Community level factors and racial inequities in delivery hospitalizations involving severe maternal morbidity in the United States, 2016-2019.

The objective of this study was to evaluate the racial and ethnic disparities in delivery hospitalizations involving severe maternal morbidity (SMM) by location of residence and community income. We used the 2016 to 2019 Healthcare Cost and Utilization Project National Inpatient Sample. International Classification of Diseases, Tenth Revision, Clinical Modification codes were used to identify delivery hospitalizations with SMM. Using logistic regression models, we examined the association between race and ethnicity and delivery hospitalizations involving SMM. In adjusted analyses, the models were stratified by location of residence and community income and adjusted for patient and hospital characteristics. In rural areas, non-Hispanic Black women (AOR 1.50; 95% CI 1.25-1.79) and women of other races (AOR 1.32; 95% CI 1.03-1.69) had an increased odds of experiencing a delivery hospitalization involving SMM when compared to non-Hispanic White women. In micropolitan areas, non-Hispanic Black women (AOR 1.88; 95% CI 1.79-1.97), non-Hispanic Asian/Pacific Islander women (AOR 1.54; 95% CI 1.16-2.05), and women of other races (AOR 1.31; 95% CI 1.03-1.67) had an increased odds of experiencing a delivery hospitalization involving SMM when compared to non-Hispanic White women. Non-Hispanic Black women also had increased odds of experiencing a delivery hospitalization involving SMM in communities with the lowest income (quartile 1) (AOR 1.59; 95% CI 1.49-1.66), middle income (quartiles 2 and 3) (AOR 1.81; 95% CI 1.72-1.91), and highest income (AOR 2.09; 95% CI 1.90-2.29) when compared to non-Hispanic White women. We found that location of residence and community income are associated with racial and ethnic differences in SMM in the United States. These factors, outside of individual factors assessed in previous studies, provide a better understanding of some of the structural and systemic factors that may contribute to SMM.

Association Between Weight Promoting Medication Use and Weight Status Among Children and Adolescents in the United States.

OBJECTIVES: The objectives of this study were to 1) examine the prevalence of prescription medication use overall and 2) examine the association between weight promoting medication (WPM) use by therapeutic class and weight status among a nationally representative sample of the children and adolescents in the United States. This study also further investigated antidepressant medication use among this population. METHODS: This cross-sectional study used data from the National Health and Nutrition Examination Survey from 2013 to 2018. Children and adolescents ages 2 to 19 years were included in this study. RESULTS: Of the 68,057,468 derived participants (34,507,154 [50.7%] male; 33,564,059 [49.3%] aged 2-10 years; 34,905,058 [51.3%] non-Hispanic White), 14,895,618 (22.2%) used a prescription medication in the prior 30 days, 21.7% (3,235,323) of which were considered weight promoting. There was no significant difference between weight status and WPM use for overall prescription medication use. Nevertheless, for overall antidepressant medication use, those with obesity were less likely to be prescribed antidepressant WPM when compared to those with normal weight (adjusted odds ratios 0.4; 95% confidence interval 0.2-0.7). CONCLUSIONS: These findings suggest that although there was no significant association between WPM use and weight status overall when examining the association by therapeutic class, most children with obesity were not using antidepressant WPM. This is reassuring and potentially an active attempt at avoiding the use of medications that have an exacerbating effect on weight gain. When choosing antidepressant medications, providers, parents, and patients consider the WPM effects and appropriately choose a medication best suited to the child's health status.

Obesity and Eligibility for Obesity Treatments Among Adults With Disabilities in the U.S.

