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1.
Transl Behav Med ; 11(6): 1283-1285, 2021 06 17.
Article in English | MEDLINE | ID: mdl-33200771

ABSTRACT

Individuals and families with limited access to healthy foods often experience increased risk for poor diet and chronic disease. Low-income communities are more likely to have a large number of small food stores (e.g., corner stores and dollar stores) compared to higher-income communities. Since many of these small food stores participate in the Supplemental Nutrition Assistance Program (SNAP), increasing healthy food offerings in these stores may expand healthy food retail in low-income communities. We recommend the provision of funding for incentive programs that encourage SNAP-authorized small food stores in low-income communities to expand their healthy food offerings. This programming should (a) provide seed grants to store owners to develop or reconfigure store infrastructure, (b) offer store owners technical assistance and educational materials on marketing strategies for promoting healthy food items to customers, and (c) give a tax break to SNAP-authorized small food stores in low-income communities that maintain a predetermined minimum stock of U.S. Department of Agriculture-recognized staple foods.


Subject(s)
Behavioral Medicine , Food Assistance , Commerce , Food Supply , Humans , Motivation
2.
Transl Behav Med ; 9(1): 179-183, 2019 01 01.
Article in English | MEDLINE | ID: mdl-29648617

ABSTRACT

The Society of Behavioral Medicine (SBM) encourages stakeholders to implement a sugar sweetened beverage excise tax. Sugar sweetened beverages are the largest source of added sugars in the USA and have detrimental effects on population health by increasing risks for chronic diseases. Based on existing research evidence, SBM supports an excise tax equivalent to at least 20% to meaningfully affect consumption patterns. As evidenced by research studies in Mexico and the USA, sugar sweetened beverage taxes can have positive impacts on population health and can raise significant tax revenue. To avoid potential unintended consequences that may arise from taxes to improve diet-related behaviors, it is important to monitor industry and consumer behavior in response to the tax.


Subject(s)
Beverages/economics , Chronic Disease/prevention & control , Dietary Sugars/economics , Health Policy , Taxes/economics , Taxes/legislation & jurisprudence , Behavioral Medicine , Chronic Disease/economics , Health Promotion/economics , Humans , Societies, Medical , United States
3.
Transl Behav Med ; 9(2): 391-394, 2019 03 01.
Article in English | MEDLINE | ID: mdl-29669063

ABSTRACT

The Society of Behavioral Medicine (SBM) recommends that Congress increase funding for fruit and vegetable production and intake in The Farm Bill reauthorization. Analysis of the U.S. Department of Agriculture's databases indicates that the availability of fruits and vegetables in the food supply is at half or less than half of what is needed to meet federal dietary recommendations for Americans. Based on the extant literature, SBM supports including funding allocations for fruit and vegetable production, including fruits and vegetables in commodity programs, providing additional insurance subsidies for producing fruits and vegetables, and maintaining or increasing funding for initiatives that promote fruit and vegetable intake. To avoid some of the unintended consequences of increasing support for fruit and vegetable production, new insurance products should be developed in collaboration with groups representing fruit and vegetable producers.


Subject(s)
Farms/legislation & jurisprudence , Food Supply , Fruit , Policy , Vegetables , Behavioral Medicine , Diet, Healthy , Feeding Behavior , Humans , Societies, Medical , United States , United States Department of Agriculture
4.
Psychoneuroendocrinology ; 90: 141-147, 2018 04.
Article in English | MEDLINE | ID: mdl-29494952

ABSTRACT

INTRODUCTION: Using Jackson Heart Study (JHS) data, we assessed the association between perceived psychosocial stressors and metabolic syndrome (MetS) severity in African American adults. METHODS: Participants included 3870 African American JHS participants aged 21-95 years (63.1% women; mean age 53.8 ±â€¯13.0). Psychosocial stressors assessed included: major life events (MLEs); global stress; and weekly stress inventory. Each stress measure was classified into tertiles (low, medium, and high). Associations of psychosocial stressors with a sex- and race/ethnic-specific MetS severity Z-score were examined after adjustment for demographics and MetS risk factors (i.e., nutrition, physical activity, smoking status, and alcohol consumption). RESULTS: Independent of lifestyle factors, participants who reported high (versus low) perceived global stress and MLEs had significantly greater MetS severity (p = .0207 and p = .0105, respectively). Weekly stress was not associated with MetS severity. Compared to men, women reported significantly higher global stress and MLEs (p < 0.0001). A significant interaction between sex and MLEs (p = .0456) demonstrated men significantly increased their MetS severity at medium levels of stress, whereas women's MetS severity was significantly increased at high levels of MLEs. CONCLUSIONS: In the total sample, higher reported global stress and MLEs were associated with increased risk of MetS severity, while weekly stress was not. Men's and women's stress responses to MLEs were differentially associated with MetS severity, with male MetS severity increasing significantly at lower levels of MLEs relative to women's MetS severity. These data may have implications for targeting stress-related factors in interventions to improve cardiometabolic health in African American adults.


