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This investigation examined how dispositional compassion and empathy were associated with prosocial behaviors and attitudes in the SARS-CoV-2 pandemic. Every two weeks from March 22 to June 15, 2020, we fielded a survey to a new cohort of adults in the U.S. Compassion related to whether one stayed home to protect others, more hours spent staying home and distancing from others, and more frequent mask wearing in public, in the past two weeks. Compassion also related to greater perceived ability to help others who were negatively affected. Empathy related to more endorsement of understanding others' fear of COVID-19, and less endorsement of the view that others were overreacting to COVID-19. There was an interaction between empathy and political ideology, suggesting that empathy may matter for understanding others' fear among those with more conservative-leaning beliefs. Empathy also related to greater understanding that sheltering-in-place helps prevent the spread of COVID-19. Findings suggest that messaging and interventions to increase compassion and empathy may promote public health behaviors during a pandemic regardless of political orientation. Targeting empathy may be one way to reach individuals with more conservative political beliefs, and it is important to use an evidence-based approach accounting for political party differences in motivated reasoning. [ABSTRACT FROM AUTHOR]

The health effects of sedentary behavior (SB) may be moderated by SB accumulation patterns (e.g., in prolonged bouts). These patterns are challenging to assess thoroughly and interpretably. Purpose: The purpose of this study is to introduce SB profiles (i.e., groups of similar SB accumulation patterns) as a new approach to pattern-focused SB research. Methods: Data came from the National Health and Nutrition Examination Survey (2003–2006). The SB bouts were determined from hip-worn accelerometer data, and k-medoid clustering was used to define three SB profiles (interrupted, intermediate, and prolonged). These were used as the exposure in logistic regression models to examine odds ratios (OR) of having high (>20%) predicted-10-yr risk of cardiovascular disease (CVD). For comparison, the models were also fitted using standard metrics (i.e., tertiles of mean SB bout duration and daily total SB time). Results: Those with interrupted profile (n = 1740) were typically sedentary ~32% of the time, in bouts ≤15 min. Those with intermediate profile (n = 2453) were typically sedentary ~47% of the time, in bouts ≤20 min. Those with prolonged profile (n = 1302) were typically sedentary ~61% of the time, frequently in bouts >20 min. The fully adjusted model showed that high CVD risk was more common for the intermediate (OR, 1.87) and prolonged (OR, 4.65) profiles than the interrupted profile (all P < 0.001). For standard metrics, OR ranged from 1.46 (middle tertile of daily total SB time) to 4.11 (upper tertile of mean bout duration) with all P < 0.002. Conclusions: The SB profiles represent a promising new avenue for understanding and combating adverse SB trends. The value of the approach was highlighted by the strong associations with CVD risk. [ABSTRACT FROM AUTHOR]

The article suggests a COVID-19 containment strategy which identifies COVID-19 cases and social groups at high risk of transmission (HRT). Topics discussed include the implication of superspreading events for containment strategies and prioritizing and deploying resources, benefit of the explicit definition of transmission risk in guidance for COVID-19 case investigation and contract tracing, and usefulness of a framework for HRT social group events investigation for future pandemics.

Background: Prior research examining the relationship between cannabis use, sedentary behavior, and physical activity has generated conflicting findings, potentially due to biases in the self-reported measures used to assess physical activity. This study aimed to more precisely explore the relationship between cannabis use and sedentary behavior/physical activity using objective measures. Methods: Data were obtained from the 2005–2006 National Health and Nutrition Examination Survey. A total of 2,092 participants (ages 20–59; 48.8% female) had accelerometer-measured sedentary behavior, light physical activity, and moderate-to-vigorous physical activity. Participants were classified as light, moderate, frequent, or non-current cannabis users depending on how often they used cannabis in the previous 30 days. Multivariable linear regression estimated minutes in sedentary behavior/physical activity by cannabis use status. Logistic regression modeled self-reported moderate-to-vigorous physical activity in relation to current cannabis use. Results: Fully adjusted regression models indicated that current cannabis users' accelerometer-measured sedentary behavior did not significantly differ from non-current users. Frequent cannabis users engaged in more physical activity than non-current users. Light cannabis users had greater odds of self-reporting physical activity compared to non-current users. Conclusions: This study is the first to evaluate the relationship between cannabis use and accelerometer-measured sedentary behavior and physical activity. Such objective measures should be used in other cohorts to replicate our findings that cannabis use is associated with greater physical activity and not associated with sedentary behavior in order to fully assess the potential public health impact of increases in cannabis use. [ABSTRACT FROM AUTHOR]

Objective: To evaluate whether sedentary time (ST) and/or sedentary behavior patterns are related to incident diabetes in the U.S.'s oldest age-groups.Research Design and Methods: Women without physician-diagnosed diabetes (n = 4,839, mean ± SD age = 79 ± 7 years) wore accelerometers for ≥4 days and were followed up to 6 years for self-reported newly diagnosed diabetes requiring treatment with medications. Hazard ratios (HRs) for incident diabetes were estimated across quartiles of accelerometer-measured ST and mean bout duration with use of Cox proportional hazards models. We conducted isotemporal substitution analyses using Cox regression and tested associations with risk for diabetes after statistically replacing ST with light physical activity (PA) or moderate-to-vigorous PA (MVPA) and after replacing light PA with MVPA.Results: During 20,949 person-years, 342 diabetes cases were identified. Women in ST quartile (Q)2, Q3, and Q4 (vs. Q1) had incident diabetes HR 1.20 (95% CI 0.87-1.65), 1.33 (0.97-1.82), and 1.21 (0.86-1.70); Ptrend = 0.04. Respective HRs following additional adjustment for BMI and MVPA were 1.04 (95% CI 0.74-1.47), 1.04 (0.72-1.50), and 0.85 (0.56-1.29); Ptrend = 0.90. Fully adjusted isotemporal substitution results indicated that each 30 min of ST replaced with MVPA (but not light PA) was associated with 15% lower risk for diabetes (HR 0.85 [95% CI 0.75-0.96]; P = 0.01); the HR for replacing 30 min of light PA with MVPA was 0.85 (95% CI 0.73-0.98); P = 0.03. Mean bout duration was not associated with incident diabetes.Conclusions: Statistically replacing ST or light PA with MVPA was associated with lower diabetes risk in older women. While reducing ST is important for several health outcomes, results indicate that to reduce diabetes risk among older adults, the primary public health focus should be on increasing MVPA. [ABSTRACT FROM AUTHOR]

