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1.
Int J Behav Med ; 2024 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-38360939

RESUMO

BACKGROUND: Skin cancer incidence and prognosis vary by ethnicity and gender, and previous studies demonstrate ethnic and gender differences in sun-related cognitions and behaviors that contribute to this disease. The current study sought to inform skin cancer interventions tailored to specific demographic groups of college students. The study applied the prototype willingness model (PWM) to examine how unique combinations of ethnic and gender identities influence sun-related cognitions. METHOD: Using data from a survey of 262 college students, the study tested whether self-reported sun-related cognitions were different for White women, Hispanic women, White men, and Hispanic men. Path modeling was also used to identify which PWM cognitions (e.g., prototypes, norms) were the strongest predictors of risk and protection intentions and willingness in each demographic group. RESULTS: Several differences in sun-related cognitions and PWM pathways emerged across groups, emphasizing the need for tailored skin cancer education and interventions. Results suggest that, for White women, interventions should primarily focus on creating less favorable attitudes toward being tan. CONCLUSION: Interventions for Hispanic women may instead benefit from manipulating perceived similarity to sun-related prototypes, encouraging closer personal identification with images of women who protect their skin and encouraging less identification with images of women who tan. For White men, skin cancer interventions may focus on creating more favorable images of men who protect their skin from the sun. Lastly, interventions for Hispanic men should increase perceived vulnerability for skin cancer.

2.
Prev Med ; 132: 105976, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31911162

RESUMO

Exposure to ultraviolet rays is associated with increased risk of sunburn - a biomarker of skin cancer risk - and physical activity can increase exposure. Sun safety behaviors can mitigate the increased risk of skin cancer. The objective of this cross-sectional study was to determine associations between physical activity behaviors, access to neighborhood physical activity resources, and sunburn across different patterning of sun safety behaviors. Data collected in 2014 from parents in the United States were analyzed (N = 1680; 75% female, primarily between the ages of 35-44 and 45-59, and 67% White). Latent class analysis was conducted to identify classes of sun safety behaviors based on engagement in sun protective behaviors (wearing a hat, shirt with sleeves, and seeking shade) and sun exposure (tanning outdoors). The latent classes were then examined as moderators of the association between physical activity related variables and sunburn. Three classes were identified corresponding to Low, Moderate, and High Risk for sunburn. There was no evidence of moderation, so equality constraints were imposed across the classes. Moderate-to-vigorous physical activity (MVPA) (odds ratio [OR] = 1.09) and neighborhood environments favoring physical activity (OR = 1.39) were associated with an increased likelihood of sunburn. Greater engagement in physical activity and access to built environments that favour activity are associated with a higher likelihood of sunburn, regardless of sun safety behaviors. Physically active parents are a vulnerable population for melanoma, and cancer prevention efforts focused on physical activity should also address sun safety.


Assuntos
Exercício Físico , Comportamento Sedentário , Queimadura Solar/prevenção & controle , Luz Solar/efeitos adversos , Protetores Solares/uso terapêutico , Raios Ultravioleta/efeitos adversos , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Melanoma/prevenção & controle , Pessoa de Meia-Idade , Roupa de Proteção/estatística & dados numéricos , Neoplasias Cutâneas/prevenção & controle , Banho de Sol/estatística & dados numéricos , Estados Unidos
3.
Prev Med ; 111: 442-450, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29425724

