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1.
J Strength Cond Res ; 2019 Aug 08.
Artículo en Inglés | MEDLINE | ID: mdl-31403571

RESUMEN

de Heer, HD, Kaufman, A, Repka, CP, Rojas, K, Charley, B, and Bounds, R. AlterG Anti-Gravity Treadmill accuracy of unloading is affected by support frame height. J Strength Cond Res XX(X): 000-000, 2019-The AlterG Anti-Gravity Treadmill uses air pressure to provide partial body-weight support (BWS), lowering impact forces and metabolic demand of walking and running. Users wear specialized shorts that zip onto a bag supported by a metal bar frame covering the treadmill. The frame is placed at hip height in positions numbered 1-9, adjusted up or down based on preference. Machine accuracy in providing BWS is important to achieve desired training effects, but it is unknown whether frame placement impacts accuracy. Twenty subjects (10 men/women) were weighed in 10% increments from 0 to 60% BWS with the frame at hip height (iliac crest), the "neutral" position, and reweighed with the frame placed up to 3 numbers above or below hip height. Although the machine displayed the same proportion BWS, placing the frame higher than the neutral position resulted in significantly more support, whereas placing the frame lower led to less support. At 10% BWS, placing the frame 3 positions higher resulted in 3% more support compared with the neutral position (13.1% BWS, p < 0.001) and 3 positions lower in 4.7% less support (5.3% BWS, p < 0.001). Deviances were greater with more BWS. At 60% BWS, 3 positions higher than neutral resulted in 71.2% BWS (11.2% more than expected, p < 0.001) and 3 below 48.1% BWS (12.9% below expected, p < 0.001), total 24.1% difference. These findings suggest that the position of the support frame significantly impacts the AlterG accuracy in providing BWS, with placement higher than hip height resulting in more support than displayed by the machine and lower placement resulting in less support.

2.
Artículo en Inglés | MEDLINE | ID: mdl-30585213

RESUMEN

Marginalized communities have a documented distrust of research grounded in negative portrayals in the academic literature. Yet, trusted partnerships, the foundation for Community-Based Participatory Research (CBPR), require time to build the capacity for joint decision-making, equitable involvement of academically trained and community investigators, and co-learning. Trust can be difficult to develop within the short time between a funding opportunity announcement and application submission. Resources to support community- and academic-based investigators' time to discuss contexts, concerns, integration of expertise and locally acceptable research designs and data collection are limited. The National Institutes of Health (NIH) funded Center for American Indian Resilience and the Southwest Health Equity Research Collaborative have implemented an internal funding mechanism to support community and academic-based investigators' travel cost and time to discuss complementary areas of interest and skills and to decide if moving forward with a partnership and a collaborative grant proposal would be beneficial to the community. The rationale and administration of this Community-Campus Partnership Support (CCPS) Program are described and four examples of supported efforts are provided. Centers and training programs frequently fund pilot grants to support junior investigators and/or exploratory research. This CCPS mechanism should be considered as precursor to pilot work, to stimulate partnership building without the pressure of an approaching grant application deadline.


Asunto(s)
Investigación Participativa Basada en la Comunidad/organización & administración , Indios Norteamericanos , Relaciones Comunidad-Institución , Conducta Cooperativa , Toma de Decisiones , Humanos , Apoyo a la Investigación como Asunto , Confianza
3.
J Allied Health ; 47(3): 196-203, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-30194826

RESUMEN

Health professions students often experience burnout and loss of empathy that worsens as they progress through their education. This study explored the impact of an evidence-based online course on physical therapy student empathy, resilience, and work engagement during their clinical internships. Participants included 36 doctoral physical therapy students who were beginning a sequence of three consecutive internships following their didactic coursework. Participants were randomly assigned to an immediate or delayed intervention group and received the online course during the first or second of the three internships. Outcome measures included the Jefferson Scale of Empathy, Utrecht Work Engagement scale, and GRIT resilience scale. The immediate intervention group made significant improvements in all three measures between the first and second internships compared to the delayed intervention group. These improvements were maintained over the 10-week duration of the second internship. The delayed intervention group made no significant changes in the three measures during the first internship; however, these each improved significantly at the end of the second internship. The study results suggest that online training can positively enhance physical therapy student empathy, resilience, and work engagement.

