An application of the reasoned action approach to clinical students' intention toward a career in geriatrics.

Guided by the reasoned action approach, this study examined select individual, information, and social factors that influence intention toward pursuing a career in geriatrics among 314 clinical medical and nursing students in Ghana. A Poisson regression showed attitude toward older persons was a significant influencing factor of intention to choose a career in geriatrics for medical students (B = 0.015, SE = 0.0048, p = 0.002) but not nursing students (B = 0.009, SE = 0.0145, p = 0.512). Personal interest was, however, a significant influencing factor for both medical and nursing students (B = 0.462, SE = 0.0592, p = 0.000) and (B = 0.015, SE = 0.0048, p = 0.002), respectively. Nursing students with moderate to strong interest were 1.6 times more likely to express an intention to specialize in geriatrics, and medical students were 1.5 times more likely to express an intention to specialize in geriatrics. The results show that the most important factor influencing geriatric career intention is students' personal interest in the field. Evidence-based interventions such as early educational and practice exposure to the field and interactions with older adults are recommended.

Coping with Community Violence: Perspectives of African American Young Adult Men and Hispanic/Latino Young Adult Men.

Further study is needed regarding the intersection of community violence exposure, coping strategies, and health behaviors among young adult African American men and Hispanic/Latino men. This study did so in Lake County, Indiana, which contains multiple areas with disproportionate prevalence of violence relative to population size. Approximately 22 miles from Chicago, Lake County includes noteworthy mid-sized cities such as Gary, Hammond, and East Chicago. This study explored the perceptions of African American men and Hispanic/Latino men ages 18 to 25 regarding coping strategies and both healthy and health risk behaviors after directly witnessing or indirectly experiencing a violent act or event. We used aspects of social cognitive theory to design this community-based participatory research study. Thirteen males who self-identified as African American, Hispanic/Latino, or both, completed 34- to 80-minute, audio-recorded phone interviews. Audio recordings were transcribed, and NVivo 12 Windows was used by the research team (primary researchers and two coders) to complete transcript analysis. Findings from this study provided insight around African American men and Hispanic/Latino men regarding (a) witnessing violence directly or indirectly experiencing violence; (b) changes in everyday life experiences; (c) coping strategies that involved socio-emotional health, spiritual health, social health, and risky health behaviors; (d) rationales for not asking for help; (e) observations of significant others' coping; (f) what to do differently in the future; (g) beliefs about mentors; and (h) beliefs about mental health providers. Delving into participants' experiences revealed that African American men and Hispanic/Latino men in Lake County, Indiana chose to adopt a range of health risk and health positive strategies after directly witnessing or indirectly experiencing violence. Becoming knowledgeable about African American men's and Hispanic/Latino men's diverse coping strategies and health behaviors may help inform the community about how best to cocreate spaces that aim to alleviate the traumatic experience of having directly or indirectly experienced community violence.

Evaluation of Unintended Consequences of COVID-19 Pandemic Restrictions and Obesity Prevalence Among Youths.

This cohort study examines the association between COVID-19 pandemic restrictions and obesity prevalence among youths aged 2 to 19 years in Monroe County, Indiana.

Air pollutants and attention deficit hyperactivity disorder medication administration in elementary schools.

Air pollution is considered a risk factor for several diseases, particularly respiratory and cardiovascular diseases. However, the effects of air pollution on neurobehavioral disorders have not been confirmed as of yet. Thus, the aim of this study was to determine whether there was an association between seven air pollutants and ADHD medication administration (ADHD-MA) in Pennsylvania-located elementary schools over a 3-year period. An ecological study design involving records of 168,825 children from elementary schools in 49 Pennsylvania counties was used. The number of children with ADHD-MA was extracted from an online software specifically designed for allowing nurses to record health conditions in schools. Daily measurements of air pollutants were obtained from the U.S Environmental Protection Agency. The differences in the number of ADHD-MA among the four seasons, for all years, were statistically significant (P<0.001). Three air pollutants (SO2, CO, and PM2.5) were significantly associated with ADHD-MA; no interactions among air pollutants were significant. Air pollution was thus likely associated with ADHD-MA. Prospective epidemiological and biomedical studies should next examine the molecular relationship between air pollution and ADHD symptoms.

Frequent Social Media Use and Its Prospective Association With Mental Health Problems in a Representative Panel Sample of US Adolescents.

