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1.
J Pediatr Gastroenterol Nutr ; 78(6): 1355-1363, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38623922

RESUMO

OBJECTIVES: The primary objective of this study is to further explore associations between social influencers of health and markers of disease severity at the time of presentation of patients with pediatric metabolic dysfunction-associated steatotic liver disease (MASLD) using neighborhood-level Area Deprivation Index (ADI) scores. METHODS: A retrospective cross-sectional study was conducted among 344 pediatric MASLD patients. Each patient received an ADI score based on their 9-digit zip code. Groups were defined as low (≤5) and high (6≥) ADI. Associations between ADI and symptomatology and laboratory values at presentation, as well as initial liver biopsy pathology were tested via analyses of covariance, χ2 testing, and logistic regressions. RESULTS: The mean ADI was 6.54 (standard deviation = 2.09). ADI groups did not significantly differ in age of presentation, type of presentation, or associated conditions, except for the higher ADI group having on average lower vitamin D levels (26.70 vs. 29.91, p = 0.02) and being two times more likely to also be diagnosed with low high-density lipoprotein (HDL) levels (p = 0.04, 95% CI 1.04-3.89). Mean transaminases and histopathologic nonalcoholic fatty liver disease (NAFLD) Activity Scores did not significantly differ between ADI groups. CONCLUSIONS: Pediatric patients with MASLD in this study span the entire spectrum of neighborhood deprivation. There were no differences in presentation characteristics or severity of MASLD, aside from lower HDL-cholesterol and vitamin D values in the high ADI group. Area deprivation was not predictive of more severe disease as assessed by serum transaminases and liver biopsy NAFLD activity scores.


Assuntos
Características de Residência , Humanos , Masculino , Estudos Transversais , Feminino , Criança , Estudos Retrospectivos , Adolescente , Pré-Escolar , Índice de Gravidade de Doença , Hepatopatia Gordurosa não Alcoólica/complicações , Fígado Gorduroso/etiologia , Fígado/patologia
2.
BMC Infect Dis ; 23(1): 105, 2023 Feb 22.
Artigo em Inglês | MEDLINE | ID: mdl-36814187

RESUMO

BACKGROUND: Monoclonal antibody (mAb) treatment for COVID-19 is associated with improved clinical outcomes. However, there is limited information regarding the impact of treatment on symptoms and the prevalence of post-COVID Conditions (PCC). Understanding of the association between time to mAb infusion and the development of PCC is also limited. METHODS: This longitudinal study was conducted among patients with COVID-19 who received mAb infusions at a Federally Qualified Health Center in San Diego, CA. A series of telephone interviews were conducted at baseline and follow-up (14 days and 28+ days). A comprehensive symptom inventory was completed and physical and mental health status were measured using PROMIS-29 and PHQ-2. Pearson's Chi-squared tests and independent two-sample t-tests were performed to test for association between time to mAb infusion and outcomes at follow-up. A Poisson regression model was used to analyze whether time to mAb infusion predicts risk of developing PCC. RESULTS: Participants (N = 411) were 53% female, ranged in age from 16 to 92 years (mean 50), and a majority (56%) were Latino/Hispanic. Cross-sectional findings revealed a high symptom burden at baseline (70% of patients had cough, 50% had fever, and 44% had headache). The prevalence of many symptoms decreased substantially by the final follow-up survey (29% of patients had cough, 3% had fever, and 28% had headache). Longitudinal findings indicated that 10 symptoms decreased in prevalence from baseline to final follow-up, 2 remained the same, and 14 increased. The severity of symptoms and most patient-reported physical and mental health measure scores decreased over time. The prevalence of PCC was 69% when PCC was defined as ≥ 1 symptom at final follow-up. Time to mAb infusion was not significantly associated with any outcome at follow-up. Time to infusion was not associated with PCC status at final follow-up in the crude or adjusted Poisson regression models. CONCLUSIONS: The prevalence of PCC was high among this patient population following COVID-19 mAb treatment. Time to mAb infusion did not predict the development of PCC. Further research in these areas is essential to answer urgent clinical questions about effective treatments of COVID-19.