Subject(s)
Black or African American/psychology , Metabolic Syndrome/psychology , Stress, Psychological/psychology , Adult , Aged , Aged, 80 and over , Female , Humans , Life Change Events , Longitudinal Studies , Male , Metabolic Syndrome/ethnology , Metabolic Syndrome/metabolism , Middle Aged , Risk Factors , Sex Factors , Stress, Psychological/ethnology , Stress, Psychological/metabolism
5.
Am J Epidemiol ; 187(2): 316-325, 2018 02 01.
Article in English | MEDLINE | ID: mdl-28992096

ABSTRACT

Reducing racial/ethnic disparities in human immunodeficiency virus (HIV) disease is a high priority. Reductions in HIV racial/ethnic disparities can potentially be achieved by intervening on important intermediate factors. The potential population impact of intervening on intermediates can be evaluated using observational data when certain conditions are met. However, using standard stratification-based approaches commonly employed in the observational HIV literature to estimate the potential population impact in this setting may yield results that do not accurately estimate quantities of interest. Here we describe a useful conceptual and methodological framework for using observational data to appropriately evaluate the impact on HIV racial/ethnic disparities of interventions. This framework reframes relevant scientific questions in terms of a controlled direct effect and estimates a corresponding proportion eliminated. We review methods and conditions sufficient for accurate estimation within the proposed framework. We use the framework to analyze data on 2,329 participants in the CFAR [Centers for AIDS Research] Network of Integrated Clinical Systems (2008-2014) to evaluate the potential impact of universal prescription of and ≥95% adherence to antiretroviral therapy on racial disparities in HIV virological suppression. We encourage the use of the described framework to appropriately evaluate the potential impact of targeted interventions in addressing HIV racial/ethnic disparities using observational data.


Subject(s)
Anti-HIV Agents/therapeutic use , Ethnicity/statistics & numerical data , HIV Infections/epidemiology , Healthcare Disparities/ethnology , Racial Groups/statistics & numerical data , Adult , Female , HIV , HIV Infections/drug therapy , HIV Infections/ethnology , Health Status Disparities , Humans , Male , Observational Studies as Topic , United States/epidemiology
6.
AIDS Behav ; 21(12): 3353-3365, 2017 Dec.
Article in English | MEDLINE | ID: mdl-28424970

ABSTRACT

Empirical evidence indicates that aspects of the neighborhood environment may affect HIV prevention efforts. Therefore, the neighborhood environment should be considered when implementing prevention interventions. However, much of the empirical evidence is derived from studies conducted among drug users, men, or adolescents. Such evidence may not be as applicable to adult women whose primary risk for HIV infection is via heterosexual sexual behavior. Therefore, a systematic review examining the relationship between neighborhood environments and HIV sexual risk behaviors among adult U.S. women was conducted. Three databases were searched for articles published in English in peer-reviewed journals between 1/1/1980 and 12/31/2016 meeting relevant criteria. Seven articles identified from the three databases or additional hand searches met inclusion criteria and were summarized. Findings were mixed with several studies indicating associations between neighborhood environments and HIV sexual risk behaviors. However, all summarized studies were cross-sectional. Longitudinal studies conducted among women are needed.