PURPOSE: This study examined the relationship between frequent social media use and subsequent mental health in a representative sample of US adolescents. Also investigated were sex differences in multiyear growth trajectories of mental health problem internalization relative to social media use. METHODS: Four waves (2013-2018) of nationally representative, longitudinal Population Assessment of Tobacco and Health data were analyzed. A total of 5,114 US adolescents aged 12-14 years at baseline had repeated data across all waves. Statistical analysis involved testing a series of sequential-weighted single-group and multi-group latent growth curve models using R version 3.6.2. RESULTS: Of the 5,114 respondents, 2,491 were girls (48.7%). The percentage of frequent social media use was 26.4% at Wave 1 and 69.1% at Wave 4 for boys compared to 38.3% and 80.6% for girls (p < .001). Boys showed an improving (-0.218, p = .005) but girls showed a deteriorating linear trend (0.229, p = .028) for mental health at the full multigroup latent growth curve model. Social media use accounted for mental health conditions across Waves 1-3 for boys (ps<.01) but only at Wave 1 for girls (p = .035). With the addition of the social media use variable alone, model fit dramatically improved, and residual variances in growth patterns (i.e., random effect) became nonsignificant for boys. Substantial sex differences existed in baseline status, directionality, and shape of mental health growth trajectories as well as interplay of social media use with other factors. DISCUSSION: Findings of the study suggest that frequent social media use is associated with poorer subsequent mental health for adolescents.

Associations between Cigarette Smoking and Health-Related Quality of Life in Adult Survivors of Adolescent and Young Adult Cancer.

This cross-sectional, secondary data analysis examines the association between cigarette smoking and self-reported health-related quality of life (HRQoL) in adult survivors of Adolescent and Young Adult Cancer. Pooled data for survivors of Adolescent and Young Adult Cancer (N = 1495) were drawn from the 2016 and 2017 Behavioral Risk Factor Surveillance Survey. Binary logistic regression models were utilized to examine independent associations between each of the four HRQoL domains (i.e., self-related general health, activity limitation days, poor physical, and mental health days) and cigarette smoking. Of the 1495 Adolescent and Young Adult Onset Cancer Survivors (AYAO-CS) in this study, approximately 30% reported currently smoking cigarettes. Relative to never smokers, the odds of reporting fair/poor general health were significantly higher for current and former smokers: (OR = 3.95, 95% CI: 2.08-7.50) and (OR = 2.51, 95% CI: 1.46-4.32), respectively. Likewise, current smokers were significantly more likely to report frequent days of poor physical health (OR = 2.79, 95% CI: 1.38-5.65). The study findings suggest a significant cross-sectional association between cigarette smoking and poor health-related quality of life in adult survivors of adolescent and young adult cancer. These findings, although cross-sectional, underscore the need for prospective studies to examine the longitudinal association between HRQoL and cigarette smoking among cancer survivors. Findings also help establish both the need for smoking cessation programs and the importance of effective strategies for addressing HRQoL issues among cancer survivors.

Elementary School Personnel and Cultural Factors Affecting Health Education Implementation in the High-Stakes Testing Era.

BACKGROUND: Despite proven health and learning benefits, health education implementation in elementary schools is not optimal. This study investigated learning environment, leadership, and training factors that may influence elementary-level health education implementation in the current standardized testing-saturated environment. METHODS: Survey data were collected from principals of 8 Michigan elementary schools and, via focus groups, 30 teachers in their schools. Teacher groups were separated into 2 categories based on principals' understanding of state health education policies. Grounded theory analysis was used. RESULTS: Despite all 30 teachers' positive attitudes toward health education, numerous consistent implementation barriers were identified; competition for instructional time with tested subjects was most critical. Teachers with principals who indicated a greater understanding of state policies reported more: consistent instruction; availability of resources, and encouragement to teach select topics, especially mental health. CONCLUSION: That these findings were produced in a state with strong CSHE polices, proven curricula, and expansive support systems are disheartening and accentuate the profound impact of standardized testing on elementary-level health education implementation. More promising, principals' understanding of applicable state-level policies appeared to generate stronger health education implementation. Future research should focus on the possible impact of time devoted to health instruction on standardized test scores.

Resilience as a Mediator between Adverse Childhood Experiences and Prescription Opioid Misuse among U.S. Adults.