Assuntos
COVID-19 , Humanos , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Masculino , Síndrome de COVID-19 Pós-Aguda , Estudos Longitudinais , Tosse , Estudos Transversais , Cefaleia
3.
Tob Control ; 32(6): 689-695, 2023 11.
Artigo em Inglês | MEDLINE | ID: mdl-35232793

RESUMO

INTRODUCTION: Removal of tobacco industry branding from cigarette packs may reduce their appeal. Adding graphic warning labels (GWLs) should enhance this effect. We investigate whether willingness to pay for various packaging designs changes after 3 months' use of: (1) US branded packs without GWLs (US), (2) non-branded packs without GWLs (Blank), and (3) rotating non-branded packs with GWLs (gangrene; throat cancer; neonatal baby) covering >75% of pack (GWL). METHODS: Californian adult daily smokers not planning to quit (n=287; 56% female; mean age=39.6) completed a discrete choice purchase task before and after 3 months' experience using one of three packaging options. Conjoint analysis and pre-post modelling evaluated the change in importance of pack attributes and willingness to pay for US, Blank or GWL (blindness; teeth; gangrene) pack designs. RESULTS: Price determined ~70% of purchase choices, while pack design determined ~22%. Irrespective of intervention arm, US packaging generated appeal valuations compared with Blank packaging, while GWLs consistently provoked strong aversive valuations at baseline and follow-up. Compared with the US pack arm, using GWL packs for 3 months decreased willingness to pay for US packaging (ß=-$0.38, 95% CI -0.76 to 0.00). Wear-out effects were detected in the discount needed to willingly purchase the gangrene-GWL pack (ß=$0.49, 95% CI 0.16 to 0.82) and Blank pack (ß=$0.42, 95% CI 0.09 to 0.74) but not for GWLs (blindness, teeth) not used in trial. CONCLUSION: Compared with US branded packs, the negative valuation of non-branded GWL packs attenuates with even 3 months' use but does not generalise to non-used GWLs. This suggests that GWLs should be regularly refreshed. The appeal valuation of industry imagery suggests that the US plan to retain such imagery on packs may ameliorate the effect of GWLs.


Assuntos
Produtos do Tabaco , Adulto , Feminino , Humanos , Masculino , Cegueira , Gangrena , Rotulagem de Produtos , Embalagem de Produtos , Fumantes
4.
Tob Control ; 32(3): 315-322, 2023 05.
Artigo em Inglês | MEDLINE | ID: mdl-34511408

RESUMO

OBJECTIVE: To identify whether three types of cigarette pack designs, including three versions of graphic warning label (GWL) plain packs, one GWL absent and branding absent pack (blank) and the smoker's own GWL absent and branding present pack (US), elicit different valence, type and levels of affect. DESIGN: US daily smokers (n=324) were asked to handle each of the five pack types and 'think aloud' their reactions. To avoid a muted familiarity response, exposure to their own US pack followed exposure to at least one GWL plain pack. Reactions were scored on a reactivity scale (-3 to +3) and the text was coded for speech polarity (-1 to +1) and emotive word frequency. RESULTS: Reactivity scores had excellent inter-rater reliability (agreement ≥86%; intraclass correlation coefficient ≥0.89) and were correlated with speech polarity (r=0.21-0.37, p<0.001). When considering their US pack, approximately two-thirds of smokers had a low (31.5%) to medium (34.6%) positive response (reactivity=1.29; polarity=0.14) with expressed feelings of joy and trust. Blank packaging prompted a largely (65.4%) neutral response (reactivity=0.03; polarity=0.00). The gangrenous foot GWL provoked mostly medium (46.9%) to high (48.1%) negative responses (reactivity=-2.44; polarity=-0.20), followed by neonatal baby (reactivity=-1.85; polarity=-0.10) and throat cancer (reactivity=-1.76; polarity=-0.08) warnings. GWLs varied in their elicitation of disgust, anger, fear and sadness. CONCLUSION: Initial reactions to GWL packs, a blank pack, and smokers' current US pack reflected negative, neutral, and positive affect, respectively. Different versions of the GWL pack elicited different levels and types of immediate negative affect.


Assuntos
Produtos do Tabaco , Recém-Nascido , Humanos , Produtos do Tabaco/efeitos adversos , Rotulagem de Produtos , Reprodutibilidade dos Testes , Embalagem de Produtos , Embalagem de Medicamentos , Prevenção do Hábito de Fumar
5.
AIDS Behav ; 26(5): 1467-1476, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-34982320

RESUMO

The goal of this paper is to determine the association between traveling to engage in sex work in another country and recent access to HIV testing among substance-using female sex workers (FSWs) in the Mexico-Guatemala border region. From 2012 to 2015, through modified time-location sampling and peer referral, 255 FSWs were recruited at Mexico's southern border. Participants completed questionnaires on sociodemographics, migration and mobility experiences, work environment factors, and substance use. A conceptual framework, as depicted by a directed acyclic graph (DAG), guided our analysis. Crude and adjusted logistic regression models were used to evaluate the relationships between mobility experiences and HIV testing in the past year. Overall HIV testing was low (41%); after considering relevant covariates (i.e., interaction with health services and organizations, and sex work characteristics) traveling to engage in sex work in another country was found to be positively associated with HIV testing in the past year. Future efforts need to consider voluntary and non-stigmatizing prevention HIV services and focus on reaching out to less mobile women.