4.
Physiother Theory Pract ; : 1-7, 2018 Mar 02.
Artículo en Inglés | MEDLINE | ID: mdl-29498558

RESUMEN

PURPOSE: Functional limitations are associated with decreased physical activity and increased body mass index. The purpose of this study was to assess the prevalence of functional limitations among adults who reported receiving health professional advice to exercise more or lose weight, and to assess involvement of health professionals, including physical therapists, in weight loss efforts with these individuals. DESIGN: A cross-sectional analysis of U.S. adults from the 2011 to 2014 National Health and Nutrition Examination Survey (n = 5,480). METHODS: Participant demographics, health history, and functional limitations were assessed via self-report and examination. Frequency distributions were calculated using SAS® analytical software, accounting for the complex survey design. Population estimates were calculated using the American Community Survey. RESULTS: 31.0% of individuals (n = 1,696), representing a population estimate of 35 million adults, advised to exercise more or lose weight by a health professional reported one or more functional limitation. Of the 31%, 57.6% attempted weight loss, and 40.1% used exercise for weight loss. Few sought health professional assistance. Physical therapists were not mentioned. CONCLUSIONS: Few individuals with functional limitations advised to lose weight or increase exercise seek health professional assistance for weight loss. Physical therapists have an opportunity to assist those with functional limitations with exercise prescription.

5.
Transl Behav Med ; 8(1): 95-104, 2018 01 29.
Artículo en Inglés | MEDLINE | ID: mdl-29385582

RESUMEN

Family health history is an accessible, clinically-recommended genomic tool that improves health risk evaluation. It captures both genetic and modifiable risk factors that cluster within families. Thus, families represent a salient context for family health history-based interventions that motivate engagement in risk-reducing behaviors. While previous research has explored how individuals respond to their personal risk information, we extend this inquiry to consider how individuals respond to their spouse's risk information among a sample of Mexican-Americans. One hundred and sixty spouse-dyads within Mexican-heritage households received a pedigree or a pedigree and personalized risk assessments, with or without behavioral recommendations. Analyses of Covariance (ANCOVAs) were conducted to assess the relationship between risk feedback, both personal and spouse, and self-reported physical activity levels at 3-month and 10-month assessments, controlling for baseline levels. The effect of being identified as an encourager of spouse's healthy weight was also evaluated. Personal feedback had no effect on participants' physical activity at either 3- or 10-month assessments. However, husbands' risk information was associated with wives' physical activity levels at 3-month assessment, with women whose husbands received both increased risk feedback and behavioral recommendations engaging in significantly higher physical activity levels than all other women. At 10-month follow-up, physical activity levels for both husbands and wives differed depending on whether they encouraged their spouse's healthy weight. Spousal risk information may be a stronger source of motivation to improve physical activity patterns than personal risk information, particularly for women. Interventions that activate interpersonal encouragement among spouses may more successfully extend intervention effects.


Asunto(s)
Conductas Relacionadas con la Salud , Cardiopatías/prevención & control , Cardiopatías/psicología , Americanos Mexicanos/psicología , Esposos/psicología , Ejercicio , Retroalimentación Psicológica , Femenino , Estudios de Seguimiento , Conductas Relacionadas con la Salud/etnología , Comunicación en Salud , Promoción de la Salud , Cardiopatías/etnología , Humanos , Relaciones Interpersonales , Masculino , Persona de Mediana Edad , Factores Sexuales , Esposos/etnología
6.
J Geriatr Phys Ther ; 2017 Nov 01.
Artículo en Inglés | MEDLINE | ID: mdl-29095771

