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Szeszulski, J, Lorenzo, E, Arriola, A, and Lee, RE. Community-based measurement of body composition in hispanic women: concurrent validity of dual- and single-frequency bioelectrical impedance. J Strength Cond Res XX(X): 000-000, 2019-We examined the concurrent validity of single-frequency (SF) and dual-frequency (DF) bioelectrical impedance (BIA) scales among Hispanic women participating in a community-based health promotion program in Arizona. Hispanic women (N = 14), age 31.9 ± 6.5 years old, with a mean body mass index (BMI) of 31.1 ± 8.1 kg·m, were measured using SF BIA, DF BIA, BMI, and skinfold calipers in 2017. Intrarater reliability and concurrent validity were calculated. Bland-Altman plots examined agreement of each BIA measure within measurement tools, between tools, and with skinfold calipers. Scatter plots were used to examine agreement between BIAs and BMI. Short-term intrarater reliability was perfect within measurements for SF and DF BIAs (α = 1.0). The coefficient of variation within a measurement tool (CV%) was slightly smaller for DF BIA (0.2%; n = 13) than for SF BIA (0.3%; n = 14). Concurrent validity measures revealed that DF (M = 39.3 ± 7.3% fat; within sample CV% = 18.6; n = 14) and SF (M = 39.4 ± 7.5% body fat; within sample CV% = 19.0; n = 14) BIAs were highly correlated (Pearson r = 0.885; p < 0.001; n = 14) and had an absolute mean difference of -0.2 ± 3.5% fat (range 0.7-6.0% fat; n = 14). The CV% between BIA measures was 5.4%. Dual-frequency and SF BIAs were both strongly correlated with BMI and skinfolds. There was evidence of bias between skinfolds and both BIA measures. Strength and conditioning practitioners should feel confident in using either SF or DF BIA measures with Hispanic women who participate in training interventions in community-based settings, because they offer similar measurement value.

Objective:To examine differences in the availability, variety and distribution of foods and beverages sold at street food stands (SFS) across neighbourhood income levels in Mexico City.Design:Cross-sectional.Setting:Twenty neighbourhoods representing low-, middle- and high-income levels in Mexico City.Participants:Direct observations of SFS (n 391).Results:The availability of healthy foods such as fruits/vegetables was high in middle- and high-income neighbourhoods, whereas the availability of unhealthy foods such as processed snacks was higher in low-income neighbourhoods. However, statistically significant differences in food availability across neighbourhoods were only observed for dairy and processed snack items (P < 0·05). Similarly, differences in variety were only observed for cereal and processed snacks (P < 0·05). No statistically significant differences were seen for variety of fruits/vegetable across neighbourhood income levels (P > 0·05). No statistically significant differences across neighbourhood income levels were observed for beverage availability and variety (P > 0·05). Although street foods and beverages were often distributed near homes, public transportation centres and worksites, no differences were observed across neighbourhood income levels (P > 0·05).Conclusions:Findings suggest that SFS can be a source of both unhealthy foods and healthy foods for communities across neighbourhoods in Mexico City. Additional studies are needed to assess the relationship between street food and beverage availability, and consumption.

Summary To prevent obesity among Latino youth in the United States and Latin America, it is necessary to understand the specific context and interplay of physical activity (PA) and the built environment (BE). This paper aims to advance the research agenda of BE and PA for obesity prevention in Latin America and among Latino youth in the United States by (1) identifying environmental indicators to inform the design of interventions and policy, (2) identifying interdisciplinary methodological approaches for the study of the complex association between BE and PA, and (3) presenting case studies of PA‐promoting BE programs. A group of U.S. and Latin American scientists collaboratively worked to propose innovative indicators of the BE, methodological approaches for the study of the complex association between BE and PA, and review case studies of PA‐promoting BE programs in both regions. The results identified gaps in knowledge, proposed environmental indicators (e.g., landscape, street design, mobility patterns, and crime and safety), reviewed methodological approaches (social network analysis, citizen science methods), and case studies illustrating PA‐promoting BE programs (i.e., play streets, active school transport, and school setting interventions). The obesity prevention among Latino and Latin American youth requires advanced research on BE and PA addressing context‐specific priorities and exchanging lessons learned.

Street food stands (SFS) are an understudied element of the food environment. Previous SFS studies have not used a rigorous approach to document the availability, density, and distribution of SFS across neighborhood income levels and points of access in Mexico City. A random sample (n = 761) of street segments representing 20 low-, middle-, and high-income neighborhoods were assessed using geographic information system (GIS) and ground-truthing methods. All three income levels contained SFS. However, SFS availability and density were higher in middle-income neighborhoods. The distribution of SFS showed that SFS were most often found near homes, transportation centers, and worksites. SFS availability near schools may have been limited by local school policies. Additional studies are needed to further document relationships between SFS availability, density, and distribution, and current structures and processes.

Almost 1 in every 8 adults in the U.S. have a physical disability that impairs mobility. This participatory project aimed to identify and describe environmental and personal barriers to healthy eating among people with mobility impairments using a rigorous, structured mixed methodology. Community-dwelling adults with a self-reported mobility impairment (N = 20, M = 40.4 years old, 60% female) participated in nominal group technique focus groups. The Ecologic Model of Obesity grounded stimulus questions asked about barriers to obtaining and preparing healthy food. Participants emphasized common barriers across everyday settings&mdash, focusing, for example, on the ability to reach shelved food inside the home, navigating to and inside stores and restaurants, and using delivery services. Home environments often did not afford suitable spaces for food preparation and storage. Participants reported inadequate transportation and numerous additional barriers in many settings to be able to eat healthfully. Participants reported lack of accessible transportation and architectural barriers inside stores, restaurants, and their own homes, highlighting the need for efforts aimed at improving accessibility and usability. Findings support the use of the Ecologic Model of Obesity to guide research and suggest the need for improvement in assessment practices and policies that enhance access to healthy food.

Although reliable strategies exist to promote healthy habits that reduce childhood obesity, the sustainability of these strategies remains an ongoing public health challenge. This study aimed to identify factors experienced in a large, multisite project aimed at reducing childhood obesity that might contribute to project sustainability. Hypothesized constructs underpinning sustainability included replicability, continuation of benefits, institutionalization, and community capacity. Key informants (n = 27) completed 60 min, in-depth interviews, which were audio recorded and transcribed. Transcripts were first coded using a combined deductive and inductive approach. Four major themes emerged (with numerous subthemes): developing partnerships, challenges to the sustainability of implemented programming, the importance of intervening in multiple settings, and ongoing implementation and evaluation strategies. Replicability of complex childhood obesity interventions is possible when there are strong partnerships. Benefits can continue to be conferred from programming, particularly when evidence-based strategies are used that employ best practices. Implementation is facilitated by institutionalization and policies that buffer challenges, such as staffing or leadership changes. Community capacity both enhances the sustainability of interventions and develops as a result of strengthening partnerships and policies that support childhood obesity programming.

Tracheoesophageal fistulae (TEF) commonly occur as part of the vertebral defects, anal atresia, cardiac defects, tracheoesophageal fistula, renal, and limb abnormalities (VACTERL) association. However, pulmonary agenesis is not typically seen with TEF. We report the anesthetic management of a TEF repair in a 33-week-old, 1.6-kg, monochorionic diamniotic twin with right lung agenesis, intrauterine growth restriction, and cardiac dextroposition. Due to the unique position of the heart, the patient periodically lost complete cardiac output during the exposure and repair of the esophagus.