Subject(s)
HIV Infections/prevention & control , Residence Characteristics , Risk-Taking , Sexual Behavior , Social Environment , Female , Humans , Male , Social Determinants of Health
7.
J Obes ; 2016: 2489021, 2016.
Article in English | MEDLINE | ID: mdl-27774314

ABSTRACT

Background. Breastfeeding is associated with a decreased risk of obesity in the early and adult years. Native Hawaiians and Pacific Islanders (NHPI) experience high rates of obesity which is often obfuscated with aggregated data. Using disaggregated data, we examined breastfeeding practices among NHPI. Methods. Seven databases and reference lists were searched. Two independent researchers extracted relevant studies based on predetermined criteria. Nine studies met our inclusion criteria and a meta-analysis was conducted using random-effects, inverse-various weighted models. Results. Few studies disaggregated NHPI populations when examining breastfeeding practices. Most studies were cross-sectional and our search yielded no randomized or quasirandomized control trials. The results of the meta-analysis indicated that 46.5% NHPI women initiated breastfeeding with 40.8% breastfeeding exclusively. These pooled analyses show that NHPI breastfeeding practices are below the recommended national and international goals and guidelines. Conclusion. Breastfeeding practices among NHPI are heterogeneous and critical disparities exist among certain NHPI subgroups and additional research needs to be conducted to determine the reasons for the disparity. Future studies should work to disaggregate data for NHPI and the various subpopulations. Multicomponent, multilevel strategies are needed to support breastfeeding practices among NHPI.


Subject(s)
Breast Feeding/statistics & numerical data , Breast Feeding/ethnology , Female , Hawaii , Humans , Infant, Newborn , Native Hawaiian or Other Pacific Islander , Obesity/prevention & control , Pacific Ocean
8.
J Community Pract ; 84(1): 18-37, 2016.
Article in English | MEDLINE | ID: mdl-27667912

ABSTRACT

Using a community-engaged participatory research approach, this study identified surrounding community residents' expectations for how a HOPE VI housing initiative might affect their community and individual health and physical activity. Fifty-nine women and men engaged in concept mapping, which is a mixed methods approach, where participants generate, sort, and rate ideas. Participants generated 197 unique statements. Thirteen thematic clusters related to expected changes for the community, health and physical activity emerged. Residents' rated 'Increased Pride in the Neighborhood' and 'Increased Safety' as the most important factors related to HOPE VI whereas 'Drawbacks of HOPE VI' was rated as least important. This research provides insight into the potential impacts of housing initiatives from the perspective of those most affected by such initiatives. The findings also highlight environmental changes as potential mechanisms that may improve residents' perceptions of the community and encourage healthy lifestyles.

9.
BMC Public Health ; 16: 521, 2016 06 28.
Article in English | MEDLINE | ID: mdl-27353149

ABSTRACT

BACKGROUND: Adequate fruit and vegetable (F&V) intake is important for disease prevention. Yet, most Americans, especially low-income and racial/ethnic minorities, do not eat adequate amounts. These disparities are partly attributable to food environments in low-income neighborhoods where residents often have limited access to affordable, healthful food and easy access to inexpensive, unhealthful foods. Increasing access to affordable healthful food in underserved neighborhoods through mobile markets is a promising, year-round strategy for improving dietary behaviors and reducing F&V intake disparities. However, to date, there have been no randomized controlled trials studying their effectiveness. The objective of the 'Live Well, Viva Bien' (LWVB) cluster randomized controlled trial is to evaluate the efficacy of a multicomponent mobile market intervention at increasing F&V intake among residents of subsidized housing complexes. METHODS/DESIGN: One housing complex served as a pilot site for the intervention group and the remaining 14 demographically-matched sites were randomized into either the intervention or control group. The intervention group received bimonthly, discount, mobile, fresh F&V markets in conjunction with a nutrition education intervention (two F&V campaigns, newsletters, DVDs and cooking demonstrations) for 12 months. The control group received physical activity and stress reduction interventions. Outcome measures include F&V intake (measured by two validated F&V screeners at baseline, six-month and twelve-months) along with potential psychosocial mediating variables. Extensive quantitative and qualitative process evaluation was also conducted throughout the study. DISCUSSION: Modifying neighborhood food environments in ways that increase access to affordable, healthful food is a promising strategy for improving dietary behaviors among low-income, racial and ethnic minority groups at increased risk for obesity and other food-related chronic diseases. Discount, mobile F&V markets address all the major barriers to eating more F&V (high cost, poor quality, limited access and limited time to shop and cook) and provide a year-round solution to limited access to healthful food in low-income neighborhoods. LWVB is the first randomized controlled trial evaluating the effectiveness of mobile markets at increasing F&V intake. If proven efficacious at increasing F&V consumption, LWVB could be disseminated widely to neighborhoods that have low access to fresh F&V. TRIALS REGISTRATION: Clinicatrials.gov registration number: NCT02669472 First Received: January 19, 2016.