RESUMO

While the general efficacy of skin cancer interventions have been reviewed, employing the cancer control continuum would be useful to identify research gaps at specific cancer control points. We characterized the intervention evidence base for specific behavioral targets (e.g., tanning, sun protection, screening) and clinically related targets (e.g., sunburn, skin exams, cancers) at each point in the cancer control continuum. The review included articles published from 1/1/2000-6/30/15 that had an experimental design and targeted behavioral intervention in skin cancer (e.g., specific behaviors or clinically related targets). The search yielded 86 articles, including seven dissemination studies. Of the 79 non-dissemination studies, 57 exclusively targeted primary prevention behaviors, five exclusively targeted screening, 10 targeted both detection and prevention, and eight addressed cancer survivorship. Among prevention studies (n=67), 29 (43%) targeted children and 38 (57%) targeted adults. Of the 15 screening studies, nine targeted high-risk groups (e.g., men aged ≥50 years) and six targeted the general population. Although research has focused on skin cancer prevention, empirically validated interventions are still needed for youth engaged in indoor tanning and for behavioral interventions to pursue change in clinically relevant targets. Research must also address detection among those at highest risk for skin cancer, amelioration of emotional distress attendant to diagnosis and treatment, and survivorship concerns. We discuss essential qualities and opportunities for intervention development and translational research to inform the field.


Assuntos
Comportamentos Relacionados com a Saúde , Neoplasias Cutâneas/prevenção & controle , Queimadura Solar/prevenção & controle , Pesquisa Biomédica , Humanos , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/terapia , Banho de Sol , Protetores Solares/uso terapêutico
4.
Prev Med ; 111: 451-458, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29277407

RESUMO

The National Cancer Institute's Skin Cancer Intervention across the Cancer Control Continuum model was developed to summarize research and identify gaps concerning skin cancer interventions. We conducted a mapping review to characterize whether behavioral interventions addressing skin cancer prevention and control from 2000 to 2015 included (1) technology, (2) environmental manipulations (policy and/or built environment), and (3) a theoretical basis. We included 86 studies with a randomized controlled or quasi-experimental design that targeted behavioral intervention in skin cancer for children and/or adults; seven of these were dissemination or implementation studies. Of the interventions described in the remaining 79 articles, 57 promoted only prevention behaviors (e.g., ultraviolet radiation protection), five promoted only detection (e.g., skin examinations), 10 promoted both prevention and detection, and seven focused on survivorship. Of the 79 non-dissemination studies, two-thirds used some type of technology (n=52; 65.8%). Technology specific to skin cancer was infrequently used: UVR photography was used in 15.2% of studies (n=12), reflectance spectroscopy was used in 12.7% (n=10), and dermatoscopes (n=1) and dosimeters (n=2) were each used in less than 3%. Ten studies (12.7%) targeted the built environment. Fifty-two (65.8%) of the studies included theory-based interventions. The most common theories were Social Cognitive Theory (n=20; 25.3%), Health Belief Model (n=17; 21.5%), and the Theory of Planned Behavior/Reasoned Action (n=12; 15.2%). Results suggest that skin cancer specific technology and environmental manipulations are underutilized in skin cancer behavioral interventions. We discuss implications of these results for researchers developing skin cancer behavioral interventions.


Assuntos
Ambiente Construído , Comportamentos Relacionados com a Saúde , Neoplasias Cutâneas/prevenção & controle , Teoria Social , Tecnologia , Humanos , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/terapia , Raios Ultravioleta/efeitos adversos
5.
Public Health Nutr ; 21(11): 2079-2087, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-29656717

RESUMO

OBJECTIVE: The present study aimed to examine the correlates of fruit and vegetable intake (FVI) separately among parents and their adolescents. DESIGN: Cross-sectional surveys. SETTING: Online survey. SUBJECTS: Parents and adolescents completed the Family Life, Activity, Sun, Health, and Eating (FLASHE) survey through the National Cancer Institute. The survey assessed daily intake frequencies of food/beverage groups, psychosocial, parenting and sociodemographic factors. Generalized linear models were run for both parents and adolescents, for a total of six models (three each): (i) sociodemographic characteristics; (ii) psychosocial factors; (iii) parent/caregiver factors. RESULTS: Parent participants (n 1542) were predominantly 35-59 years old (86 %), female (73 %), non-Hispanic White (71 %) or non-Hispanic Black (17 %), with household income <$US 100 000 (79 %). Adolescents (n 805) were aged 12-14 years (50 %), non-Hispanic White (66 %) and non-Hispanic Black (15 %). Parents consumed 2·9 cups fruits and vegetables (F&V) daily, while adolescents consumed 2·2 cups daily. Educational attainment (higher education had greater FVI) and sex (men consumed more than women; all P<0·001) were significant FVI predictors. Parents with greater autonomous and controlled motivation, self-efficacy and preferences for fruit reported higher FVI (all P<0·001). Similarly, adolescents with greater autonomous and controlled motivation, self-efficacy and knowledge reported higher FVI (all P<0·001). Parenting factors of importance were co-deciding how many F&V teens should have, rules, having F&V in the home and cooking meals from scratch (all P<0·05). CONCLUSIONS: Findings suggest factors that impact FVI among parents and their adolescent(s), which highlight the importance of the role of parent behaviour and can inform tailored approaches for increasing FVI in various settings.