Background: Active transportation (AT) increases physical activity, reducing cardiometabolic risk among non-Hispanic white adults; however, research on these linkages in racial/ethnic minority women is sparse. This study explored these associations in 327 African American and Hispanic/Latina women. Methods: This analysis used sociodemographics, self-reported AT via the International Physical Activity Questionnaire, accelerometer-measured moderate to vigorous physical activity (MVPA), body mass index, systolic and diastolic blood pressures, resting heart rate, and body fat percentage (BF). Unadjusted bivariate associations and associations adjusted for sociodemographic factors were examined. Results: AT users had higher levels of objective MVPA, but this was not statistically significant. AT was not associated with cardiometabolic risk factors in adjusted models (Ps > .05); however, systolic blood pressure was lower for AT users. MVPA was negatively associated with diastolic blood pressure and BF overall, body mass index and BF in African American women, and BF in Hispanic/Latina women (Ps Conclusions: MVPA was associated with improvements in body mass index, diastolic blood pressure, and BF among minority women, and these relationships may vary by race/ethnicity. Practitioners should recommend increased participation in MVPA. Future research, using longitudinal designs should investigate AT’s potential for increasing MVPA and improving cardiometabolic health along with the role of race/ethnicity in these associations.

Highlights • Aerobic physical activity interventions had a large effect on memory. • Aerobic physical activity interventions had a small effect on executive function. • Meeting U.S. physical activity guidelines resulted in a large effect on memory. • Studies with a no treatment control had a large effect on memory., The worldwide population of adults ages 50 and older continues to increase and is projected to reach over 2.3 billion by 2030. Aging is the biggest risk factor for cognitive impairment and dementia. Aerobic physical activity may improve cognitive functioning, thus delaying aging-related cognitive decline. The purpose of this review was to examine the effect of aerobic physical activity on memory and executive function in sedentary adults with no known cognitive impairment. PubMed, CINAHL, Psycinfo, and Cochrane Library databases were systematically searched for peer-reviewed articles up to July 2019. Randomized controlled trials of sedentary adults, aged 50 and older, that compared an aerobic physical activity intervention to either no treatment or alternative active comparator and reported outcome measures of memory and/or executive function were included. A random effects meta-analysis was performed to examine the separate effect sizes for memory and executive function. Nine studies met inclusion criteria and contributed either memory and/or executive function effect sizes (n = 547). Results from the random effects meta-analysis suggested, by post-intervention, a large effect size for the aerobic physical activity interventions on memory (g = 0.80, 95%CI: 0.14–1.47; n = 7; p = 0.02) and a small effect on executive function (g = 0.37, 95%CI: 0.04–0.69; n = 6; p = 0.03). Aerobic physical activity may improve memory and executive function in sedentary adults without cognitive impairment. Policymakers and providers should promote aerobic physical activity in this population, and further research should investigate the most effective ways to promote aerobic physical activity in mid-life to older adults.

Purpose: To investigate relationships among physical activity, changes in physical function, and health-related quality of life (HRQOL) among patients with pancreatic adenocarcinoma enrolled in a home-based exercise prehabilitation program. Methods: Patients with resectable pancreatic adenocarcinoma receiving preoperative chemotherapy and/or chemoradiation were enrolled on this prospective, single-arm trial and were advised to perform ≥60 minutes each of moderate-intensity aerobic exercise and strengthening exercise weekly. Activity was measured via self-report and accelerometers, including moderate-to-vigorous physical activity (MVPA), light physical activity (LPA), and sedentary activity (SA). Physical function measures at baseline and restaging follow-up included 6-minute walk test (6MWT), 5 times sit-to-stand (5×STS), handgrip strength (HGS), 3-m walk for gait speed (GS), and the PROMIS Physical Function Short Form. HRQOL was measured via the FACT-Hep questionnaire. Results: Fifty participants with mean age 66 years (standard deviation = 8 years) were enrolled. The 6MWT, 5×STS, and GS significantly improved from baseline to restaging follow-up (P=.001, P=.049, and P=.009, respectively). Increases in self-reported aerobic exercise, weekly MVPA, and LPA were associated with improvement in 6MWT (β=.19, P=.048; β=.18, P=.03; and β=.08, P=.03, respectively) and self-reported physical functioning (β=.02, P=.03; β=.03, P=.005; and β=.01, P=.02, respectively). Increased weekly LPA was associated with increased HRQOL (β=.03, P=.02). Increased SA was associated with decreased HRQOL (β=-.02,P=.01). Conclusions: Patients with potentially resectable pancreatic cancer exhibit meaningful improvement in physical function with prehabilitation; physical activity was associated with improved physical function and HRQOL. These data highlight the importance of physical activity during treatment for pancreatic cancer.

This systematic review and meta-analysis examined the literature on early care and education center (ECEC)-based physical activity interventions to identify ecologic environmental factors that improve cardiovascular fitness (CVF) in preschool-aged children. Data sources included PubMed, Web of Science, Cochrane Library Trials, CINHAL, Science Direct, PsychINFO and SPORTDiscus. Peer-reviewed publications of studies that met the following criteria were eligible for inclusion: (1) mean age of participants between two and a half and five and a half years old enrolled in a pre-primary school; (2) randomized controlled trials or quasi-experimental interventions with a control group; (3) interventions occurring before, during, or immediately after school; (4) use of an objective measure or field-based estimate of CVF; (5) enrolled apparently healthy children. In June of 2018, titles (n = 1197) were reviewed for inclusion into the study and 74 abstracts/full texts were assessed for eligibility. Ten articles met all eligibility criteria and were included in the final review. A random effects meta-analysis suggested a moderate-to-large effect size for ECEC-based interventions to increase CVF (g = 0.75; 95%CI [0.40–1.11]). Interventions that included three or more ecologic environments (g = 0.79 [0.34–1.25]) were more effective than interventions occurring at the individual level (g = 0.67 [0.12–1.22]). Study quality was moderate, and (mean ± SD) 17.9 ± 4.3 (63.9%) of 28 checklist items were reported. Preliminary evidence suggests that ECEC-based interventions to increase CVF are highly effective at improving preschool children's exercise test scores. Although ECEC-based interventions show promise, the small number of studies included in this review limits confidence in these findings. Review registered at PROSPERO CRD42018099115. Keywords: Child, Preschool, Cardiorespiratory fitness, Systematic review, Physical activity, Social ecology

OBJECTIVES: We assessed the agreement between self-reported and accelerometer-assessed physical activity (PA) in African-American adults by sex, education, income, and weight status. METHODS: Participants (N = 274) completed the International PA Questionnaire short form (IPAQ-S), Behavioral Risk Factor Surveillance System (BRFSS) PA questions, and PA Questionnaire (PAQ) and a 7-day accelerometer protocol using a waist-worn ActiGraph GT3X accelerometer. Interrelationships among PA measures were assessed by sociodemographics. RESULTS: Participants consistently reported doing ≥150 minutes of moderate-to-vigorous-intensity PA (MVPA) per week via self-report measures and did 113.5±179.4 minutes of accelerometer-assessed MVPA/week. Men self-reported and did more MVPA than women (p < .01). Regardless of sex, there were low correlations between self-report and accelerometer-assessed MVPA (r = .092–.190). Poor agreement existed between self-report and accelerometry for classifying participants as meeting PA recommendations (Cohen k = .054−.136); only half of the participants were classified the same by both self-report and accelerometry. CONCLUSIONS: There was generally poor relative agreement between self-report and accelerometer-based assessments of MVPA in this sample of African-American adults. Findings suggest that self-report measures may perform better among African-American women than men, regardless of socioeconomic or weight status.