RESUMEN: El objetivo de este artículo es determinar la asociación entre viajar a otro país para ejercer el comercio sexual y el acceso a una prueba reciente de VIH, en una población de mujeres trabajadoras sexuales en la frontera de México con Guatemala. Entre el 2012 y 2015, utilizando un muestreo por conveniencia y por referencia de pares, se invitó a 255 mujeres trabajadoras sexuales en la frontera sur de México a participar en este proyecto de investigación. Las participantes completaron una encuesta que comprendió preguntas sociodemográficas así como experiencias de migración y movilidad, características del trabajo sexual, y patrones de uso de sustancia. Utilizamos un marco conceptual que se ilustra en una Gráfica Acíclica Dirigida (DAG) el cual sirvió para guiar nuestro análisis. Realizamos análisis de regresión logística cruda y ajustada para evaluar la asociación entre experiencias de movilidad y haber recibido una prueba de VIH en el último año. En general, el porcentaje de haber recibido una prueba de VIH en el último año fue bajo (41%); después de considerar covariables relevantes; (ej., interacción con organizaciones y servicios de salud, características del trabajo sexual) encontramos que viajar a otro país para ejercer el comercio sexual está asociado con haber recibido una prueba de VIH en el último año. Es importante que, en el futuro, se concentren esfuerzos en servicios de prevención del VIH que sean voluntarios, no estigmatizantes, y que se enfoquen en mujeres trabajadoras sexuales menos móviles.


Assuntos
Infecções por HIV , Profissionais do Sexo , Feminino , Guatemala , Infecções por HIV/diagnóstico , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Teste de HIV , Humanos , México/epidemiologia
6.
Int J Behav Med ; 29(3): 334-345, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34341956

RESUMO

BACKGROUND: The impact of physical activity interventions for Latina women can be enhanced by identifying and implementing strategies to achieve long-term physical activity maintenance. Physical activity promotion research has mainly focused on physical activity initiation and we know little regarding individual, interpersonal, or environmental factors that influence maintenance of physical activity. This study aimed to qualitatively explore and understand factors associated with maintenance and non-maintenance of physical activity among Latinas. METHODS: Semi-structured individual interviews were conducted with 21 Latinas who increased their physical activity as a result of an intervention, and who completed a 3-month maintenance period without contact from research staff. Data were analyzed using thematic analysis. RESULTS: Important facilitators of physical activity maintenance described by participants included having made physical activity a habit; the ability to proactively overcome obstacles to engaging in physical activity, and satisfaction with outcomes obtained from engaging in physical activity. Additional facilitators mentioned by both maintainers and non-maintainers included having motivation, social support, and opportunities to be active. Both maintainers and non-maintainers reported high self-efficacy for PA maintenance in the future. CONCLUSIONS: Guiding intervention participants to form habits and to set realistic expectations could help them to independently continue engaging in physical activity upon completion of physical activity interventions. Teaching them skills to proactively overcome obstacles may also be important for physical activity maintenance.


Assuntos
Exercício Físico , Motivação , Feminino , Hábitos , Hispânico ou Latino , Humanos , Pesquisa Qualitativa
7.
Int J Behav Med ; 28(5): 540-551, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33415695

RESUMO

BACKGROUND: Physical activity (PA) research extensively focuses on initiation of PA, yet lapse and relapse among PA intervention participants are less well understood, particularly among minority populations such as Latinas in the USA. This study aimed to (1) determine the probability of lapse during two PA interventions for Latinas; (2) assess demographic, psychosocial, and environmental predictors of the amount of time until first lapse; and (3) identify factors predictive of lapse recovery. METHODS: Data from 176 Latina intervention participants were pooled. Survival functions and Kaplan-Meier curves were used to illustrate probability of lapse. Cox proportional hazard models assessed predictors of time to lapse. Logistic regressions identified predictors of lapse recovery. RESULTS: The probability of lapse after 1 month of starting to exercise was 18%, escalating to 34% after 4 months. Predictors of earlier lapse included various psychosocial constructs (i.e., self-efficacy and various processes of change), but none of the measured environmental factors, and only one demographic factor (≥ 2 children under 18). Increased use of consciousness raising at 2 months was associated with lower likelihood of lapse recovery, yet use of behavioral processes of change at 6 months was associated with higher likelihood of recovery. CONCLUSIONS: Lapsing may not be pre-determined by demographic and environmental characteristics. On the other hand, skills that can be learned through interventions, such as skills to improve self-efficacy, seem important in the delay or prevention of lapses. Results pertaining to lapse recovery are less clear.