Assuntos
Dieta/estatística & dados numéricos , Ingestão de Alimentos/psicologia , Comportamento Alimentar/psicologia , Frutas , Verduras , Adolescente , Comportamento do Adolescente/psicologia , Adulto , Criança , Estudos Transversais , Inquéritos sobre Dietas , Feminino , Inquéritos Epidemiológicos , Humanos , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Motivação , Poder Familiar/psicologia , Pais/psicologia , Autoeficácia
6.
J Community Health ; 42(4): 748-756, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28260144

RESUMO

Obesity among adolescents in the United States has risen by 16% in the past 30 years. One important contributing factor may be the increased consumption of sugar sweetened beverages (SSBs), which is encouraged by advertisements for unhealthy foods and drinks that are targeted to adolescents. The purpose of this analysis was to determine the association between susceptibility to food and drink advertisements and sugar-sweetened beverage (SSB) consumption in non-Hispanic black (NHB) and non-Hispanic white (NHW) adolescents and to examine if BMI is associated with SSB consumption. Data were obtained from 765 NHB and NHW of ages 14-17 who were surveyed in the Family Life, Activity, Sun, Health, and Eating study sponsored by the National Cancer Institute. Two weighted adjusted logistic regression models were conducted. The first examined the associations of advertisement susceptibility, race, and BMI with SSB consumption. The second examined the associations of race and BMI with advertisement susceptibility. Adolescents with high advertisement susceptibility were more likely to consume at least one SSB daily (OR 1.73, 95% CI 1.21, 2.47). Additionally, non-Hispanic blacks were more likely to consume at least one SSB daily (OR 1.75, 95% CI 1.08, 2.85) and more likely to be highly susceptible to advertisements (OR 1.72, 95% CI 1.19, 2.48) than non-Hispanic whites. No significant associations were found between BMI and advertising susceptibility or BMI and daily SSB consumption. One approach to addressing the consumption of SSBs may be to reduce advertising that markets unhealthy food and beverages to adolescents and minorities.


Assuntos
Publicidade/estatística & dados numéricos , Bebidas , Índice de Massa Corporal , Obesidade Infantil/etnologia , Edulcorantes , Adolescente , Negro ou Afro-Americano , Bebidas Gaseificadas , Sacarose Alimentar , Feminino , Humanos , Modelos Logísticos , Masculino , Fatores Socioeconômicos , Estados Unidos , População Branca
7.
Nicotine Tob Res ; 18(3): 321-9, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25964503

RESUMO

INTRODUCTION: Absolute and comparative risk perceptions, worry, perceived severity, perceived benefits, and self-efficacy are important theoretical determinants of tobacco use, but no measures have been validated to ensure the discriminant validity as well as test-retest reliability of these measures in the tobacco context. The purpose of the current study is to examine the reliability and factor structure of a measure assessing smoking-related health cognitions and emotions in a national sample of current and former heavy smokers in the National Lung Screening Trial. METHODS: A sub-study of the National Lung Screening Trial assessed current and former smokers' (age 55-74; N = 4379) self-reported health cognitions and emotions at trial enrollment and at 12-month follow-up. Items were derived from the Health Belief Model and Self-Regulation Model. RESULTS: An exploratory factor analysis of baseline responses revealed a five-factor structure for former smokers (risk perceptions, worry, perceived severity, perceived benefits, and self-efficacy) and a six-factor structure for current smokers, such that absolute risk and comparative risk perceptions emerged as separate factors. A confirmatory factor analysis of 12-month follow-up responses revealed a good fit for the five latent constructs for former smokers and six latent constructs for current smokers. Longitudinal stability of these constructs was also demonstrated. CONCLUSIONS: This is the first study to examine tobacco-related health cognition and emotional constructs over time in current and former heavy smokers undergoing lung screening. This study found that the theoretical constructs were stable across time and that the factor structure differed based on smoking status (current vs. former).