Background:Obesity is a critical problem among Mexican youth, but few studies have investigated associations among physical activity (PA) modes and anthropometrics in this population. This study examined associations among active commuting to school (ACS), sports or other organized PA, outdoor play, and body mass index (BMI) percentile and waist circumference (WC) among Mexican youth.Methods:Parents of school children (N = 1996, ages 6 to 14 years, 53.1% female) in 3 Mexican cities reported PA participation using the (modified) fourth grade School Physical Activity and Nutrition Survey. Trained assessors measured BMI percentile and WC in person.Results:Parents reported that 52.3% of children engaged in ACS, 57.3% participated in sports or organized PA, and a median of 2 days in the previous week with at least 30 minutes of outdoor play. In complete case analyses (n = 857), ACS was negatively associated with BMI percentile, and outdoor play was negatively associated with WC after adjusting for school, age, sex, and income. In analyses incorporating data from multiple imputation (N = 1996), outdoor play was negatively associated with WC (all Ps < . 05).Conclusions:ACS and outdoor play are favorably associated with anthropometrics and may help prevent childhood obesity in Mexico. ACS and outdoor play should be priorities for increasing youth PA in Mexico.

Psychological stressors can contribute to adverse health outcomes and lead to health disparities. To examine associations among psychological stressors, coping, blood pressure, body mass index, and body fat in ethnic minority women, we conducted a secondary analysis using data from 178 African American and Hispanic/Latina women who completed measures of perceived racial discrimination and stress, coping, blood pressure, and body composition. The mean age of participants was 45.3 (±9.3 years), and most were obese (74.2%) and had prehypertensive systolic blood pressure (125.7 ± 14.6 mmHg). Hierarchical multiple regression models indicated a significant negative relationship between racial discrimination and percent body fat, and positive associations between stress and blood pressure. Coping did not moderate the association between racial discrimination and blood pressure or body composition. Health care providers should consider psychological stressors as underlying causes for hypertension and address tailored stress-reduction coping strategies when treating African American and Hispanic/Latina women with hypertension.

Reach is a key factor in translating research to practical application. This study examined reach and representativeness of a multi-city, randomized controlled community health trial in African American (AA) and Hispanic or Latina (HL) women. Participants completed measures of demographics, body mass index (BMI), percent body fat, resting heart rate, and blood pressure followed by a run-in procedure and a randomization meeting. AA were more likely to be screened out initially; HL were more likely to drop out. Participation did not differ by city or recruitment method. Women who completed the post-intervention assessment were more likely to be AA, older, and have higher socioeconomic status (p values

Background: Physical activity and exercise appear to benefit patients receiving preoperative treatment for cancer. Supports and barriers must be considered to increase compliance with home-based exercise prescriptions in this setting. Such influences have not been previously examined. Methods: The authors used quantitative and qualitative methods to examine potential physical activity influences among patients who were prescribed home-based aerobic and strengthening exercises concurrent with preoperative chemotherapy or chemoradiation for pancreatic cancer. Physical activity was measured using exercise logs and accelerometers. Social support for exercise and perceived neighborhood walkability were measured using validated surveys. Relationships between influences and physical activity were evaluated using linear regression analyses and qualitative interviews. Results: Fifty patients received treatment for a mean of 16 (9) weeks prior to planned surgical resection. Social support from friends and neighborhood esthetics were positively associated with physical activity (P Conclusions: Interpersonal and environmental motivators of exercise and physical activity must be considered in the design of future home-based exercise interventions designed for patients receiving preoperative therapy for cancer.

Strategies are needed to help early care and education centers (ECEC) comply with policies to meet daily physical activity and fruit and vegetable guidelines for young children. This manuscript describes the design and methodology of Sustainability via Active Garden Education (SAGE), a 12-session cluster-randomized controlled crossover design trial using community-based participatory research (CBPR) to test a garden-based ECEC physical activity and fruit and vegetables promotion intervention for young children aged 3–5 years in 20 sites. The SAGE curriculum uses the plant lifecycle as a metaphor for human development. Children learn how to plant, water, weed, harvest, and do simple food preparation involving washing, cleaning, and sampling fruit and vegetables along with active learning songs, games, science experiments, mindful eating exercises, and interactive discussions to reinforce various healthy lifestyle topics. Parents will receive newsletters and text messages linked to the curriculum, describing local resources and events, and to remind them about activities and assessments. Children will be measured on physical activity, height, and weight and observed during meal and snack times to document dietary habits. Parents will complete measures about dietary habits outside of the ECEC, parenting practices, home physical activity resources, and home fruit and vegetable availability. SAGE fills an important void in the policy literature by employing a participatory strategy to produce a carefully crafted and engaging curriculum with the goal of meeting health policy guidelines and educational accreditation standards. If successful, SAGE may inform and inspire widespread dissemination and implementation to reduce health disparities and improve health equity.

PURPOSE: Guidelines recommend exercise to cancer survivors, but limited data exists regarding exercise among patients undergoing preoperative cancer treatment. We examined differences in weekly self-reported exercise and accelerometer-measured physical activity among participants in a home-based exercise program administered during preoperative treatment for pancreatic cancer. METHODS: Participants were encouraged to perform at least 60 minutes/week of moderate-intensity aerobic exercise and at least 60 minutes/week of full-body strengthening exercises concurrent with chemotherapy, chemoradiation therapy or both sequentially and received resistance equipment, program instruction, and biweekly follow-up calls to encourage adherence. Self-reported aerobic and strengthening exercise minutes were measured using daily logs, and physical activity was measured objectively using accelerometers. RESULTS: Fifty participants (48% female, mean age 66 ± 8 years) participated for an average of 16 ± 9 preoperative weeks. Participants reported overall means of 126 ± 83 weekly minutes of aerobic exercise and 39 ± 33 weekly minutes of strengthening exercise in daily logs. Participants performed 158.7 ± 146.7 weekly minutes of accelerometer-measured moderate-to-vigorous physical activity. There were no significant differences in exercise or physical activity between treatment phases. CONCLUSIONS: These findings suggest that it is feasible to target the entire preoperative course for exercise prescription. Although participants exceeded aerobic exercise recommendations on average, we observed low strengthening exercise adherence and wide variability in self-reported exercise and accelerometer physical activity variables. These findings suggest that additional support, including program adaptations, may be necessary to overcome barriers to exercise or improve motivation when prescribing exercise in this clinical scenario.

