Actions taken to reduce sodium intake among adults with self-reported hypertension: HealthStyles survey, 2005 and 2008.

Consuming high amounts of dietary sodium is associated with hypertension. The authors analyzed the HealthStyles 2005 and 2008 survey for behaviors to lower blood pressure related to dietary sodium, including the reduction of sodium intake and reading food labels for sodium content among hypertensives. All estimates were based on self-reported data. The relative percent change (RPC) in the prevalence of these behaviors between 2005 and 2008 was assessed. During the 3-year period, there were increases in the prevalence of reducing dietary sodium (RPC=17.2%, 56.6% in 2008 vs 48.3% in 2005; P<.05) and reading food labels for sodium content (RPC=7.9%, 53.0% vs 49.1%; P<.05). In 2005, the proportion of hypertensive adults who reported reducing dietary sodium was higher for persons 65 years and older, for blacks, for those with income <$25,000, and for those with more than a high school education compared with those in their comparison groups. In 2008, those aged 65 years and older had the highest percentage, while Hispanics and blacks had essentially the same percentage for reducing sodium. Based on 2005 and 2008 HealthStyles surveys, about half of hypertensive patients reported reducing their intake of sodium and reading food labels for salt. Health care providers should emphasize the importance of knowing the daily recommended limit for dietary sodium to help adults lower this intake.

Changing the conversation about prostate cancer among African Americans: results of formative research.

OBJECTIVES: To understand obstacles to and opportunities for improving prostate cancer communication to and within African American communities. DESIGN: Researchers conducted interviews with 19 community leaders and five focus groups with healthy men and survivors. The team also conducted process evaluations of two outreach projects in which survivors spoke to African American men about prostate cancer and screening. RESULTS: Three levels of obstacles to prostate cancer screening and treatment were identified. Individual-level obstacles included limited knowledge about the condition, about prevention and treatment, and fear of cancer. Socio-cultural barriers included distrust of the medical system, lack of a provider for routine and preventive care, reluctance to talk about cancer, and aversion to aspects of screening. Institutional deficits included the scarcity of educational efforts targeting prostate cancer. Outreach project evaluations suggested that survivors can be effective in building prostate cancer knowledge, promoting positive attitudes toward screening, and fostering conversations about prostate cancer. Educational efforts included little information about screening risks and decision-making however. CONCLUSIONS: The findings suggest that most potent interventions may combine survivor-led education with mass media and institution-based outreach. Such comprehensive programs could shift social norms that inhibit conversation and foster fear, leading in turn to more informed decisions and better treatment outcomes.

Active neighborhood checklist: a user-friendly and reliable tool for assessing activity friendliness.

PURPOSE: To test the reliability of the Active Neighborhood Checklist (the Checklist), a user-friendly audit tool for assessing neighborhood environmental supports for physical activity. METHODS: Sixty-four street segments in St. Louis and southeastern Missouri were selected among diverse areas that varied with respect to socioeconomic levels, urbanization, and land use. Fifteen public health researchers and seven community stakeholders conducted audits in April 2005 following a two-hour training session. Interrater reliability was measured for the items in each section of the Checklist (land use characteristics, sidewalks, shoulders and bike lanes, street characteristics, and quality of the environment for a pedestrian) using observed agreement and the kappa statistic. RESULTS: The mean observed agreement for 57 evaluated items was 0.87 (range, 0.61-1.00). The mean kappa statistic was 0.68 (range, 0.21-1.00). DISCUSSION: With minimal training of the auditors, the Checklist demonstrated strong reliability. Future studies are needed to provide information about its usability for various stakeholders and across different settings.

How reliably do community members audit the neighborhood environment for its support of physical activity? Implications for participatory research.

Environmental audits are used to assess supports for physical activity in the community. Understanding the suitability of such instruments for use by community members is crucial for advocacy and participatory research. This study examined the reliability of an audit instrument filled out by trained researchers and untrained community members. Two researchers and five community members conducted environmental audits on a total of 335 street segments in lower-income areas in St Louis, Missouri (representing a "low-walkable city"), and Savannah, Georgia (representing a "high-walkable" city). The audit tool consisted of six major sections--land use environment, recreational facilities, transportation environment, aesthetics, signage, and social environment. Interrater agreement between researchers and community members was assessed using percent observed agreement and the kappa statistic. According to observed agreement, the majority of audit items (67 of 76) had substantial to almost perfect agreement (> or =0.60) between researchers and community members. However, much lower agreement was observed using the kappa statistic (only 8 of 76 items with kappas > or =0.60). With some formal training, this audit tool may be useful for advocacy and participatory research to assess the activity friendliness of neighborhood environments.