Subject(s)
Diet , Health Education , Housing , Cluster Analysis , Female , Financing, Government , Food Supply , Fruit/supply & distribution , Humans , Male , Middle Aged , Minority Groups , Pilot Projects , Poverty , Research Design , Rhode Island , Vegetables/supply & distribution
10.
Prev Chronic Dis ; 12: E176, 2015 Oct 15.
Article in English | MEDLINE | ID: mdl-26469949

ABSTRACT

INTRODUCTION: Eating fruits and vegetables is associated with lowered risk for many chronic diseases. However, most Americans, especially members of low-income and minority populations, do not eat adequate amounts. Fresh to You is a public-private partnership program that brings discount fresh produce markets into low-income neighborhoods. We conducted a mixed-methods evaluation of Fresh to You to assess the effect of the program on children's consumption of fruits and vegetables. METHODS: A local produce distributor brought the Fresh to You markets to 6 community organizations serving low-income families in Rhode Island. The markets, held weekly for 5 months at each site, sold fresh produce at below-retail prices. Parents (N = 480) of children aged 3 to 13 years were recruited at the markets to participate in a 5-month cohort study. The primary outcome was change in children's fruit and vegetable intake, measured by a validated screener. We also conducted postintervention focus groups at each site with parents and qualitative interviews with site contacts to collect feedback about Fresh to You. RESULTS: From baseline to 5 months, there was a significant increase in children's daily fruit and vegetable consumption of 0.48 cups (t = 4.16, P < .001). Data from follow-up parent surveys, focus groups, and site contact interviews provided positive feedback about Fresh to You and recommendations for improvement. CONCLUSION: Fresh to You was effective at increasing consumption of fruits and vegetables among racially and ethnically diverse low-income children aged 3 to 13 years whose parents shopped at the markets. The intervention could serve as a model program for replication in other cities. Refinements and a more rigorous evaluation are needed.


Subject(s)
Commerce/standards , Energy Intake , Food Supply/methods , Fruit/economics , Vegetables/economics , Adolescent , Child , Child Nutritional Physiological Phenomena , Child, Preschool , Cohort Studies , Commerce/methods , Environment Design , Feedback , Female , Focus Groups , Food Supply/economics , Humans , Interviews as Topic , Male , Minority Groups , Outcome Assessment, Health Care , Poverty , Program Evaluation , Public-Private Sector Partnerships , Qualitative Research , Residence Characteristics , Rhode Island , Social Determinants of Health
11.
Int J Behav Nutr Phys Act ; 12: 130, 2015 Oct 07.
Article in English | MEDLINE | ID: mdl-26445486

ABSTRACT

BACKGROUND: Effective, low-cost approaches are needed to enhance dietary behavior change. While both video and tailoring technology have been effective interventions to improve diet, these approaches have never been combined to study the effectiveness of tailored videos. The purpose of this paper is to discuss the results of Good For You!, a randomized trial that tested the efficacy of innovative, individually tailored videos in helping worksite employees decrease dietary fat and increase fruit and vegetable (F&V) intake. METHODS: Worksites were matched on approximate size, type of company and workforce composition and randomized to one of three experimental conditions: Non-Tailored written information (NT) (n = 14), Tailored Written information (TW) (n = 14), or Tailored Written + Tailored Video (TW + TV) (n = 15). Evaluation was conducted at baseline, 4 and 7 months. We used the NCI Fat Screener and an adapted Food Habits Questionnaire (FHQ) to estimate fat intake and fat-related behaviors, the NCI F&V Screener and F&V Habits Questionnaire (FVHQ) to measure F&V intake and behaviors. Generalized linear models were examined for all outcome measurements. RESULTS: 2525 worksite employees were recruited. At 4 months, dietary fat intake decreased significantly more for TW (-2.95 %) and TW + TV (-3.14%) compared with NT (-2.42%). FHQ scores decreased significantly more for TW + TV than the other two groups. Fruit intake increased the most for TW + TV compared to NT and TW. Both TW (1.30 cups) and TW + TV (1.59 cups) increased F&V intake significantly more than NT (0.78 cups). TW + TV showed the largest increase in F&V behaviors on the FVFQ. At 8 months, dietary fat change continued to be significantly better for TW + TV (-3.48%) than NT (3.01%). F&V intake increased significantly more for the TW + TV group (1.38 cups) compared to the NT group (1.04 cups) and FVHQ changes were significantly greater in TW + TV and TW than for NT. CONCLUSIONS: The tailored intervention participants were more likely to decrease fat and increase F&V intake. The TW + TV group was generally the stronger of the two tailored interventions, especially at the longer term follow-up, demonstrating the promise of tailored video as an intervention to change eating habits. Future studies should explore newer channels and technologies in addition to DVDs for delivering tailored video interventions such as the internet and smart phones. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT00301678.