RESUMEN

BACKGROUND AND PURPOSE: Several measures of fall risk have been previously developed and include forward walking, turning, and stepping motions. However, recent research has demonstrated that backwards walking is more sensitive at identifying age-related changes in mobility and balance compared with forward walking. No clinical test of backwards walking currently exists. Therefore, this article describes a novel clinical test of backwards walking, the 3-m backwards walk (3MBW), and assessed whether it was associated with 1-year retrospective falls in a population of healthy older adults. Diagnostic accuracy of the 3MBW was calculated at different cutoff points and compared with existing clinical tests. METHODS: This study was a retrospective cohort study including residents of a retirement community without a history of neurological deficits. Demographics, medical history, and falls in the past year were collected, and clinical tests included the 3MBW and the Timed Up and Go (TUG), the 5 times sit-to-stand, and the 4-square step test. Frequency distributions and t tests compared baseline characteristics of people who reported falling with people who did not. Diagnostic accuracy (sensitivity and specificity) was calculated for a series of cutoffs for the 3MBW, the TUG (≥8, 10, and 13.5 seconds), 5 times sit-to-stand (≥12 and ≥15 seconds), and 4-step square test (>15 seconds). Receiver operating curve analyses were used to define 3MBW optimal cutoffs, and the difference between the overall area under the curve (AUC) was statistically tested. SPSS 24.0 and MedCalc 17.1 were used for all analyses. RESULTS AND DISCUSSION: Fifty-nine adults with a mean (SD) age of 71.5 (7.6) years participated, with 25 people reporting falls in the past year. The mean (SD) time for the 3MBW was 4.0 (2.1) seconds. People who fell had a significantly slower 3MBW time (4.8 vs 3.5 seconds for people who did not fall, P = .015), but not a significantly slower 4-step square test (9.5 vs 8.1 seconds, P = .056), TUG (9.3 vs 8.0 seconds, P = .077), and 5 times sit-to-stand (12.5 vs 10.3 seconds, P = .121). The highest overall AUC for any measure was for the 3MBW at 3.5 seconds (0.707, 95% confidence interval = 0.570-0.821; sensitivity = 74%, specificity = 61%), which was significantly higher than the TUG at 8 seconds (AUC = 0.560, P = .023) and 13.5 seconds (AUC = 0.528, P = .011), the 4-step square test (AUC = 0.522, P = .004), but not significantly higher than the TUG at 10 seconds (P = .098) and the 5 times sit-to-stand at 12 (P = .092) or 15 seconds (P = .276). On the 3MBW, more than 75% of people who were faster than 3.0 seconds did not report any falls, and 94% of people who did not report falling were faster than 4.5 seconds. Of the people who were slower than 4.5 seconds, 81% reported falling. CONCLUSIONS: In a study of healthy older adults, the 3MBW demonstrated similar or better diagnostic accuracy for falls in the past year than most commonly used measures. People walking faster than 3.0 seconds on the 3MBW were unlikely to have reported falling, whereas people slower than 4.5 seconds were very likely to have reported falling. Further validation of the 3MBW in prospective studies, larger samples, and clinical populations is recommended.

7.
Spine (Phila Pa 1976) ; 41(19): 1515-22, 2016 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-26998645

RESUMEN

STUDY DESIGN: A retrospective cohort study. OBJECTIVE: The aim of this study was to evaluate associations between receipt and quantity of outpatient physical therapy (PT) during an episode of care and 30-day and 180-day hospital admissions for any condition and lumbar spine conditions. SUMMARY OF BACKGROUND DATA: Low back pain (LBP) is a common cause of hospitalization and the most common reason Medicare beneficiaries utilize outpatient PT. The association between PT and hospitalization among patients with LBP is unknown. METHODS: A national sample of Medicare Fee-for-Service claims included 413,608 beneficiaries with an International Classification of Disease 9th revision (ICD-9) code of LBP and 1,415,037 episodes of care between June 1, 2010, and June 30, 2011. Episodes were classified as PT episodes or non-PT episodes. Relative risk of hospitalization from the episode start date was caldulated, adjusting for health status (Charlson comorbidity index), prior care utilization (number of prior hospitalizations and total number of episodes), an indicator of LBP severity (number of LBP ICD-9 codes), and demographics (sex, race/ethnicity, age). RESULTS: The proportion of 30-day hospitalization for any condition was 3.42% for PT episodes of care and 6.54% for non-PT episodes. For 180-day hospitalization, proportions were 15.45% (PT) and 21.65% (non-PT). The adjusted relative risk reduction of PT (vs. non-PT) was 41% for 30 days [99% confidence interval (CI) 38-44] and 22% for 180 days (20-24). For admitting diagnoses of lumbar spine, reductions were 65% at 30 days and 32% at 180 days. More PT treatment days showed greater 30-day risk reductions. For any condition, compared with non-PT, reductions were 24% for 1 to 2 treatment days (lowest tertile), 45% for 3 to 7 days, and 65% for more than 8 days (highest tertile). Stronger effects were found for lumbar spine admissions. Associations between PT quantity and 180-day hospitalization were less consistent. Limitations of Medicare claims include the potential for inaccuracies, limited knowledge about disease severity, and which PT interventions were conducted. CONCLUSION: Receipt of PT during an episode had a 22% to 65% reduced relative risk of hospitalization, with greater short-term reductions for more PT treatment days. LEVEL OF EVIDENCE: 3.