INTRODUCTION: Obesity has been associated with disability; yet, the proportion who meet clinical criteria for obesity treatment among adults with disabilities remains poorly defined. Characterization of obesity and treatment eligibility by disability type may prioritize high-need groups. This study assessed the prevalence of obesity and eligibility for antiobesity pharmacotherapy and/or bariatric surgery in adults with disability. METHODS: This cross-sectional weighted analysis of the 2019 National Health Interview Survey, including self-reported health and sociodemographic information, was conducted in 2021. Burden of obesity defined by BMI and odds of meeting consensus criteria for antiobesity pharmacotherapy and/or surgery were calculated by functional disability type: vision, hearing, cognition, communication, mobility, and self-care. RESULTS: From 29,170 community-dwelling adult respondents (59.1% response), the overall prevalence of disability was 10%. The prevalence of obesity among adults with a disability was 40.1% vs 30.5% for U.S. adults overall (p<0.0001). An estimated 17.1% with disability met the criteria for both bariatric surgery and antiobesity pharmacotherapy; another 39.8% were eligible for pharmacotherapy alone (vs 7.9% and 33.2%, respectively, for adults overall; p<0.0001). In fully adjusted models, disability was associated with greater ORs for mild obesity (OR=1.2; 95% CI=1.1, 1.4), moderate‒severe obesity (OR=2.1; 95% CI=1.8, 2.3), and criteria for bariatric surgery (OR=2.4; 95% CI=2.1, 2.7) and pharmacotherapy (OR=1.3; 95% CI=1.2, 1.4). Mobility, self-care, and cognition disabilities were associated with eligibility for bariatric surgery and antiobesity pharmacotherapy. CONCLUSIONS: Individuals with disabilities have higher odds of obesity and eligibility for antiobesity treatments. Comorbidities should be considered, accommodations should be provided, and insurance coverage should be expanded to ensure access to antiobesity treatments for adults with disabilities.

Treatment of Obesity: Pharmacotherapy Trends of Office-Based Visits in the United States From 2011 to 2016.

OBJECTIVE: To examine pharmacotherapy for obesity in the United States from 2011 to 2016 using a large, nationally representative sample. METHODS: Data were obtained during 6 years, 2011 to 2016, from the National Ambulatory Medical Care Survey. There were 3 types of visits identified: patients with obesity and an antiobesity drug mention; patients with obesity and no antiobesity drug mention; and patients without obesity and with antiobesity drug mention. The χ2 test was used to compare characteristics across each type of visit. To predict the odds of an antiobesity medication mention for patients with obesity, a logistic regression analysis was conducted. RESULTS: Of the overall weighted 196,872,870 office-based physician visits made by patients with obesity from 2011 to 2016, 1% mentioned an antiobesity drug. In addition, there were 760,470 office-based physician visits by patients without obesity but with an antiobesity medication mention. An antiobesity drug mention was more likely for those aged 51 years or older and those residing in the South (adjusted odds ratio, 5.31 95% CI, 1.19 to 23.59). CONCLUSION: There was a slight increase in antiobesity medication mentions, from 0.26% in 2011 to 0.28% in 2016, but only 1% of office-based visits for patients with obesity received a prescription for an antiobesity medication. Physicians tended to prescribe antiobesity medications to those with obesity aged 51 years or older and residing in the South. Antiobesity medication for treatment of obesity is significantly underused.

Associations between gestational weight gain and preterm birth in Puerto Rico.

BACKGROUND: Preterm birth (PTB; gestational age < 37 weeks) is the leading cause of infant morbidity and mortality worldwide. Low and excessive gestational weight gain (GWG) have been previously cited as risk factors for PTB, however the magnitude of association varies across populations. No studies have examined low and excessive GWG as modifiable risk factors for PTB in Puerto Rico, an area with inexplicably high PTB rates. METHODS: To examine the relationship between GWG and PTB, we conducted a retrospective analysis using birth certificate data files from the Puerto Rico Department of Health from 2005 to 2012. GWG was standardized to a 40-week gestational duration and was categorized into low, adequate, or excessive for each category of pre-pregnancy body mass index using American College of Obstetricians and Gynecologists guidelines. Logistic regression was used to determine the crude and adjusted odds ratios (OR) and 95% confidence intervals (CI) for the association between GWG and PTB. RESULTS: There were 320,695 births included in this analysis; 40.6% with high GWG and 27.3% with low GWG. A greater percentage of women with low GWG were less than 20 years of age, had less than a high school education, and were underweight compared to women with adequate and excessive GWG. Women with low compared to adequate GWG had increased odds of PTB (OR = 1.34, 95% CI = 1.30-1.37). However, excessive compared to adequate GWG was not associated with PTB (OR = 0.99, 95% CI = 0.97-1.02). CONCLUSIONS: Among women in Puerto Rico, low GWG was associated with increased odds of PTB. With the exception of obesity, these associations persisted within all strata of pre-pregnancy body mass index, highlighting the importance of maintaining a healthy weight during pregnancy. Future research should examine other factors that may contribute to GWG, such as dietary nutrients, and explore pathways through which GWG may be contributing to PTB.

