Does weight status influence perceptions of physical activity barriers among African-American women?

BACKGROUND: Many African-American women fail to participate in regular physical activity. Weight status may influence physical activity barriers. This study examined the frequency and type of barriers. METHODS: Participants in this study were enrolled in Project EXE-L (Exercising Ladies Excel), a six-month, church-based, randomized trial of moderate-intensity physical activity based in Baltimore city and county in Maryland. Participants were composed of African-American women who attended one of the participating churches, had friends who were church members, or who lived in neighborhoods surrounding one of the churches. Individuals who were between the ages of 25 and 70 years, were not regularly physically active (defined as not engaging in moderate-intensity activity more than three times per week), and were able to participate in moderate-intensity activity met eligibility criteria to participate in the trial. Barriers to physical activity were evaluated with the Steinhardt/Dishman Barriers for Habitual Physical Activity Scale at baseline. RESULTS: One hundred twenty women were classified as normal weight (body mass index [BMI]: <25 kg/m2), overweight (BMI: 25-29.9 kg/m2), or obese (BMI: > or = 30 kg/m2). Obese participants were more likely to report "lack of motivation" as a barrier compared with normal-weight participants (63% vs 31%). Normal-weight and overweight participants were more likely to report no barriers compared with the obese (31%, 0%, 5%, respectively, P<.05). CONCLUSIONS: Barriers for African-American women may vary by BMI status. By defining these unique barriers, effective physical activity interventions can be developed.

Prevalence and correlates of suicidal ideation among young injection vs. noninjection drug users.

The objective of this study was to identify correlates of suicidal ideation and to examine the hypothesis that injection drug users (IDUs) were more likely to report suicidal ideation than noninjection drug users (NIDUs). Participants included IDUs (n = 244) and NIDUs (n = 73) from Baltimore, Maryland, aged 15-30 who began snorting or smoking heroin or cocaine/crack (NIDUs) or injecting drugs (IDUs) within the past 5 years who were recruited between August 2000 and March 2002. Among the 317 participants, 42% were female, 59% were white, and median age was 24. The prevalence of suicidal ideation was 27%. IDUs were more likely to report suicidal ideation than NIDUs (31% vs. 14%, p = 0.003). Adjusting for age, gender, and race, IDUs were 2.4 times more likely than NIDUs to report suicidal ideation [95% Confidence Interval (CI): 1.1-5.2]. However, on further adjustment for homelessness, depressive symptoms, and gay/lesbian/bisexual identity, IDU status was no longer independently associated with suicidal ideation. These results suggest that factors associated with injection drug users' lifestyles and mental health status may account for the higher prevalence of suicidal ideation in IDUs vs. NIDUs. Further study into these associations is warranted in identifying avenues for suicide prevention among these populations.

Changes in willingness to participate in HIV vaccine trials among HIV-negative injection drug users.

Injection drug users (IDUs) represent an important risk group for HIV infection. We assessed correlates of IDUs' willingness to participate (WTP) in HIV vaccine trials, and examined temporal changes in WTP. Participants were enrolled in ALIVE, a prospective study of HIV among IDUs in Baltimore; semi-annual visits include interviews and HIV serology. Questionnaires regarding WTP were administered in 1993-1994 and again in 2001-2002. Logistic regression was conducted to identify correlates of WTP. Wave 1 of the survey included 440 participants; Wave 2 included 582 participants (189 participated in both waves). WTP increased modestly over time (83.4 vs. 86.3%; p = 0.16). Monetary incentives were the strongest predictor of WTP (adjOR = 2.73; 95% CI: 1.72-4.35). High expectations of HIV treatment effectiveness did not predict WTP. In this cohort, WTP remained strong and modestly increased over the study period. These results should be considered in the planning of sampling and retention strategies for future vaccine trials.

Circumstances surrounding the first injection experience and their association with future syringe sharing behaviors in young urban injection drug users.

Young injection drug users are at heightened risk for acquisition of blood-borne infections because of their high rates of unsafe injection behaviors, yet there has been little research examining the circumstances surrounding injection drug users' first injection experience ('hit'). We examined the relationship between factors associated with young drug users' first hit and their future syringe sharing behaviors among 420 new initiates to injection drug use (less than 5 years), aged 15-30 years old in urban Baltimore, Maryland. Contingency table analysis and logistic regression were used to determine the association between circumstances surrounding the first hit and recent receptive syringe sharing. Participants were primarily male (58.8%), White (71.2%), and were a median age of 24 years (interquartile range [IQR]: 21-27 years). Adjusting for race, gender, and homelessness, the following variables were independently associated with recent receptive syringe sharing: age at first hit (adjusted odds ratio [AOR] = 0.92 per year increase; 95% confidence interval [CI]: 0.87-0.98), self-injection at initiation (AOR = 0.55; 95% CI: 0.32-0.97) and using a syringe that had previously been used by someone else at first hit (AOR = 2.81; 95% CI: 1.70-4.64). These data suggest that injection-related risk behaviors may be established as early as the onset of injection initiation, supporting the need to educate non-injectors of the harms associated with unsafe injection practices.

Health status among urban African American women: associations among well-being, perceived stress, and demographic factors.

The purpose of this study was to evaluate the associations among health status, well-being, and perceived stress in a sample of urban African American women. African American women (n = 128) (Mean +/- SD, 49.3 +/- 10.5) from Baltimore, Maryland, enrolled in a church-based physical activity randomized trial were included in the analysis. Health status was assessed from the SF-36. Well-being, perceived stress, and demographics were also determined from self-report. Results indicated that the sample reported favorable health status, well-being, and stress levels compared to mean levels reported in the literature. Spearman rank-order correlations indicated that perceived stress score negatively correlated with most health status dimensions and well-being in the present, past, and future. Multiple regression analyses, adjusting for potential demographic confounders, indicated that higher perceived stress was associated with lower health status and well-being. If these results are confirmed in prospective investigations, they suggest that interventions designed to reduce stress may impact health status and future morbidity and mortality.