Assuntos
Cultura , Conhecimentos, Atitudes e Prática em Saúde , Programas de Rastreamento/métodos , Autoeficácia , Fumar/psicologia , Fumar/terapia , Idoso , Cognição , Emoções , Feminino , Seguimentos , Humanos , Estudos Longitudinais , Masculino , Programas de Rastreamento/psicologia , Pessoa de Meia-Idade , Abandono do Hábito de Fumar/métodos , Abandono do Hábito de Fumar/psicologia
8.
Appetite ; 96: 87-94, 2016 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-26321416

RESUMO

Despite knowing that fruit and vegetable (FV) intake promotes health and well-being, few U.S. adults meet current guidelines. Thus, understanding people's motivation for FV intake is important for predicting dietary behavior. Applying self-determination theory, the goal of this study was to examine the role of social support as a potential moderator of the link between autonomous and controlled motivations and FV intake. Cross-sectional data from 2959 adults in the United States were analyzed. Autonomous motivation and perceived social support were positively associated with FV intake, while controlled motivation was negatively associated with FV intake. Additionally, there was evidence that the negative association between controlled motivation and FV intake was attenuated by higher levels of perceived social support. Findings suggest the need for a more comprehensive approach to understanding the role of motivation in health behaviors like FV intake and the potential roles played by friends and family in these motivational processes.


Assuntos
Ingestão de Alimentos/psicologia , Frutas , Motivação , Apoio Social , Verduras , Adolescente , Adulto , Estudos Transversais , Dieta/psicologia , Comportamento Alimentar/psicologia , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Autonomia Pessoal , Estados Unidos , Adulto Jovem
9.
Ann Behav Med ; 49(5): 685-95, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-25894276

RESUMO

BACKGROUND: Showing people a personal ultraviolet (UV) photograph depicting skin damage can be an effective method for changing sun protection cognitions and behaviors. PURPOSE: We examined whether people opt not to see their UV photograph if given a choice. We also examined predictors of avoidance of skin damage feedback. METHODS: College students (N = 257) completed questionnaires, viewed example UV photographs, and received the opportunity to see a UV photograph of their face. RESULTS: Over one-third of participants opted not to see their UV photograph. Greater perceived risk of sun damage and having fewer coping resources corresponded with greater avoidance, particularly among participants who reported infrequent sun protection behavior. CONCLUSION: The health benefits of UV photography are realized only if people are willing to view the photograph. Our findings suggest the need for interventions that increase receptivity to viewing one's UV photograph.


Assuntos
Aprendizagem da Esquiva , Retroalimentação Psicológica , Conhecimentos, Atitudes e Prática em Saúde , Dermatopatias/prevenção & controle , Dermatopatias/psicologia , Estudantes/psicologia , Adaptação Psicológica , Adolescente , Adulto , Feminino , Humanos , Masculino , Protetores Solares/farmacologia , Protetores Solares/uso terapêutico , Adulto Jovem
10.
Patient Educ Couns ; 127: 108358, 2024 Jun 24.
Artigo em Inglês | MEDLINE | ID: mdl-38936161