8.
Int J Behav Nutr Phys Act ; 17(1): 133, 2020 10 27.
Artigo em Inglês | MEDLINE | ID: mdl-33109190

RESUMO

BACKGROUND: Sedentary time is associated with chronic disease and premature mortality. We tested a multilevel workplace intervention with and without sit-stand workstations to reduce sedentary time and lower cardiometabolic risk. METHODS: Stand and Move at Work was a group (cluster) randomized trial conducted between January 2016 and December 2017 among full-time employees; ≥18 years; and in academic, industry/healthcare, and government worksites in Phoenix, Arizona and Minneapolis/St. Paul, Minnesota, USA. Eligible worksites were randomized to (a) MOVE+, a multilevel intervention targeting reduction in sedentary time and increases in light physical activity (LPA); or (b) STAND+, the MOVE+ intervention along with sit-stand workstations to allow employees to sit or stand while working. The primary endpoints were objectively-measured workplace sitting and LPA at 12 months. The secondary endpoint was a clustered cardiometabolic risk score (blood pressure, glucose, insulin, triglycerides, and HDL-cholesterol) at 12 months. RESULTS: Worksites (N = 24; academic [n = 8], industry/healthcare [n = 8], and government [n = 8] sectors) and employees (N = 630; 27 ± 8 per worksite; 45 ± 11 years of age, 74% female) were enrolled. All worksites were retained and 487 participants completed the intervention and provided data for the primary endpoint. The adjusted between arm difference in sitting at 12 months was - 59.2 (CI: - 74.6,-43.8) min per 8 h workday, favoring STAND+, and in LPA at 12 months was + 2.2 (- 0.9,5.4) min per 8 h workday. Change in the clustered metabolic risk score was small and not statistically significant, but favored STAND+. In an exploratory subgroup of 95 participants with prediabetes or diabetes, the effect sizes were larger and clinically meaningful, all favoring STAND+, including blood glucose, triglycerides, systolic blood pressure, glycated hemoglobin, LDL-cholesterol, body weight, and body fat. CONCLUSIONS: Multilevel workplace interventions that include the use of sit-stand workstations are effective for large reductions in sitting time over 12 months. Among those with prediabetes or diabetes, clinical improvements in cardiometabolic risk factors and body weight may be realized. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02566317 . Registered 2 October 2015, first participant enrolled 11 January 2016.


Assuntos
Doenças Cardiovasculares/prevenção & controle , Exercício Físico/fisiologia , Promoção da Saúde/métodos , Comportamento Sedentário , Local de Trabalho , Arizona , Glicemia , Pressão Sanguínea , Humanos , Minnesota
9.
Appetite ; 144: 104478, 2020 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-31563453

RESUMO

INTRODUCTION: Meat consumption has been linked to some negative health and environmental outcomes. Studies have assessed motivations among those who have reduced or eliminated meat consumption; less work identifies strategies to reduce meat consumption among those who consume meat. This paper describes factors associated with lower meat consumption and reviews experimental studies that targeted those factors to either change behavior or intention/willingness to reduce meat. METHODS: A systematic review of the literature was conducted among four databases. Inclusion criteria were experimental and quasi-experimental designs and studies that measured variables indirectly or directly related to meat consumption. RESULTS: Twenty-two articles were identified. These studies targeted factors such as knowledge and skills with informational provisions about health and the environment; values and attitudes concerning the relationship between social dominance and meat; evocation of emotion such as empathy and disgust; social norms both dynamic and growing; changes to the food environment with default vegan menu options, perceived behavioral control, and intentions. The majority of studies (n = 15) investigated the effects of providing information such as personal health effects of meat consumption. In general, increasing knowledge alone or when combined with other methods was shown to successfully reduce meat consumption behavior or intentions/willingness to eat meat. Evoking emotions with animal images and making changes to the environment proved effective. DISCUSSION: Factors identified in correlational studies were generally found to be useful agents of behavior change in experimental studies. However, several factors have not been tested experimentally. More experimental studies are required to confirm the results of this review; for example, experiments focused on modifications of the food environment such as increasing the number of meatless meals on restaurant menus.


