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1.
Artigo em Inglês | MEDLINE | ID: mdl-39227545

RESUMO

PURPOSE: To examine the association between adherence to sleep, dietary, screen time, and physical activity (PA) (8-5-2-1-0) guidelines and risk of high body mass index (BMI ≥ 85 percentile) among U.S. adolescents and to assess for racial inequities and age-varying effects in these associations. METHODS: Data from the 2019 Youth Risk Behavior Surveillance System survey were used to conduct multivariable logistic regression models and moderation analysis by race/ethnicity and age using time-varying varying effect models (TVEM) and estimate associations of interest. RESULTS: Of the 13,518 adolescents aged ≥ 14 years, only 0.5% met all guidelines. Adolescents adhering to sleep guidelines had a 21% reduction in their odds of having a high BMI (OR 0.79, 95% CI 0.67-0.93). Those adhering to PA guidelines had a 34% reduction in their odds of having a high BMI (OR 0.66, 95% CI 0.56-0.79), and those adhering to screen time guidelines had a 17% reduction in their odds of having a high BMI (OR 0.83, 95% CI 0.72-0.95). TVEM showed associations between adherence to sleep and screen time guidelines with high BMI fluctuate and are at specific ages. TVEM revealed substantial racial/ethnic differences in the age-varying association between adherence to 8-5-2-1-0 guidelines and high BMI throughout adolescence. CONCLUSIONS: Associations between adherence to sleep and screen time guidelines and high BMI fluctuate with age, highlighting the need for nuanced interventions targeting 24-h movement guidelines (sleep, PA, and screen time) across adolescence, particularly given racial/ethnic disparities.

2.
J Cancer Surviv ; 2024 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-38775900

RESUMO

PURPOSE: To examine associations between walkability, metropolitan size, and physical activity (PA) among cancer survivors and explore if the association between walkability and PA would vary across United States metropolitan sizes. METHODS: This study used data from the 2020 National Health Interview Survey to examine independent associations of walkability and metropolitan size with engaging in moderate-to-vigorous PA (MVPA) and to explore the effect modification of metropolitan size using log-binomial regression. The dependent variable was dichotomized as < vs. ≥ 150 min/week of MVPA. The predictors were perceived walkability, a total score comprising eight neighborhood attributes, and metropolitan size. Covariates included sociodemographic and health characteristics, geographic region, cancer type, and time since cancer diagnosis. RESULTS: Engaging in 150 + min/wk of MVPA significantly increased among cancer survivors (n = 3,405) who perceived their neighborhoods as more walkable (prevalence ratio:1.04; p = 0.004). Engaging in 150 + min/wk of MVPA significantly increased among cancer survivors living in medium and small metropolitan areas vs. those living in large central metropolitan areas (prevalence ratio:1.12; p = 0.044). Perceived walkability levels were similar among cancer survivors in nonmetropolitan areas vs. those living in large central metropolitan areas. Association between walkability and PA did not significantly vary across metropolitan sizes. CONCLUSIONS: Perceived neighborhood walkability is positively associated with MVPA among cancer survivors, regardless of metropolitan size. IMPLICATIONS FOR CANCER SURVIVORS: Findings highlight the importance of investing in the built environment to increase walkability among this population and translating lessons from medium and small metropolitan areas to other metropolitan areas to address the rural-urban disparity in PA among cancer survivors.