RESUMO

OBJECTIVE: To better understand cancer clinical trials (CCT) information-seeking, a necessary precursor to patient and provider engagement with CCT. METHODS: Data from the National Cancer Institute's Cancer Information Service (CIS) were used to examine CCT information-seeking patterns over a 5-year period. Descriptive and logistic regression analyses were conducted to examine characteristics of CIS inquiries and their associations with having a CCT discussion. RESULTS: Between September 2018 - August 2023, 117,016 CIS inquiries originated from cancer survivors, caregivers, health professionals, and the general public; 27.5 % of these inquiries included a CCT discussion (n = 32,160). Among CCT discussions, 35.5 % originated from survivors, 53.5 % from caregivers, 6.1 % from the public, and 4.9 % from health professionals. Inquiries in Spanish had lower odds of a CCT discussion (OR=.26, [.25-.28]), whereas inquiries emanating from the CIS instant messaging (OR=2.29, [2.22-2.37]) and email (OR=1.24, [1.18-1.30]) platforms were associated with higher odds of discussing CCT compared to the telephone. Individuals who were male, younger, insured, and had higher income and education had significantly higher odds of a CCT discussion while those who were non-Hispanic Black and living in rural locales had significantly lower odds. CONCLUSIONS: Disparities in CCT information-seeking may contribute to downstream CCT participation. PRACTICE IMPLICATIONS: Quality, language-concordant health information is needed to enable equitable awareness of - and ultimately engagement in - CCT.

11.
Artigo em Inglês | MEDLINE | ID: mdl-38248527

RESUMO

Background: Cancer is one of the leading causes of death in the United States. It is critical to understand the associations among multilevel determinants of cancer prevention and control behaviors. This study examined associations of neighborhood factors with perceived risk of cancer and self-efficacy for reducing cancer risk. Methods: Cross-sectional analyses included 2324 U.S. adults from the Midlife in the U.S. Wave 3. Participants completed surveys of neighborhood environment (perceived neighborhood trust and safety, built environment conditions, social integration), perceived cancer risk and cancer prevention efficacy. Multivariate linear regressions examined associations of neighborhood context with risk perceptions and self-efficacy. Results: In the model that adjusted for sociodemographic characteristics, better perceived neighborhood trust and safety were associated with lower perceived cancer risk. In fully adjusted models for sociodemographic characteristics and contextual factors, higher perceptions of neighborhood trust and safety were associated with higher cancer prevention self-efficacy. Perceptions of better built neighborhood conditions and higher social integration were significantly associated with lower perceived cancer risk and higher perceived cancer prevention efficacy. Conclusions: Perceptions of neighborhood context may play a role in shaping psychosocial factors such as perceived cancer risk and self-efficacy, even after controlling for robust predictors of these perceptions.


Assuntos
Neoplasias , Autoeficácia , Adulto , Humanos , Estudos Transversais , Confiança , Controle Comportamental , Neoplasias/epidemiologia , Neoplasias/prevenção & controle
12.
Soc Sci Med ; 315: 115521, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-36384086

RESUMO

Patient-clinician interactions are critical to patient-centered care, including in cancer care contexts which are often defined by multiple patient-clinician interactions over an extended period. Research on these dyadic interactions has been guided by perspectives in clinical communication science, but the study of clinical communication has not been fully integrated with perspectives on interpersonal interactions from relationship science research. An overlapping concept in both fields is the concept of responsive socialsupport. In this article, we discuss responsiveness as a concept that offers opportunities for connections between these two disciplines. Next, we focus on how relationship science can be applied to research in clinical settings. We discuss how three areas of relationship science define responsiveness and have potential for extension to clinical communication: (1) (in)visibility of social support, (2) attachment orientations, and (3) shared meaning systems. We also discuss how social biases can impede responsiveness and suggest research avenues to develop ideas and understand potential challenges in connecting these two fields. Many opportunities exist for interdisciplinary theory development that can generate momentum in understanding interpersonal processes in cancer care.