OBJECTIVE African American (AA) women are at greater risk for cardiovascular disease (CVD) compared to White women, which can be attributed to disparities in risk factors. The built environment may contribute to improving CVD risk factors by increasing physical activity (PA). This study used recursive partitioning, a multivariate decision tree risk classification approach, to determine which built environment characteristics contributed to the classification of AA women as having 4 or more CVD risk factors at optimal levels. METHOD Recursive partitioning has the ability to detect interactions and does not have sample size limitations to detect effects. The Classification and Regression Trees (CR&T) growing method was used to group participants as having 4 or more versus 3 or fewer risk factors at optimal levels. Risk factors were smoking, body mass index (BMI), PA, healthy diet, cholesterol, glucose, and blood pressure. Built environment predictors were presence and quality of neighborhood PA resources (PARs), walkability, traffic safety, and crime. RESULTS Participants (N = 30, mean age of 54.1 ± 7.5) all had at least 1 risk factor at the optimal level, none had all 7, and 66.7% had 4 or more risk factors at optimal levels. The CR&T identified participants with few, low-quality neighborhood PARs and who were older than 55 as least likely to have 4 or more CVD risk factors at optimal levels. CONCLUSION Being younger than 55 years old and having many, high-quality neighborhood PARs may predict lower risk for CVD in AA women. Results should be used in future studies with larger sample sizes to inform logistic regression models. (PsycINFO Database Record

Neighborhood disadvantage (ND), incivilities, and crime disproportionately impact minority women, discouraging physical activity (PA). Social support (SS) is a cultural tool promoting PA in minority women. Socially supportive environments may promote PA in disadvantaged neighborhoods, yet few studies have investigated the mediating role of social support among minority women. This study examined SS as a mediator among ND, incivilities, crime, and PA. The Health Is Power study aimed to increase PA in African American and Hispanic Latina women (N=410) in Houston and Austin, TX. ND and crime data were taken from the National Neighborhood Crime Study. Incivilities was measured using the Pedestrian Environment Data Scan (PEDS). SS was measured using the Family and Friend Support for Exercise Habits scale and physical activity was measured using the International Physical Activity Questionnaire. Linear regression analysis were used to examine SS as a mediator following the Baron and Kenny method. ND was negatively associated with PA and SS. SS was not a mediator as it was not significantly associated with ND, crime, and incivilities (F(3,264)=2.02, p>.05) or PA (F(1,266)=3.8 p=.052). ND significantly discourages PA and limits SS. Future research should focus on developing strategies to overcoming these negative environmental factors. Language: en

The Childhood Obesity Research Demonstration (CORD) project links public health and primary care interventions in three projects described in detail in accompanying articles in this issue of Childhood Obesity. This article describes a comprehensive evaluation plan to determine the extent to which the CORD model is associated with changes in behavior, body weight, BMI, quality of life, and healthcare satisfaction in children 2-12 years of age.The CORD Evaluation Center (EC-CORD) will analyze the pooled data from three independent demonstration projects that each integrate public health and primary care childhood obesity interventions. An extensive set of common measures at the family, facility, and community levels were defined by consensus among the CORD projects and EC-CORD. Process evaluation will assess reach, dose delivered, and fidelity of intervention components. Impact evaluation will use a mixed linear models approach to account for heterogeneity among project-site populations and interventions. Sustainability evaluation will assess the potential for replicability, continuation of benefits beyond the funding period, institutionalization of the intervention activities, and community capacity to support ongoing program delivery. Finally, cost analyses will assess how much benefit can potentially be gained per dollar invested in programs based on the CORD model.The keys to combining and analyzing data across multiple projects include the CORD model framework and common measures for the behavioral and health outcomes along with important covariates at the individual, setting, and community levels. The overall objective of the comprehensive evaluation will develop evidence-based recommendations for replicating and disseminating community-wide, integrated public health and primary care programs based on the CORD model.

Integrating physical activity (PA) counseling in routine clinical practice remains a challenge. The purpose of this study was to evaluate the implementation and effectiveness of a pragmatic strategy aimed to improve physician PA counseling and patient PA. An effectiveness-implementation type-2 hybrid design was used to evaluate a 3-h training (i.e., implementation strategy-IS) to increase physician use of the 5-As (assess, advise, agree, assist, arrange) for PA counseling (i.e., clinical intervention-CI) and to determine if the CI improved patient PA. Patients of trained and untrained physicians reported on PA and quality of life pre-post intervention. Medical charts (N = 1700) were examined to assess the proportion of trained physicians that used the 5-As. The RE-AIM framework informed our evaluation. 305/322 of eligible physicians participated in the IS (M age = 40 years, 52% women) and 683/730 of eligible patients in the CI (M age = 49 years, 77% women). The IS was adopted by all state regions and cost ~ $20 Mexican pesos (US$1) per provider trained. Physician adoption of any of the 5-As improved from pre- to post-training (43 vs. 52%, p

ObjectiveFast-food restaurants (FFR) are prevalent. Binge eating is common among overweight and obese women. For women prone to binge eating, neighbourhood FFR availability (i.e. the neighbourhood around one's home) may promote poor diet and overweight/obesity. The present study tested the effects of binge eating and neighbourhood FFR availability on diet (fat and total energy intake) and BMI among African American and Hispanic/Latino women.DesignAll measures represent baseline data from the Health is Power randomized clinical trial. The numbers of FFR in participants’ neighbourhoods were counted and dichotomized (0 or ≥1 neighbourhood FFR). Participants completed measures of binge eating status and diet. Weight and height were measured and BMI calculated. 2 (binge eating status) × 2 (neighbourhood FFR availability) ANCOVA tested effects on diet and BMI while controlling for demographics.SettingHouston and Austin, TX, USA.SubjectsAfrican American and Hispanic/Latino women aged 25–60 years.ResultsOf the total sample (n162), 48 % had 1–15 neighbourhood FFR and 29 % were binge eaters. There was an interaction effect on BMI (P= 0·05). Binge eaters with ≥1 neighbourhood FFR had higher BMI than non-binge eaters or binge eaters with no neighbourhood FFR. There were no significant interactions or neighbourhood FFR main effects on total energy or fat intake (P> 0·05). A main effect of binge eating showed that binge eaters consumed more total energy (P= 0·005) and fat (P= 0·005) than non-binge eaters.ConclusionsBinge eaters represented a substantial proportion of this predominantly overweight and obese sample of African American and Hispanic/Latino women. The association between neighbourhood FFR availability and weight status is complicated by binge eating status, which is related to diet.

Background Low physical activity (PA) and fruit and vegetable (F&V) consumption in early childhood are continued public health challenges. This manuscript describes outcomes from two pilot studies for Sustainability via Active Garden Education (SAGE), a program designed to increase PA and F&V consumption among 3 to 5 year old children. Methods SAGE was developed using community-based participatory research (CBPR) and delivered to children (N = 89) in early care and education centers (ECEC, N = 6) in two US cities. Children participated in 12 one-hour sessions that included songs, games, and interactive learning activities involving garden maintenance and taste tests. We evaluated reach, efficacy, adoption, implementation, and potential for maintenance of SAGE following the RE-AIM framework. Reach was evaluated by comparing demographic characteristics among SAGE participants and residents of target geographic areas. Efficacy was evaluated with accelerometer-measured PA, F&V consumption, and eating in the absence of hunger among children, parenting practices regarding PA, and home availability of F&V. Adoption was evaluated by the number of ECEC that participated relative to the number of ECEC that were recruited. Implementation was evaluated by completion rates of planned SAGE lessons and activities, and potential for maintenance was evaluated with a parent satisfaction survey. Results SAGE reached ECEC in neighborhoods representing a wide range of socioeconomic status, with participants’ sociodemographic characteristics representing those of the intervention areas. Children significantly increased PA during SAGE lessons compared to usual lessons, but they also consumed more calories in the absence of hunger in post- vs. pre-intervention tests (both p

Few studies have examined neighborhood influences on physical activity (PA) among low-income African Americans living in public housing. This study measured the associations of PA resources and land use with PA among 216 African Americans living in 12 low-income housing developments in Houston, Texas. Neighborhood measures included both detailed information from in-person audits and geographic information systems (GIS) data. Hierarchical linear regression models tested the associations of neighborhood PA resource availability and quality and land use density and diversity with individual-level, self-reported PA. Land use diversity was positively associated with walking among men after controlling for other neighborhood characteristics. Policies that promote land use diversity or improve the pedestrian environment in areas with diverse destinations may encourage PA among public housing residents.