3.
JMIR Pediatr Parent ; 6: e43961, 2023 May 08.
Artigo em Inglês | MEDLINE | ID: mdl-37155230

RESUMO

BACKGROUND: Social media holds promise as an intervention platform to engage youths in healthy weight management and target racial inequities in obesity. OBJECTIVE: This mixed methods study aimed to examine social media habits, preferences, and obesity-related behaviors (eg, diet and physical activity) among adolescents of color and understand preferences for healthy weight management interventions delivered via social media. METHODS: This mixed methods study is comprised of a cross-sectional web-based survey and a series of digital focus groups. Study participants (English-speaking youths of color ages 14-18 years) were recruited from high schools and youth-based community settings in Massachusetts and California. For surveys, participants were invited to complete an anonymous web-based survey assessing self-reported sociodemographics, social media habits and preferences, health behaviors (diet, physical activity, sleep, and screen time), and height and weight. For focus groups, participants were invited to participate in 45- to 60-minute web-based group discussions assessing social media habits, preferred social media platforms, and preferences for physical activity and nutrition intervention content and delivery. Survey data were analyzed descriptively; focus group transcripts were analyzed using a directed content analysis approach. RESULTS: A total of 101 adolescents completed the survey and 20 adolescents participated in a total of 3 focus groups. Participants reported most frequently using TikTok, followed by Instagram, Snapchat, and Twitter; preference for platform varied by purpose of use (eg, content consumption, connection, or communication). TikTok emerged as the platform of choice as an engaging way to learn about various topics, including desired health information on physical fitness and diet. CONCLUSIONS: Findings from this study suggest that social media platforms can be an engaging way to reach adolescents of color. Data will inform future social media-based interventions to engage adolescents of color in healthy weight management content.

4.
Early Interv Psychiatry ; 17(12): 1207-1215, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37081818

RESUMO

AIM: To identify the demographic predictors of lack of current mental health (MH) treatment among university students with a schizophrenia spectrum disorder (SSD). METHODS: Adult university students with a self-identified diagnosis of an SSD (schizophreniform, schizophrenia, schizoaffective disorder) were identified from the 2019-2020 Healthy Minds Study survey. In this study, pertinent demographic factors included age, race/ethnicity, sex assigned at birth, gender identity, sexual orientation, parental education, financial stress, and employment. Multivariable modelling was used to investigate the demographic predictors of lack of current psychotherapy treatment, no current antipsychotic use, and lack of any MH treatment (defined as concurrent lack of psychotherapy and antipsychotic treatment). RESULTS: Of the 135 included students with a SSD, the median age was 23 years old and 79 (58.5%) were assigned female at birth. Fifty-five participants (40.7%) lacked any current MH treatment. In fully adjusted models, lack of current MH treatment was associated with working more than 20 h per week (OR 2.9 [1.2-7.1], p = 0.02). No current antipsychotic use was associated with Hispanic/Latino race/ethnicity (OR 4.2 (1.2-14.5), p = 0.04). Lack of current psychotherapy treatment was associated with cisgender male identity (OR 5.5 [2.0-15.2], p < 0.01), working greater than 20 hours per week (OR 6.5 [2.2-19.2], p < 0.01), and having one or more structural or attitudinal barriers to care (OR = 4.6 [1.5-13.9], p < 0.01). CONCLUSIONS: The demographic predictors of lack of current MH treatment varied between psychotherapy and antipsychotic use, suggesting university health centres should consider interventions targeting several at-risk populations to increase treatment use among students with a SSD.


Assuntos
Antipsicóticos , Esquizofrenia , Adulto , Recém-Nascido , Feminino , Masculino , Humanos , Adulto Jovem , Esquizofrenia/terapia , Esquizofrenia/tratamento farmacológico , Antipsicóticos/uso terapêutico , Saúde Mental , Universidades , Identidade de Gênero , Psicoterapia , Etnicidade , Estudantes/psicologia
5.
Womens Health Issues ; 22(6): e553-61, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22964361

RESUMO

PURPOSE: Single motherhood is a well-established risk factor for depression in women. The goal of this study is to analyze the relationships among partner status, having children, and depression among women of White, Black, and Hispanic race/ethnicity. METHODS: Stratified analyses were conducted on 2002, 2003, 2005, 2006, and 2008 cross-sectional survey data from 10,520 White women, 7,655 Black women, and 7,343 Hispanic women aged at least 18 years and residing in New York City. Depression was evaluated using Kessler's K6 scale. Race/ethnicity-specific logistic regression analysis assessed the association between partner status and depression among women with and without children. RESULTS: Partner status was significantly associated with depression among White (p < .0001) and Hispanic (p = .0001) women, but not among Black women (p = .82), after adjusting for age, nativity, employment, education, poverty level, general health, and health insurance. Among White women, the conditional odds of depression were elevated for single relative to partnered women both with (odds ratio [OR], 2.10; 95% confidence interval [CI], 1.57-2.81; p < .0001) and without (OR, 1.29; 95% CI, 1.06-1.56; p = .01) children, but the size of the effect was significantly larger for those with children than for those without children (p = .006). Among Hispanic women, the conditional odds of depression were elevated for single relative to partnered women with children (OR, 1.58; 95% CI, 1.29-1.95; p < .0001), but not for single versus partnered women without children (OR, 1.09; 95% CI, 0.82-1.46; p = .54). Among Black women, there was no evidence of elevated depression in single relative to partnered women, either overall or conditional on the presence of children (with children: OR, 1.21 [95% CI, 0.95-1.54; p = .13]; without children: OR, 0.75 [95% CI, 0.56-1.02; p = .06]). CONCLUSION: Past focus on single mothers as a high-risk group has oversimplified the relationship between partner status and depression, obscuring important distinctions between women of different racial backgrounds.