Asunto(s)
Hospitalización , Dolor de la Región Lumbar/terapia , Modalidades de Fisioterapia , Anciano , Anciano de 80 o más Años , Planes de Aranceles por Servicios , Femenino , Humanos , Dolor de la Región Lumbar/diagnóstico , Masculino , Medicare , Persona de Mediana Edad , Estudios Retrospectivos , Estados Unidos
8.
Public Health Genomics ; 19(2): 93-101, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-26854931

RESUMEN

BACKGROUND: This study investigated diabetes and heart disease family health history (FHH) knowledge and changes after providing personalized disease risk feedback. METHODS: A total of 497 adults from 162 families of Mexican origin were randomized by household to conditions based on feedback recipient and content. Each provided personal and relatives' diabetes and heart disease diagnoses and received feedback materials following baseline assessment. Multivariate models were fitted to identify factors associated with the rate of 'don't know' FHH responses. RESULTS: At baseline, US nativity was associated with a higher 'don't know' response rate (p = 0.002). Though confounded by country of birth, younger age showed a trend toward higher 'don't know' response rates. Overall, average 'don't know' response rates dropped from 20 to 15% following receipt of feedback (p < 0.001). An intervention effect was noted, as 'don't know' response rates decreased more in households where one family member (vs. all) received supplementary risk assessments (without behavioral recommendations; p = 0.011). CONCLUSIONS: Limited FHH knowledge was noted among those born in the US and younger participants, representing a key population to reach with intervention efforts. The intervention effect suggests that 'less is more', indicating the potential for too much information to limit health education program effectiveness.


Asunto(s)
Diabetes Mellitus , Salud de la Familia , Conductas Relacionadas con la Salud , Promoción de la Salud/métodos , Cardiopatías , Anamnesis , Adulto , Anciano , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Masculino , Anamnesis/estadística & datos numéricos , México/etnología , Persona de Mediana Edad , Análisis Multivariante , Medición de Riesgo , Factores de Riesgo , Texas
9.
Health Promot Pract ; 17(3): 343-52, 2016 05.
Artículo en Inglés | MEDLINE | ID: mdl-26542302

RESUMEN

INTRODUCTION: Limited research has documented interventions aimed at promoting use of existing recreational community resources among underserved populations. This study (HEART [Health Education Awareness Research Team] Phase 2) reports findings of an intervention (Mi Corazón Mi Comunidad) where community health workers facilitated use of diet and exercise programming at local recreational facilities among Mexican American border residents. The aim was to evaluate overall attendance rates and to assess which factors predicted higher attendance. METHOD: The design was a cohort study. From 2009 to 2013, a total of 753 participants were recruited across 5 consecutive cohorts. The intervention consisted of organized physical activity and nutrition programming at parks and recreational facilities and a free YWCA membership. Attendance at all activities was objectively recorded. Regression analyses were used to evaluate whether demographic factors, health status, and health beliefs were associated with attendance. Results Participants included mostly females at high risk for cardiovascular disease (72.4% were overweight/obese and 64% were [pre-]hypertensive). A total of 83.6% of participants attended at least one session. On average, total attendance was 21.6 sessions (range: 19.1-25.2 sessions between the different cohorts), including 16.4 physical activity and 5.2 nutrition sessions. Females (p = .003) and older participants (p < .001) attended more sessions. Participants low in acculturation (vs. high) attended on average seven more sessions (p = .003). Greater self-efficacy (p < .001), perceived benefits (p = .038), and healthy intentions (p = .024) were associated with higher attendance. Conclusions The intervention was successful in promoting use of recreational facilities among border residents at high risk for cardiovascular disease. Findings were similar across five different cohorts.


Asunto(s)
Agentes Comunitarios de Salud/organización & administración , Promoción de la Salud/organización & administración , Americanos Mexicanos , Parques Recreativos/organización & administración , Características de la Residencia , Adulto , Factores de Edad , Enfermedades Cardiovasculares/etnología , Estudios de Cohortes , Agentes Comunitarios de Salud/estadística & datos numéricos , Dieta , Ejercicio , Femenino , Conocimientos, Actitudes y Práctica en Salud , Estado de Salud , Humanos , Intención , Masculino , Persona de Mediana Edad , Sobrepeso/etnología , Evaluación de Programas y Proyectos de Salud , Factores de Riesgo , Autoeficacia , Factores Sexuales , Factores Socioeconómicos , Poblaciones Vulnerables
10.
Hisp Health Care Int ; 13(4): 197-208, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-26671560

RESUMEN

The purpose of this study was to determine the association between income, insurance status, acculturation, and preventive screening for diabetes, high blood pressure, and cholesterol in Mexican American adults living in El Paso, Texas. This is a secondary data analysis using data from El Paso, Texas, that was collected between November 2007 and May 2009. Bivariate and stepwise regression analysis was used to determine the relationships between income, insurance, and acculturation factors on preventive screenings. Findings indicate that insurance status was associated with blood pressure check, blood sugar check, cholesterol screening, and any preventive screening. The association for income $40,000 + was explained by insurance. The only significant acculturation variable was language use for cholesterol. Disparities in preventive health screening in Mexican Americans were associated with primary insurance coverage in El Paso, Texas. With the border region being among the most medically underserved and underinsured areas in the United States, the results from this study suggest policy efforts are essential to ensure equal access to resources to maintain good health. Intervention efforts may include increasing awareness of enrollment information for insurance programs through the Affordable Care Act.


