Body mass index, physical activity, and dietary behaviors among members of an urban community fitness center: a questionnaire survey

<p>Abstract</p> <p>Background</p> <p>Development of effective behavioral interventions to promote weight control and physical activity among diverse, underserved populations is a public health priority. Community focused wellness organizations, such as YMCAs, could provide a unique channel with which to reach such populations. This study assessed health behaviors and related characteristics of members of an urban YMCA facility.</p> <p>Methods</p> <p>We surveyed 135 randomly selected members of an urban YMCA facility in Massachusetts to examine self-reported (1) physical activity, (2) dietary behaviors, (3) body mass index, and (4) correlates of behavior change among short-term (i.e., one year or less) and long-term (i.e., more than one year) members. Chi-square tests were used to assess bivariate associations between variables, and multivariate linear regression models were fit to examine correlates of health behaviors and weight status.</p> <p>Results</p> <p>Eighty-nine percent of short-term and 94% of long-term members reported meeting current physical activity recommendations. Only 24% of short-term and 19% of long-term members met fruit and vegetable consumption recommendations, however, and more than half were overweight or obese. Length of membership was not significantly related to weight status, dietary behaviors, or physical activity. Most respondents were interested in changing health behaviors, in the preparation stage of change, and had high levels of self-efficacy to change behaviors. Short-term members had less education (p = 0.02), lower household incomes (p = 0.02), and were less likely to identify as white (p = 0.005) than long-term members. In multivariate models, females had lower BMI than males (p = 0.003) and reported less physical activity (p = 0.008). Physical activity was also inversely associated with age (p = 0.0004) and education (p = 0.02).</p> <p>Conclusion</p> <p>Rates of overweight/obesity and fruit and vegetable consumption suggested that there is a need for a weight control intervention among members of an urban community YMCA. Membership in such a community wellness facility alone might not be sufficient to help members maintain a healthy weight. The data indicate that YMCA members are interested in making changes in their dietary and physical activity behaviors. Targeting newer YMCA members might be an effective way of reaching underserved populations. These data will help inform the development of a weight control intervention tailored to this setting.</p

Examining Patient Conceptions: A Case of Metastatic Breast Cancer in an African American Male to Female Transgender Patient

An African American male to female transgender patient treated with estrogen detected a breast lump that was confirmed by her primary care provider. The patient refused mammography and 14 months later she was diagnosed with metastatic breast cancer with spinal cord compression. We used ethnographic interviews and observations to elicit the patient’s conceptions of her illness and actions. The patient identified herself as biologically male and socially female; she thought that the former protected her against breast cancer; she had fears that excision would make a breast tumor spread; and she believed injectable estrogens were less likely than oral estrogens to cause cancer. Analysis suggests dissociation between the patient’s social and biological identities, fear and fatalism around cancer screening, and legitimization of injectable hormones. This case emphasizes the importance of eliciting and interpreting a patient’s conceptions of health and illness when discordant understandings develop between patient and physician

College campus smoking policies and programs and students' smoking behaviors

BACKGROUND: Although tobacco use in the United States has declined over the past 20 years, cigarette use among college students remains high. Additional research is thus needed to determine how university tobacco control policies and preventive education programs affect college students' smoking behaviors. METHODS: Approximately 13,000 undergraduate students at 12 universities or colleges in the state of Texas completed a web-based survey. College smoking policies were obtained from a survey of college administrators and from college websites. Logistic regression analyses were conducted to estimate the effects of individual smoking policies and programs on the odds of cigarette smoking. RESULTS: Of the individual programs, only having a preventive education program on campus was associated with lower odds of smoking. The existence of smoking cessation programs and designated smoking areas were associated with higher odds of smoking. Policies governing the sale and distribution of cigarettes were insignificantly associated with smoking. CONCLUSION: Rather than focusing on policies restricting cigarette sales and use, college administrators should consider implementing or expanding tobacco prevention and education programs to further reduce student smoking rates

Spirituality as an Essential Determinant for the Good Life, its Importance Relative to Self-Determinant Psychological Needs

This study focuses on the relevance of spirituality as an essential element for the Good Life. Despite spirituality’s prominence in people’s lives and cultures, it has been mostly neglected in psychological needs theories. This paper investigates the value of spirituality compared to that of the three basic psychological needs of self-determination theory: relatedness, competence and autonomy. In a scenario study design, participants in two samples (students and train passengers) were asked to judge a survey on the personal well-being of an imaginary person. The results show that spirituality positively contributes to the qualification of a good life, in terms of desirability and moral goodness. In addition, the crucial role of relatedness was confirmed