Predictors of genetic beliefs toward cancer risk perceptions among adults in the United States: Implications for prevention or early detection.

The objective of this study is to assess predictors of genetic beliefs toward cancer risk perceptions among adults, aged 18 years and over, in the United States (US). Data were obtained from the National Cancer Institute's (NCI) Health Information National Trends Survey 2014 (HINTS) 4 Cycle 4. Bivariate and multivariable logistic regression analyses were conducted to assess factors associated with an individual's beliefs about genetic and cancer risk perceptions. The results showed that African Americans, Non-White Hispanics, Non-Hispanic Asians, individuals with a high school education or less, and annual household incomes less than $20,000 and do not believe that health behaviors play some role in determining whether a person will develop cancer was significantly less likely to report that genetics plays at least some role in whether a person will develop cancer. Findings of this study provide an opportunity for genetic counselors to address beliefs about genetics and cancer risk perceptions among minority populations and promote health equity.

Factors associated with self-reported history of depression diagnosis among cancer survivors aged 18 years and over in the United States.

OBJECTIVE: According to the American Cancer Society, 25% of cancer survivors in the United States develop depression. The objective of this study is to assess factors associated with self-reported history of depression diagnosis among cancer survivors aged ≥18 years in the United States. METHODS: Data were analyzed from the 2014 Behavioral Risk Factor Surveillance System (N = 6079). The Behavioral Risk Factor Surveillance System collects data about US residents regarding their health-related risk behaviors and events, chronic health conditions, and use of preventive services. Respondents were considered to have a history of depression diagnosis if they answered yes to the question "Has a doctor or other health care provider EVER told you that you have a depressive disorder, including depression, major depression, dysthymia, or minor depression?" Bivariate and multivariable logistic regression analyses were conducted to assess factors associated with depression in cancer survivors. Analyses were conducted using SAS 9.4. RESULTS: After adjusting for demographic and socioeconomic factors, females (AOR: 1.70; 95% CI, 1.50-1.97); those with an annual household income of $24 999 or less (AOR: 2.48; 95% CI, 1.95-3.16); $25 000 to $49 999 (AOR: 1.62; 95% CI, 1.31-2.02), and $50 000 to $74 999 (AOR: 1.35; 95% CI, 1.10-1.71); those who were not married (AOR = 1.37; 95% CI, 1.17-1.60); and those who perceived their health as poor (AOR = 2.33; 95% CI, 2.01-2.70), were significantly more likely to report a diagnosis of depression. CONCLUSIONS: The results indicate that gender, income, marital status, and perceived health status were associated with self-reported depression among cancer survivors aged ≥18 years in the United States.

Health-related quality of life of African-American female breast cancer survivors, survivors of other cancers, and those without cancer.

PURPOSE: The purpose of this study was to compare differences in health-related quality of life (HRQOL) between African-American female breast cancer survivors, African-American female survivors of other cancers, and African-American women with no history of cancer. METHODS: Using data from the 2010 National Health Interview Survey (NHIS), the HRQOL of African-American women aged 35 years or older was compared by cancer status. Physical and mental health items from the Patient-Reported Outcomes Measurement Information System (PROMIS) global health scale were used to assess differences in HRQOL. RESULTS: For summary physical and mental health measures, no significant differences were found between breast cancer survivors and women with no history of cancer; survivors of other cancers reported poorer physical and mental health than did women with no history of cancer. Similar differences were found at the item level. When we examined the two African-American female cancer survivor groups, we found that cancer survivors whose cancer was being treated reported substantially poorer physical health and mental health than did those whose cancer was not being treated. Survivors who had private insurance and were cancer free reported better physical and mental health than did those who did not have private insurance and those who were not cancer free. Breast cancer survivors reported slightly better physical and mental health than did survivors of other cancers. CONCLUSIONS: Our findings highlight the need for public health agencies to adopt practices to improve the mental and physical health of African-American female survivors of cancer.