Subject(s)
Diet , Feeding Behavior , Health Education/methods , Health Promotion/methods , Videotape Recording , Adolescent , Adult , Aged , Female , Humans , Internet , Male , Middle Aged , Surveys and Questionnaires , Workplace , Young Adult
12.
Soc Sci Med ; 139: 90-9, 2015 Aug.
Article in English | MEDLINE | ID: mdl-26164364

ABSTRACT

OBJECTIVES: This study uses a mixed methods approach to 1) identify surrounding residents' perceived expectations for Housing Opportunities for People Everywhere (HOPE VI) policy on physical activity outcomes and to 2) quantitatively examine the odds of neighborhood-based physical activity pre-/post-HOPE VI in a low socioeconomic status, predominantly African American community in Birmingham, Alabama. METHODS: To address aim one, we used group concept mapping which is a structured approach for data collection and analyses that produces pictures/maps of ideas. Fifty-eight residents developed statements about potential influences of HOPE VI on neighborhood-based physical activity. In the quantitative study, we examined whether these potential influences increased the odds of neighborhood walking/jogging. We computed block entry logistic regression models with a larger cohort of residents at baseline (n = 184) and six-months (n = 142, 77% retention; n = 120 for all informative variables). We examined perceived neighborhood disorder (perceived neighborhood disorder scale), walkability and aesthetics (Neighborhood Environment Walkability Scale) and HOPE VI-related community safety and safety for physical activity as predictors. RESULTS: During concept mapping, residents generated statements that clustered into three distinct concepts, "Increased Leisure Physical Activity," "Safe Play Areas," and "Generating Health Promoting Resources." The quantitative analyses indicated that changes in neighborhood walkability increased the odds of neighborhood-based physical activity (p = 0.04). When HOPE VI-related safety for physical activity was entered into the model, it was associated with increased odds of physical activity (p = 0.04). Walkability was no longer statistically significant. CONCLUSIONS: These results suggest that housing policies that create walkable neighborhoods and that improve perceptions of safety for physical activity may increase neighborhood-based physical activity. However, the longer term impacts of neighborhood-level policies on physical activity require more longitudinal evidence to determine whether increased participation in physical activity is sustained.


Subject(s)
Environment Design/trends , Health Behavior , Perception , Public Housing/trends , Residence Characteristics , Female , Humans , Logistic Models , Male , Surveys and Questionnaires
13.
J Adolesc Health ; 56(5): 536-42, 2015 May.
Article in English | MEDLINE | ID: mdl-25907652

ABSTRACT

PURPOSE: African-American youth are at high risk for physical inactivity. This study explored social and cultural environment facilitators of physical activity among 12- to 14-year-old African-American adolescents living in a metropolitan area in the Southeast. METHODS: Youth (n = 51; 45% male) participated in brainstorming focus groups responding to the prompt, "What about your family, friends, and community, encourages you to be physically active?" In a second meeting, participants (n = 56; 37.5% male) sorted statements (n = 84) based on similarity in meaning and rated statements on relative importance. Statement groups and ratings were entered into Concept Systems software where multidimensional scaling and hierarchical cluster analysis were used to create graphical representation of ideas. Finally, researchers named clusters according to the gestalt of grouped statements. RESULTS: The total sample included 28.9% of youth with household incomes ≤$30,000 (area median income = $30,701), 29% who perceived themselves as overweight, and 14.5% who reported being active for 60+ minutes everyday. Nine clusters, in rank order, emerged as follows: access/availability of physical activity resources; family and friend support; physical activity with friends; physical activity with family members; inspiration to/from others; parental reinforcement; opportunities in daily routine; pressure from social networks; and seeing consequences of activity/inactivity. Themes analyzed by gender were very similar (r = .90); however, "pressure from social networks" was more important for girls than boys (r = .10). CONCLUSIONS: Clear patterns of social and cultural facilitators of physical activity are perceived by African-American adolescents. Interventions targeting this group may benefit by incorporating these themes.