Background: Self-reported time spent standing has been associated with lower risk of mortality. No previous studies have examined this association using device-measured standing.Method: This was a prospective cohort study of 5878 older (median age = 80 years), racial/ethnically diverse, community-dwelling women in the WHI Objective Physical Activity and Cardiovascular Health Study (OPACH). Women wore accelerometers for 1 week and were followed for mortality. The study applied previously validated machine learning algorithms to ActiGraph GT3X+ accelerometer data to separately measure time spent standing with and without ambulation. Cox proportional hazards models were used to estimate mortality risk adjusting for potential confounders. Effect modification by age, body mass index, moderate-to-vigorous physical activity, sedentary time, physical functioning, and race/ethnicity was evaluated.Results: There were 691 deaths during 26 649 person-years of follow-up through March 31, 2018 (mean follow-up = 4.8 years). In fully adjusted models, all-cause mortality risk was lower among those with more standing without ambulation (quartile [Q] 4 vs Q1 HR = 0.63; 95% CI = 0.49-0.81, p-trend = .003) and more standing with ambulation (Q4 vs Q1 HR = 0.50; 95% CI = 0.35-0.71, p-trend < .001). Associations of standing with ambulation and mortality were stronger among women with above-median sedentary time (HR = 0.51; 95% CI = 0.38-0.68) compared to women with below-median sedentary time (HR = 0.80; 95% CI = 0.59-1.07; p-interaction = .02).Conclusions: In this prospective study among older women, higher levels of accelerometer-measured standing were associated with lower risks of all-cause mortality. Standing is an achievable approach to interrupting prolonged sedentary time, and if not contraindicated, is a safe and feasible behavior that appears to benefit health in older ages. [ABSTRACT FROM AUTHOR]

Background: Sedentary behavior (SB) is linked to negative health outcomes in older adults. Most studies use summary values, e.g., total sedentary minutes/day. Diurnal timing of SB accumulation may further elucidate SB-health associations. Methods: Six thousand two hundred four US women (mean age = 79 ± 7; 50% White, 34% African-American) wore accelerometers for 7-days at baseline, yielding 41,356 person-days with > 600 min/day of data. Annual follow-up assessments of health, including physical functioning, were collected from participants for 6 years. A novel two-phase clustering procedure discriminated participants' diurnal SB patterns: phase I grouped day-level SB trajectories using longitudinal k-means; phase II determined diurnal SB patterns based on proportion of phase I trajectories using hierarchical clustering. Mixed models tested associations between SB patterns and longitudinal physical functioning, adjusted for covariates including total sedentary time. Effect modification by moderate-vigorous-physical activity (MVPA) was tested. Results: Four diurnal SB patterns were identified: p1 = high-SB-throughout-the-day; p2 = moderate-SB-with-lower-morning-SB; p3 = moderate-SB-with-higher-morning-SB; p4 = low-SB-throughout-the-day. High MVPA mitigated physical functioning decline and correlated with better baseline and 6-year trajectory of physical functioning across patterns. In low MVPA, p2 had worse 6-year physical functioning decline compared to p1 and p4. In high MVPA, p2 had similar 6-year physical functioning decline compared to p1, p3, and p4. Conclusions: In a large cohort of older women, diurnal SB patterns were associated with rates of physical functioning decline, independent of total sedentary time. In particular, we identified a specific diurnal SB subtype defined by less SB earlier and more SB later in the day, which had the steepest decline in physical functioning among participants with low baseline MVPA. Thus, diurnal timing of SB, complementary to total sedentary time and MVPA, may offer additional insights into associations between SB and physical health, and provide physicians with early warning of patients at high-risk of physical function decline. [ABSTRACT FROM AUTHOR]

Improving sedentary measurement is critical to understanding sedentary-health associations in youth. This study assessed agreement between the thigh-worn activPAL and commonly used hip-worn ActiGraph accelerometer methods for assessing sedentary patterns in children. Both devices were worn by 8–12-year-olds (N = 195) for 4.6 ± 1.9 days. Two ActiGraph cut-points were applied to two epoch durations: ≤25 counts (c)/15 s, ≤75c/15s, ≤100c/60s, and ≤300c/60s. Bias, mean absolute deviation (MAD), and intraclass correlation coefficients (ICCs) tested agreement between devices for total sedentary time and 11 sedentary pattern variables (usual bout duration, sedentary time accumulated in various bout durations, breaks/day, break rate, and alpha). For most sedentary pattern variables, ActiGraph 25c/15s, 75c/15s, and 100c/60s had poor ICCs, with bias and MAD >20%. ActiGraph 300c/60s had a better agreement than the other cut-points, but all ICCs were <0.587. ActiGraph underestimated sedentary time in longer bouts and usual bout duration, and overestimated sedentary time in shorter bouts, breaks/day, and alpha. For total sedentary time, ActiGraph 25c/15s, 300c/60s, and 75c/15s had good/fair ICCs, with bias and MAD <20%. Sedentary patterns derived from two commonly used ActiGraph cut-points did not appear to reflect postural changes. These differences between measurement devices should be considered when interpreting findings from sedentary pattern studies. [ABSTRACT FROM AUTHOR]

Background: We examined associations of sedentary time and sedentary accumulation patterns (ie, how sedentary time is accumulated) with prevalent diabetes in an ethnically diverse cohort of older women.Methods: Community-dwelling women aged 63-99 (n = 6,116; median age = 79) wore ActiGraph GT3X+ accelerometers 24 h/day for up to 7 days from which we derived average daily sedentary time and three measures of sedentary accumulation patterns: breaks in sedentary time, usual sedentary bout duration, and alpha. Odds ratios (ORs) and 95% confidence intervals (CIs) for prevalent diabetes were estimated using multivariable logistic regression.Results: Twenty-one percent (n = 1,282) of participants had diabetes. Women in the highest quartile of sedentary time (≥10.3 h/day) had higher odds of diabetes (OR = 2.18; 95% CI = 1.77-2.70) than women in the lowest quartile (≤8.3 h/day). Prolonged accumulation patterns (ie, accumulating sedentary time in longer sedentary bouts) was associated with higher odds of diabetes than regularly interrupted patterns (comparing quartiles with the most vs least prolonged patterns: usual bout duration OR = 1.57, 95% CI = 1.28-1.92; alpha OR = 1.61, 95% CI = 1.32-1.97); however, there was no significant association for breaks in sedentary time (OR = 1.00, 95% CI = 0.82-1.20).Conclusions: High levels of sedentary time and accumulating it in prolonged patterns were associated with increased odds of diabetes among older women. [ABSTRACT FROM AUTHOR]