Patterns of Internet-based health information seeking in adult survivors of childhood cancer.

BACKGROUND: To assess where, when, and why survivors of childhood cancer seek health information. PROCEDURE: Data from the Childhood Cancer Survivor Study (CCSS) cohort (n = 1386) and Health Information National Trends Survey (n = 2385) were analyzed to determine the health information seeking strategies of childhood cancer survivors. Descriptive frequencies, χ2 analyses, t-tests, and multivariable logistic regression models were used. RESULTS: To seek health-related information for themselves, 54% (n = 742) of the childhood survivors reported using the Internet in the past 12 months, compared to 45% of the general population (adjusted OR: 2.76; 95% CI: 2.40-3.19). Childhood cancer survivors who used the Internet for health information were more likely to be female, between the ages of 18-34, have received some college education or be a college graduate, and report being in poor health. Although survivors were less likely than the general population to trust health information from the Internet (P < 0.01), they indicated that they would like a secure website that uses information from their medical records to provide individualized health-related information. CONCLUSION: The use of the Internet to access health information among the childhood cancer survivors was over 50%. Information on late effects was a high priority for most survivors, as was their interest in websites related to late effects and a website on patient information tailored to personal situations. Identification of factors associated with searching the Internet for cancer information may provide direction for development of effective cancer communication interventions for this at-risk population.

Factors Associated with Self-Reported Cervical Cancer Screening Among Women Aged 18 Years and Older in the United States.

In 2016, an estimated 4120 women will die as a result of cervical cancer. The objective of this study was to examine the factors associated with cervical cancer screening among women 18 years of age and older in the United States (U.S.). Using the 2012 Behavioral Risk Factor Surveillance System survey, women over the age of 18 in the U.S. were examined to assess factors associated with cervical cancer screening. Analyses were conducted using SAS 9.2. Of the 272,692 study participants, 258,496 (95 %) had obtained cervical cancer screening. After adjusting for demographic and socioeconomic factors, being non-Hispanic White, Hispanic or Latino, Asian, Native Hawaiian or Other Pacific Islander, in the age group 18-44 years and 75 years and above, having less than a high school education and an annual household income of less than a $25,000, having never married, and residing in the West region of the U.S. reduced the likelihood of participation in cervical cancer screening. Also, after adjusting for demographic and socioeconomic factors, being between the ages of 45-74 years of age, having more than a high school education, having a higher income, and residing in the South region of the U.S. increased the likelihood of participation in cervical cancer screening. The results of this study suggest that socio-demographic factors and region of residence are predictors of cervical cancer screening. These findings highlight the need to identify potential prevention strategies to promote cervical cancer screening among at-risk populations and groups.

Factors associated with body mass index among African American breast cancer survivors.

BACKGROUND: Weight gain after diagnosis and treatment is common among breast cancer survivors (BCSs). Little information exists regarding associations between body mass index (BMI) and lifestyle factors and health-related quality of life (HR-QoL) among African American (AA) BCSs. The present study sought to determine associations between BMI, dietary intake, and physical activity as lifestyle modification strategies and HR-QoL among AA BCSs. METHODS: For this cross-sectional study, a lifestyle assessment tool was administered to 195 AA BCSs. Possible predictor variables included socio-demographic and medical characteristics, dietary intake and physical activity patterns, and physical health. The outcome variable was BMI. RESULTS: Many BCSs (63%) had BMIs ≥25 Kg/M2 and presented with stage I cancer (41%) at diagnosis. Among those presenting with late-stage cancer (IIIA, IIIB, IV), 76% were overweight or obese (p=0.0008). Eighty-four percent reported excellent-to-good physical health (p=0.0499) and were less likely to have higher BMIs compared to those reporting fair-to-poor physical health (OR=0.616 [CI=0.192-1.978]). Responders with graduate level education were more likely to have healthy body weights than those attaining high school or less educational levels (OR=2.379 [CI=0.617-9.166]). CONCLUSIONS: Most AA BCSs surveyed were overweight or obese, did not engage in recommended physical activity levels and failed to consume diets linked to breast cancer prevention. Interventions are needed to promote weight loss, improve dietary intake, and enhance physical activity among AA BCSs.