Assuntos
Neoplasias , Apoio Social , Humanos , Comunicação , Neoplasias/terapia , Relações Interpessoais , Assistência Centrada no Paciente
13.
Eat Behav ; 41: 101500, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33812125

RESUMO

OBJECTIVE: Emotion suppression (ES) is associated with unhealthy coping strategies, such as emotional eating. Physical activity (PA) is a healthy coping strategy that may attenuate the association between emotion suppression and emotional eating (EE). This study evaluated whether: 1) ES is associated with body mass index (BMI) through EE and/or dietary patterns, 2) PA moderates these relationships, and 3) these patterns differ by race/ethnicity and gender. METHODS: Adult participants (N = 1674) of the Family Life, Activity, Sun, Health, and Eating study completed modified versions of the Emotion Regulation, Eating in the Absence of Hunger, and International Physical Activity Questionnaires; a validated dietary assessment; and items on demographics, height, and weight. RESULTS: Analyses revealed a serial mediation pathway in the full sample where greater ES was associated with higher BMI through greater EE and lower fruit and vegetable (F&V) intake (B = 0.0017, CI 95% [0.0001, 0.0042]) after controlling for age, gender, and education. Hedonic snack food (HSF) intake was not a significant mediator of the ES-BMI association. Greater PA attenuated associations of ES and EE with dietary intake and BMI. The serial pathway remained significant for non-Hispanic White women only in subgroup analyses. EE was a significant mediator among women, and PA effects were largely found among Hispanics and men. CONCLUSIONS: ES was associated with higher BMI through greater EE and lower F&V, but not HSF intake. PA attenuated these associations. Differences in patterns of coping strategies may help to explain disparities in obesity-related health behavior.


Assuntos
Emoções , Comportamento Alimentar , Adaptação Psicológica , Adulto , Índice de Massa Corporal , Feminino , Humanos , Masculino , Inquéritos e Questionários
14.
Prev Med Rep ; 22: 101358, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33854906

RESUMO

Adolescents in the U.S. do not meet current physical activity guidelines. Ecological models of physical activity posit that factors across multiple levels may support physical activity by promoting walkability, such as the neighborhood built environment and neighborhood socioeconomic status (nSES). We examined associations between neighborhood built environment factors and adolescent moderate-to-vigorous physical activity (MVPA), and whether nSES moderated associations. Data were drawn from a national sample of adolescents (12-17 years, N = 1295) surveyed in 2014. MVPA (minutes/week) were estimated from self-report validated by accelerometer data. Adolescents' home addresses were geocoded and linked to Census data from which a nSES Index and home neighborhood factors were derived using factor analysis (high density, older homes, short auto commutes). Multiple linear regression models examined associations between neighborhood factors and MVPA, and tested interactions between quintiles of nSES and each neighborhood factor, adjusting for socio-demographics. Living in higher density neighborhoods (B(SE): 9.22 (2.78), p = 0.001) and neighborhoods with more older homes (4.42 (1.85), p = 0.02) were positively associated with adolescent MVPA. Living in neighborhoods with shorter commute times was negatively associated with MVPA (-5.11 (2.34), p = 0.03). Positive associations were found between MVPA and the high density and older homes neighborhood factors, though associations were not consistent across quintiles. In conclusion, living in neighborhoods with walkable attributes was associated with greater adolescent MVPA, though the effects were not distributed equally across nSES. Adolescents living in lower SES neighborhoods may benefit more from physical activity interventions and environmental supports that provide opportunities to be active beyond neighborhood walkability.

15.
Front Public Health ; 9: 706151, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34858916

RESUMO

Introduction: Neighborhood environment factors are relevant for dietary behaviors, but associations between home neighborhood context and disease prevention behaviors vary depending on the definition of neighborhood. The present study uses a publicly available dataset to examine whether associations between neighborhood socioeconomic status (NSES) and fruit/vegetable (FV) consumption vary when NSES is defined by different neighborhood sizes and shapes. Methods: We analyzed data from 1,736 adults with data in GeoFLASHE, a geospatial extension of the National Cancer Institute's Family Life, Activity, Sun, Health, and Eating Study (FLASHE). We examined correlations of NSES values across neighborhood buffer shapes (circular or street network) and sizes (ranging from 400 to 1,200 m) and ran weighted simple and multivariable regressions modeling frequency of FV consumption by NSES for each neighborhood definition. Regressions were also stratified by gender. Results: NSES measures were highly correlated across various neighborhood buffer definitions. In models adjusted for socio-demographics, circular buffers of all sizes and street buffers 750 m and larger were significantly associated with FV consumption frequency for women only. Conclusion: NSES may be particularly relevant for women's FV consumption, and further research can examine whether these associations are explained by access to food stores, food shopping behavior, and/or psychosocial variables. Although different NSES buffers are highly correlated, researchers should conceptually determine spatial areas a priori.