This study identified inconsistencies in physical activity (PA) reported at screening and baseline of a 6-month health promotion intervention and explored how these inconsistencies influenced intervention effectiveness in African American and Hispanic women. Participants completed a telephone screener to determine eligibility for a PA intervention. Inactive participants (≤90 minutes of PA/week) were invited to a baseline assessment, where they completed the International Physical Activity Questionnaire, measuring work, transportation, gardening/housework, and leisure-time PA. Women returned after 6 months to complete an identical post-intervention assessment. Despite being screened as inactive, baseline Questionnaire data indicated that 85.0% of participants (N = 274, M age = 44.6 years, M body mass index = 34.8 kg/m2) were active (>90 minutes of PA/week). Women who reported any work-related PA were 20.9 times more likely to be active at baseline than those who did not (p < .001). Participants who were inactive at both screening and baseline reported greater increases in domestic and gardening PA and total PA from baseline to postintervention (ps < .05). Overweight/obese ethnic minority women may misreport being physically inactive during screening if specific questions about type of PA are not included. Post hoc analyses controlling for screening inaccuracies may improve effectiveness of PA interventions and help intervention programs reach women who may benefit the most.

Perceptions of neighborhood attributes for physical activity may be influenced by individual level income. This study examined differences in perceptions of neighborhood attributes for walking and bicycling in high and low income African American women. African American women (n = 388) aged 20-65 years completed the International Physical Activity Prevalence Study's Environmental Survey Module. Independent t-tests determined differences in perceptions of neighborhood attributes by income group. Principal component factor analysis explored differences in factor structure for survey items. Low income African American women perceived their neighborhood as being less safe with regard to crime and traffic, having fewer free recreational opportunities, and having more public transportation stops nearby. Survey items weighed differently on each factor between income groups. Household income should be taken into consideration when interpreting perceptions of neighborhood for physical activity in African American women.

Physical inactivity is among the most pressing public health challenges facing industrialized nations, and low socioeconomic status (SES) populations report lower rates of physical activity than high SES populations. The Ecologic Model of Physical Activity (EMPA) accounts for individual, social and environmental factors that contribute to physical activity, and can be used to demonstrate possible pathways by which SES may influence physical activity, illuminating strategies for intervention. This review examines current approaches to physical activity promotion in low SES populations couched within the EMPA. Findings suggest that limitations and challenges remain for physical activity promotion in low SES populations. Coordinated and consistent physical activity promotion efforts, targeting multiple levels of influence and a range of settings, including political, corporate and community support, are needed to prevent and treat the disparity in physical activity in this vulnerable population.

Background Active transportation (AT) is a form of physical activity (PA), which improves cardiometabolic risk factors among non-Hispanic white adults in the United States. However, research among minority women is sparse. This study explored associations between AT and cardiometabolic risk factors among urban African American and Hispanic women (N=410). Methods This was a secondary analysis of data from the Health is Power study, a randomized controlled trial conducted in Houston and Austin, Texas (2006–2008) to increase PA or fruit and vegetable consumption among minority women. The sample comprised 63% African American and 37% Hispanic/Latina women (N=367 M=45.0±9.4 years). Sociodemographics (ethnicity, age, education, household income) and the International Physical Activity Questionnaire metabolic equivalent of task (MET)-minutes per week spent in AT and total PA were measured via interviewer administered questionnaire. Cardiometabolic risk factors (body mass index [BMI], body fat percentage [BF%], resting heart rate [RHR], systolic [SBP] and diastolic blood pressures [DBP]) were collected using established protocols. Unadjusted bivariate associations and associations adjusted for covariates (sociodemographics, site, total PA minus AT) between dichotomized AT use (any AT use [n=159] versus no AT use [n=208]) and cardiometabolic risk factors were examined. Results Participants reported mean AT MET-min/wk of 219.86±827.3. AT use was not significantly related to sociodemographic factors. AT users reported more AT MET-min/wk (M=507.5±1199.4) and total PA (M=3408.5±3930.0 MET-min/wk) than non-users (M=2324.3±3552.9 MET-min/wk; t(365)=-2.77, p=.006). When comparing PA levels excluding AT, the PA levels of AT users remained higher (M=2901.0±3499.0 MET-min/wk), though this difference was not significant (p=.122). SBP was lower for AT users (M=122.8±18.9) compared to non-users (M=125.0±13.4), but not significantly so (p=.208). AT was not associated with BMI, RHR, BF%, SBP, or DBP (all ps>.05). Conclusions Results showed no significant associations between AT use and cardiometabolic outcomes; however, SBP was slightly lower for AT users. Mean MET-min/wk of AT use was slightly lower than the minimum recommended PA guideline of 600 MET-min/wk to achieve health benefits with most (82%) AT users falling below 500 MET-min/wk. Total PA for both AT users and non-users was well above recommended guidelines, demonstrating small doses of AT may not provide additional benefits when meeting current recommendations. Further research should investigate the presence of a dose response in larger samples with participants engaging in higher levels of AT. This study was supported by a grant from the National Cancer Institute (1R01CA109403) to Dr. Rebecca E. Lee and Jonas Scholar Nurse Leader Cohort 2016–2018 to Elizabeth Lorenzo.

Introduction: Residence in a deprived neighbourhood is associated with lower rates of physical activity. Little is known about the manifestation of deprivation that mediates this relationship. This study aimed to investigate whether access to physical activity resources mediated the relationship between neighbourhood socioeconomic status and physical activity among women. Method: Individual data from women participating in the Stanford Heart Disease Prevention Program (1979–90) were linked to census and archival data from existing records. Multilevel regression models were examined for energy expenditure and moderate and vigorous physical activity as reported in physical activity recalls. Results: After accounting for individual-level socioeconomic status, women who lived in lower-socioeconomic status neighbourhoods reported greater energy expenditure, but undertook less moderate physical activity, than women in moderate-socioeconomic status neighbourhoods. In contrast, women living in higher-socioeconomic status neighbourhoods reported more vigorous physical activity than women in moderate-socioeconomic status neighbourhoods. Although availability of physical activity resources did not appear to mediate any neighbourhood socioeconomic status associations, several significant interactions emerged, suggesting that women with low income or who live in lower-socioeconomic status neighbourhoods may differentially benefit from greater physical activity resource availability. Discussion: Although we found expected relationships between residence in a lower-socioeconomic status neighbourhood and undertaking less moderate or vigorous physical activity among women, we also found that these same women reported greater overall energy expenditure, perhaps as a result of greater work or travel demands. Greater availability of physical activity resources nearby appears to differentially benefit women living in lower-socioeconomic status neighbourhoods and low-income women, having implications for policy-making and planning.

