Item development, internal consistency, and known-groups validity of the Self-Directed Mobility Scale.

PURPOSE: The aims of the current study include to: (1) describe the item development; and (2) begin the process of establishing the internal consistency and known-groups validity of the Self-Directed Mobility Scale. The purpose of the scale is to assess paediatric physical and occupational therapists' views towards self-directed mobility and their perceived ability and intentions to advocate for children's access to self-directed mobility. METHODS: Three individuals with expertise in kinesiology, psychology, paediatric rehabilitation, and disability studies served as the expert panel for item development. Four samples were included to determine internal consistency and known-groups validity: 350 physical therapists, 89 occupational therapists, 279 kinesiology undergraduate students, and 528 health and wellness undergraduate students. RESULTS: The internal consistency was above the acceptable level of 0.70 (range = 0.72-0.77) for all samples when two items regarding promoting other motor skills prior to powered mobility use and the temporary use of a mobility device were removed. Known-groups validity was established between all samples. CONCLUSIONS: The Self-Directed Mobility Scale appears to be a valid tool for assessing views of self-directed mobility and mobility advocacy intentions in paediatric physical and occupational therapists, as well as undergraduate students. Future work should examine the internal consistency based on study sample to ensure the (> 0.70) acceptable Cronbach's alpha level is met.Implications for rehabilitationThe Self-Directed Mobility Scale is a viable measurement tool to assess views of self-directed mobility and mobility advocacy intentions of pediatric physical and occupational therapists.In combination with other measures, the Self-Directed Mobility Scale may be used in future rehabilitation research to evaluate factors associated with provision of mobility technology to children with disabilities.

Mobility is a fundamental human right: Factors predicting attitudes toward self-directed mobility.

BACKGROUND: Emergent disability studies research is interested in the community's views on how disability, including self-directed mobility, influences social and environmental policies. We anticipate that individuals' alignment with disability models, or sets of assumptions about the cause, nature, and treatment of disability, will influence attitudes about self-directed mobility. Self-directed mobility is defined as mobility that is controlled by an individual and may include walking or assisted ambulation through the use of mobility technology such as prosthetics, walking aids, manual wheelchairs, or motorized wheelchairs. OBJECTIVE: The purpose of this study was to explore how demographic factors, contact with people with disabilities, attitudes toward people with disabilities, and alignment with social or medical models of disability predict attitudes toward self-directed mobility. METHODS: 1545 students at a public university completed demographic questions, and measures of disability attitudes, disability model orientation, and self-directed mobility. RESULTS: The predictors explained 16.60% of the variance in participants' attitudes toward self-directed mobility (R2 = 0.166, F(7,1537) = 43.9, p < .001). Significant predictors included: female gender (ß = -0.14, p < .01), more positive attitudes toward people with disabilities (ß = -0.30, p < .001), and social model orientation (ß = 0.59, p < .001). CONCLUSIONS: Participants who more strongly agreed with disability as a social construct (social model) were in stronger agreement that self-directed mobility is a fundamental right. Future research extending to rehabilitation professionals is warranted.

What barriers thwart postpartum women's physical activity goals during a 12-month intervention? A process evaluation of the Na Mikimiki Project.

Approximately 70% of new mothers do not meet national guidelines for moderate-to-vigorous physical activity (MVPA). The Na Mikimiki ("the active ones") Project (2008-2011) was designed to increase MVPA among women with infants 2-12 months old. Participants' barriers to exercising and achievement of specific MVPA goals were discussed during telephone counseling calls over 12 months. Healthy, inactive women (n = 115, mean age = 31 ± 5 years, infants' mean age = 5.5 ± 3 months; 80% racial/ethnic minorities) received a total of 17 calls over 12 months in three phases. During Phase 1 weekly calls were made for a month, in Phase 2 biweekly calls were made for 2 months, and in Phase 3 monthly calls were made for 9 months. Across all phases, the most frequent barriers to achieving MVPA goals were: time/too busy (25%), sick child (11%), and illness (10%). Goals for MVPA minutes per week were achieved or surpassed 40.6% of the time during weekly calls, 39.9% during biweekly calls, and 42.0% during monthly calls. The least likely MVPA goals to be achieved (p < 0.04) were those which the woman encountered and for which she failed to overcome the barriers she had previously anticipated would impair her improvement of MVPA. This process evaluation demonstrated that telephone counseling somewhat facilitated the resolution of barriers and achievement of MVPA goals; thus, if clinical settings adopted such methods, chronic disease risks could be reduced in this vulnerable population of new mothers.