Colorectal cancer prevention for low-income, sociodemographically-diverse adults in public housing: baseline findings of a randomized controlled trial

Background: This paper presents the study design, intervention components, and baseline data from Open Doors to Health, a study designed to address social contextual factors in colorectal cancer (CRC) prevention for low-income, racial/ethnic minority populations. Methods: A cluster randomized design with 12 housing sites as the primary sampling units was used: 6 sites were assigned to a Peer-led plus Screening Access (PL) condition, and 6 were assigned to Screening Access only (SCR) condition. Study-related outcomes were CRC screening, physical activity (measured as mean steps/day), and multivitamin use. Results: At baseline (unweighted sample size = 1554), two-thirds self-reported that they were current with screening recommendations for CRC (corrected for medical records validation, prevalence was 52%), with half having received a colonoscopy (54%); 96% had health insurance. Mean steps per day was 5648 (se mean = 224), and on average 28% of the sample reported regular multivitamin use. Residents reported high levels of social support [mean = 4.40 (se = .03)] and moderately extensive social networks [mean = 2.66 (se = .02)]. Conclusion: Few studies have conducted community-based studies in public housing communities; these data suggest areas for improvement and future opportunities for intervention development and dissemination. Findings from the randomized trial will determine the effectiveness of the intervention on our health-related outcomes as well as inform future avenues of research

Correlates of cigarette smoking among male college students in Karachi, Pakistan

<p>Abstract</p> <p>Background</p> <p>About 1.3 billion people are regular smokers world wide and every day between 8,200 and 9,900 young people start to smoke, risking rapid addiction to nicotine. Transition from high school to college is a critical period to adopt healthy habits and life style. Therefore, it is important to understand the factors that might influence their smoking habit. Our study aims to assess the influence of factors that encourage college students to smoke cigarettes.</p> <p>Methods</p> <p>The data used in this survey were obtained from a representative sample of registered colleges of Karachi. A random sample of 576 male college students of ages ranging from 15–30 years was interviewed using a questionnaire administered by survey officers, by applying multi stage cluster sampling during the academic year 2004–2005.</p> <p>Results</p> <p>In this study, we found 26.7% of students had ever tried smoking, whereas 24%(95% CI: 21.0%–28.0%) of college students reported current smoking (that is whether one had smoked a cigarette in past 30 days). Among different age groups, prevalence of current smoking was 19.2% in 15–17 years, 26.5% in 18–20 years and 65% in 21 years and above. After adjusting for age of respondent, students in public schools were more likely to smoke as compared to students in private schools (adjusted OR = 2.3; 95% CI: 1.3–4.2). Students whose friends are smokers were 5 times more likely to smoke compared to those whose friends are non-smokers (adjusted OR = 4.8; 95%CI: 3.1 – 7.4). Those students having fathers with no formal schooling were more likely to smoke (adjusted OR = 2.2; 95% CI: 1.1–4.2) as compared to those whose fathers had some degree of education. Students having non-working mothers were more likely to smoke as compared to students with working mothers (adjusted OR = 2.8; 95% CI: 0.9–9.1). Students belonging to Bin Qasim (adjusted OR = 2.1; 95% C.I: 1.1–4.1) and Gadap town (adjusted OR = 2.1; 95%C.I) were more likely to smoke as compared to students residing in other towns.</p> <p>Conclusion</p> <p>This study shows that smoking is strongly associated with age, which may suggest social tolerance to smoking in this setting and that social and educational variables appear to play a significant role in smoking among college students. Our study suggests that such factors should be taken into account when designing effective tobacco control programs among college students. This is an effort which has been done to reduce tobacco consumption among college students and introduce awareness programs to amend their health risk behavior.</p

Demographic, social cognitive and social ecological predictors of intention and participation in screening for colorectal cancer

Extent: 10p.Background: Previous research points to differences between predictors of intention to screen for colorectal cancer (CRC) and screening behavior, and suggests social ecological factors may influence screening behavior. The aim of this study was to compare the social cognitive and social ecological predictors of intention to screen with predictors of participation. Methods: People aged 50 to 74 years recruited from the electoral roll completed a baseline survey (n = 376) and were subsequently invited to complete an immunochemical faecal occult blood test (iFOBT). Results: Multivariate analyses revealed five predictors of intention to screen and two predictors of participation. Perceived barriers to CRC screening and perceived benefits of CRC screening were the only predictor of both outcomes. There was little support for social ecological factors, but measurement problems may have impacted this finding. Conclusions: This study has confirmed that the predictors of intention to screen for CRC and screening behaviour, although overlapping, are not the same. Research should focus predominantly on those factors shown to predict participation. Perceptions about the barriers to screening and benefits of screening are key predictors of participation, and provide a focus for intervention programs.Tess A Gregory, Carlene Wilson, Amy Duncan, Deborah Turnbull, Stephen R Cole and Graeme Youn