Background Continuous monitoring technologies such as accelerometers and pedometers are the gold standard for physical activity (PA) measurement. However, inconsistencies in use, analysis, and reporting limit the understanding of dose–response relationships involving PA and the ability to make comparisons across studies and population subgroups. These issues are particularly detrimental to the study of PA across different ethnicities with different PA habits. This systematic review examined the inclusion of published guidelines involving data collection, processing, and reporting among articles using accelerometers or pedometers in Hispanic or Latino populations. Methods English (PubMed; EbscoHost) and Spanish (SCIELO; Biblioteca Virtual en Salud) articles published between 2000 and 2013 using accelerometers or pedometers to measure PA among Hispanics or Latinos were identified through systematic literature searches. Of the 253 abstracts which were initially reviewed, 57 met eligibility criteria (44 accelerometer, 13 pedometer). Articles were coded and reviewed to evaluate compliance with recommended guidelines (N = 20), and the percentage of accelerometer and pedometer articles following each guideline were computed and reported. Results On average, 57.1 % of accelerometer and 62.2 % of pedometer articles reported each recommended guideline for data collection. Device manufacturer and model were reported most frequently, and provision of instructions for device wear in Spanish was reported least frequently. On average, 29.6 % of accelerometer articles reported each guideline for data processing. Definitions of an acceptable day for inclusion in analyses were reported most frequently, and definitions of an acceptable hour for inclusion in analyses were reported least frequently. On average, 18.8 % of accelerometer and 85.7 % of pedometer articles included each guideline for data reporting. Accelerometer articles most frequently included average number of valid days and least frequently included percentage of wear time. Discussion Inclusion of standard collection and reporting procedures in studies using continuous monitoring devices in Hispanic or Latino population is generally low. Conclusions Lack of reporting consistency in continuous monitoring studies limits researchers' ability to compare studies or draw meaningful conclusions concerning amounts, quality, and benefits of PA among Hispanic or Latino populations. Reporting data collection, computation, and decision-making standards should be required. Improved interpretability would allow practitioners and researchers to apply scientific findings to promote PA.

Objectives. We developed the policy indicator checklist (PIC) to identify and measure policies for calorie-dense foods and sugar-sweetened beverages to determine how policies are clustered across multiple settings. Methods. In 2012 and 2013 we used existing literature, policy documents, government recommendations, and instruments to identify key policies. We then developed the PIC to examine the policy environments across 3 settings (communities, schools, and early care and education centers) in 8 communities participating in the Childhood Obesity Research Demonstration Project. Results. Principal components analysis revealed 5 components related to calorie-dense food policies and 4 components related to sugar-sweetened beverage policies. Communities with higher youth and racial/ethnic minority populations tended to have fewer and weaker policy environments concerning calorie-dense foods and healthy foods and beverages. Conclusions. The PIC was a helpful tool to identify policies that promote healthy food environments across multiple settings and to measure and compare the overall policy environments across communities. There is need for improved coordination across settings, particularly in areas with greater concentration of youths and racial/ethnic minority populations. Policies to support healthy eating are not equally distributed across communities, and disparities continue to exist in nutrition policies.

Background Physical activity (PA) public health programming has been widely used in Mexico; however, few studies have documented individual and organizational factors that might be used to evaluate their public health impact. The RE-AIM framework is an evaluation tool that examines individual and organizational factors of public health programs. The purpose of this study was to use the RE-AIM framework to determine the degree to which PA programs in Mexico reported individual and organizational factors and to investigate whether reporting differed by the program’s funding source. Methods Public health programs promoting PA were systematically identified during 2008–2013 and had to have an active program website. Initial searches produced 23 possible programs with 12 meeting inclusion criteria. A coding sheet was developed to capture behavioral, outcome and RE-AIM indicators from program websites. Results In addition to targeting PA, five (42%) programs also targeted dietary habits and the most commonly reported outcome was change in body composition (58%). Programs reported an average of 11.1 (±3.9) RE-AIM indicator items (out of 27 total). On average, 45% reported reach indicators, 34% reported efficacy/effectiveness indicators, 60% reported adoption indicators, 40% reported implementation indicators, and 35% reported maintenance indicators. The proportion of RE-AIM indicators reported did not differ significantly for programs that were government supported (M = 10, SD = 3.1) and programs that were partially or wholly privately or corporately supported (M = 12.0, SD = 4.4). Conclusion While reach and adoption of these programs were most commonly reported, there is a need for stronger evaluation of behavioral and health outcomes before the public health impact of these programs can be established. Electronic supplementary material The online version of this article (doi:10.1186/s12889-015-1474-2) contains supplementary material, which is available to authorized users.

Background. This study documented the frequency and correlates of directly observed physicians' counseling on dietary habits and exercise in private medical practices. Methods. Trained medical students observed physician, office, and patient characteristics in 4344 patient visits in 38 nonmetropolitan primary care physician offices. Results. Counseling rates ranged from 0% in some offices to 55% in others. Physicians counseled patients on dietary habits in 25% of visits and exercise in 20% of visits. Physicians counseled new patients 30% more often than established ones (P < 0.05). Dietary counseling was associated with having dietary and exercise brochures in the office (P < 0.05). When counseling occurred, physicians (rather than patients) initiated both dietary and exercise counseling 61% of the time. Counseling for dietary habits was associated with counseling for exercise (P < 0.05); some physicians may be more likely to give preventive counseling. Counseling was not associated with physicians' age, years in practice, or number of patients per week. Conclusion. Physician counseled patients in 20–25% of visits, and this was not affected by physician characteristics. Results suggest that physician counseling protocols and other office prompts should be developed and promoted. Strategies targeting both physician and the health care system may improve the consistency of physician preventive counseling practices.

The present study examined smoking culture and lifestyle Web sites listed on Yahoo!, a popular Internet search catalog, to determine whether the sites were easily accessible to youth, featured age or health warnings, and mentioned specific tobacco brands. A content analysis of photographs on these sites assessed the demographics of individuals depicted and the amount of smoking and nudity in the photographs. The sample included 30 Web sites, all of which were accessible to youth and did not require age verification services to enter them. Cigarette brand names were mentioned in writing on 35% of the sites, and brand images were present on 24% of the sites. Nearly all of the photographs (95%) depicted smoking, 92% featured women, and 7% contained partial or full nudity. These results underscore the need for greater research and monitoring of smoking-related Internet content by health educators and tobacco control advocates.

Physical inactivity is an ongoing challenge in the US that contributes to at least 4 of the leading causes of death: heart disease, stroke, diabetes and cancer.1 Self-report measures suggest that nearly 50% of the adult population fail to meet physical activity recommendations,2 and objective measures suggest that only 5% of adults actually meet aerobic physical activity recommendations of 30 minutes per day on 5 or more days per week.3 Despite increases in physical activity over the past decade,4,5 the majority of Americans still do not meet guideline minimums. The problem is particularly evident among African Americans, or non-Hispanic Blacks, and Hispanics, who are less likely to meet physical activity guidelines and who engage in less physical activity than non-Hispanic Whites do.4,6,7 Thus, in the US and among ethnic minorities, primary prevention efforts aimed at reducing cancer and cardiovascular disease risk have included strategies to increase physical activity adoption and promote physical activity maintenance.8 Although several physical activity interventions have been developed for large population groups, few have succeeded among ethnic minority adults, suggesting a lack of suitability and need to target additional, ethnically relevant correlates related to physical activity.9–11 Theoretical frameworks, such as Social Cognitive Theory and the Transtheoretical Model, have identified intrapersonal factors related to physical activity (eg, biologic and physiologic characteristics, self-efficacy, beliefs, attitudes or knowledge related to physical activity) and interpersonal relationships (eg, support from family and friends to do physical activity regularly) as important correlates of physical activity. Previous research has shown that psychosocial factors, including intrapersonal and interpersonal factors, are related and contribute significantly to behavioral mechanistic pathways for physical activity adoption and maintenance in African Americans and Hispanics.12 Although psychosocial factors related to physical activity often are included as intervention components based on theoretical frameworks, the effectiveness of interventions based on improving psychosocial factors as pathways to physical activity adoption or maintenance remains unclear.13–15 For example, Resnick et al16 found that an intervention which promoted self-efficacy through group exercise sessions, education materials, and discussions led to increased physical activity among older African American women.17 However, other studies in African Americans reported that interventions that included one or more psychosocial factors did not lead to hypothesized increases in physical activity.14,18 Because the reported findings are inconclusive, it is important to understand which psychosocial factors are effective for physical activity adoption and whether these psychosocial factors individually or in combination lead to increases in physical activity adoption in African Americans and Hispanics. Psychosocial factors are usually linked to a particular theory or theory-related construct or to multiple theories and/or constructs; they can vary from study to study and may be included individually or in combination with other psychosocial factors within a study. Because of these variations, a systematic review is needed to improve understanding of the theoretical foundations of interventions and to identify the psychosocial factors that are found to be effective for physical activity engagement in African American and Hispanic adults. Previous systematic reviews that looked at the effectiveness of physical activity interventions in ethnic minority groups mostly focused on environmental interventions versus interventions that included psychosocial factors.19–22 Studies that included psychosocial factors as intervention components looked at them in the context of overall behavior change related to obesity and weight loss and were not specific to physical activity.23 This systematic review goes beyond previous reviews by examining the use of theory in physical activity interventions, focusing on interventions that target psychosocial factors related to physical activity, and synthesizing the results of interventions that address these factors. The purposes of this study were to summarize (1) the results of physical activity interventions that include psychosocial factors to increase physical activity among adult African Americans and Hispanics in randomized controlled trials; and (2) the use of theory and theoretical constructs in physical activity interventions.