Assuntos
Comportamento do Consumidor , Dieta Saudável/psicologia , Dieta Vegetariana/psicologia , Comportamento Alimentar/psicologia , Carne , Adulto , Comportamento de Escolha , Ensaios Clínicos como Assunto , Emoções , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Motivação
10.
Int J Behav Nutr Phys Act ; 14(1): 117, 2017 08 31.
Artigo em Inglês | MEDLINE | ID: mdl-28859679

RESUMO

BACKGROUND: To identify social ecological correlates of objectively measured workplace sedentary behavior. METHODS: Participants from 24 worksites - across academic, industrial, and government sectors - wore an activPAL-micro accelerometer for 7-days (Jan-Nov 2016). Work time was segmented using daily logs. Sedentary behavior outcomes included time spent sitting, standing, in light intensity physical activity (LPA, stepping cadence <100 steps/min), and in prolonged sitting bouts (>30 min). Outcomes were standardized to an 8 h work day. Two electronic surveys were completed to derive individual (job type and work engagement), cultural (lunch away from the desk, walking at lunch and face-to-face interaction), physical (personal printer and office type) and organizational (sector) factors. Mixed-model analyses with worksite-level clustering were performed to examine multi-level associations. Secondary analyses examined job type and sector as moderators of these associations. All models were adjusted for age, race/ethnicity and gender. RESULTS: Participants (N = 478; 72% female; age: 45.0 ± 11.3 years; 77.8% non-Hispanic white) wore the activPAL-micro for 90.2 ± 15.5% of the reported workday. Walking at lunch was positively associated with LPA (5.0 ± 0.5 min/8 h, P < 0.001). Regular face-to-face interaction was negatively associated with prolonged sitting (-11.3 ± 4.8 min/8 h, P < 0.05). Individuals in private offices sat more (20.1 ± 9.1 min/8 h, P < 0.05), stood less (-21.5 ± 8.8 min/8 h, P < 0.05), and engaged in more prolonged sitting (40.9 ± 11.2 min/8 h, P < 0.001) than those in public office space. These associations were further modified by job type and sector. CONCLUSIONS: Work-specific individual, cultural, physical and organizational factors are associated with workplace sedentary behavior. Associations vary by job type and sector and should be considered in the design of workplace interventions to reduce sedentary behavior. TRIAL REGISTRATION: Clinical trial No. NCT02566317 ; Registered Sept 22nd 2015.


Assuntos
Comportamento Sedentário , Meio Social , Local de Trabalho/psicologia , Adulto , Análise por Conglomerados , Estudos Transversais , Exercício Físico/psicologia , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Postura , Inquéritos e Questionários , Caminhada/psicologia
11.
Fam Community Health ; 40(3): 183-191, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28525437

RESUMO

High-intensity resistance training (RT) shows promise for improved cardiometabolic health in children. Achieving high-intensity RT safely is a challenge for community-based programs because of parental concerns and group engagement. Twenty preadolescent children completed an 8-week, twice per week program using slow speed to achieve high-intensity RT. Parent and child surveys were conducted to measure acceptability and effectiveness. Child fitness levels were assessed, and fasting blood draws and dual-energy x-ray absorptiometry were performed on a subset population. Perceived RT safety, self-efficacy, body composition, waist circumference, and fitness tests exhibited significant improvements. Using slow speed to achieve high-intensity RT may provide a safe and effective community-based alternative for preadolescents.


Assuntos
Pais/psicologia , Treinamento Resistido/métodos , Criança , Estudos de Viabilidade , Feminino , Humanos , Masculino , Fatores de Tempo
12.
Public Health Nutr ; 18(11): 2055-66, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-25374257