Association between intimate partner violence and mentally unhealthy days in women in the U.S.

BACKGROUND: In the United States (U.S.), intimate partner violence (IPV) is a serious public health concern, mainly affecting the health and well-being of women. The objective of this study was to identify the IPV and socio-demographic factors associated with mentally unhealthy days among women in the U.S. of ages ≥18 years. METHODS: Data for this study were obtained from the 2007 Behavioral Risk Factor Surveillance System. Multivariable analyses were used to estimate adjusted odds ratios (AORs) and 95% confidence intervals (95% CIs) for factors associated with IPV and 14 or more mentally unhealthy days per month. Analyses were conducted using SAS 9.3. RESULTS: The analyses show that the following factors increase the likelihood of self-reported 14 or more mentally unhealthy days: having a high school level of education or less (AOR: 1.732; 95% CI: 1.415-2.119) and having an income < $50,000. In addition, experiencing IPV such as: ever being threatened by a sex partner (AOR: 1.499; 95% CI: 1.264-1.779); having a sex partner ever attempt violence (AOR: 1.461; 95% CI: 1.224-1.743); having a sex partner ever become violent (AOR: 1.541; 95% CI: 1.303-1.823); and ever having unwanted sex with a partner (AOR: 1.929; 95% CI: 1.584-2.350) also increased the likelihood of self-reported 14 or more mentally unhealthy days per month. CONCLUSIONS: The results indicate that, for women in the U.S., IPV and socio-demographic factors have an effect on self-reported 14 or more mentally unhealthy days. Improving access to services that offer protection and guidance for women abused by their intimate partner could decrease the likelihood of selfreported 14 or more mentally unhealthy days and long-term negative mental health outcomes among women.

Factors Associated with Self-Reported HIV Testing Among Persons 18 Years and Over in the United States - Findings from the 2012 Behavioral Risk Factor Surveillance System (BRFSS).

BACKGROUND: The Centers for Disease Control and Prevention (CDC) estimates that 14 percent of persons infected with HIV in the United States (US) are unaware of their infection and many of the estimated 50,000 new HIV infections each year are transmitted by people who do not know that they are HIV-positive. HIV testing is an important component of HIV prevention. This study examined predictors of self-reported HIV testing among persons 18 years and over in the US. METHODS: Data from the 2012 BRFSS were utilized. We used univariate analysis to calculate relative frequencies for gender, race or ethnicity, age, education, income, marital status, region of residence, and having engaged in HIV/AIDS risky behaviors to characterize the overall sample. We conducted bivariate analysis for an initial assessment of factors independently associated with HIV testing. Multivariable logistic regression models were used to obtain the Adjusted Odds Ratios (AORs) and 95% Confidence Intervals (95% CIs) for factors associated with getting tested for HIV. Analyses were conducted using SAS version 9.2. RESULTS: Of the 439,327 respondents, 30% had been tested for HIV. Of those who had been tested for HIV, 59% were female; 41% were two or more races and 47% were between 18-44 years of age. The majority (39%) of the respondents were college graduates. Over one-third (31%) of the participants who had been tested had annual household incomes which were less than $25,000. Half (50%) were married and 24% of the respondents were from the Western region of the US. Five percent of the respondents reported that they had engaged in HIV/AIDS risky behaviors. Factors associated with lower odds of getting tested included being Asian (AOR=0.56; 95% CI=0.41, 0.78); Native Hawaiian or Other Pacific Islander (AOR=0.42; 95% CI=0.18, 0.90); and having an income between $25,000 to $49,000 (AOR=0.82; 95% CI=0.78-0.87); $50,000 to $74,999 (AOR=0.86; 95% CI=0.79-0.93); or $75,000 or more (AOR=0.87; 95% CI=0.81-0.94). Also, respondents from the Midwest (AOR=0.78; 95% CI=0.73, 0.83) and the West (AOR=0.88; 95% CI=0.83, 0.93) were less likely to get tested for HIV. Our adjusted analyses also showed that being non-Hispanic Black or African American, Hispanic or Latino, identifying as having two or more races, and being American Indian or Alaska Native increased the likelihood of getting tested for HIV. Having engaged in HIV/AIDS risky behaviors had significantly higher odds of being tested for HIV (AOR=2.45; 95% CI=2.19, 2.74). CONCLUSION: Our findings suggest that the HIV/AIDS prevention education and training programs in the US that have focused on traditionally classified high-risk populations have been effective. Findings from this study uncover an interesting paradox, which suggests that populations with higher incomes have been overlooked in efforts to combat HIV/AIDS. Our results suggest that these populations are at greatest risk of not knowing their HIV status and are therefore most likely to unknowingly contribute to the number of new HIV infections. Future research on multiple interacting factors that affect HIV testing behaviors should be considered top priorities. This is of upmost importance because knowing one's HIV status allows those who are infected to seek and receive treatment and prevention services, which are designed to improve health and reduce the likelihood of further transmission.