BACKGROUND:: Studies have shown some linkage between adverse childhood experiences (ACEs) and prescription opioid misuse. While preventable, once an individual is exposed to ACEs, they can have irreparable health impacts. Resilience could have protective effects on preventing those with ACEs from adulthood health-risk behaviors. Objectives: To examine how resilience mediates the association between ACEs and adulthood prescription opioid misuse among U.S. adults. Methods: Adult respondents (n = 33,613) from the National Epidemiologic Survey on Alcohol and Related Conditions-III (2012-2013) were included. A count of ten types of ACEs constituted the ACE score (range: 0-10). A latent variable was created to measure resilience based on the Connor-Davidson Resilience Scale. Generalized structural equation modeling (GSEM) was utilized to conduct the mediation analysis. The Problem Behavior Theory was used to guide covariate selection. Results: The GSEM measurement model estimated the latent variable resilience and determined that tolerance of negative effects, self-control, acceptance of change, and spiritual influence were all associated with resilience, holding personal competence constrained for estimation purposes. Respondents with a higher ACE score were more likely to misuse prescription opioids in the past year (OR = 1.08; p < 0.01), where 40.8% of the association was mediated by resilience (indirect effect OR = 1.06). Conclusion: Reducing prescription opioid misuse is an essential step in alleviating the current opioid epidemic. Findings suggested that resilience mediated the relationship between ACEs and adulthood prescription opioid misuse. To prevent adults with ACEs from misusing prescription opioids, interventions designed to address ACEs' impact should include behavioral and educational components for enhancing the priority dimensions of resilience.

Medical students perspectives and consideration of geriatrics for future practice. An exploratory study of a public medical school in Ghana.

Ghana has one of the fastest growing aging populations in sub-Sahara Africa, but little is known about the geriatric workforce. A sample of 12 medical students in one Ghanaian public university participated in an exploratory qualitative study to share their perspectives on specialty choices in Ghana, interest in working with older patients, and their consideration of geriatrics for future practice. The findings revealed limited knowledge of geriatrics as well as low interest in its selection as a specialty for future practice. These were attributable to multi-faceted factors, including the lack of both exposure to geriatric medicine and geriatrics-focused training for students in this institution. It is critical that geriatric education be prioritized and incorporated in medical schools to nurture students' interest and future consideration of the specialty. This will help bolster the number of geriatric-oriented physicians and secure specialized care for the aging population.

The role of family conflict in mediating impulsivity to early substance exposure among preteens.

OBJECTIVES: Preadolescence substance exposure, which increases the risk of regular substance use, has been a public health concern. Although studies found that impulsivity is a predisposing factor of early substance exposure, the pathways through which impulsivity is associated with early substance exposure remain unclear. This study examined how family conflict mediates this association among U.S. preteens as family environment plays an essential role in pre-adolescent development. METHODS: Respondents (N = 11,800, 9-10 years old) from the Adolescent Brain Cognitive Development (ABCD) Study Release 2.01 (July 2019) were included in this study. Generalized structural equation modeling was performed to investigate the mediation effects of family conflict on the associations between childhood impulsivity and early exposure to alcohol and tobacco use, controlling for covariates based on the Problem Behavior Theory. RESULTS: Pre-adolescents with high impulsivity levels (≥90th percentile) were more likely to report early alcohol and tobacco exposure (total effect: ORs = 1.49 and 1.70, respectively), where 4.13% and 12.41% of the associations, respectively, were meditated by family conflict (indirect effect: ORs = 1.02 and 1.07; Sobel test ps = 0.022 and 0.005, respectively). CONCLUSIONS: Family conflict mediates the associations between childhood impulsivity and early substance exposure among preteens, with higher impulsivity leading to more severe family conflicts that are, in turn, associated with a higher likelihood of early substance exposure. To prevent preteens with high impulsivity level from early use of substances, interventions may focus on reducing family conflicts such as parenting counseling that guides parents to strengthen conflict-resolution skills and create a stable home environment for preteens.

Stimulators of medical students' interest in geriatric medicine-A Systematic Review.

OBJECTIVES: This study is a systematic review on stimulators of interest in pursuing a geriatric career among medical students in different countries. The review also assessed whether there were differences or similarities based on geographic regions or income categorisations. METHODS: A 20-year (1998-2018) review of quality primary research articles was conducted (n = 10). For analysis, studies were categorised into low- and middle-income countries (LMICs), and high-income countries, based on World Health Organization and World Bank's income grouping for the 2019 fiscal year. RESULTS: The frequently mentioned stimulators of interest in geriatrics were as follows: cultivating positive attitudes towards older people, participation in geriatric-related interventions and positive experiences during a geriatric training. Lack of published peer-reviewed articles from the LMICs limited the researchers' ability to compare the two income groups. CONCLUSION: Suggestions to improve future systematic reviews that consider global factors, global participation or any aspect of global inclusion are discussed.