Subject(s)
Black or African American/ethnology , Environment , Motor Activity , Social Support , Socioeconomic Factors , Adolescent , Black or African American/psychology , Child , Family/psychology , Female , Humans , Male , Parents/psychology , Risk Factors , Sex Factors , Southeastern United States/ethnology
14.
Am J Health Behav ; 39(2): 285-94, 2015 Mar.
Article in English | MEDLINE | ID: mdl-25564841

ABSTRACT

OBJECTIVE: To examine the association of cultural beliefs with physical activity (PA) among African-American adolescents. METHODS: For a list of 42 leisure-time physical activities, adolescents (N = 116) indicated whether they believed the activity was 'Mostly a Black Thing', 'Equally a Black and White Thing', or 'Mostly a White Thing'. Moderate-to-vigorous physical activity was assessed using accelerometers. RESULTS: Participants scoring in the highest quartile of Mostly Black score engaged in more PA and were less likely to be overweight or obese compared to those in lower quartiles. However, these findings were not statistically significant. CONCLUSION: Further research to validate the association of cultural beliefs with PA is needed to inform health-enhancing PA interventions for this population.


Subject(s)
Adolescent Behavior/ethnology , Black or African American/ethnology , Culture , Motor Activity , Adolescent , Child , Female , Humans , Male
15.
Obesity (Silver Spring) ; 22(2): 497-503, 2014 Feb.
Article in English | MEDLINE | ID: mdl-24039204

ABSTRACT

OBJECTIVE: To examine and compare the relationships among diet, physical activity, and adiposity between home-schooled children (HSC) and traditionally schooled children (TSC). DESIGN AND METHODS: Subjects were HSC (n = 47) and TSC (n = 48) aged 7-12 years old. Dietary intakes were determined via two 24-h recalls and physical activity was assessed with 7 days of accelerometry. Fat mass (FM), trunk fat, and percent body fat (%BF) were measured by dual-energy X-ray absorptiometry (DXA). RESULTS: Relative to HSC, TSC demonstrated significantly higher BMI percentiles, FM, trunk fat, and %BF; consumed 120 total kilocalories more per day; and reported increased intakes of trans fats, total sugar, added sugars, calcium, and lower intakes of fiber, fruits, and vegetables (P < 0.05). At lunch, TSC consumed significantly more calories, sugar, sodium, potassium, and calcium compared to HSC (P < 0.05). Physical activity did not differ between groups. Traditional schooling was associated with increased consumption of trans fat, sugar, calcium (P < 0.05); lower intakes of fiber, and fruits and vegetables (P < 0.05); and higher FM, %BF, and trunk fat (P < 0.01), after adjustment for covariates. CONCLUSIONS: These data suggest HSC may consume diets that differ in energy and nutrient density relative to TSC, potentially contributing to differences in weight and adiposity.


Subject(s)
Adiposity , Child Development , Child Nutritional Physiological Phenomena , Motor Activity , Overweight/prevention & control , Parent-Child Relations , Parenting , Alabama/epidemiology , Body Mass Index , Child , Cohort Studies , Cross-Sectional Studies , Energy Intake , Female , Food Services , Humans , Lunch , Male , Overweight/epidemiology , Overweight/etiology , Risk , Schools
16.
BMC Public Health ; 13: 440, 2013 May 04.
Article in English | MEDLINE | ID: mdl-23642107