RESUMO

OBJECTIVE: The Social Ecological Model (SEM) has been used to describe the aetiology of childhood obesity and to develop a framework for prevention. The current paper applies the SEM to data collected at multiple levels, representing different layers of the SEM, and examines the unique and relative contribution of each layer to children's weight status. DESIGN: Cross-sectional survey of randomly selected households with children living in low-income diverse communities. SETTING: A telephone survey conducted in 2009-2010 collected information on parental perceptions of their neighbourhoods, and household, parent and child demographic characteristics. Parents provided measured height and weight data for their children. Geocoded data were used to calculate proximity of a child's residence to food and physical activity outlets. SUBJECTS: Analysis based on 560 children whose parents participated in the survey and provided measured heights and weights. RESULTS: Multiple logistic regression models were estimated to determine the joint contribution of elements within each layer of the SEM as well as the relative contribution of each layer. Layers of the SEM representing parental perceptions of their neighbourhoods, parent demographics and neighbourhood characteristics made the strongest contributions to predicting whether a child was overweight or obese. Layers of the SEM representing food and physical activity environments made smaller, but still significant, contributions to predicting children's weight status. CONCLUSIONS: The approach used herein supports using the SEM for predicting child weight status and uncovers some of the most promising domains and strategies for childhood obesity prevention that can be used for designing interventions.


Assuntos
Meio Ambiente , Obesidade Infantil/etiologia , Características de Residência , Meio Social , Adolescente , Adulto , Índice de Massa Corporal , Peso Corporal , Criança , Pré-Escolar , Estudos Transversais , Dieta , Exercício Físico , Feminino , Humanos , Modelos Logísticos , Masculino , Sobrepeso , Pais , Obesidade Infantil/prevenção & controle , Inquéritos e Questionários , Adulto Jovem
13.
Artigo em Inglês | MEDLINE | ID: mdl-37195591

RESUMO

BACKGROUND: Cervical and other vaccine-preventable HPV-associated cancers disproportionately impact Hispanic/Latinos in the USA. HPV vaccine uptake may be impacted by community agreement with common HPV vaccine misperceptions. It is unknown whether Hispanics/Latinos have a greater agreement with these misperceptions relative to non-Hispanic whites. METHODS: HPV vaccine misperceptions were assessed through a 12-item Likert scale included in a population health assessment mailed to households in the southwest United States. Linear regression models assessed the association between identifying as Hispanic/Latino and summed misperception score. RESULTS: Among the 407 individuals in the analytic sample, 111 (27.3%) were Hispanic/Latino and 296 (72.7%) were non-Hispanic white. On average, Hispanics/Latinos had a 3.03-point higher HPV vaccine misperception sum score relative to non-Hispanic whites, indicating greater agreement with misperceptions (95% confidence interval: 1.16-4.88; p < 0.01). DISCUSSION: Culturally relevant interventions are needed to address HPV vaccine misperceptions among Hispanics/Latinos as part of efforts toward HPV-associated cancer health equity.

14.
LGBT Health ; 10(1): 41-50, 2023 01.
Artigo em Inglês | MEDLINE | ID: mdl-35917560

RESUMO

Purpose: Human papillomavirus (HPV)-related oral cancers are increasing, and lesbian, gay, bisexual, and other people with a minority sexual orientation may be disproportionately impacted. This study examined the relationship between sexual orientation and HPV-related oral cancer knowledge. Methods: Data from 10,859 adult participants in the 2017-2019 Health Information National Trends Survey 5, cycles 1-3, were obtained. The three data sets were merged, and weighted multiple imputation (n = 15) was applied to address missingness. Weighted logistic regression analyses examined differences in HPV-related oral cancer knowledge between sexual minority versus heterosexual participants by sex, after adjustment for race, ethnicity, age, education, income, insurance, regular medical provider, and smoking status. Results: In this weighted sample, age ranged from 18 to 101 years (mean = 56.3 years); 42% were males, 5.2% were sexual minority men/women, and 94.8% were heterosexual/straight. Overall, only 19% of respondents were aware that HPV can cause oral cancer. After controlling for sociodemographic factors, there were no significant differences in HPV-related oral cancer knowledge for sexual minority men (adjusted odds ratio [AOR]: 1.10; 95% confidence interval [95% CI]: 0.86-1.42) or women (AOR: 0.98; 95% CI: 0.76-1.26) compared with those who were heterosexual/straight. Conclusion: Overall, knowledge of HPV-related oral cancer was low, regardless of sexual orientation. There were no differences in HPV-related oral cancer knowledge between sexual minority men and women compared with their heterosexual counterparts. Educational programs are needed to increase awareness of the HPV/oral cancer link. Further research on differences in HPV-related oral cancer knowledge and attitudes by sexual orientation and the intersection of other demographic factors is warranted.