Asunto(s)
Aculturación , Enfermedad Crónica , Renta , Cobertura del Seguro , Lenguaje , Tamizaje Masivo , Americanos Mexicanos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , México , Persona de Mediana Edad , Patient Protection and Affordable Care Act , Factores Socioeconómicos , Texas , Adulto Joven
12.
Complement Ther Med ; 23(1): 32-7, 2015 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-25637150

RESUMEN

This brief lifestyle intervention, including a vegan diet rich in fresh fruits and vegetables, whole grains and various legumes, nuts and seeds, significantly improved health risk factors and reduced systemic inflammation as measured by circulating CRP. The degree of improvement was associated with baseline CRP such that higher levels predicted greater decreases. The interaction between gender and baseline CRP was significant and showed that males with higher baseline CRP levels appeared to have a more robust decrease in CRP due to the intervention than did their female counterparts. It is likely that the vegetable and high fiber content of a vegan diet reduces CRP in the presences of obesity. Neither the quantity of exercise nor the length of stay was significant predictors of CRP reduction. Additionally, those participants who had a vegan diet prior to the intervention had the lowest CRP risk coming into the program. Direct measure of body fat composition, estrogen and other inflammatory mediators such as IL-6 and TNF-alpha would enhance current understanding of the specific mechanisms of CRP reduction related to lifestyle interventions.


Asunto(s)
Proteína C-Reactiva/metabolismo , Dieta Vegetariana , Conducta Alimentaria/fisiología , Femenino , Humanos , Estilo de Vida , Masculino , Persona de Mediana Edad , Factores de Riesgo
13.
Eur J Appl Physiol ; 115(5): 905-10, 2015 May.
Artículo en Inglés | MEDLINE | ID: mdl-25488671

RESUMEN

PURPOSE: Body weight-supported treadmill training using positive air pressure has become increasingly popular, but little is known about the metabolic adaptations to these treadmills. This study aimed to evaluate the existence and length of a metabolic accommodation period to running on a lower body positive pressure (LBPP) treadmill. METHODS: A total of eight recreational runners (5 males and 3 females) ran 15 min trials (5 min at 50, 70, and 90 % body weight) on the AlterG Anti-gravity(®) P200 treadmill. No verbal instruction was given on how to run on the device. Their trial pace corresponded to 70-80 % of their velocity measured at [Formula: see text]O2max on a standard treadmill. Trials were continued until no significant metabolic change was observed. Two-way repeated measures analysis of variance was used to analyze changes in [Formula: see text]O2 across trials and levels of unloading. RESULTS: Participants completed 7 trials. Comparing trial 1 to the average of trials 5, 6, and 7, [Formula: see text]O2 decreased from 29.6 ± 3.8 to 23.6 ± 4.4 ml/kg/min at 50 % body weight (~20 % reduction), from 33.7 ± 4.5 to 29.2 ± 5.1 ml/kg/min at 70 % body weight (~13 % reduction), and from 41.0 ± 7.7 to 36.6 ± 5.6 ml/kg/min at 90 % body weight (~11 % reduction). No significant reduction occurred after trial 4 at any level of support. CONCLUSIONS: An accommodation effect of running on a treadmill with LBPP was observed and reached after 60 min of running (4 trials of 15 min). The accommodation effect was the largest at the greatest level of body weight support. These data suggest the importance of an accommodation period for reliable measures of metabolic cost to be made.