Factors Associated with Self-Reported 14 or More Activity Limitation Days among Adults in the United States.

OBJECTIVE: It is estimated that 41 million American adults 18 and older experience poor physical or mental health which limits their ability to engage in their daily activities. The objective of this study was to assess the prevalence of and factors associated with ≥14activity limitation days (ALD) due to poor physical or mental health as self-reported by persons aged 18 years and over in the United States (U.S). METHODS: Using the 2012 Behavioral Risk Factors Surveillance System (BRFSS), persons over the age of 18 in the U.S. were examined to assess the prevalence of and factors associated with ≥ 14ALD due to poor physical or mental health. The BRFSS is administered on a continuous basis by telephone using random-digit dial sampling methods. A clustering sample design was used to account for differences in the probability of selection and non-response in order to accurately derive US and state-based population estimates. The design consists of a probability sample of all households with telephones in the state. Analyses were conducted using SAS 9.2. RESULTS: Of the 104,257 participants included in the analyses, 40% reported having ≥14 ALD due to poor physical or mental health. After adjusting for demographic and socioeconomic factors, males (AOR1.17, 95% CI: 1.14-1.21), those with high school or less education (AOR: 1.42, 95% CI: 1.37-1.21), those who were separated (AOR: 1.23; 95% CI=1.14-1.32), divorced (AOR: 1.10; 95% CI=1.06-1.15), those from the Southern Black Belt States (AOR1.14, 95% CI: 1.10-1.20), and those from the remainder of the Southern region of the U.S. (AOR1.14, 95% CI: 1.08-1.21) were significantly more likely to report ≥14ALD due to poor physical or mental health. CONCLUSION: The prevalence of ≥14ALD due to poor physical or mental health among the study population was associated with sociodemographic and region of residence factors. These findings highlight the need for prevention strategies specifically for populations who might be more at risk for ALD due to social determinants of health.

The Role of Obesity Training in Medical School and Residency on Bariatric Surgery Knowledge in Primary Care Physicians.

Objective. US primary care physicians are inadequately educated on how to provide obesity treatment. We sought to assess physician training in obesity and to characterize the perceptions, beliefs, knowledge, and treatment patterns of primary care physicians. Methods. We administered a cross-sectional web-based survey from July to October 2014 to adult primary care physicians in practices affiliated with the Massachusetts General Hospital (MGH). We evaluated survey respondent demographics, personal health habits, obesity training, knowledge of bariatric surgery care, perceptions, attitudes, and beliefs regarding the etiology of obesity and treatment strategies. Results. Younger primary care physicians (age 20-39) were more likely to have received some obesity training than those aged 40-49 (OR: 0.08, 95% CI: 0.008-0.822) or those 50+ (OR: 0.03, 95% CI: 0.004-0.321). Physicians who were young, had obesity, or received obesity education in medical school or postgraduate training were more likely to answer bariatric surgery knowledge questions correctly. Conclusions. There is a need for educational programs to improve physician knowledge and competency in treating patients with obesity. Obesity is a complex chronic disease, and it is important for clinicians to be equipped with the knowledge of the multiple treatment modalities that may be considered to help their patients achieve a healthy weight.

Lifestyle Modification Experiences of African American Breast Cancer Survivors: A Needs Assessment.