Ethnic differences and predictors of colonoscopy, prostate-specific antigen, and mammography screening participation in the multiethnic cohort.

PURPOSE: Given the relation between screening and improved cancer outcomes and the persistence of ethnic disparities in cancer mortality, we explored ethnic differences in colonoscopy, prostate-specific antigen (PSA), and mammography screening in the Multiethnic Cohort Study. METHODS: Logistic regression was applied to examine the influence of ethnicity as well as demographics, lifestyle factors, comorbidities, family history of cancer, and previous screening history on self-reported screening participation collected in 1999-2002. RESULTS: The analysis included 140,398 participants who identified as white, African American, Native Hawaiian, Japanese American, US born-Latino, or Mexican born-Latino. The screening prevalences overall were mammography: 88% of women, PSA: 45% of men, and colonoscopy: 35% of men and women. All minority groups reported 10-40% lower screening utilization than whites, but Mexican-born Latinos and Native Hawaiian were lowest. Men were nearly twice as likely to have a colonoscopy (OR=1.94, 95% CI=1.89-1.99) as women. A personal screening history, presence of comorbidities, and family history of cancer predicted higher screening utilization across modalities, but to different degrees across ethnic groups. CONCLUSIONS: This study confirms previously reported sex differences in colorectal cancer screening and ethnic disparities in screening participation. The findings suggest it may be useful to include personal screening history and family history of cancer into counseling patients about screening participation.

Association of physical activity and sedentary behavior with biological markers among U.S. pregnant women.

BACKGROUND: To examine the association between objectively measured light-intensity and moderate-to-vigorous-intensity physical activity (MVPA), sedentary behaviors, and biological markers in a national sample of U.S. pregnant women, as few studies have examined these relationships among this population. METHODS: The sample of noninstitutionalized U.S. civilians was selected by a complex, multistage probability design. Data from the 2003-2006 National Health and Examination Survey were used. Two hundred six pregnant women were included in the data analysis. Physical activity and sedentary data were objectively measured via accelerometry (ActiGraph 7164). Biomarker data was obtained in the mobile examination center from urine, blood samples, blood pressure, and anthropometric measurements. Urine and blood samples were obtained to determine pregnancy status, C-reactive protein (CRP), high-density lipoprotein (HDL) cholesterol, total cholesterol, and cotinine as well as fasting glucose, fasting triglycerides, and fasting low-density lipoprotein (LDL) cholesterol data. Multivariable regression was employed to examine the association between physical activity, sedentary behavior, and biomarker levels. RESULTS: There was a positive association between sedentary behavior and CRP levels (beta coefficient [b]=0.001, p=0.02) and LDL cholesterol (b=0.12, p=0.02). There was an inverse association between light-intensity physical activity and CRP (b=-0.003; p=0.008) and diastolic blood pressure (b=-0.03; p=0.02), with those engaging in higher levels of MVPA having higher HDL cholesterol (b=6.7; p=0.01). CONCLUSION: Physical activity and sedentary behavior were favorably associated with various biomarkers among pregnant women, suggesting that healthcare providers should encourage pregnant women to participate in safe forms of physical activity behaviors while also reducing their amount of time spent in sedentary behaviors.

An examination of sex differences in relation to the eating habits and nutrient intakes of university students.

OBJECTIVES: To examine sex differences in eating habits and nutrient intakes and explore whether eating habits mediate the effects of sex on nutrient intakes and whether sex moderates the effects of eating habits on nutrient intakes. METHODS: Cross-sectional survey of eating habits and food-intake frequency in a convenience sample of college students. RESULTS: Male students (n = 172) consumed a higher energy content from fat, a larger amount of fiber, and more fruits and vegetables, and engaged less often in various healthful eating habits (eg, reading food labels, having breakfast) than female students (n = 316). Sex predicted the 3 dietary nutrient intakes partially through eating habits. Interactions between sex and eating habits were nonsignificant. CONCLUSIONS AND IMPLICATIONS: Results reinforce that university students' nutrient intakes are less than ideal. Women and men may have different needs for nutritional improvement. However, the effects of health promotion concerning eating habits may be similarly effective between the sexes.