Background: Evidence that higher sedentary time is associated with higher risk for cardiovascular disease (CVD) is based mainly on self-reported measures. Few studies have examined whether patterns of sedentary time are associated with higher risk for CVD.Methods: Women from the Objective Physical Activity and Cardiovascular Health (OPACH) Study (n=5638, aged 63-97, mean age=79±7) with no history of myocardial infarction (MI) or stroke wore accelerometers for 4-to-7 days and were followed for up to 4.9 years for CVD events. Average daily sedentary time and mean sedentary bout duration were the exposures of interest. Cox regression models estimated hazard ratios (HR) and 95% confidence intervals (CI) for CVD using models adjusted for covariates and subsequently adjusted for potential mediators (body mass index (BMI), diabetes, hypertension, and CVD-risk biomarkers [fasting glucose, high-density lipoprotein, triglycerides, and systolic blood pressure]). Restricted cubic spline regression characterized dose-response relationships.Results: There were 545 CVD events during 19,350 person-years. Adjusting for covariates, women in the highest (≥ ~11 hr/day) vs. the lowest (≤ ~9 hr/day) quartile of sedentary time had higher risk for CVD (HR=1.62; CI=1.21-2.17; p-trend <0.001). Further adjustment for potential mediators attenuated but did not eliminate significance of these associations (p-trend<.05, each). Longer vs. shorter mean bout duration was associated with higher risks for CVD (HR=1.54; CI=1.27-2.02; p-trend=0.003) after adjustment for covariates. Additional adjustment for CVD-risk biomarkers attenuated associations resulting in a quartile 4 vs. quartile 1 HR=1.36; CI=1.01-1.83; p-trend=0.10). Dose-response associations of sedentary time and bout duration with CVD were linear (P-nonlinear >0.05, each). Women jointly classified as having high sedentary time and long bout durations had significantly higher risk for CVD (HR=1.34; CI=1.08-1.65) than women with both low sedentary time and short bout duration. All analyses were repeated for incident coronary heart disease (MI or CVD death) and associations were similar with notably stronger hazard ratios.Conclusions: Both high sedentary time and long mean bout durations were associated in a dose-response manner with increased CVD risk in older women, suggesting that efforts to reduce CVD burden may benefit from addressing either or both component(s) of sedentary behavior. [ABSTRACT FROM AUTHOR]

Introduction Exposure to fine particulate matter in the home from sources such as smoking, cooking, and cleaning may put residents, especially children, at risk for detrimental health effects. A randomized clinical trial was conducted from 2011 to 2016 to determine whether real-time feedback in the home plus brief coaching of parents or guardians could reduce fine particle levels in homes with smokers and children. Design A randomized trial with two groups—intervention and control. Setting/participants A total of 298 participants from predominantly low-income households with an adult smoker and a child aged <14 years. Participants were recruited during 2012–2015 from multiple sources in San Diego, mainly Women, Infants and Children Program sites. Intervention The multicomponent intervention consisted of continuous lights and brief sound alerts based on fine particle levels in real time and four brief coaching sessions using particle level graphs and motivational interviewing techniques. Motivational interviewing coaching focused on particle reduction to protect children and other occupants from elevated particle levels, especially from tobacco-related sources. Main outcome measures In-home air particle levels were measured by laser particle counters continuously in both study groups. The two outcomes were daily mean particle counts and percentage time with high particle concentrations (>15,000 particles/0.01 ft 3 ). Linear mixed models were used to analyze the differential change in the outcomes over time by group, during 2016–2017. Results Intervention homes had significantly larger reductions than controls in daily geometric mean particle concentrations (18.8% reduction vs 6.5% reduction, p <0.001). Intervention homes’ average percentage time with high particle concentrations decreased 45.1% compared with a 4.2% increase among controls (difference between groups p <0.001). Conclusions Real-time feedback for air particle levels and brief coaching can reduce fine particle levels in homes with smokers and young children. Results set the stage for refining feedback and possible reinforcing consequences for not generating smoke-related particles. Trial registration This study is registered at www.clinicaltrials.gov NCT01634334. [ABSTRACT FROM AUTHOR]

Background: High amounts of time spent sitting can increase cardiovascular disease risk and are deleteriously associated cardio-metabolic risk biomarkers. Though evidence suggests that accruing sitting time in prolonged periods may convey additional risk, verification using high-quality measures is needed. We examined this issue in adults from the Australian Diabetes, Obesity and Lifestyle Study, using accurate measures of sitting accumulation. Methods: In 2011/12, 739 adults aged 36 to 89 years (mean±SD 58±10 years) wore activPAL3™ monitors (which provide accurate objective measures of sitting); 678 provided ≥4 valid days of monitor data and complete cardio-metabolic biomarker and confounder data. Multivariable linear regression models examined associations of sitting time, sitting time accrued in ≥30 minute bouts (prolonged sitting time), and three measures of sitting accumulation patterns with cardio-metabolic risk markers: body mass index (BMI), waist circumference, blood pressure, high- and low- density lipoprotein (HDL and LDL) cholesterol, triglycerides, glycated haemoglobin (HbA1c), fasting plasma glucose (FPG) and 2-hour post-load glucose (PLG). Interactions tests examined whether associations of sitting time with biomarkers varied by usual sitting bout duration. Results: Adjusted for potential confounders, greater amounts of sitting time and prolonged sitting time were significantly (p<0.05) deleteriously associated with BMI, waist circumference, HDL cholesterol, and triglycerides. Total sitting time was also significantly associated with higher PLG. Sitting accumulation patterns of frequently interrupted sitting (compared to patterns with relatively more prolonged sitting) were significantly beneficially associated with BMI, waist circumference, HDL cholesterol, triglycerides, PLG, and with FPG. Effect sizes were typically larger for accumulation patterns than for sitting time. Significant interactions (p<0.05) showed that associations of sitting time with HDL, triglycerides and PLG became more deleterious the longer at a time sitting was usually accumulated. Conclusions: Adding to previous evidence reliant on low-quality measures, our study showed that accumulating sitting in patterns where sitting was most frequently interrupted had significant beneficial associations with several cardio-metabolic biomarkers and that sitting for prolonged periods at a time may exacerbate some of the effects of sitting time. The findings support sedentary behavior guidelines that promote reducing and regularly interrupting sitting. [ABSTRACT FROM AUTHOR]

Children are at risk for adverse health outcomes from occupant-controllable indoor airborne contaminants in their homes. Data are needed to design residential interventions for reducing low-income children's pollutant exposure. Using customized air quality monitors, we continuously measured fine particle counts (0.5 to 2.5 microns) over a week in living areas of predominantly low-income households in San Diego, California, with at least one child (under age 14) and at least one cigarette smoker. We performed retrospective interviews on home characteristics, and particle source and ventilation activities occurring during the week of monitoring. We explored the relationship between weekly mean particle counts and interview responses using graphical visualization and multivariable linear regression (base sample n = 262; complete cases n = 193). We found associations of higher weekly mean particle counts with reports of indoor smoking of cigarettes or marijuana, as well as with frying food, using candles or incense, and house cleaning. Lower particle levels were associated with larger homes. We did not observe an association between lower mean particle counts and reports of opening windows, using kitchen exhaust fans, or other ventilation activities. Our findings about sources of fine airborne particles and their mitigation can inform future studies that investigate more effective feedback on residential indoor-air-quality and better strategies for reducing occupant exposures. [ABSTRACT FROM AUTHOR]