BACKGROUND: Little is known about the rates of obesity among African American (AA) breast cancer survivors (BCSs), the availability and use of lifestyle modification methods suitable for this population, and the impact of changes in dietary intake and physical activity on health-related quality of life (HR-QoL). OBJECTIVE: The objectives of the study were to describe obesity rates, dietary intake, and physical activity as lifestyle modification strategies; examine predictors of engagement in these strategies post diagnosis; and learn more about salient features of lifestyle interventions from AA BCSs participating in a breast cancer support group. METHODS: The needs assessment included four components: (1) a literature review to determine existing lifestyle modification strategies of AA BCSs; (2) secondary data analysis of the 2010 National Health Interview Survey, Cancer Control Supplement to examine HR-QoL; (3) administration, to 200 AA BCSs, of an assessment tool relating to weight and breast cancer history, dietary intake, and physical activity through a variety of approaches (eg, Internet, mail, in-person, and telephone); and (4) focus group discussions to frame lifestyle interventions. RESULTS: Preliminary findings indicate that AA BCSs are underrepresented in lifestyle intervention research, have disparities in HR-QoL outcomes, do not meet current cancer prevention guidelines, and have recommendations for effective strategies for lifestyle modification. CONCLUSIONS: As analyses of the needs assessment are completed, the research team is partnering with community coalitions and breast cancer support groups in Miami, Chicago, Houston, Los Angeles, and Philadelphia to develop community-engaged intervention approaches for promoting adherence to cancer prevention guidelines.

The influence of an individual's weight perception on the acceptance of bariatric surgery.

OBJECTIVE: This study assessed the proportion of US adults with excess weight and obesity who consider bariatric surgery to be appropriate for themselves and how their own weight perception influences this consideration. METHODS: A stratified sample of 920 US adults in June 2014 was obtained through an online survey. The respondents were queried about bariatric surgery acceptability and personal weight perception. Average body mass index (BMI) was determined for each demographic variable, and responses were characterized according to BMI and concordance with perceived weight status. Chi-square analyses served to assess perceived weight concordance in relation to bariatric acceptance. RESULTS: Only 32% of respondents with Class III obesity indicated that bariatric surgery would be an acceptable option for them, most often because they considered it to be too risky. Respondents with Class III obesity and concordant perception of weight status were more likely (P < 0.03) than discordant Class III respondents to accept bariatric surgery. Likewise, concordant respondents with excess weight, but not obesity, were more likely (P < 0.001) to correctly consider bariatric surgery to be inappropriate for them. CONCLUSIONS: Despite good safety and efficacy, many persons still believe bariatric surgery is too risky. Weight perception concordance or discordance influences one's decision to consider this treatment option.

Lifestyle Modification Experiences of African American Breast Cancer Survivors: A Needs Assessment.

BACKGROUND: Little is known about the rates of obesity among African American (AA) breast cancer survivors (BCSs), the availability and use of lifestyle modification methods suitable for this population, and the impact of changes in dietary intake and physical activity on health-related quality of life (HR-QoL). OBJECTIVE: The objectives of the study were to describe obesity rates, dietary intake, and physical activity as lifestyle modification strategies; examine predictors of engagement in these strategies post diagnosis; and learn more about salient features of lifestyle interventions from AA BCSs participating in a breast cancer support group. METHODS: The needs assessment included four components: (1) a literature review to determine existing lifestyle modification strategies of AA BCSs; (2) secondary data analysis of the 2010 National Health Interview Survey, Cancer Control Supplement to examine HR-QoL; (3) administration, to 200 AA BCSs, of an assessment tool relating to weight and breast cancer history, dietary intake, and physical activity through a variety of approaches (eg, Internet, mail, in-person, and telephone); and (4) focus group discussions to frame lifestyle interventions. RESULTS: Preliminary findings indicate that AA BCSs are underrepresented in lifestyle intervention research, have disparities in HR-QoL outcomes, do not meet current cancer prevention guidelines, and have recommendations for effective strategies for lifestyle modification. CONCLUSIONS: As analyses of the needs assessment are completed, the research team is partnering with community coalitions and breast cancer support groups in Miami, Chicago, Houston, Los Angeles, and Philadelphia to develop community-engaged intervention approaches for promoting adherence to cancer prevention guidelines.