Objective. To assess the informational, educational and instrumental environments among Mexican healthcare settings for their potential to promote physical activity (PA).Materials and methods. The Environmental Physical Activity Assessment Tool for Healthcare Settings (EPATHS) was developed to assess the PA environments of 40 clinics/hospitals representing the three Mexican healthcare systems in Guadalajara. The EPATHS assessed the presence and quality of PA enhancing features in the informational (e.g. signage),educational (e.g. pamphlets), and instrumental (e.g. stairs)environments of included clinics/hospitals. Results. 28 (70%) clinics/hospitals had more than one floor with stairs; 60% of these had elevators. Nearly 90% of stairs were visible, accessible and clean compared to fewer than 30% of elevators. Outdoor spaces were observed in just over half (55%) of clinics/hospitals, and most (70%) were of good quality. Only 25% clinics/hospitals had educational PA materials. Conclusions.The PA instrumental environment of Mexican healthcare settings is encouraging. The informational and educational environments could improve.

Background Women are typically less physically active than men, and active transport can help women meet physical activity recommendations. Little is known about special populations of women, such as women with young children, who may be especially sensitive to neighborhood conditions. The purpose of this study was to investigate the associations of neighborhood context with active transport among women with children after controlling for sociodemographic variables. Methods We used data from the Geographic Research on Wellbeing study (GROW). In 2012-2013, GROW surveyed mothers who participated in California’s Maternal and Infant Health Assessment. The dependent variable was active transport vs. inactive transport. Mothers were coded as doing active transport if they responded that they “walked,” “walked and took public transportation,” or ‘rode a bike,” to most places they went in the past 7 days, and were coded as doing inactive transport if they responded that they “drove” any kind of vehicle or “got rides from someone else.” The independent variables were neighborhood-level (census tract) poverty rates, and income inequality, and perceived neighborhood safety. Using a stratified sample of poor or near-poor ( Results One seventh of mothers reported active transport with mothers in poor/near-poor families having higher proportion of active transport than mothers in higher income families (24% vs. 3%). In adjusted models, poor/near-poor mothers in very unsafe neighborhoods had 2.5 times higher odds of active transport compared with those in very safe neighborhoods, and non-poor mothers in very unsafe neighborhoods had 7.5 times higher odds of active transport compared with those in very safe neighborhoods. Neighborhood-level poverty and income inequality were not statistically significant in the adjusted models. Conclusions Both poor and non-poor women with young children have higher rates of active transportation if they perceive their neighborhoods as very unsafe vs. very safe, presenting added risk for crime, injury, and psychological distress to these most vulnerable women. In contrast, objectively measured poverty rates and income inequality were not related to active transportation. Policy and community resources should be allocated to provide safe routes for women in very unsafe areas where active transport is most likely to occur.

Innovative and empirically tested strategies are needed to define and understand obesity prevention and reduction in a transcultural society. This manuscript describes the development of Science & Community, a partnership developed over a 3-year period with the end goal of implementing a community-based participatory research (CBPR) trial to reduce and prevent obesity. Outreach strategies focused on promoting the project via existing and new channels and identifying and contacting potential partners using established strategies. Science & Community developed and fostered partnerships by hosting a series of interactive meetings, including three Opportunity Receptions, four Community Open Forum Symposia, and quarterly Community Advisory Board (CAB) meetings. Opportunity Reception ( N = 62) and Symposia attendees ( N = 103) represented the diversity of the community, and participants reported high satisfaction with content and programming. From these events, the CAB was formed and was comprised of 13 community representatives. From these meetings, a Partnership representing 34 organizations and 614 individuals emerged that has helped to guide the development of future proposals and strategies to reduce obesity in Houston/Harris County.

The purpose of this review was to determine the degree to which physical activity interventions for Latin American populations reported on internal and external validity factors using the RE-AIM framework (reach & representativeness, effectiveness, adoption, implementation, maintenance). We systematically identified English (PubMed; EbscoHost) and Spanish (SCIELO; Biblioteca Virtual en Salud) language studies published between 2001 and 2012 that tested physical activity, exercise, or fitness promotion interventions in Latin American populations. Cross-sectional/descriptive studies, conducted in Brazil or Spain, published in Portuguese, not including a physical activity/fitness/exercise outcome, and with one time point assessment were excluded. We reviewed 192 abstracts and identified 46 studies that met the eligibility criteria (34 in English, 12 in Spanish). A validated 21-item RE-AIM abstraction tool was used to determine the quality of reporting across studies (0-7 = low, 8-14 = moderate, and 15-21 = high). The number of indicators reported ranged from 3-14 (mean = 8.1 ± 2.6), with the majority of studies falling in the moderate quality reporting category. English and Spanish language articles did not differ on the number of indicators reported (8.1 vs. 8.3, respectively). However, Spanish articles reported more across reach indicators (62% vs. 43% of indicators), while English articles reported more across effectiveness indicators (69% vs 62%). Across RE-AIM dimensions, indicators for reach (48%), efficacy/effectiveness (67%), and implementation (41%) were reported more often than indicators of adoption (25%) and maintenance (10%). Few studies reported on the representativeness of participants, staff that delivered interventions, or the settings where interventions were adopted. Only 13% of the studies reported on quality of life and/or potential negative outcomes, 20% reported on intervention fidelity, and 11% on cost of implementation. Outcomes measured after six months of intervention, information on continued delivery and institutionalization of interventions, were also seldom reported. Regardless of language of publication, physical activity intervention research for Latin Americans should increase attention to and measurement of external validity and cost factors that are critical in the decision making process in practice settings and can increase the likelihood of translation into community or clinical practice. Published version

OBJECTIVES To compare restaurant marketing by restaurant and neighborhood type. METHODS All restaurants (61=fast food, FF; 72=table service, TS) within an 800-meter radius of 13 public housing developments (HD) and 4 comparison neighborhoods were audited using the Restaurant Assessment Tool©2010. HD neighborhoods were lower income and higher minority than comparison neighborhoods with similar density and street connectivity. RESULTS Restaurants in HD neighborhoods had fewer healthy entrees than comparison neighborhoods. FF restaurants had cheaper beverages and more children's meals, supersize drinks, free prize with purchase, super-size items, special characters, and more items geared to driving than TS restaurants. CONCLUSIONS Residents of lower socioeconomic neighborhoods may be differentially exposed to unhealthy food options.

