today’s adolescents are digital front-runners, technology-based obesity prevention strategies are age-appropriate for this population. The use of remote and wireless technologies may be suitable for extending the reach and engagement of obesity prevention efforts among high-risk Hispanic youths, as this subgroup is disproportionately affected by barriers that limit participation in traditional, in-person interventions. ObjectiveThe purpose of this scoping review was to examine the intervention and sample characteristics of technology-based obesity prevention interventions among Hispanic adolescents. We also examined feasibility criteria to assess the acceptability and appropriateness of technology-based strategies among Hispanic youths. MethodsA comprehensive search of Embase and PubMed identified 7 studies that met the inclusion criteria. Data were extracted by 2 independent reviewers. ResultsOf the 7 included studies, half (n=4, 57%) used a randomized control trial design, with equal implementation in school (n=3, 43%) and clinic (n=4, 57%) settings. Studies commonly targeted improvements in diet (n=4, 57%) and physical activity (n=7, 100%), with only 1 (14%) study focused on sedentary behaviors. Just 2 (29%) studies reported the use of behavioral theories or models. Studies focused primarily on youths in early (n=5, 71%) or middle (n=6, 86%) adolescence, and there was limited information reported on socioeconomic status. Only 3 (43%) study conducted formative work, and few (n=3, 43%) reported on acceptability. Only 1 (14%) study reported that materials were available in Spanish and English, and only 1 (14%) study used culturally tailored content. Additionally, 3 (43%) studies used strategies that considered social determinants of health. ConclusionsTo increase our understanding of the feasibility and effectiveness of technology-based obesity prevention strategies among Hispanic adolescents, there is a need for more feasibility studies that are theoretically grounded and comprehensively report on feasibility-related outcomes. Future studies should also leverage technology to simultaneously address multiple health behaviors beyond diet and physical activity. The result of this review can be used to guide the development of future technology-based obesity prevention strategies among Hispanic adolescents. Trial RegistrationCliniclaTrials.gov NCT04953442; https://clinicaltrials.gov/ct2/show/NCT0495344

Physical Activity Resource and User Characteristics in Puerto Vallarta, Mexico

Physical activity resources (PARs) are valuable settings for physical activity (PA) in Latin countries. PAR quality, amenities, and features are strongly associated with PA. However, the relationship between PAR characteristics and PAR usege has not been investigated in Mexico. This study aimed to describe and evaluate PARs and their association with PAR users and determine whether user and PAR characteristics differed by resource type, proximity to the ocean, or neighborhood socioeconomic status (SES) status in Puerto Vallarta, Mexico. Assessed PARs (N=8) included parks (N=5), a freestanding plaza (N=1), and plazas combined with a park (N=2).The Physical Activity Resource Assessment (PARA ©2010) was used to evaluate PAR amenities, features, and incivilities. The PARA was adapted to include plazas and open green spaces to reflect cultural and land use differences in Mexico. The System for Observing Play and Recreation in Communities (SOPARC) was used to code the age, gender, and ethnicity of each user. Descriptive analyses were used to describe PARs and users. Correlations among PAR characteristics and users were investigated. T-tests and one-way ANOVAs were used to determine whether PAR and user characteristics differed by PAR type. All PARs were accessible, free for use, about the size of a city block, and were on average, 1.9 kilometers from the water (SD=1.3, Range=.1-3.2). PARs had an average of 4.4 amenities (SD=1.6), 2.5 features (SD=1.4), and 3.5 incivilities (SD=2.1). The quality of amenities (Range=0-39, M=11.0, SD=4.8) and features (Range=0-36, M=6.4, SD=3.6) was low, and severity of incivilities was high (Range=0-36, M=29.9, SD=4.1). Eighty-one users (60.5% men) were observed, with plazas attracting more users (m=38.0) than parks (m=6.8) or combination resources (m=4.5). PAR users were mostly adults (59.2%), with some children (28.4%) and few adolescents (12.4%). The quality of amenities was correlated with the total number of users (r=.74, p=.04). There were no differences in count or quality of amenities, features, or incivilities (ps>.05) by resource type. The plaza attracted more women compared to parks and combination resources (F=15.84, df=2.5, p=.01). More adolescents (F=7.29, df=2.5, p=.03) and adults (F=14.64, df=2.5, p=.01) were observed at the plaza compared to the parks or combination resources. PARs were highly accessible, yet the presence and quality of amenities and features was poor and incivilities were high. Parks were most common; however, the plaza attracted the most users, including women, teens, and adults. Findings indicate that increasing the quality of amenities may be an effective strategy for promoting PA. Poor quality of amenities and features may have limited the ability to detect associations with users.Antecedentes: Los recursos de actividad física (RsAF) son ámbitos de valor para la actividad física (AF) en los países latinos. La calidad, comodidades y características de los RAF están fuertemente asociadas con la AF. Sin embargo, la relación entre las características y el uso de los RAF no se han investigado en México. Objetivo: Este estudio tuvo como objetivo describir y evaluar los RAF y su asociación con los usuarios de los RAF, y determinar si los usuarios y las características de los RAF difieren por tipo de recurso, la proximidad al mar, o el nivel socioeconómico del vecindario, en el estado de Puerto Vallarta, México. Métodos: Los RsAF fueron evaluados (N = 8) incluyendo parques (N = 5), una plaza independiente (N = 1), y plazas combinadas con un parque (N = 2). La Evaluación de los Recursos de Actividad física (PARA © 2010) fue usada para evaluar las comodidades, las características y los actos incívicos de los RAF. El PARA fue adaptado para incluir plazas y espacios verdes para reflejar las diferencias culturales y el uso de la tierra en México. El Sistema de Observación de Juego y Recreación en Comunidades (SOPARC) se utilizó para codificar la edad, el género y la etnia de cada usuario. Los análisis descriptivos fueron usados para describir los RsAF y los usuarios. Se investigaron las correlaciones entre los usuarios y las características de los RAF. Se utilizaron Pruebas T y un ANOVAs unidireccional para determinar si las características del usuario y las características de los RAF diferían según el tipo de RAF. Resultados: Todos los RAF eran accesibles, gratis para su uso, aproximadamente del tamaño de una manzana de la ciudad, y estaban, de promedio, a 1,9 km del agua (SD = 1.3, rango = .1-3.2). Los RAF tenían una media de 4.4 instalaciones (SD = 1.6), 2.5 características (SD = 1.4) y 3.5 actos incívicos (DE = 2.1). La calidad de las instalaciones (Rango = 0-39, M = 11.0, SD = 4.8) y características (rango = 0-36, M = 6.4, SD = 3.6) fueron bajas, y la gravedad de los actos incívicos fue alta (gama = 0- 36, M = 29,9, SD = 4.1). Ochenta y un usuarios (60.5% varones) fueron observados, las plazas atraen a más usuarios (m = 38.0) que los parques (m = 6.8) o recursos combinados (m = 4.5). Los usuarios de los RAF eran en su mayoría adultos (59.2%) con algunos niños (28.4%) y pocos adolescentes (12.4%). El número total de usuarios se correlacionó con la calidad de las instalaciones (r = 0,74, p = 0,04). No hubo diferencias en el recuento o la calidad de las instalaciones, características o actos incívicos (p> .05) por tipo de recurso. La plaza atrajo a más mujeres en comparación con los parques y los recursos combinados (F = 15,84, df = 2,5; p = 0,01). Más adolescentes (F = 7.29, df = 2.5; p = 3.) y adultos (F = 14.64, df = 2.5; p = .01) se observaron en la plaza frente a los parques o recursos combinados. Conclusiones: Los RAF eran muy accesibles, sin embargo, la presencia y calidad de instalaciones y servicios fue deficiente y los actos incívicos eran altos. Los parques fueron más comunes; sin embargo, la plaza atrajo la mayor cantidad de usuarios, incluidas las mujeres, adolescentes y adultos. Los resultados indican que el aumento de la calidad de las instalaciones puede ser una estrategia eficaz para promover la AF. La mala calidad de las instalaciones y servicios puede haber limitado la capacidad de detectar asociaciones con los usuario