ABSTRACT

BACKGROUND: According to recent research studies, the built and socioeconomic contexts of neighborhoods are associated with African American adolescents' participation in physical activity and obesity status. However, few research efforts have been devoted to understand how African American adolescents' perceptions of their neighborhood environments may affect physical activity behaviors and obesity status. The objective of the current study was to use a perceived neighborhood disorder conceptual framework to examine whether physical activity mediated the relationship between perceived neighborhood disorder and obesity status among African American adolescents. METHODS: The data were obtained from a cross-sectional study that examined social and cultural barriers and facilitators of physical activity among African American adolescents. The study included a sample of 101 African American adolescents age 12 to 16 years and their parents who were recruited from the Birmingham, Alabama metropolitan area. The primary outcome measure was obesity status which was classified using the International Obesity Task Force cut off points. Moderate-to-vigorous physical activity was assessed via accelerometry. Perceived neighborhood disorder was assessed using the Perceived Neighborhood Disorder Scale. Mediation models were used to examine whether the relationship between neighborhood disorder and obesity status was mediated by physical activity. RESULTS: Perceived neighborhood disorder was significantly and positively related to obesity status and moderate-to-vigorous physical activity was inversely associated with obesity status. However, there was no evidence to support a significant mediating effect of moderate-to-vigorous physical activity on the relationship between neighborhood disorder and obesity status. CONCLUSION: Future studies should longitudinally assess perceived neighborhood disorder characteristics and childhood adiposity to examine the timing, extent, and the mechanisms by which perceived neighborhood disorder characteristics increase the risk of obesity.


Subject(s)
Black or African American , Exercise/physiology , Obesity/prevention & control , Residence Characteristics , Adolescent , Female , Humans , Male
17.
J Epidemiol Community Health ; 66(1): 24-9, 2012 Jan.
Article in English | MEDLINE | ID: mdl-20736487

ABSTRACT

BACKGROUND: Characteristics associated with low socioeconomic status neighbourhoods may put children at risk for unique chronic stressors that affect cortisol levels. This research sought to explore whether neighbourhood stressor exposure affected serum cortisol levels among children. METHODS: A total of 148 African and European-American children with an average age of 8.28 years participated in a longitudinal study evaluating ethnic differences in body composition and disease risk. Five waves of data were included in analyses. Mixed modelling was used to explore neighbourhood stressors, which was a composite index of five items for zip code level poverty and physical disorder, and serum cortisol outcomes for the full sample, by race/ethnicity and gender. Adjustments were made for individual level correlates age, pubertal status, gender and total fat mass. RESULTS: Neighborhood disorder was predictive of lower serum cortisol levels among African-American children (p<0.05), such that higher neighbourhood stressor exposure resulted in lower serum cortisol over time compared with individuals in socially ordered neighbourhoods. Neighbourhood disorder was marginally significant and predictive of higher serum cortisol among European-American children (p<0.10). Transition to a higher pubertal status, nested in age was also predictive of lower serum cortisol levels (p<0.01) among European-American children. CONCLUSION: Children who are exposed to negative socioenvironmental climates over time are more likely to have altered serum cortisol levels. This may be an adaptive mechanism to cope with stress; however, disrupted cortisol levels may have negative effects on general physical and mental health.


Subject(s)
Environmental Exposure/adverse effects , Hydrocortisone/blood , Residence Characteristics/statistics & numerical data , Stress, Psychological/blood , Adaptation, Psychological , Black or African American/psychology , Black or African American/statistics & numerical data , Body Composition , Child , Female , Health Status Disparities , Humans , Longitudinal Studies , Male , Models, Psychological , Social Class , Time Factors , United States , White People/psychology , White People/statistics & numerical data
18.
Appetite ; 58(1): 347-53, 2012 Feb.
Article in English | MEDLINE | ID: mdl-22100186

ABSTRACT

Parental feeding practices have been associated with children's weight status, but results have been inconsistent across populations. Research is needed to elucidate the relationship between parental feeding practices and adiposity in diverse populations. The present study tested if: (1) parental feeding practices differed by race/ethnicity, (2) parental pressure to eat and parental restriction were associated with adiposity levels, and (3) to investigate the relationship between parental feeding practices and/or child adiposity with socioeconomic status (SES). Structural equations modeling was conducted to test the model in 267 children aged 7-12 years self-identified as African American (AA), European American (EA), or Hispanic American (HA) from economically diverse backgrounds. Dual energy X-ray absorptiometry and computed tomography scanning were used to determine body composition and abdominal fat distribution, respectively. Parental restriction was a significant predictor of child adiposity while parental pressure to eat had an inverse relationship with child adiposity. HA parents reported significantly higher levels of restriction and pressure to eat, whereas EA parents reported the lowest. SES was positively associated with child adiposity and inversely related to parental restriction and pressure to eat. Thus, parental feeding practices differ across racial/ethnic groups and SES and may contribute to population differences in child adiposity.


