Prevalence and impact of unhealthy weight in a national sample of US adolescents with autism and other learning and behavioral disabilities.

We estimated the prevalence of obesity, overweight, and underweight among US adolescents with and without autism and other learning and behavioral developmental disabilities (DDs) and assessed the health consequences of obesity among adolescents with DDs. From the 2008 to 2010 National Health Interview Survey, we selected 9,619 adolescents ages 12-17 years. Parent respondents reported weight, height, presence of DDs and health conditions. We calculated body mass index (BMI) and defined obesity, overweight, and underweight as ≥95th, ≥85th to <95th, and <5th percentiles, respectively, using established criteria. We created mutually-exclusive DD subgroups using the following order of precedence: autism; intellectual disability; attention-deficit-hyperactivity-disorder; learning disorder/other developmental delay. We compared BMI outcomes among adolescents in each DD group versus adolescents without DDs using multivariable logistic regression. Socio-demographic factors and birthweight were included as confounders. Estimates were weighted to reflect the US population. Both obesity and underweight prevalences were higher among adolescents with than without DDs [adjusted prevalence ratios (aPR) 1.5 (1.25-1.75) and 1.5 (1.01-2.20), respectively]. Obesity was elevated among adolescents with all DD types, and was highest among the autism subgroup [aPR 2.1 (1.44-3.16)]. Adolescents with either a DD or obesity had higher prevalences of common respiratory, gastrointestinal, dermatological and neurological conditions/symptoms than nonobese adolescents without DDs. Adolescents with both DDs and obesity had the highest estimates for most conditions. Obesity is high among adolescents with autism and other DDs and poses added chronic health risks. Obesity prevention and management approaches for this vulnerable population subgroup need further consideration.

Major gene effect and additive familial pattern of inheritance of asthma exist among families of probands with sickle cell anemia and asthma.

In the United States, sickle cell anemia (SCA) affects approximately 1 in 400 African-American newborns. Acute episodes of pain and acute chest syndrome (ACS) are the two leading causes of hospitalization. A relationship between the diagnosis of asthma and the incidence of pain and ACS has been established. We tested the hypothesis that a familial pattern of inheritance of asthma exists among first degree relatives of probands with SCA and asthma. Segregation analysis was performed in 104 families ascertained through affected probands. Of these, 19.7% (41/208) of the parents and 31.8% (28/88) of siblings of affected probands reported having been told by a doctor he or she had asthma at any age. Modes of inheritance were tested, using the Pedigree Analysis Package parameterized for the discrete trait of asthma affection status. A major effect was present and significant. Further tests were performed to determine whether transmission probabilities of the major effect followed Mendelian expectations. The additive mode of inheritance was the most parsimonious, while the residual heritability was found negligible. Our results support the hypothesis that a familial pattern of inheritance of asthma exists among first degree relatives of probands with SCA and asthma, suggesting that asthma is a co-morbid condition with SCA rather than a lung disease phenotype mimicking asthma.

Diffusing an HIV prevention intervention for African American Women: integrating afrocentric components into the SISTA Diffusion Strategy.

Although race and gender are not indicators for HIV/AIDS, both have disproportionately impacted African American women. African American women represent 13% of the U.S. female population and 67% of the AIDS cases among women (Fitzpatrick, The U.S. HIV/AIDS Epidemic in Women and Adolescent Females, HIV Prevention Conference, Atlanta, GA, 2005). The statistics underscore the need for targeted interventions that employ culturally relevant activities to enhance self-esteem and communication skills while encouraging positive behavior change. Factors facilitating intervention effectiveness include culturally relevant components such as cultural practices, beliefs, values, norms, and ideologies (Janz et al., "Evaluation of 37 AIDS Projects," Health Education Quarterly, 23(1), 80-97, 1996). HIV prevention programs targeting African American women should incorporate an approach that includes ethnic heritage as ameans to instill pride, therebymotivating positive behavior change and empowering women. Afrocentric approaches incorporate philosophies relevant to people of African descent and may be spiritually based. Coupling culturally relevant HIV prevention interventions with a culturally relevant diffusion strategy may enhance community receptiveness. The SISTA intervention (DiClemente & Wingood, "A Randomized Controlled Trial of an HIV Sexual Risk Reduction Intervention for Young African-American Women," Journal of the American Medical Association, 274(16), 1271-1276, 1995) incorporates both culturally and gender-relevant activities to empower African American women to make healthy life choices. The article presents the strategy used to nationally diffuse SISTA, which incorporated Afrocentric components within implementation delivery. Lessons learned demonstrate the significance of integrating additional Afrocentric and gender-relevant material to an existing intervention for African American women.