Physical Activity and Cardiovascular Risk among Kidney Transplant Patients.

PURPOSE: Research examining the relationship between physical activity (PA) and cardiovascular disease (CVD) risk factors among kidney transplant recipients (KTR) is limited. Accordingly, we sought to 1) describe the levels of PA in KTR and 2) analyze the associations between PA levels and CVD risk factors in KTR. METHODS: Baseline data from KTR participants in a large multiethnic, multicenter trial (the Folic Acid for Vascular Outcome Reduction in Transplantation) were examined. PA was categorized in tertiles (low, moderate, and high) derived from a modified PA summary score from the Yale Physical Activity Survey. CVD risk factors were examined across levels of PA by ANOVA, Kruskal-Wallis rank test, and hierarchical multiple regression. RESULTS: The 4034 participants were 37% female (mean ± SD = 51.9 ± 9.4 yr of age, 75% White, 97% with stage 2T-4T chronic kidney disease, and 20% with prevalent CVD. Participants in the "high" PA tertile reported more vigorous PA and walking, compared with participants in moderate and low tertiles (both P < 0.001). No differences were observed in daily household, occupational, or sedentary activities across PA tertiles. More participants in the "low" PA tertile were overweight/obese, had a history of prevalent diabetes, and/or had CVD compared with more active participants (all P < 0.001). Hierarchical modeling revealed that younger age (P = 0.002), cadaveric donor source (P = 0.006), shorter transplant vintage (P = 0.025), lower pulse pressure (P < 0.001), and no history of diabetes (P < 0.001) were associated with higher PA scores. CONCLUSION: The most active KTR engaged in more intentional exercise. Lower levels of PA were positively associated with more CVD risk factors. Higher PA levels were associated with younger age and with more positive KTR outcomes.

Perceptions of breast and cervical cancer risk and screening among Dominicans and Puerto Ricans in Rhode Island.

This study explored perceptions of cancer, risk, and screening among Dominicans and Puerto Ricans in Rhode Island. Qualitative interviews were conducted with a community-based sample of 147 adults. Perceived risks for breast cancer were predominantly associated with carelessness about health care, trauma to the breast, and breastfeeding. Cervical cancer risks were mostly attributed to carelessness about health care and sexual behaviors. A strong sense of fatalism and embarrassment coexisted with positive beliefs about check-ups and screening. Participants cited confianza (trust, confidence) in their doctor, and their doctor's provision of information and explanations, as important factors in decreasing embarrassment and increasing their likelihood of getting screened. While familiarity with mammography and Pap testing was great among participants, many did not practice sustained, regular screening, and held misconceptions about tests and screening guidelines. Respondents' perceptions of having sufficient information often did not correspond to their having the accurate information necessary to promote informed screening decisions.

Comparison of baseline fat-related eating behaviors of Puerto Rican, Dominican, Colombian, and Guatemalan participants who joined a cholesterol education project.

OBJECTIVE: The objective is to compare baseline fat-related eating behaviors among Hispanic subgroups who joined a cholesterol education research project in New England. DESIGN: Participants attended baseline screenings as part of the study. They had their height, weight, and blood cholesterol measured and completed baseline surveys with demographic, risk factor, dietary, and psychosocial questions. PARTICIPANTS: A total of 370 Puerto Rican, 210 Colombian, 357 Dominican, and 102 Guatemalan subjects participated in the baseline. MAIN OUTCOME MEASURES: Dietary behavior was measured using the Food Habits Questionnaire (FHQ), which was originally developed to assess food choices and preparation patterns related to adopting a low-fat diet. Measures include FHQ fat summary scores (a reflection of total fat intake), fat behavior subscales, and individual fat-related behaviors. ANALYSIS: Analysis of variance was used to compare FHQ fat summary scores and multivariate analysis of variance was used to compare fat behavior scores and individual food item scores for the 4 Hispanic subgroups. Age and gender were covariates in the models. RESULTS: Puerto Rican participants had a significantly higher mean FHQ fat summary score than Dominicans and Guatemalans and a higher prevalence of many fat-related eating behaviors. Although there were some differences by subgroup, the 4 most prevalent fat-related behaviors were similar: cooking with fat/oil, eating higher-fat sweets, eating higher-fat snacks, and eating dinners with meat. CONCLUSIONS AND IMPLICATIONS: Future educational programs and materials for diverse Hispanic audiences in the northeastern United States should include the above issues; however, educational materials and programs ought to be tailored to individuals whenever possible. Efforts may need to focus on Puerto Ricans, who had a higher prevalence of many fat-related behaviors in this study.