Objectives: Preventive health services are important for child development, and parents play a key role in facilitating access to services. This study examined how parents' reasons for not having a usual source of care were associated with their children's receipt of preventive services. Methods: We used pooled data from the 2011-2014 National Health Interview Survey (n = 34 843 participants). Parents' reasons for not having a usual source of care were framed within the Penchansky and Thomas model of access and measured through 3 dichotomous indicators: financial barriers (affordability), attitudes and beliefs about health care (acceptability), and all other nonfinancial barriers (accessibility, accommodation, and availability). We used multivariable logistic regression models to test associations between parental barriers and children's receipt of past-year well-child care visits and influenza vaccinations, controlling for other child, family, and contextual factors. Results: In 2014, 14.3% (weighted percentage) of children had at least 1 parent without a usual source of care. Children of parents without a usual source of care because they "don't need a doctor and/or haven't had any problems" or they "don't like, trust, or believe in doctors" had 35% lower odds of receiving well-child care (adjusted odds ratio = 0.65; 95% CI, 0.56-0.74) and 23% lower odds of receiving influenza vaccination (adjusted odds ratio = 0.77; 95% CI, 0.69-0.86) than children of parents without those attitudes and beliefs about health care. Financial and other nonfinancial parental barriers were not associated with children's receipt of preventive services. Results were independent of several factors relevant to children's access to preventive health care, including whether the child had a usual source of care. Conclusions: Parents' attitudes and beliefs about having a usual source of care were strongly associated with their children's receipt of recommended preventive health services. Rates of receipt of child preventive services may be improved by addressing parents' attitudes and beliefs about having a usual source of care. Future studies should assess causes of these associations. [ABSTRACT FROM AUTHOR]

This study aimed to determine whether fatalistic beliefs were associated with elevated levels of glycated hemoglobin (HbA1c) and to establish the role of religiosity in this relationship. A cross-sectional survey was conducted on a sample of 183 Jewish adults with diabetes visiting a large medical center in northern Israel. Self-administered questionnaires assessed level of religiosity, fatalistic beliefs, diabetes management behaviors, and demographic/personal characteristics; laboratory tests were used to measure HbA1c. Multivariate regression indicated that fatalism was significantly associated with HbA1c ( β = 0.51, p = 0.01). The association was no longer statistically significant after including self-reported religiosity in the model ( β = 0.31, p = 0.13). This phenomenon is likely due to a confounding relationship between the religious/spiritual coping component of the fatalism index and self-reported religiosity ( r = 0.69). The results indicate that addressing fatalistic attitudes may be a viable strategy for improving diabetes management, but call for a better understanding of the interplay between religiosity and fatalism in this context. [ABSTRACT FROM AUTHOR]

Studies linking depressive symptoms and coronary artery calcium (CAC), a measure of subclinical atherosclerosis, have yielded mixed results. No longitudinal studies of depressive symptoms and CAC have included older adults of both genders. This study examined the association of depressive symptoms with CAC and CAC progression in older men and women. Participants were 417 community-dwelling older adults (mean age = 67 ± 7) with no history of heart disease who attended a 1997 to 1999 research clinic visit when depressive symptoms were assessed using the Beck Depression Inventory (BDI). CAC was measured using electron-beam computed tomography in 2000 to 2002 and again in 2005 to 2007. Median BDI was 3, range = 0 to 37; 39% of men and 10% of women had severe CAC (Agatston score ≥ 400) in 2000 to 2002. Ordinal logistic regression analyses examining the odds of greater compared with lesser CAC severity by BDI quartiles showed an unexpected negative association whereby women with the lowest depressive symptoms had 2.4 times the odds of increasing CAC severity compared with women in the second BDI quartile (95% CI 1.1 to 5.4). A nonlinear, U-shaped association was observed in men with those in the first and fourth BDI quartiles having 2.6 and 3.0 times higher odds of increasing CAC severity than subjects in the second quartile (95% CI 1.2 to 5.6 and 1.3 to 6.9, respectively) after adjustment for coronary heart disease risk factors. No significant associations were observed for CAC progression although similar nonlinear patterns were observed in men. In conclusion, our results suggest that depressive symptoms have a gender-specific, cross-sectional association with CAC but no statistically significant associations with CAC progression. [ABSTRACT FROM AUTHOR]

Background: We examined the relationships between objective and self-reported sedentary time and health indicators among older adults residing in retirement communities.Methods: Our cross-sectional analysis used data from 307 participants who completed baseline measurements of a physical activity trial in 11 retirement communities in San Diego County. Sedentary time was objectively measured with devices (accelerometers) and using self-reports. Outcomes assessed included emotional and cognitive health, physical function, and physical health (eg, blood pressure). Linear mixed-effects models examined associations between sedentary behavior and outcomes adjusting for demographics and accelerometer physical activity.Results: Higher device-measured sedentary time was associated with worse objective physical function (Short Physical Performance Battery, balance task scores, 400-m walk time, chair stand time, gait speed), self-reported physical function, and fear of falling but with less sleep disturbance (all ps < .05). TV viewing was positively related to 400-m walk time (p < .05). Self-reported sedentary behavior was related to better performance on one cognitive task (trails A; p < .05).Conclusions: Sedentary time was mostly related to poorer physical function independently of moderate-to-vigorous physical activity and may be a modifiable behavior target in interventions aiming to improve physical function in older adults. Few associations were observed with self-reported sedentary behavior measures. [ABSTRACT FROM AUTHOR]