Is E-cigarette use a gateway to marijuana use? Longitudinal examinations of initiation, reinitiation, and persistence of e-cigarette and marijuana use.

BACKGROUND: Concerns have been raised regarding e-cigarette use as a potential stepping-stone to marijuana use. Based on Kandel's gateway hypothesis, this study investigated if e-cigarette use could lead to marijuana use by testing two hypotheses with a longitudinal national U.S. adult sample, including (1) primary hypothesis: e-cigarette use is a gateway to marijuana use; and (2) falsification hypothesis: marijuana use is not a gateway to e-cigarette use. METHODS: Adults were extracted from the Population Assessment of Tobacco and Health Study Waves 1-3 (2013-2016). For primary hypotheses, based on baseline e-cigarette use statuses, three study groups were defined, and three logistic regressions were conducted to examine associations between baseline e-cigarette use and follow-up marijuana use initiation, reinitiation, and persistence, respectively. Similarly, for falsification hypotheses, three additional study groups were defined, and three logistic regressions were conducted to examine associations between baseline marijuana use and follow-up e-cigarette use behaviors. RESULTS: Baseline e-cigarette use was associated with marijuana use initiation and reinitiation (ORs = 2.08, 1.37, respectively, both ps < .05) but not persistence at follow-up. Additionally, baseline marijuana use was associated with only e-cigarette use initiation (OR = 2.23, p < .01) but not reinitiation or persistence at follow-up. CONCLUSIONS: Findings partially support the gateway hypothesis that e-cigarette use could be a steppingstone to marijuana use reinitiation among the U.S. adults. The mechanisms and behavioral characteristics, such as etiological and psychosocial factors, that may pertain to the progression from e-cigarette use to reinitiation of other substance use should be further investigated to inform effective behavioral, educational, and policy interventions.

A Salient Belief Elicitation Examining Adolescents' Meditation Beliefs Using the Reasoned Action Approach.

The purpose of this study was to identify adolescents' consequence, referent, and circumstance beliefs about trying to meditate at least twice in the next week in order to inform subsequent meditation intervention design. A survey based on reasoned action approach (RAA) constructs was developed and pilot-tested. Thereafter, adolescents (N = 129), recruited from a northeastern U.S. high school, responded to open-ended survey questions eliciting beliefs underlying intention to try meditating. Thematic analysis was executed to examine beliefs and frequencies of beliefs. Five types of salient meditation beliefs were identified: advantages (e.g., reduces stress, increases relaxation, improves focus), disadvantages (e.g., slows everything down), supporters and disapprovers (e.g., family and friends), and facilitating circumstances (e.g., more time, fewer distractions). Adolescents recognize meditation as having health benefits but as also taking time. They further viewed meditation as socially acceptable but need sufficient time and a conducive environment to try it. To be effective, interventions designed to promote adolescents' self-regulation through meditation should address identified salient beliefs.

Defining Food Education Standards through Consensus: The Pilot Light Food Education Summit.

BACKGROUND: Consistent with the Whole School, Whole Community, Whole Child Approach, food education encompasses nutritional status, culture, community, environment, and society. Unifying standards are needed to support food education integration in K-12 curricula. Pilot Light, a Chicago-based nonprofit, sought to generate such standards. This study reports a formative evaluation research process that led to the development of Food Education Standards (FES). METHODS: Nine FES were drafted within the context of the National Health Education Standards. The 2-day Pilot Light Food Education Summit convened 26 experts and community members to review draft FES. A facilitated, consensus-building process generated refined FES and K-12 competencies. Drawing on Summit outcomes and expert feedback, a team of teachers subsequently drafted final FES. Summit participants completed pre- and post-Summit surveys to assess changes in food education priorities. RESULTS: The initial 9 FES were refined to 7. Comparison data indicated shifts in endorsed priorities for food education, moving from prioritizing specific knowledge, such as "categorizing food into food groups," toward "students having a conscious decision-making process around food." CONCLUSIONS: Developed with input from experts across multidisciplinary fields, the evidence-based Pilot Light FES can be feasibly implemented in multiple subjects across all school types and community socio-demographic levels.