Asunto(s)
Peso Corporal/fisiología , Consumo de Oxígeno/fisiología , Carrera/fisiología , Adulto , Composición Corporal , Metabolismo Energético , Prueba de Esfuerzo , Femenino , Humanos , Masculino , Adulto Joven
14.
J Strength Cond Res ; 29(3): 863-8, 2015 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-25226319

RESUMEN

Body weight (BW)-supported treadmill training has become increasingly popular in professional sports and rehabilitation. To date, little is known about the accuracy of the lower-body positive pressure treadmill. This study evaluated the accuracy of the BW support reported on the AlterG "Anti-Gravity" Treadmill across the spectrum of unloading, from full BW (100%) to 20% BW. Thirty-one adults (15 men and 16 women) with a mean age of 29.3 years (SD = 10.9), and a mean weight of 66.55 kg (SD = 12.68) were recruited. Participants were weighed outside the machine and then inside at 100-20% BW in 10% increments. Predicted BW, as presented by the AlterG equipment, was compared with measured BW. Significant differences between predicted and measured BW were found at all but 90% through 70% of BW. Differences were small (<5%), except at the extreme ends of the unloading spectrum. At 100% BW, the measured weight was lower than predicted (mean = 93.15%, SD = 1.21, p < 0.001 vs. predicted). At 30 and 20% BW, the measured weight was higher than predicted at 35.75% (SD = 2.89, p < 0.001), and 27.67% (SD = 3.76, p < 0.001), respectively. These findings suggest that there are significant differences between reported and measured BW support on the AlterG Anti-Gravity Treadmill®, with the largest differences (>5%) found at 100% BW and the greatest BW support (30 and 20% BW). These differences may be associated with changes in metabolic demand and maximum speed during walking or running and should be taken into consideration when using these devices for training and research purposes.


Asunto(s)
Peso Corporal/fisiología , Prueba de Esfuerzo/instrumentación , Adulto , Calibración , Diseño de Equipo , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven
15.
J Strength Cond Res ; 29(3): 854-62, 2015 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-25162650

RESUMEN

Lower body positive pressure (LBPP) or antigravity treadmills are becoming increasingly popular in sports and rehabilitation settings. Running at a decreased body weight (BW) reduces metabolic cost, which can be offset by running at faster speeds. To date, however, little is known about how much faster someone must run to offset the reduced metabolic cost. This study aimed to develop a user-friendly conversion table showing the speeds required on an LBPP treadmill to match the equivalent metabolic output on a regular, non-LBPP, treadmill across a range of body weight supports. A total of 20 recreational runners (11 males, 9 females) ran multiple 3-minute intervals on a regular treadmill and then on an LBPP treadmill at 6 different BWs (50-100%, 10% increments). Metabolic outputs were recorded and matched between the regular and LBPP treadmill sessions. Using regression analyses, a conversion table was successfully created for the speeds from 6.4 to 16.1 km·h (4 to 10 mph) in 0.8 km·h (0.5 mph) increments on the regular treadmill and BW proportions of 50, 60, 70, 80, 90, and 100% on an LBPP treadmill. The table showed that a greater increase in speed on the LBPP treadmill was needed with more support (p < 0.001) but that the proportion increase was smaller at higher speeds (p < 0.001). This research has implications for coaches or practitioners using or prescribing training on an LBPP treadmill.


Asunto(s)
Prueba de Esfuerzo/instrumentación , Consumo de Oxígeno/fisiología , Carrera/fisiología , Adulto , Diseño de Equipo , Femenino , Humanos , Masculino , Persona de Mediana Edad , Modelos Biológicos , Valores de Referencia , Análisis de Regresión , Adulto Joven
16.
J Ambul Care Manage ; 37(3): 241-9, 2014 Jul-Sep.
Artículo en Inglés | MEDLINE | ID: mdl-24887525

RESUMEN

Coalescence of culturally relevant and community-based research with traditional scientific inquiry is necessary for the translation of science into practice. One methodology that has been identified as an important missing link in achieving the goal of combining science and community practice is the community-based participatory research approach, or CBPR. To demonstrate how CBPR has been successfully blended with randomized control trial (RCT) methodology, we showcase a randomized community trial that has shown efficacy in reducing cardiovascular risk factors integrating community health workers. The purpose of this article is 2-fold. First, it describes the process of merging the CBPR approach within an RCT framework and, second, it describes lessons learned in conducting CBPR-RCT research initiatives.


Asunto(s)
Agentes Comunitarios de Salud/organización & administración , Investigación Participativa Basada en la Comunidad/organización & administración , Educación en Salud/organización & administración , Cardiopatías/prevención & control , Ensayos Clínicos Controlados Aleatorios como Asunto/normas , Investigación Participativa Basada en la Comunidad/métodos , Relaciones Comunidad-Institución , Educación en Salud/métodos , Humanos , Estudios de Casos Organizacionales , Proyectos Piloto , Ensayos Clínicos Controlados Aleatorios como Asunto/métodos , Recursos Humanos
17.
Int J Environ Res Public Health ; 11(2): 1873-84, 2014 Feb 10.
Artículo en Inglés | MEDLINE | ID: mdl-24518646