Background: Total sedentary time varies across population groups with important health consequences. Patterns of sedentary time accumulation may vary and have differential health risks. The purpose of this study is to describe sedentary patterns of older adults living in retirement communities and illustrate gender and age differences in those patterns. Methods: Baseline accelerometer data from 307 men and women (mean age = 84±6 years) who wore ActiGraph GT3X+ accelerometers for ≥ 4 days as part of a physical activity intervention were classified into bouts of sedentary time (<100 counts per minute). Linear mixed models were used to account for intra-person and site-level clustering. Daily and hourly summaries were examined in mutually non-exclusive bouts of sedentary time that were 1+, 5+, 10+, 20+, 30+, 40+, 50+, 60+, 90+ and 120+ minutes in duration. Variations by time of day, age and gender were explored. Results: Men accumulated more sedentary time than women in 1+, 5+, 10+, 20+, 30+, 40+, 50+ and 60+ minute bouts; the largest gender-differences were observed in 10+ and 20+ minute bouts. Age was positively associated with sedentary time, but only in bouts of 10+, 20+, 30+, and 40+ minutes. Women had more daily 1+ minute sedentary bouts than men (71.8 vs. 65.2), indicating they break up sedentary time more often. For men and women, a greater proportion of time was spent being sedentary during later hours of the day than earlier. Gender differences in intra-day sedentary time were observed during morning hours with women accumulating less sedentary time overall and having more 1+ minute bouts. Conclusions: Patterns identified using bouts of sedentary time revealed gender and age differences in the way in which sedentary time was accumulated by older adults in retirement communities. Awareness of these patterns can help interventionists better target sedentary time and may aid in the identification of health risks associated with sedentary behavior. Future studies should investigate the impact of patterns of sedentary time on healthy aging, disease, and mortality. [ABSTRACT FROM AUTHOR]

• Recently, cigarette use has declined while cannabis use has increased. • Smoking cannabis produces second- and third-hand emissions that may impact health. • Comparisons of in-home cannabis and tobacco smoking have not been available. • In-home smoking of cannabis was more prevalent than tobacco. • Global cannabis acceptability movements urge research on use patterns & health effects. Early evidence from studies of home smoking policies suggests that in-home cannabis smoking is more often allowed than in-home tobacco smoking, but there are not yet data on whether cannabis is more often smoked in the home compared to tobacco, or whether in-home cannabis and tobacco smoking differs by usage status. Using cross-sectional data from over 100,000 sentinel drug users from 17 countries, we compared cannabis and tobacco smoking in the homes of Global Drug Survey 2019 respondents who currently used cannabis only, tobacco only, both tobacco and cannabis, or neither. Complete data on cannabis and tobacco use and in-home smoking were available for 107,272 adults (average age = 30 ± 12, 34% women, countries with the three highest response rates; Germany = 32%, USA = 10%, New Zealand = 9%). In total, 53.6% and 50.6% of respondents reported past-year cannabis and tobacco smoking in their home respectively. Stratifying respondents into current cannabis-only users, tobacco-only users, dual users, and non-users, past-year in-home cannabis smoking was more prevalent (78.8%) among cannabis-only users than was in-home tobacco smoking (67.9%) among tobacco-only users. Among dual users, past-year in-home cannabis smoking (82.8%; 95%CI = 80%-86%) was higher than in-home tobacco smoking (75.9%; 95%CI = 69%–81%; p < 0.001). In-home cannabis and tobacco smoking was similar among non-users (20.2% and 20.5%, respectively). Past-year in-home cannabis smoking was more prevalent than tobacco smoking in the homes of participants who used cannabis and/or tobacco, supporting our speculation that in-home cannabis smoking might be more socially acceptable than in-home tobacco smoking. [ABSTRACT FROM AUTHOR]

Purpose: Maximal oxygen uptake (V ̇ O 2 max ) is the criterion measure of cardiorespiratory fitness. Lower cardiorespiratory fitness is a strong predictor of poor health outcomes, including all-cause mortality. Because V ̇ O 2 max testing is resource intensive, several non–exercise-based V˙O2max prediction equations have been published. We assess these equations' ability to predict measured V˙O2max, recalibrate these equations, and quantify the association of measured and predicted V˙O2max with all-cause mortality. Methods: Baltimore Longitudinal Study of Aging participants with valid V˙O2max tests were included (n = 1080). Using published V˙O2max prediction equations, we calculated predicted V˙O2max and present performance metrics before and after recalibration (deriving new regression estimates by regressing measured V˙O2max on Baltimore Longitudinal Study of Aging covariates). Cox proportional hazards models were fit to quantify associations of measured, predicted, and recalibration-predicted values of V˙O2max with mortality. Results: Mean age and V˙O2max were 69.0 ± 10.4 yr and 21.6 ± 5.9 mL·kg−1·min−1, respectively. The prediction equations yielded root mean square error values ranging from 4.2 to 20.4 mL·kg−1·min−1. After recalibration, these values decreased to 3.9–4.2 mL·kg−1·min−1. Adjusting for all covariates, all-cause mortality risk was 66% lower for the highest quartile of measured V˙O2max relative to the lowest. Predicted V˙O2max variables yielded similar estimates in unadjusted models but were not robust to adjustment. Conclusions: Measured V˙O2max is an extremely strong predictor of all-cause mortality. Several published V˙O2max prediction equations yielded the following: 1) reasonable performance metrics relative to measured V˙O2max especially when recalibrated, and 2) all-cause mortality hazard ratios similar to those of measured V˙O2max, especially when recalibrated, yet 3) were not robust to adjustment for basic demographic covariates likely because these were used in the equation for predicted V˙O2max. [ABSTRACT FROM AUTHOR]

Purpose Of the Research: Early evidence from studies of home smoking policies suggests that in-home cannabis smoking is more often allowed than in-home tobacco smoking, but there are not yet data on whether cannabis is more often smoked in the home compared to tobacco, or whether in-home cannabis and tobacco smoking differs by usage status. Using cross-sectional data from over 100,000 sentinel drug users from 17 countries, we compared cannabis and tobacco smoking in the homes of Global Drug Survey 2019 respondents who currently used cannabis only, tobacco only, both tobacco and cannabis, or neither.Principal Results: Complete data on cannabis and tobacco use and in-home smoking were available for 107,272 adults (average age = 30 ± 12, 34% women, countries with the three highest response rates; Germany = 32%, USA = 10%, New Zealand = 9%). In total, 53.6% and 50.6% of respondents reported past-year cannabis and tobacco smoking in their home respectively. Stratifying respondents into current cannabis-only users, tobacco-only users, dual users, and non-users, past-year in-home cannabis smoking was more prevalent (78.8%) among cannabis-only users than was in-home tobacco smoking (67.9%) among tobacco-only users. Among dual users, past-year in-home cannabis smoking (82.8%; 95%CI = 80%-86%) was higher than in-home tobacco smoking (75.9%; 95%CI = 69%-81%; p < 0.001). In-home cannabis and tobacco smoking was similar among non-users (20.2% and 20.5%, respectively).Major Conclusions: Past-year in-home cannabis smoking was more prevalent than tobacco smoking in the homes of participants who used cannabis and/or tobacco, supporting our speculation that in-home cannabis smoking might be more socially acceptable than in-home tobacco smoking. [ABSTRACT FROM AUTHOR]