Assuntos
Negro ou Afro-Americano/psicologia , Depressão/etnologia , Hispânico ou Latino/psicologia , Estado Civil/etnologia , População Branca/psicologia , Adolescente , Adulto , Negro ou Afro-Americano/estatística & dados numéricos , Idoso , Cuidadores/psicologia , Criança , Pré-Escolar , Estudos Transversais , Depressão/psicologia , Características da Família/etnologia , Feminino , Hispânico ou Latino/estatística & dados numéricos , Humanos , Lactente , Recém-Nascido , Entrevistas como Assunto , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Cidade de Nova Iorque/epidemiologia , Prevalência , Fatores de Risco , Parceiros Sexuais , Fatores Socioeconômicos , Inquéritos e Questionários , População Branca/estatística & dados numéricos , Adulto Jovem
6.
Obstet Gynecol ; 115(4): 717-726, 2010 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-20308830

RESUMO

OBJECTIVE: To examine 2009 H1N1 influenza illness severity and the effect of antiviral treatment on the severity of illness among pregnant women. METHODS: We abstracted medical records from hospitalized pregnant (n=62) and nonpregnant (n=74) women with laboratory-confirmed 2009 H1N1 influenza in New York City, May through June 2009. We compared characteristics of pregnant and nonpregnant women and of severe and moderate influenza illness among pregnant women, with severe defined as illness resulting in intensive care admission or death. RESULTS: The 2009 H1N1 hospitalization rate was significantly higher among pregnant than nonpregnant women (55.3 compared with 7.7 per 100,000 population). Eight pregnant (including two deaths) and 16 nonpregnant (including four deaths) cases were severe. Pregnant women represented 6.4% of hospitalized cases and 4.3% of deaths caused by 2009 H1N1 influenza. Only 1 in 30 (3.3%) pregnant women who received oseltamivir treatment within 2 days of symptom onset had severe illness compared with 3 of 14 (21.4%) and four of nine (44.4%) pregnant women who started treatment 3-4 days and 5 days or more after symptom onset, respectively (P=.002 for trend). Severe and moderate 2009 H1N1 influenza illness occurred in all pregnancy trimesters, but most women (54.8%) were in the third trimester. Twenty-two women delivered during their influenza hospitalization, and severe neonatal outcomes (neonatal intensive care unit admission or death) occurred among five of six (83.3%) women with severe illness compared with 2 of 16 (12.5%) women with moderate illness (P=.004). CONCLUSION: Our findings highlight the potential for severe illness and adverse neonatal outcomes among pregnant 2009 H1N1 influenza-infected women and suggest the benefit of early oseltamivir treatment. LEVEL OF EVIDENCE: II.


Assuntos
Surtos de Doenças , Vírus da Influenza A Subtipo H1N1 , Influenza Humana/epidemiologia , Complicações Infecciosas na Gravidez/epidemiologia , Adolescente , Adulto , Antivirais/uso terapêutico , Cesárea , Parto Obstétrico , Feminino , Idade Gestacional , Hospitalização , Humanos , Recém-Nascido , Influenza Humana/complicações , Influenza Humana/tratamento farmacológico , Tempo de Internação , Cidade de Nova Iorque/epidemiologia , Gravidez , Complicações Infecciosas na Gravidez/tratamento farmacológico , Adulto Jovem
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