RESUMEN

Although prior research has shown that Community Health Workers/Promotores de Salud (CHW/PS) can facilitate access to care, little is known about how CHW/PS are perceived in their community. The current study reports the findings of a randomized telephone survey conducted in a high-risk urban community environment along the U.S.-Mexico border. In preparation for a community-based CHW/PS intervention called the HEART ecological study, the survey aimed to assess perceptions of CHW/PS, availability and utilization of community resources (recreational and nutrition related) and health behaviors and intentions. A total of 7,155 calls were placed to complete 444 surveys in three zip codes in El Paso, Texas. Results showed that participants felt that healthful community resources were available, but utilization was low and variable: 35% reported going to a park, 20% reported having taken a health class, few reported using a gym (12%), recreation center (8%), or YMCA/YWCA (0.9%). Awareness and utilization of CHW/PS services were low: 20% of respondents had heard of CHW/PS, with 8% reporting previous exposure to CHW/PS services. Upon review of a definition of CHW/PS, respondents expressed positive views of CHW/PS and their value in the healthcare system. Respondents who had previous contact with a CHW/PS reported a significantly more positive perception of the usefulness of CHW/PS (p = 0.006), were more likely to see CHW/PS as an important link between providers and patients (p = 0.008), and were more likely to ask a CHW/PS for help (p = 0.009). Participants who utilized CHW/PS services also had significantly healthier intentions to reduce fast food intake. Future research is needed to evaluate if CHW/PS can facilitate utilization of available community resources such as recreational facilities among Hispanic border residents at risk for CVD.


Asunto(s)
Enfermedades Cardiovasculares , Agentes Comunitarios de Salud/estadística & datos numéricos , Conductas Relacionadas con la Salud , Conocimientos, Actitudes y Práctica en Salud , Adolescente , Adulto , Enfermedades Cardiovasculares/etnología , Enfermedades Cardiovasculares/prevención & control , Enfermedades Cardiovasculares/terapia , Agentes Comunitarios de Salud/psicología , Ejercicio/fisiología , Femenino , Alimentos , Conductas Relacionadas con la Salud/etnología , Conocimientos, Actitudes y Práctica en Salud/etnología , Humanos , Masculino , México/epidemiología , México/etnología , Persona de Mediana Edad , Instalaciones Públicas/economía , Recreación/economía , Recreación/fisiología , Conducta de Reducción del Riesgo , Factores Socioeconómicos , Estados Unidos/epidemiología , Estados Unidos/etnología , Adulto Joven
18.
Health Educ Res ; 29(2): 222-34, 2014 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-24463396

RESUMEN

Little is known about the effect of personalized risk information on risk perceptions over time, particularly among ethnically diverse subpopulations. The present study examines Mexican American's (MAs) risk perceptions for heart disease and diabetes at baseline and following receipt of risk feedback based on family health history. Participants comprising 162 households received a pedigree or personalized risk feedback, with or without behavioral risk reduction recommendations. Multiple logistic regression analyses were used to assess lifetime perceived risk (LPR) at baseline, 3 months and 10 months following the receipt of risk feedback. Having an elevated familial risk of heart disease or diabetes increased the odds of an elevated LPR for both diseases at baseline. At 3 months, compared with receipt of a pedigree only, MAs receiving elevated risk feedback for both diseases were more likely to have an elevated LPR for both diseases. At 10 months, participants receiving weak risk feedback for both diseases indicated an adjustment to a lower LPR for heart disease only. Results suggest that communicating risk for multiple diseases may be more effective than a single disease, with responses to increased risk feedback more immediate than to weak risk feedback.


Asunto(s)
Diabetes Mellitus/etnología , Retroalimentación Psicológica , Educación en Salud/métodos , Cardiopatías/etnología , Americanos Mexicanos/psicología , Adolescente , Adulto , Anciano , Diabetes Mellitus/etiología , Diabetes Mellitus/psicología , Familia , Femenino , Cardiopatías/etiología , Cardiopatías/psicología , Humanos , Masculino , Americanos Mexicanos/estadística & datos numéricos , Persona de Mediana Edad , Medición de Riesgo/métodos , Factores de Riesgo , Conducta de Reducción del Riesgo , Adulto Joven
19.
Obesity (Silver Spring) ; 22(4): 1194-200, 2014 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-24318861