AbstractWe examined the prospective associations of social isolation and loneliness with incident cardiovascular disease (CVD) among aging nonveteran and veteran women, and effect modification by veteran status. Participants with no history of myocardial infarction (MI), stroke, coronary heart disease (CHD), or coronary heart failure from the Women’s Health Initiative Extension Study II self-reported social isolation, loneliness, health behaviors, health status, and veteran status. CVD and CVD subevents were physician adjudicated. Hazard ratios (HR) and 95% confidence intervals (CI) for the Interquartile Range (IQR) in social isolation (IQR = 1) and loneliness (IQR=.33) were calculated using Cox proportional hazard models adjusting for sociodemographic, health behavior, and health status characteristics. Veteran status was tested as an effect modifier. Among 52,442 women (Mean age = 79 ± 6.1; veterans n = 1023; 89.2% non-Hispanic White), 3579 major CVD events occurred over an average 5.8 follow-up years. Compared to nonveterans, veteran women reported higher levels of social isolation (p < .01) and loneliness (p < .01). The CVD HR was 1.07 (95% CI, 1.04–1.10) for the IQR in social isolation and 1.03 (95% CI, 1.10–1.06) for the IQR in loneliness. The HR for the IQR in both social isolation and loneliness was 1.10 (95% CI, 1.05–1.15). Social isolation was associated with CHD (HR = 1.12; 95% CI, 1.03–1.21). The CHD HR for the IQR in social isolation was 1.12 (95% CI, 1.03–1.21). Associations did not differ by veteran status (all p-interactions > 0.08). Findings suggest that the adverse associations of social isolation and loneliness with CVD are similar among veteran and nonveteran women. [ABSTRACT FROM AUTHOR]

Background: Perception of health risk can influence household rules, but little is known about how the perception of harm from cannabis secondhand smoke (cSHS) is related to having a complete ban on in-home cannabis smoking. We examined this association among a nationally representative sample of United States adults. Methods: Respondents were 21,381 adults from the cross-sectional Marijuana Use and Environmental Survey recruited from December 2019-February 2020. Perceived harm of cSHS exposure (extremely harmful, somewhat harmful, mostly safe, or totally safe) and complete ban of cannabis smoking anywhere in the home (yes or no) were self-reported. Logistic regression for survey-weighted data estimated covariate-adjusted odds ratios (OR) and 95% confidence intervals (CI) for the association between perceived harm of cSHS and complete ban on in-home cannabis smoking. Stratified subgroup analyses (by cannabis smoking status, cannabis use legalization in state of residence, and children under age 6 living in the home) were conducted to quantify effect measure modification of the association between perception of harm and complete ban. Results: A complete ban on in-home cannabis smoking was reported by 71.8% of respondents. Eight percent reported cSHS as "totally safe"; 20.5% "mostly safe"; 38.3% "somewhat harmful"; and 33.0% "extremely harmful". Those who reported cSHS as "extremely harmful" had 6 times the odds of a complete ban on in-home cannabis smoking (OR = 6.0, 95%CI = 4.9–7.2) as those reporting smoking as "totally safe". The odds of a complete ban were higher among those reporting cSHS as "somewhat harmful" (OR = 2.6, 95%CI = 2.2–3.1) or "mostly safe" (OR = 1.4, 95%CI = 1.2–1.7) vs those reporting cSHS as "totally safe". In each subgroup of cannabis smoking status, state cannabis use legalization, and children under the age of 6 living in the home, perceived harm was associated with a complete ban on in-home cannabis smoking. Conclusions: Our study demonstrates perceiving cSHS as harmful is strongly associated with having a complete in-home cannabis smoking ban. With almost a third of US adults perceiving cSHS as at least "mostly safe", there is strong need to educate the general population about potential risks associated with cSHS exposure to raise awareness and encourage adoption of household rules prohibiting indoor cannabis smoking. [ABSTRACT FROM AUTHOR]

Background: Good lower extremity physical functioning is paramount to healthy aging as it prevents social isolation, enables civic engagement, and facilitates physical activity. Strong evidence links physical functioning with all-cause mortality, but little is known about its relationship to cardiovascular disease (CVD). Methods: Women (n=5043, mean age=79±7) with no history of myocardial infarction or stroke completed the Short Physical Performance Battery (SPPB) consisting of three timed tasks to assess standing balance, strength (5 chair stands), and gait (4m walk). Results were summarized using prespecified cutpoints yielding a score from 0 (worst) to 12 (best). Women were followed for CVD events for up to 6 years. Hazard ratios (HR) were estimated for women with poor, low, moderate, and high functioning (respective SPPB ranges for each group; 0-3, 4-6, 7-9, and 10-12) using Cox proportional hazard models adjusted for several covariates including accelerometer-measured moderate to vigorous physical activity (MVPA) and sedentary behavior. Effect modification of associations between SPPB and CVD by age, MVPA, Reynolds Risk Score, race-ethnicity, and self-rated health were tested by including multiplicative interaction terms in fully adjusted Cox models with statistical significance for interactions set to 0.10. Results: Covariate-adjusted HRs (95% CIs) for CVD [ 1.00 (ref.); 0.85 (0.62, 1.15); 0.69 (0.51, 0.93); 0.49 (0.35, 0.68)] and CVD mortality [ 1.00 (ref.); 0.72 (0.45, 1.15); 0.44 (0.27, 0.72); 0.35 (0.19, 0.62)] decreased across poor, low, moderate, and high SPPB subgroups, respectively (p-trend<.001 [ABSTRACT FROM AUTHOR]

Introduction: Experimental evidence suggests sedentary time (ST), in part, contributes to cardiovascular disease risk by eliciting detrimental hemodynamic changes (blood pooling, turbulent blood flow) in the lower limbs. However, few studies have examined the association of ST and peripheral artery disease (PAD). Hypothesis: We hypothesized that longer daily ST is associated with higher odds of PAD, independent of moderate-to-vigorous physical activity (MVPA). Methods: We examined cross-sectional associations of accelerometer-measured ST (measured over 7 days) and the ankle brachial index (ABI) among 7,677 Hispanic adults (ages 45-74) who were enrolled in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). ST (<100 counts/min) was standardized to 16 hours/d of wear time. Using multivariable logistic regression accounting for the complex survey design, we analyzed quartiles of ST then used restricted cubic splines (RCS) to assess non-linear associations of ST with odds of PAD (ABI ≤ 0.9), all models controlled for claudication, MVPA, and traditional cardiovascular risk factors. Results: Median ST was 12.2 hours/day (76% of wear time) and 366 (5%) participants had PAD. Using RCS with 3 knots (10th, 50th & 90th percentile), ST had a significant non-linear association with PAD (p= 0.004). As seen in the dose-response figure, a threshold effect was seen such that time spent above median ST was associated with significantly higher odds of PAD. For example, compared to median ST, 2 hours above median ST (14.2 hours/day) was associated with 1.60 times the odds of PAD (OR 1.60, 1.24-2.07). Conclusions: Among Hispanic/Latino adults, higher ST is associated with higher odds of PAD, independent of claudication, MVPA, and traditional cardiovascular risk factors. Importantly, this effect was only observed at higher levels of ST. Further study is warranted to determine if reducing high levels of ST may reduce risk of PAD or prevent progression of the disease. [ABSTRACT FROM AUTHOR]