Assuntos
Homossexualidade Feminina , Neoplasias Bucais , Infecções por Papillomavirus , Minorias Sexuais e de Gênero , Adulto , Feminino , Humanos , Masculino , Adolescente , Adulto Jovem , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Papillomavirus Humano , Infecções por Papillomavirus/epidemiologia , Comportamento Sexual , Neoplasias Bucais/epidemiologia
15.
Artigo em Inglês | MEDLINE | ID: mdl-38248521

RESUMO

Dysmenorrhea is highly prevalent, ranging from 16% to 91% among women, and it can lead to multiple reproductive disorders. However, risk factors associated with dysmenorrhea remain unexamined. Cold exposures can significantly disturb blood circulation and prostaglandin production in the uterus, leading to dysmenorrhea. This study investigated the relationship between cold exposures and dysmenorrhea, as well as potential disparities between Asians and Whites and the potential cultural influences on these associations. This was a cross-sectional survey among 197 Asian and 222 non-Asian women recruited from the U.S., with more than 40% from California. We assessed cold exposures, such as the frequency of consumption of cold water/drinks and ice cream, as well as room temperatures at home and public places, for both summer and winter over the past 12 months. The type of cold exposure associated with dysmenorrhea differs between Asian and White women. We found that among Asian women, a higher frequency of ice cream consumption in winter (beta = 1.19, p = 0.0002 when comparing high to low categories) was associated with dysmenorrhea; however, among White women, increased consumption of cold water/drinks in winter (beta = 0.49, p = 0.04 when comparing high to low categories) was also associated with dysmenorrhea. Higher home room temperatures in winter were associated with reduced severity of dysmenorrhea among White women but not among Asian women. All these associations supported our hypothesis and were stronger among women who lived in states with colder winters. However, there are a few exceptions. For instance, women who drank cold water/drinks less frequently during their menstrual period were more likely to experience more severe dysmenorrhea. In conclusion, this study provides crucial evidence to support the link between cold exposures and dysmenorrhea among Asians and Whites. The associations contradictory to our hypothesis are likely due to reserved causation influenced by Asian cultural practice. This paper sheds light on an understudied area that profoundly affects women's quality of life.


Assuntos
Dismenorreia , Qualidade de Vida , Humanos , Feminino , Dismenorreia/epidemiologia , Estudos Transversais , Brancos , Temperatura Baixa , Água
17.
Ann Behav Med ; 43(1): 84-100, 2012 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-22215470

RESUMO

BACKGROUND: Community-based interventions are needed to reduce the burden of childhood obesity. PURPOSE: To evaluate the impact of a multi-level promotora-based (Community Health Advisor) intervention to promote healthy eating and physical activity and prevent excess weight gain among Latino children. METHODS: Thirteen elementary schools were randomized to one of four intervention conditions: individual/family level (Family-only), school/community level (Community-only), combined (Family + Community), or a measurement-only condition. Participants were 808 Latino parents and their children enrolled in kindergarten through 2(nd) grade. Measures included parent and child body mass index (BMI) and a self-administered parent survey that assessed several parent and child behaviors. RESULTS: There were no significant intervention effects on children's BMI z-score. The family intervention changed several obesity-related child behaviors (e.g., fruit/vegetable consumption) and these were mediated by changes in parenting variables (e.g., parent monitoring). CONCLUSION: A promotora-based behavioral intervention was efficacious at changing parental factors and child obesity-related health behaviors.


Assuntos
Serviços de Saúde Comunitária , Família/etnologia , Promoção da Saúde/métodos , Hispânico ou Latino , Obesidade/prevenção & controle , Pais/educação , Medicina do Comportamento , Índice de Massa Corporal , California , Criança , Comportamento Infantil/etnologia , Exercício Físico , Feminino , Humanos , Masculino , Obesidade/etnologia , Poder Familiar , Serviços de Saúde Escolar , Instituições Acadêmicas
18.
Prev Med ; 55(3): 201-5, 2012 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-22766008

RESUMO

OBJECTIVE: Parents who overestimate their child's physical activity (PA) level may not encourage their children to increase their PA. We assessed parental awareness of child PA, and investigated potential correlates of overestimation. METHOD: Child PA (accelerometer) and parent-classified child PA ['active' ≥ 60 min/day vs. 'inactive' <60 min/day moderate and vigorous PA (MVPA)] were measured over 7 days [n=329, 44% male, 39% Latino; mean (SD) 9.1 (0.7)years] in an obesity prevention study in San Diego (Project MOVE). Agreement between date-matched objective MVPA and parent-classified child PA was assessed; % days parental overestimation was the outcome variable. Associations between parental overestimation and potential correlates were investigated using three-level mixed-effects linear regression. RESULTS: Children met the PA guidelines on 43% of days. Parents overestimated their children's PA on 75% of days when children were inactive. Most parents (80%) overestimated their child's PA on ≥ 1 measurement day. Parental support for child PA (transport, encouragement and participation with child) (p<0.01) was positively associated with higher overestimation. Parents of girls showed more overestimation than parents of boys (p=0.04). CONCLUSION: Most parents incorrectly classified their child as active when their child was inactive. Strategies addressing parental overestimation may be important in PA promotion.