RESUMEN

OBJECTIVE: Increases in overweight and obesity (O/O)-related morbidities and health care costs raise questions about how weight influences patients' health care use and care experiences. Past research has been inconsistent; however, prior study designs and samples have limited exploration of how this association might be influenced by gender, race, and the joint impact of these factors. METHODS: This analysis of 1,036 young, relatively healthy, ethnically diverse, insured adults assessed the influence of O/O, gender, and race on, and the role of health care experiences in primary and preventive care use over a 12-month period. RESULTS: The association of weight status with care use differed by gender. O/O men used more primary care visits; O/O women used fewer preventive care visits than their healthy weight counterparts. O/O men had poorer health care experiences than healthy weight men. African-American women reported poorer experiences, but those who were O/O reported greater trust in their provider. Care experience ratings did not explain the associations between BMI and care use. CONCLUSIONS: Gender, race, and visit type together provide a context for O/O patient's care that may not be explained by care experiences. This context must be considered in efforts to encourage appropriate use of services.


Asunto(s)
Peso Corporal/etnología , Obesidad/etnología , Sobrepeso/etnología , Aceptación de la Atención de Salud/etnología , Aceptación de la Atención de Salud/estadística & datos numéricos , Adulto , Afroamericanos/etnología , Afroamericanos/estadística & datos numéricos , Índice de Masa Corporal , Grupos de Población Continentales/estadística & datos numéricos , Grupo de Ascendencia Continental Europea/etnología , Grupo de Ascendencia Continental Europea/estadística & datos numéricos , Femenino , Humanos , Estudios Longitudinales , Masculino , Modelos Estadísticos , Obesidad/prevención & control , Obesidad/terapia , Sobrepeso/prevención & control , Sobrepeso/terapia , Relaciones Médico-Paciente , Servicios Preventivos de Salud/estadística & datos numéricos , Atención Primaria de Salud/estadística & datos numéricos , Estudios Retrospectivos , Factores Sexuales
20.
Rev Panam Salud Publica ; 34(3): 147-54, 2013 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-24233106

RESUMEN

OBJECTIVE: To assess whether U.S.-Mexico border residents with diabetes 1) experience greater barriers to medical care in the United States of America versus Mexico and 2) are more likely to seek care and medication in Mexico compared to border residents without diabetes. METHODS: A stratified two-stage randomized cross-sectional health survey was conducted in 2009 - 2010 among 1 002 Mexican American households. RESULTS: Diabetes rates were high (15.4%). Of those that had diabetes, most (86%) reported comorbidities. Compared to participants without diabetes, participants with diabetes had slightly greater difficulty paying US$ 25 (P = 0.002) or US$ 100 (P = 0.016) for medical care, and experienced greater transportation and language barriers (P = 0.011 and 0.014 respectively) to care in the United States, but were more likely to have a person/place to go for medical care and receive screenings. About one quarter of participants sought care or medications in Mexico. Younger age and having lived in Mexico were associated with seeking care in Mexico, but having diabetes was not. Multiple financial barriers were independently associated with approximately threefold-increased odds of going to Mexico for medical care or medication. Language barriers were associated with seeking care in Mexico. Being confused about arrangements for medical care and the perception of not always being treated with respect by medical care providers in the United States were both associated with seeking care and medication in Mexico (odds ratios ranging from 1.70 - 2.76). CONCLUSIONS: Reporting modifiable barriers to medical care was common among all participants and slightly more common among 1) those with diabetes and 2) those who sought care in Mexico. However, these are statistically independent phenomena; persons with diabetes were not more likely to use services in Mexico. Each set of issues (barriers facing those with diabetes, barriers related to use of services in Mexico) may occur side by side, and both present opportunities for improving access to care and disease management.


Asunto(s)
Diabetes Mellitus/etnología , Turismo Médico/estadística & datos numéricos , Americanos Mexicanos , Aceptación de la Atención de Salud/etnología , Adulto , Anciano , Barreras de Comunicación , Comorbilidad , Estudios Transversales , Diabetes Mellitus/economía , Diabetes Mellitus/terapia , Emigración e Inmigración/estadística & datos numéricos , Femenino , Accesibilidad a los Servicios de Salud/economía , Encuestas Epidemiológicas , Humanos , Renta/estadística & datos numéricos , Cobertura del Seguro , Lenguaje , Masculino , Indigencia Médica/estadística & datos numéricos , Turismo Médico/economía , Americanos Mexicanos/psicología , Americanos Mexicanos/estadística & datos numéricos , México/epidemiología , México/etnología , Persona de Mediana Edad , Aceptación de la Atención de Salud/estadística & datos numéricos , Pobreza/estadística & datos numéricos , Muestreo , Texas/epidemiología , Transportes/economía , Adulto Joven
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