Walking for exercise is becoming widely recognized for bestowing health benefits. This study examined the association of walking for exercise and mood in sedentary, ethnic minority women over a five-month period. Ethnic minority women (N = 102) participated in a randomized, controlled trial of a 7-week behaviorally based telephone and mail intervention that promoted the adoption of walking for exercise compared to a non-behavioral minimal intervention. At 2-month post-test and 5-month follow-up, participants reported significant decreases in depressive mood and increases in vigor. Increase in walking over the course of the study was associated with change in vigor. Limited evidence was found to support a relationship between walking for exercise and mood improvement in ethnic-minority women.

The VITAL Project is an interdisciplinary project that uses teams of students from multiple courses in a single semester to investigate a health-related topic, propose programs or therapies to ameliorate the health issue and deliver a presentation at a virtual three-day health conference held in Second Life. The purpose of VITAL is to provide opportunities for the students to gain a better understanding of the multifactorial nature of many public and individual health issues, as well as exposing them to technologies that enable them to virtually collaborate. The teams are composed of students from each of the four courses participating in VITAL in a given semester so that the content area of each course is represented on a given team. All team activities, such as meetings and presentation practice, are conducted on the department’s island in Second Life.

Ethnic minority women have been underrepresented in health promotion research. There is a need to develop effective methods of recruiting ethnic minority women to health promotion programs and research studies. This article evaluates several methods for recruiting ethnic minority women to a study of a telephone and mail intervention encouraging participation in a home-based walking program. One hundred twenty-six sedentary ethnic minority women between the ages of 25 and 55 were recruited using two types of approaches. Number of participants screened, number enrolled, and recruitment efficiency (ratio of number recruited/ number screened) were assessed. “Active” recruitment, contacting targeted individuals in person, by phone, or by mail, yielded 236 screened and 29 recruited with a recruitment efficiency of 11%. “Passive” recruitment, informing the community through public notices and waiting for volunteers to call, yielded 151 screened and 97 recruited with a recruitment efficiency of 64%. Those recruited by active or passive methods did not differ by demographic characteristics, baseline psychosocial variables, or dropout rates. Passive recruits walked significantly more at five-month follow-up than active recruits. Passive recruitment may be more economical at the cost of potentially biased samples.

Both physical and social environmental factors influence young children’s physical activity, yet little is known about where Hispanic children are more likely to be active. We assessed the feasibility of simultaneously measuring, then processing objective measures of location and physical activity among Hispanic preschool children. Preschool-aged Hispanic children (n = 15) simultaneously wore QStarz BT100X global positioning system (GPS) data loggers and Actigraph GT3X accelerometers for a 24- to 36-hour period, during which time their parents completed a location and travel diary. Data were aggregated to the minute and processed using the personal activity location measurement system (PALMS). Children successfully wore the GPS data loggers and accelerometers simultaneously, 12 of which yielded data that met quality standards. The average percent correspondence between GPS- and diary-based estimates of types of location was high and Kappa statistics were moderate to excellent, ranging from 0.49-0.99. The between-method (GPS monitor, parent-reported diary) correlations of estimated participant-aggregated minutes spent on vehicle-based trips were strong. The simultaneous use of GPS and accelerometers to assess Hispanic preschool children’s location and physical activity is feasible. This methodology has the potential to provide more precise findings to inform environmental interventions and policy changes to promote physical activity among Hispanic preschool children.

Health care satisfaction ratings were studied in 365 (131 male and 234 female) members of a Health Maintenance Organization (HMO) (ages 60-89) with osteoarthritis (OA). A hierarchical multiple regression analysis to account for variance in health care ratings showed that subjects with higher satisfaction ratings were older, tended to be male, and made fewer contacts with health care providers over the previous year. They also scored higher on arthritis self-efficacy, showing less perceived disability related to arthritis. Those with higher satisfaction ratings also believed that health care services were more accessible to them, despite their equal access. Of four factor-analytically derived subscales of health care attitudes (inconvenience, reluctance, dependence, and knowledge), only inconvenience and reluctance were significatly correlated with health care satisfaction ratings. The results suggest that perceived symptom control and inconvenience to services are important predictors of health c...

Reach is a key factor in translating research to practical application. This study examined reach and representativeness of a multi-city, randomized controlled community health trial in African American (AA) and Hispanic or Latina (HL) women. Participants completed measures of demographics, body mass index (BMI), percent body fat, resting heart rate, and blood pressure followed by a run-in procedure and a randomization meeting. AA were more likely to be screened out initially; HL were more likely to drop out. Participation did not differ by city or recruitment method. Women who completed the post-intervention assessment were more likely to be AA, older, and have higher socioeconomic status (p values

Findings from previous research linking sedentary time with cardiometabolic risk factors and body composition are inconsistent, and few studies address population groups most vulnerable to these compromising conditions. The purpose of this paper was to investigate the relationship of sitting time to cardiometabolic risk factors and body composition among African American women. A subsample of African American women (N=135) completed health and laboratory assessments, including measures of blood pressure, resting heart rate, cholesterol, triglycerides, glucose, body mass index, body fat, sitting time, and demographics. Simultaneous, adjusted regression models found a positive association between weekend sitting time and glucose and an inverse association between weekly sedentary time and cholesterol (ps<.05). There were no significant associations between sedentary behavior and body composition. The unexpected relationship between sedentary time and cholesterol suggests that the relationship of sedentary behavior to cardiometabolic risk factors may depend on existing characteristics of the population and measurement definition of sedentary behavior. Results suggest distinctly different relationships between weekend and weekday sitting time, implicating a need for careful measurement and intervention that reflects these differences.

Purpose. To measure the concordance of directly and indirectly measured neighborhood attributes and to determine the correlates of the concordance between directly and indirectly measured built environment attributes. Design. Environmental cross-sectional design. Setting. Urban and suburban neighborhoods within Harris County, Houston, and Travis County, Austin, Texas. Subjects. Community-dwelling African-American and Hispanic or Latina women. Measures. Physical activity resource accessibility, path maintenance, and pedestrian and bicycle facilities were measured directly and indirectly. Directly or objectively measured neighborhood attributes were measured by the Physical Activity Resource Assessment and Pedestrian Environmental Data Scan instruments. Indirectly measured or self-reported neighborhood attributes were measured by the International Physical Activity Prevalence Study environmental survey module. Analysis. Logistic regression was used to measure the concordance between directly and indirectly measured neighborhood attributes with ethnicity as a covariate. Residual values were calculated to determine the strength and direction of concordance. Results. Participants' (N = 409) average body mass index (BMI) was classified as obese (MBMI = 34.5 kg/m2, SD = 7.9), and the mean body fat percentage was 42.8% (SD = 7.1). The correlates BMI, body fat percentage, physical activity, and ethnicity were not significantly associated with any built environment attribute or concordance value, and none of our models significantly predicted indirectly measured built environment attributes. Conclusion. Being less familiar with certain built environment attributes may not be associated with weight status or physical activity levels among African-American and Hispanic or Latina women.