Assuntos
Exercício Físico , Conhecimentos, Atitudes e Prática em Saúde , Pais , Actigrafia/instrumentação , California , Criança , Comportamento Infantil/fisiologia , Pré-Escolar , Feminino , Humanos , Masculino , Obesidade/prevenção & controle , Fatores Sexuais
19.
Br J Sports Med ; 46(9): 684-8, 2012 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-21903618

RESUMO

BACKGROUND: Few prospective studies have examined predictors of change in specific physical activity (PA) behaviours in different ethnic groups. PURPOSE: To assess predictors of change in sports participation in Latino and non-Latino 5-8 year-old children in San Diego, California. METHODS: Average sports participation frequency (days/week) was assessed by validated parent-report at baseline (Nov 2006-May 2008) and 1 year later in 541 children (45.0% male, 41.1% Latino; mean ± SD age: 6.6 ± 0.7 years) taking part in an obesity prevention study (Project MOVE). Biological (sex, age, Body Mass Index z-score), socio-cultural (ethnicity, income, care giver education), parental (PA rules, PA encouragement) and environmental factors (home PA equipment, PA location) were assessed at baseline. Associations between change in sports participation and potential predictors were studied using multilevel linear regression stratified by Latino ethnicity, adjusted for sex, baseline sport participation, study condition and recruitment area. RESULTS: Sports participation increased over 1 year (mean change: +0.5 days; p<0.001) and change was similar for boys and girls (p=0.95), but Latino children showed a greater increase (p=0.03). The number of locations used for PA (p=0.024) and the total frequency of PA location use (p=0.018) were positively associated with increased sports participation among Latinos. No predictors were identified for non-Latino children. CONCLUSIONS: Only factors relating to PA location were identified as predictors of change in sports participation for Latino children. Interventions targeting specific PA behaviours such as sports participation may need to consider PA locations for Latino children and be tailored for specific ethnic groups.


Assuntos
Hispânico ou Latino/psicologia , Esportes/psicologia , Fatores Etários , California/epidemiologia , Criança , Pré-Escolar , Feminino , Hispânico ou Latino/estatística & dados numéricos , Humanos , Masculino , Comportamento Sedentário/etnologia , Fatores Sexuais , Fatores Socioeconômicos , Esportes/estatística & dados numéricos
20.
Artigo em Inglês | MEDLINE | ID: mdl-35010795

RESUMO

The ongoing 2019 novel coronavirus disease (COVID-19) pandemic continues to impact the health of individuals worldwide, including causing pauses in lifesaving cancer screening and prevention measures. From time to time, elective medical procedures, such as those used for cancer screening and early detection, were deferred due to concerns regarding the spread of the infection. The short- and long-term consequences of these temporary measures are concerning, particularly for medically underserved populations, who already experience inequities and disparities related to timely cancer care. Clearly, the way out of this pandemic is by increasing COVID-19 vaccination rates and doing so in an equitable manner so that communities most affected receive preferential access and administration. In this article, we provide a perspective on vaccine equity by featuring the experience of the California Hispanic community, who has been disproportionately impacted by the pandemic. We first compared vaccination rates in two United States-Mexico border counties in California (San Diego County and Imperial County) to counties elsewhere in California with a similar Hispanic population size. We show that the border counties have substantially lower unvaccinated proportions of Hispanics compared to other counties. We next looked at county vaccination rates according to the California Healthy Places Index, a health equity metric and found that San Diego and Imperial counties achieved more equitable access and distribution than the rest of the state. Finally, we detail strategies implemented to achieve high and equitable vaccination in this border region, including Imperial County, an agricultural region that was California's epicenter of the COVID-19 crisis at the height of the pandemic. These United States-Mexico border county data show that equitable vaccine access and delivery is possible. Multiple strategies can be used to guide the delivery and access to other public health and cancer preventive services.


Assuntos
Vacinas contra COVID-19 , COVID-19 , California/epidemiologia , Hispânico ou Latino , Humanos , SARS-CoV-2 , Estados Unidos , Vacinação
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