Addressing Challenges to the Reliable, Large-Scale Implementation of Effective School Health Education.

The long-held priority of teaching young people the knowledge and skills needed for healthy living has recently been diminished in many preK-12 schools. Driven by federal and state priorities, laws, and policies associated with high-stakes testing, instruction in untested subjects has been reduced or eliminated in most schools in order to devote more attention to tested subjects, like reading, math, writing, and science. This article proposes a pathway to ensure that all children are able to learn what society knows about health. To that end, four challenges to the reliable, large-scale implementation of effective school health education are identified: (1) establishing school health education as an undeniable social and cultural priority through improved advocacy; (2) strengthening educational institutions' capacities to reliably deliver large-scale, high-quality, school-based health education; (3) collaboratively coordinating efforts of health-promoting governmental and nongovernmental organizations that generate thought leadership for school health education; and (4) creating multidisciplinary research capacities for solving problems associated with the implementation of reliable, large-scale, effective school health education. By implementing specific strategies associated with each challenge, health educators can promote the social and system-level conditions required to support, elevate, and ensure delivery of effective health education to every student in every school every year.

Quality Assurance in Teaching K-12 Health Education: Paving a New Path Forward.

To be effective, school health instruction should be taught by health educators who have graduated from accredited health education teacher education programs and are certified in health education. Unfortunately, the nation has failed to ensure that all those who teach health in schools are well prepared. States vary in the required coursework for health teachers in terms of initial licensure and continuing education for licensure renewal; most elementary teachers are not required to receive preparation in health education; health education and physical education are often viewed as synonymous disciplines; support for in-service education of health teachers is often lacking; and more research is needed in professional preparation and development of school health educators. This article provides a call to action in five areas to strengthen both the professional preparation and professional development of school health educators. Given that education is a social determinant of health, public health educators must become stronger allies in supporting school health to promote health equity. Public health practitioners can advocate to state and community school decision makers for comprehensive school health education taught by teachers with appropriate professional preparation and certification in health education. Public health faculty can educate their students about the Whole School, Whole Community, Whole Child framework and effective strategies for its implementation, and seek rigorous professional preparation and certification and accreditation standards for their school teacher preparation programs. National health and education organizations can call for new leadership and investments in health education teacher preparation and development for a brighter future.

Associations between e-cigarette and combustible cigarette use among U.S. cancer survivors: implications for research and practice.

PURPOSE: Prior studies established significant associations between e-cigarette use and combustible cigarette smoking in the general population; however, little is known about such associations among cancer survivors. Thus, the current study examined possible associations between e-cigarette use and combustible cigarette smoking among U.S. cancer survivors. METHODS: Cross-sectional data were drawn from the 2016 Behavioral Risk Factor Surveillance System Survey. Binary logistic regression was used to analyze the associations between e-cigarette user status and combustible cigarette-smoking status in a sample of 4680 cancer survivors, controlling for alcohol use and sociodemographic factors. Analyses were weighted for unequal probability of sample selection to reflect national cancer survivor population estimates. RESULTS: Prevalence for current e-cigarette use and combustible cigarette smoking for cancer survivors was 2.57% and 16.16%, respectively. In the adjusted analyses, cancer survivors who reported current e-cigarette use, compared to never-users, had greater odds of being current combustible cigarette smokers (odds ratio [OR] = 11.81, 95% confidence interval [CI] = 5.38-25.93). Likewise, former e-cigarette users, compared to never-users, had greater odds of being current combustible cigarette smokers (OR = 15.90, 95% CI = 10.68-23.36). CONCLUSION: Among cancer survivors in the USA, e-cigarette use had a positive and highly significant association with combustible cigarette smoking. IMPLICATIONS FOR CANCER SURVIVORS: In order to prevent multiple and substitute use of nicotine-delivery products, prevention interventions and cessation programs designed for cancer survivors should specifically target both current combustible cigarette smokers and non-smokers who report former and current e-cigarette use.

Physical activity and fitness among pediatric cancer survivors: a meta-analysis of observational studies.