Understanding young adult physical activity, alcohol and tobacco use in community colleges and 4-year post-secondary institutions: A cross-sectional analysis of epidemiological surveillance data

<p>Abstract</p> <p>Background</p> <p>Young adults experience many adverse health behavior changes as they transition from adolescence into adulthood. A better understanding of the relationships between health promoting and risky health behaviors may aid in the development of health promotion interventions for various types of young adult post-secondary students. Therefore, the purpose of this study was to examine associations between alcohol and tobacco use and physical activity among 2-year and 4-year college students.</p> <p>Methods</p> <p>Cross-sectional analyses were conducted using 2007 survey data, collected as part of an on-going post-secondary health surveillance system in Minnesota. Students were randomly selected to participant from 14 Minnesota colleges and universities (six 2-year community and/or technical colleges, eight 4-year post-secondary institutions). The 2007 surveillance data included 9,931 respondents.</p> <p>Results</p> <p>The prevalence of demographic characteristics and health behaviors (e.g., physical activity, tobacco use) differed between young adults attending 2-year and 4-year post-secondary institutions; in general, those attending 2-year institutions are representative of more at-risk populations. Overall, higher levels of moderate, vigorous and strengthening physical activity were associated with higher levels of alcohol consumption and lower levels of smoking. In general, despite the disparities in the prevalence of these risk behaviors, the associations between the behaviors did not differ substantially between 2-year and 4-year post-secondary populations.</p> <p>Conclusions</p> <p>These findings illustrate links between leading risk behaviors. Interventions targeting multiple risk behaviors among young adults may warrant further consideration. Overall, future research is needed to support and inform young adult health promotion efforts that may be implemented in a wide array of post-secondary institutions.</p

Design of a randomized controlled trial for multiple cancer risk behaviors among Spanish-speaking Mexican-origin smokers

Background: Smoking, poor diet, and physical inactivity account for as much as 60% of cancer risk. Latinos experience profound disparities in health behaviors, as well as the cancers associated with them. Currently, there is a dearth of controlled trials addressing these health behaviors among Latinos. Further, to the best of our knowledge, no studies address all three behaviors simultaneously, are culturally sensitive, and are guided by formative work with the target population. Latinos represent 14% of the U. S. population and are the fastest growing minority group in the country. Efforts to intervene on these important lifestyle factors among Latinos may accelerate the elimination of cancer-related health disparities

Complementary and alternative medicine use among women at increased genetic risk of breast and ovarian cancer

<p>Abstract</p> <p>Background</p> <p>Complementary and alternative medicine (CAM) use is well documented among breast cancer patients and survivors, but little evidence is available to describe rates and patterns of use among women at increased genetic risk of breast cancer.</p> <p>Methods</p> <p>A pre-visit telephone interview was conducted to ascertain CAM use among the <it>BRCA </it>mutation carriers enrolled in a high-risk breast cancer screening study. Participants were asked to report on their use of thirteen therapies within the year prior to enrollment into the study. Logistic regression was used to evaluate the association between various factors and CAM use in this population.</p> <p>Results</p> <p>Among the 164 <it>BRCA1 </it>or <it>BRCA2 </it>mutation-positive (<it>BRCA</it>+) women in this analysis, 78% reported CAM use, with prayer and lifestyle diet being the two most commonly reported modalities. Many subjects used multiple CAM therapies, with 34% reporting use of three or more modalities. The most commonly used modalities were mind-body therapies and biologically-based practices, 61.6% and 51.8%, respectively. High-risk women were more likely to use CAM if they were older, more educated, more worried about ovarian cancer risk, or had a previous cancer diagnosis.</p> <p>Conclusion</p> <p>This study suggests that the prevalence of CAM use is high among <it>BRCA </it>mutation carriers, with frequency of use comparable to that of breast cancer patients and survivors. Given the high prevalence of CAM use in our subjects, especially biologically-based therapies including herbal supplements, whose safety and efficacy in relation to cancer risk are unknown, our study suggests that future research is necessary to clarify these risks, and that it is important for providers to inquire about and to discuss the pros and cons of CAM use with their <it>BRCA+ </it>patients.</p