Subject(s)
Adiposity/ethnology , Obesity/epidemiology , Parenting , Social Class , Abdominal Fat , Absorptiometry, Photon , Black or African American , Body Composition , Body Weight , Child , Choice Behavior , Cross-Sectional Studies , Eating , Feeding Behavior , Female , Hispanic or Latino , Humans , Male , Parents , Prevalence , White People
19.
J Pediatr Gastroenterol Nutr ; 54(3): 336-42, 2012 Mar.
Article in English | MEDLINE | ID: mdl-22067112

ABSTRACT

OBJECTIVE: Obesity prevalence among African American (AA) girls is higher than that in other groups. Because typical energy-restriction obesity treatment strategies have had limited success, alterations in macronutrient composition may effectively improve metabolic outcomes in this population and affect future body composition trajectories. The objective was to evaluate the efficacy of a moderately restricted carbohydrate (CHO) versus a standard CHO diet on weight/fat loss and metabolic parameters in overweight/obese AA girls ages 9 to 14 years. METHODS: A total of 26 AA girls (ranging from 92nd body mass index percentile and above) were assigned to either a reduced- (SPEC: 42% energy from CHO, n = 12) or a standard- (STAN: 55% of energy from CHO, n = 14) CHO diet (protein held constant) for 16 weeks. All of the meals were provided and clinically tailored to meet the estimated energy requirements (resting energy expenditure × 1.2 in eucaloric phase and resting energy expenditure × 1.2 - 1000 kcal in energy deficit phase). The first 5 weeks encompassed a eucaloric phase evaluating metabolic changes in the absence of weight change. The subsequent 11 weeks were hypocaloric (1000 kcal/day deficit) to promote weight/fat loss. Meal tests were performed during the eucaloric phase for metabolic analyses. Dual-energy x-ray absorptiometry was used to evaluate body composition. RESULTS: Both groups experienced reductions in weight/adiposity, but the difference did not reach significance. The solid meal test indicated improved glucose/insulin homeostasis on the SPEC diet up to 3 hours postingestion. In addition, significantly lower triglycerides (P < 0.001) were observed on the SPEC diet. CONCLUSIONS: Dietary CHO reduction favorably influences metabolic parameters but did not result in greater weight/fat loss relative to a standard diet in obese AA girls. Future research is needed to determine long-term effectiveness of a reduced CHO diet on glucose and insulin homeostasis and how it may apply to weight maintenance/fat loss during development alone and/or in combination with additional weight loss/metabolic improvement strategies.


Subject(s)
Adipose Tissue/metabolism , Black or African American , Blood Glucose/metabolism , Diet, Carbohydrate-Restricted , Insulin/blood , Obesity/prevention & control , Weight Loss , Absorptiometry, Photon , Adiposity , Adolescent , Child , Diet, Reducing , Dietary Carbohydrates/administration & dosage , Female , Humans , Obesity/ethnology , Postprandial Period , Puberty , Treatment Outcome , Triglycerides/blood
20.
Ethn Racial Stud ; 34(4): 662-682, 2011 Apr.
Article in English | MEDLINE | ID: mdl-21532908

ABSTRACT

This paper examines whether children of marginalized racial/ethnic groups have an awareness of race at earlier ages than youth from non-marginalized groups, documents their experiences with racial discrimination, and utilizes a modified racism-related stress model to explore the relationship between perceived racial discrimination and self-esteem. Data were collected for non-Hispanic black, non-Hispanic white, and Hispanic children aged 7 - 12 using face-to-face interviews (n = 175). The concept of race was measured by assessing whether children could define race, if not a standard definition was provided. Racial discrimination was measured using the Williams Every-day-Discrimination Scale, self-esteem was measured using the Rosenberg Scale, and ethnic identity was assessed using the Multi-group Ethnic Identity Measure. Non-Hispanic black children were able to define race more accurately, but overall, Hispanic children encountered more racial discrimination, with frequent reports of ethnic slurs. Additionally, after accounting for ethnic identity, perceived racial discrimination remained a salient stressor that contributed to low self-esteem.

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