Background/Objective: Falls cause significant problems for older adults. Sedentary time is associated with lower physical function and could increase the risk for falls. Design: Prospective study. Setting: Sites across the United States. Participants: Older women (N = 5,545, mean age 79 years) from the Women's Health Initiative Objective Physical Activity and Cardiovascular Health study. Measurements: Accelerometers worn at the hip for up to 1 week collected measures of daily sedentary time and the mean sedentary bout duration, a commonly used metric for sedentary accumulation patterns. For up to 13 months after accelerometer wear, women reported daily whether they had fallen on monthly calendars. Results: In fully adjusted models, the incident rate ratios (95% confidence interval) for quartiles 1 (lowest), 2, 3, and 4 of sedentary time respectively were 1.0 (ref.), 1.07 (0.93–1.24), 1.07 (0.91–1.25), and 1.14 (0.96–1.35; P‐trend =.65) and for mean sedentary bout duration was 1.0 (ref.), 1.05 (0.92–1.21), 1.02 (0.88–1.17), and 1.17 (1.01–1.37; P‐trend =.01), respectively. Women with a history of two or more falls had stronger associations between sedentary time and falls incidence compared with women with a history of no or one fall (P for interaction =.046). Conclusions: Older women in the highest quartile of mean sedentary bout duration had a significantly increased risk of falling. Women with a history of frequent falling may be at higher risk for falling if they have high sedentary time. Interventions testing whether shortening total sedentary time and/or sedentary bouts lowers fall risk are needed to confirm these observational findings. [ABSTRACT FROM AUTHOR]

Introduction: Exposure to fine particulate matter in the home from sources such as smoking, cooking, and cleaning may put residents, especially children, at risk for detrimental health effects. A randomized clinical trial was conducted from 2011 to 2016 to determine whether real-time feedback in the home plus brief coaching of parents or guardians could reduce fine particle levels in homes with smokers and children.Design: A randomized trial with two groups-intervention and control.Setting/participants: A total of 298 participants from predominantly low-income households with an adult smoker and a child aged <14 years. Participants were recruited during 2012-2015 from multiple sources in San Diego, mainly Women, Infants and Children Program sites.Intervention: The multicomponent intervention consisted of continuous lights and brief sound alerts based on fine particle levels in real time and four brief coaching sessions using particle level graphs and motivational interviewing techniques. Motivational interviewing coaching focused on particle reduction to protect children and other occupants from elevated particle levels, especially from tobacco-related sources.Main Outcome Measures: In-home air particle levels were measured by laser particle counters continuously in both study groups. The two outcomes were daily mean particle counts and percentage time with high particle concentrations (>15,000 particles/0.01 ft3). Linear mixed models were used to analyze the differential change in the outcomes over time by group, during 2016-2017.Results: Intervention homes had significantly larger reductions than controls in daily geometric mean particle concentrations (18.8% reduction vs 6.5% reduction, p<0.001). Intervention homes' average percentage time with high particle concentrations decreased 45.1% compared with a 4.2% increase among controls (difference between groups p<0.001).Conclusions: Real-time feedback for air particle levels and brief coaching can reduce fine particle levels in homes with smokers and young children. Results set the stage for refining feedback and possible reinforcing consequences for not generating smoke-related particles.Trial Registration: This study is registered at www.clinicaltrials.gov NCT01634334. [ABSTRACT FROM AUTHOR]

Background: We examined the associations between accelerometry-measured physical activity (PA) and incidence of 13 cancers among a cohort of postmenopausal women.Methods: In this prospective study, 6382 women wore ActiGraph GT3X+ accelerometers at the hip for up to 7 days during 2012-2013, and were followed over a median of 4.7 years for diagnosis of 13 invasive cancers. Calibrated intensity cut points were used to define minutes per day of total, light and moderate-to-vigorous PA. We used multivariable Cox regression to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for tertiles, and one-standard deviation (SD) unit increments of PA exposures in relation to cancer incidence. We examined effect measure modification by age, race/ethnicity, body mass index and smoking history.Results: The highest (vs. lowest) tertiles of total, light and moderate-to-vigorous PA were associated with covariate-adjusted HRs of 0.72 (95% CI = 0.53-0.97), 0.81 (95% CI = 0.60-1.09) and 0.66 (95% CI = 0.48-0.91), respectively. In age-stratified analyses, HRs for total PA were lower among women <80 years (HRper one-SD = 0.75, 95% CI = 0.63-0.90) than among women ≥80 years (HRper one-SD = 0.99, 95% CI = 0.82-1.18) (PInteraction = 0.03). Race/ethnicity, BMI and smoking did not strongly modify these associations.Conclusions: Engaging in physical activity may play a beneficial role in the prevention of certain cancers in older women. [ABSTRACT FROM AUTHOR]

Background: Positive affect and emotional resources, such as optimism, may play a major role in women's health and promote healthy well-being later in life. However, positive affect and optimism measures have not been psychometrically assessed in older women, despite relations to health. Therefore, the objective of this study was to psychometrically assess measures of positive affect and optimism and test their association with other measures of well-being. Methods: In a Women's Health Initiative subcohort of 58,810 women (mean age [standard deviation] 79.0 [6.1]; 89% White), positive affect and optimism were measured using the modified Differential Emotions Scale (mDES) and Life Orientation Test-Revised (LOT-R), respectively. Reliability was tested using Cronbach's alpha and McDonald's omega. Performance was assessed using item response theory. Factor analysis was used to explore the construct validity of the LOT-R. Convergent and divergent validity with other well-being measures was tested. Results: Results suggest good reliability (mDES: Cronbach's alpha = 0.90 and omega total = 0.92; LOT-R: Cronbach's alpha = 0.79, omega hierarchical = 0.61, and omega total = 0.83). Item response analyses indicate mDES's ability to discriminate across positive affect; LOT-R was skewed toward lower optimism levels. Exploratory factor analyses suggest a two-factor solution for the LOT-R. Significant, but small correlations in expected directions to well-being measures confirmed validity hypotheses. Conclusions: The mDES and LOT-R measured positive affect and optimism with good reliability, item performance, and validity in a large sample of older postmenopausal women, supporting use of these measures to quantify effects of positive affect and optimism-promoting interventions. [ABSTRACT FROM AUTHOR]