Assuntos
Comportamento Alimentar , Características de Residência , Adulto , Feminino , Frutas , Humanos , Classe Social , Verduras
16.
JAMA Oncol ; 10(2): 159-160, 2024 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-38060244

RESUMO

This Viewpoint discusses the impact of the COVID-19 public health emergency on the trajectory of cancer deaths.


Assuntos
COVID-19 , Humanos , Pandemias/prevenção & controle
17.
Prev Med Rep ; 14: 100835, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30886817

RESUMO

Schools are an important context to promote adolescent physical activity (PA). However, following ecologic frameworks, little is known about the influence of multiple school contextual levels - environment and policy - on adolescent PA. This study aimed to examine associations of school neighborhood environment factors and state laws with PA, and the moderating effects of school neighborhood socioeconomic status (SES) on these associations. Analyses used cross-sectional data from a national sample of middle (n = 387) and high (n = 591) school adolescents from the Family Life, Activity, Sun, Health, and Eating study conducted in 2014. Outcomes included self-report school-time PA and active transport to/from school (ATS), and estimated minutes/week of school-related moderate-to-vigorous PA (MVPA) and total MVPA. Separate regression models for middle and high school respondents examined state laws (school PA or physical education (PE) time requirements) and school neighborhood factors (density, age, and commute times), and their interactions with school neighborhood SES, in relation to each PA outcome, adjusting for socio-demographic and psychosocial factors. The high school models showed strong PE laws (B[SE]: 0.3[0.1], p = 0.02) and any PA law (B[SE]: 0.3[0.1], p = 0.0003) were related to higher school-time PA, and shorter school neighborhood commute times were related to lower ATS (OR [95% CI]: 0.4 [0.2-0.7]). We found similar associations with estimated school-related MVPA. The middle school models showed no significant state law or school neighborhood main effects. Interactions with school neighborhood SES were not significant. Our findings provide further support for state laws to promote PA in school regardless of school neighborhood SES.

18.
J Cancer Surviv ; 13(6): 968-980, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31646462

RESUMO

PURPOSE: To examine whether interpersonal aspects of patient-clinician interactions, such as patient-perceived medical discrimination, clinician mistrust, and treatment decision-making contribute to racial/ethnic/educational disparities in breast cancer care. METHODS: A telephone interview was administered to 542 Asian/Pacific Islander (API), Black, Hispanic, and White women identified through the Greater Bay Area Cancer Registry, ages 20 and older diagnosed with a first primary invasive breast cancer. Adjusted odds ratios (aOR) and 95% confidence intervals (CI) were calculated from logistic regression models that assessed associations between race/ethnicity/education, medical discrimination, clinician mistrust, and treatment decision-making with concordance to breast cancer treatment guidelines (guideline-concordant treatment) and perceived quality of care (pQoC). RESULTS: Approximately three-quarters of women received treatment that was guideline-concordant (76.6%) and reported that their breast cancer care was excellent (72.1%). Non-college-educated Black women had lower odds of guideline-concordant care (aOR (CI) = 0.29 (0.12-0.67)) vs. college-educated White women. Odds of excellent pQoC were lower among the following: college-educated Hispanic women (aOR (CI) = 0.09 (0.02-0.47)) and API women regardless of education (aORs ≤ 0.50) vs. college-educated White women, women reporting low and moderate levels of discrimination (aORs ≤ 0.44) vs. none, and women reporting any clinician mistrust (aOR (CI) = 0.50 (0.29-0.88)) vs. none. Disparities in guideline-concordant care and pQoC persisted after controlling for medical discrimination, clinician mistrust, and decision-making. CONCLUSIONS: Interpersonal aspects of the patient-clinician interaction had an impact on pQoC but not receipt of guideline-concordant treatment and did not explain disparities in either outcome. IMPLICATIONS FOR CANCER SURVIVORS: Although breast cancer survivors' interpersonal interactions with clinicians did not influence receipt of appropriate treatment, intervention strategies to improve patient-clinician relations may help attenuate disparities in survivors' pQoC.


