Identifying the Complexity of Multiple Risk Factors for Obesity Among Urban Latinas.

The prevalence of obesity is rising rapidly among Hispanics/Latinas. We evaluated the prevalence of being obese or overweight and associated risk factors among 630 low-income, Latina women from ambulatory care clinics in Upper Manhattan. Overall, 37 % of the sample was overweight and 41 % of the sample was obese, and yet, almost half of women who are overweight considered their weight "just about right." After adjusting for socio-demographic, behavioral, and biological risk factors, being obese was strongly associated with having hypertension [relative risk ratio (RRR) 3.93, 1.75-8.82], pre-hypertension (RRR 2.59, 1.43-4.67), diabetes (RRR 2.50, 1.21-5.14) and moderate/moderately severe/severe depression (RRR 2.09, 1.03-4.26). Women who reported that finding time was a barrier to physical activity were also more likely to be obese (RRR 1.78, 1.04-3.02). Chronic financial stress was associated with lower risk of being overweight (RRR 0.47, 0.28-0.79) or obese (RRR 0.51, 0.31-0.86), as well as eating out at restaurants (RRR 0.75, 0.62-0.89). Opportunities for intervention relate to understanding cultural factors around perceptions of weight and helping women find the time for physical activity.

Reliability and validity of the patient activation measure in hospitalized patients.

OBJECTIVE: The purposes of this paper are to describe the internal consistency reliability and construct validity of the PAM-13 for hospitalized cardiology and oncology patients and to examine the predictors of low patient activation in the same population. METHODS: We evaluated the internal consistency reliability of the PAM-13 in the inpatient setting. Construct validity of the PAM-13 was then assessed using two approaches: expected known-groups differences between patients with planned and unplanned admissions PAM-13 levels and convergence of PAM-13 levels with other measures. RESULTS: The PAM demonstrated adequate internal consistency overall (Cronbach α=0.81). Patients with unplanned admissions were more likely to have low activation than patients with planned admissions (adjusted OR=5.7, p=0.008). The PAM-13 was modestly correlated (p<0.001) with each of the PROMIS Global Health components used in this study (global, physical and mental health). CONCLUSION: This study demonstrates the PAM-13 is a reliable and valid measure for use in the inpatient hospital setting and that type of admission (planned versus unplanned) is an important predictor of patient activation. PRACTICE IMPLICATIONS: By measuring patient activation with the PAM-13, clinicians and researchers can provide tailored communication and care strategies to meet patient's needs.