Sugar-Sweetened Beverage Consumption and Caries Prevalence in Underserved Black Adolescents.

Purpose: The purpose of this study was to examine the association between sugar-sweetened beverage (SSB) consumption and dental caries prevalence among underserved Black adolescents. Methods: This was a cross-sectional study of 545 Black adolescents, ages 12 to 17 years, who participated in the Howard Meharry Adolescent Caries Study (HMACS). The outcome was dental caries prevalence, measured using the decayed, missing, and filled permanent tooth surfaces (DMFS) index. Participants were recruited from middle and high schools in Washington, D.C., USA, and Nashville, Tenn., USA. Questionnaires were used to assess beverage intake, demographic, and health-related behavioral characteristics. The multivariable analysis used marginalized zero-inflated Poisson regression (MZIP) stratified by toothbrushing frequency to estimate adjusted mean caries ratios (MRs), adjusted odds ratios (ORs), and 95 percent confidence intervals (95 percent CIs). Results: The mean age of the participants was 14.1 years. Participants in the highest quartile for SSB consumption had a higher caries ratio than those in the lowest quartile [MR equals (=) 1.59, 95 percent CI equals 1.15 to 2.20] and a lower odds of not being at risk for caries (OR = 0.24, 95 percent CI = 0.09 to 0.61). These findings were only observed among those brushing once a day or less (n =202). Conclusions: Among Black adolescents in this study who brushed once a day or less, high levels of sugar-sweetened beverage consumption were associated with greater caries prevalence and a reduced likelihood of remaining caries-free than those with lower levels of SSB consumption. Future studies will focus on interventions to reduce SSB consumption.

Food Insecurity, Meal Behaviors, Beverage Intake, and Body Mass Index in Underserved Adolescents.

OBJECTIVE: Associations between food insecurity, meal patterns, beverage intake, and body mass index (BMI) were investigated using data from the Howard Meharry Adolescent Caries Study. METHODS: Secondary analyses of food security status used the Wilcoxon rank sum, chi-square, and Fisher's exact tests. RESULTS: The group of adolescents (n=627) was 42.1% male, 14.2±1.9 years, 86.9% African American, and 19.9% food-insecure. Meal frequency, meal structure, most beverage intake, and BMI did not differ by food-security status. Adolescents from Washington, DC were more likely to be food insecure than adolescents from Nashville, TN (P=0.003). Most had unstructured meal patterns and irregular breakfast intake. Median milk intake was below and sugar-sweetened beverage intake above dietary recommendations. CONCLUSIONS: This study extends our knowledge concerning food insecurity in urban African American adolescents and suggests public health initiatives designed to encourage meal structure, increase milk intake, and reduce sugar-sweetened beverage intake can improve diet quality of underserved youth.

An Approach to Engaging Schools In Oral Health Initiatives: The Howard Meharry Adolescent Caries Study (HMACS).

Use of community-based participatory research (CBPR) principles can help identify strategies for development and implementation of studies that can address oral health disparities disfavoring African American youth. This paper summarizes approaches of the Howard Meharry Adolescent Caries Study (HMACS) to provide sustained oral health services beyond the life of a research study.

Factors Associated with Smoking Cessation Among Quit Smart(™) Participants.

OBJECTIVES: To evaluate social and program factors associated with the one-year smoking cessation rate among participants of a smoking cessation program at a managed care organization (MCO). METHODS: As implemented at this MCO, the Quit Smart(™) program incorporated group sessions taught by health educators, discount vouchers for nicotine replacement patches, self-help manuals, and a relaxation audiotape. A survey of 97 patients who participated in the program during 1999 or 2000 or both was administered one year after these participants completed the program. RESULTS: Of the 97 participants, 58 responded to the survey. Nineteen (33%) reported not smoking at one year after completing the program; and 11 (19%) reported that they were smoking-abstinent for 12 months after completing the program. Compared with patients who did not use the nicotine patch, respondents who used the nicotine patch were significantly more likely (OR = 4.42 [1.12, 17.35]) to report not smoking at 12 months after completing the program and to be smoking-abstinent for 12 months after completing the program (OR = 8.31 [1.15-60.22]). Respondents who were exposed to smoking in two or three settings (ie, at home, with friends, at work) were significantly less likely to report smoking cessation at 12 months (OR = 0.12 [0.02, 0.70]) and to have abstained from smoking for 12 months (OR = 0.04 [0.01, 0.42]) than were respondents who were not exposed to smoking in these settings. CONCLUSIONS: The Quit Smart(™) program achieved 12-month smoking cessation and abstinence rates comparable with those achieved by other multifactorial programs to promote smoking cessation. Subsidized therapy using the nicotine patch was effective for promoting smoking cessation. However, program success was inhibited by exposure to smoking in domestic and social situations.