Assuntos
Neoplasias da Mama/terapia , Sobreviventes de Câncer/psicologia , Disparidades em Assistência à Saúde/normas , Qualidade da Assistência à Saúde/normas , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias da Mama/mortalidade , Feminino , Humanos , Pessoa de Meia-Idade , Relações Médico-Paciente
19.
J Phys Act Health ; 15(5): 361-368, 2018 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-29569999

RESUMO

BACKGROUND: Neighborhood and psychosocial variables are related to physical activity (PA), yet interactions between these factors in predicting PA are infrequently studied. METHODS: This analysis examines the independent associations and interactions between self-reported neighborhood and psychosocial variables in relation to moderate to vigorous PA (MVPA) among adults from a US panel sample. RESULTS: In adjusted models, neighborhood social capital was positively associated with meeting MVPA guidelines. Fewer barriers, greater self-efficacy, and greater autonomous motivation also corresponded with greater odds of meeting MVPA guidelines. An interaction between social capital and autonomous motivation showed that social capital was only associated with MVPA when autonomous motivation was high. Participants who reported both high autonomous motivation and high social capital were most likely to meet MVPA guidelines. CONCLUSIONS: Neighborhood social capital, barriers, self-efficacy, and autonomous motivation may be important correlates in promoting adults' PA. Future directions include using objective neighborhood and PA data in similar analyses and investigating associations of neighborhood and psychosocial variables with multiple PA activities. Intervention research to promote PA should also examine whether effects of interventions targeting psychosocial constructs are moderated by features of an individual's neighborhood or whether perceived social capital can be addressed in interventions in conjunction with psychosocial variables.


Assuntos
Exercício Físico/psicologia , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Percepção , Características de Residência , Adulto Jovem
20.
Health Psychol ; 37(8): 767-774, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-30024232

RESUMO

OBJECTIVE: Family-based physical activity interventions have the potential to reduce obesity, but more information is needed regarding physical activity in the family context. This study used an actor-partner interdependence model to estimate the dyadic association between perceived weight status and barriers to physical activity in dyads of adults and their adolescent children. It was hypothesized that greater perceived weight would be associated with greater barriers perceived by both one's self and one's partner. METHOD: Data from 1,568 dyads in the Family Life, Activity, Sun, Health, and Eating study were used to examine the dyadic association between perceived weight status (i.e., greater perceived weight category) and barriers to physical activity. Models were stratified by actual weight (an overweight or obese dyad member vs. two normal weight dyad members) and adjusted for parent education, parent and adolescent age, gender, and race. RESULTS: Among dyads with at least 1 overweight/obese member, greater perceived weight status was positively associated with one's own perceived barriers (significant actor effects, ßs = 1.17 and 1.03, ps < 0.01) and one's partner's perceived barriers (significant partner effects, ßs = 0.38 and 0.62, ps < 0.01). No statistically significant relationships were found for dyads with only normal weight members. CONCLUSIONS: Among dyads with at least 1 overweight or obese member, significant partner effects for parents and adolescents demonstrate that the weight perception of 1 dyad member correlates with the barriers of the other member. These dyadic associations highlight the potential importance of family-based interventions for physical activity. (PsycINFO Database Record


Assuntos
Exercício Físico/psicologia , Obesidade/terapia , Relações Pais-Filho , Pais/psicologia , Adolescente , Adulto , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/psicologia , Percepção , Adulto Jovem
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