PURPOSE: The number of pediatric cancer survivors has increased dramatically over recent decades. Prior studies involving pediatric cancer survivors have reported reduced physical activity and fitness levels. Thus, the aim of this meta-analysis was to synthesize previous findings on physical activity and fitness levels of pediatric cancer survivors, who had completed cancer treatment and are in complete remission compared with age-matched, non-athletic healthy controls with no history of cancer diagnosis. METHODS: Three electronic databases (PubMed, Web of Science, and EBSCO) were searched using a combination of 24 terms. Observational studies examining the post-treatment physical activity and/or fitness levels of pediatric cancer survivors compared with that of non-cancer controls and published in peer-reviewed, English-language journals before August 22, 2018 were eligible. Random-effect models were used in Comprehensive Meta-Analysis software for effect-size estimations of eight studies for physical activity and eight for fitness. RESULTS: The studies included a total sample of 2628; 1413 pediatric cancer survivors and 1215 non-cancer controls. Both physical activity and fitness were significantly lower in childhood cancer survivors than in non-cancer controls (g = - 0.889; 95% confidence interval [CI] = - 1.648 - 0.130; p = 0.022) and (g = - 1.435; 95% CI = - 2.615 - 0.225; p = 0.017), respectively, with high heterogeneity. CONCLUSIONS: Pediatric cancer sequelae and its treatment may limit participation in physical activity and fitness activities by survivors of pediatric cancer. Accentuating the need to incorporate physical activity and fitness into treatment protocols and post-treatment recommendations may improve pediatric cancer survivors' health and well-being.

Adolescent Weight and Electronic Vapor Product Use: Comparing BMI-Based With Perceived Weight Status.

INTRODUCTION: This study examined the associations of BMI-based and perceived body weight status with electronic vapor product use, cigarette smoking, and dual use among U.S. adolescents. METHODS: A cross-sectional analysis was conducted in 2017 on data from 15,129 adolescents in the National Youth Risk Behavior Survey, 2015. Multiple logistic regression analyses were used to examine the associations of BMI-based and perceived weight status with electronic vapor product use, cigarette smoking, and dual use, after adjusting for all other covariates. The regression models were stratified by gender. RESULTS: Overall, 25.5% of males used electronic vapor products, 11.6% smoked cigarettes, and 8.1% used both; percentages among females were 22.6%, 9.8%, and 6.8%, respectively. Females who perceived themselves as overweight were more likely than those who perceived themselves as normal weight to be current electronic vapor product users (AOR=1.09, 95% CI=1.01, 1.19) and dual users (AOR=1.23, 95% CI=1.01, 1.49). When compared with normal BMI-based category, males with obese BMI status were more likely to be current cigarette smokers (AOR=1.61, 95% CI=1.06, 2.44), however, only females with overweight BMI status were more likely to be current smokers (AOR=1.89, 95% CI=1.25, 2.86). CONCLUSIONS: Findings suggest that the influence of adolescents' body weight perceptions and BMI-based status should be accounted for when developing nicotine-containing product use prevention programs for adolescents. Specific strategies for influencing female adolescents who perceive themselves as overweight should be included to prevent emerging electronic vapor product and dual use.

BMI and Central Obesity With Falls Among Community-Dwelling Older Adults.

INTRODUCTION: This study examined the associations of BMI category and central obesity status, with falls among community-dwelling older adults in the U.S. METHODS: Data were drawn from the 2012 and 2014 U.S. Health and Retirement Study, a nationally representative longitudinal panel study funded by the National Institute of Aging. The study participants were U.S. community-dwelling older adults aged ≥65 years (N=3,383). Multiple logistic regression and Poisson regression analyses examined the associations of BMI category and central obesity (waist circumference >102 cm in men and >88 cm in women) with experiencing a fall and fall injury, after adjusting for all other covariates. A prospective analysis was conducted in which independent variables from 2012 were examined in relation to dependent variables measured in the same participants in 2014. RESULTS: Overall, 35.2% of older adults experienced at least one fall in the past 2 years. Compared with those who were not, centrally obese older adults were more likely to experience a fall (AOR=1.37, 95% CI=1.01, 1.85) and fall more frequently (incidence rate ratio=1.15, 95% CI=1.03, 1.29). Fallers in the obese BMI category were less likely than normal-weight fallers to experience a fall injury (AOR=0.56, 95% CI=0.35, 0.91). CONCLUSIONS: These findings suggest that (1) central obesity be measured when assessing older adults' fall risk and (2) specific community prevention strategies for centrally obese older adults be developed to better prevent falls and fall-related injuries.