Background: Few studies have examined accelerometer‐measured physical activity and incident breast cancer (BC). Thus, this study examined associations between accelerometer‐measured vector magnitude counts per 15 seconds (VM/15s) and average daily minutes of light physical activity (LPA), moderate‐to‐vigorous PA (MVPA), and total PA (TPA) and BC risk among women in the Women's Health Accelerometry Collaboration (WHAC). Methods: The WHAC comprised 21,089 postmenopausal women (15,375 from the Women's Health Study [WHS]; 5714 from the Women's Health Initiative Objective Physical Activity and Cardiovascular Health Study [OPACH]). Women wore an ActiGraph GT3X+ on the hip for ≥4 days and were followed for 7.4 average years to identify physician‐adjudicated in situ (n = 94) or invasive (n = 546) BCs. Multivariable stratified Cox regression estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for tertiles of physical activity measures in association with incident BC overall and by cohort. Effect measure modification was examined by age, race/ethnicity, and body mass index (BMI). Results: In covariate‐adjusted models, the highest (vs. lowest) tertiles of VM/15s, TPA, LPA, and MVPA were associated with BC HRs of 0.80 (95% CI, 0.64–0.99), 0.84 (95% CI, 0.69–1.02), 0.89 (95% CI, 0.73–1.08), and 0.81 (95% CI, 0.64–1.01), respectively. Further adjustment for BMI or physical function attenuated these associations. Associations were more pronounced among OPACH than WHS women for VM/15s, MVPA, and TPA; younger than older women for MVPA; and women with BMI ≥30 than <30 kg/m2 for LPA. Conclusion: Greater levels of accelerometer‐assessed PA were associated with lower BC risk. Associations varied by age and obesity and were not independent of BMI or physical function. In a study of over 20,000 US postmenopausal women, higher levels of accelerometer‐measured physical activity were associated with lower risk of breast cancer. Associations varied by age and obesity and were not independent of body mass index or physical function. [ABSTRACT FROM AUTHOR]

Self-reported experiences of discrimination and sense of coherence (SOC) have been found to be associated with health. A face-to-face survey of Long Term Jewish Residents (LTJR), Arabs and former Soviet Union (fSU) immigrants in Israel was performed. Respondents reported their physical and mental health, self-reported experiences of discrimination, SOC and socioeconomic status. Multivariable logistic regressions and bootstrapping path analyses were performed. Discrimination was associated with health after adjusting for all other variables. SOC was also associated with health. SOC did not mediate the strong association between discrimination and health among Israeli LTJR, but was a significant mediator among Arabs and fSU immigrants. Discrimination seems to have a direct effect on health only among the majority and not among minority populations. High levels of SOC may reduce the negative effects of discrimination on health by serving as a coping resource, however only among minorities. [ABSTRACT FROM AUTHOR]

Purpose: This study examined relationships between sedentary behavior accumulated in different bout durations and quality of life (QoL) among breast cancer survivors.Methods: Postmenopausal breast cancer survivors completed the Short Form Health Survey to assess QoL and wore an accelerometer to measure sedentary behavior and physical activity between August 2011 and May 2013.Results: Participants (n = 134) averaged 509.7 min/day in sedentary time with 285.2 min/day in short bouts (<20 min) and 224.5 min/day long bouts (≥20 min). Linear regression models indicated that greater total sedentary time was significantly associated with worse physical QoL (b = -0.70, p = 0.02) but not mental QoL (p = 0.92). Models that examined the accumulation of sedentary time in short bouts and long bouts together showed that time in long sedentary bouts was significantly related to physical QoL (b = -0.72, p = 0.02), while time in short bouts was not (p = 0.63). Moderate-to-vigorous intensity physical activity (MVPA) was a significant effect modifier of the relation between time spent in long sedentary bouts and physical QoL (p = 0.028) such that greater time in long bouts was associated with worse physical QoL only among women with lower levels of MVPA.Conclusions: Findings indicate that time spent in long sedentary bouts is associated with worse physical QoL among breast cancer survivors who do not engage in high levels of MVPA. Future research should examine reducing sedentary time as a potential strategy to improve physical QoL. [ABSTRACT FROM AUTHOR]

Background: Social support may be a modifiable risk factor for cognitive impairment. However, few long-term, large prospective studies have examined associations of various forms of social support with incident mild cognitive impairment (MCI) and dementia. Objective: To examine associations of perceived social support with incident MCI and dementia among community-dwelling older women. Methods: This prospective cohort study included 6,670 women from the Women's Health Initiative Memory Study who were cognitively unimpaired at enrollment. We used Cox proportional hazards models to assess associations between perceived social support with incident MCI, dementia, or either MCI/dementia during an average 10.7 (SD = 6.1)-year follow-up. Modelling was repeated for emotional/information support, affection support, tangible support, and positive social interaction subscales of social support. Results: Among 6,670 women (average age = 70 years [SD = 3.8]; 97.0% non-Hispanic/Latina; 89.8% White), greater perceived social support was associated with lower risk of MCI/dementia after adjustment for age, ethnicity, race, hormone therapy, education, income, diabetes, hypertension, and body mass index (Tertile [T]3 versus T1: HR = 0.85, 95% CI 0.74–0.99; ptrend = 0.08). Associations were significant for emotional/information support (T3 versus T1: HR = 0.84, 95% CI 0.72–0.97; ptrend = 0.04) and positive social interaction (T3 versus T1: HR = 0.85, 95% CI 0.73–0.99; ptrend = 0.06) subscales. Associations were attenuated and not significant after adjustment for depressive symptom severity. Objective: Perceived social support, emotional/information support, and positive social interaction were associated with incident MCI/dementia among older women. Results were not significant after adjustment for depressive symptom severity. Improving social support may reduce risk of MCI and dementia in older women. [ABSTRACT FROM AUTHOR]

Psychological well-being is linked to healthy aging in older women, but associations with health behaviors are not well understood. Our study aims to evaluate the relationships between objectively-measured physical behavior (including physical activity and sedentary behavior) with optimism and positive affect in a diverse sample of older women. Our cross-sectional study of 4168 American women (aged 63–99) with accelerometer-measured physical behavior from the Objective Physical Activity and Cardiovascular Health Study assessed associations using multiple linear regression. Effect modification by age, race and ethnicity, social support, and number of chronic conditions was examined as well. In unadjusted models, positive associations for physical activity and negative associations for sedentary behaviors were generally linear for optimism and positive affect. In adjusted models, every one-hour increment in weekly moderate-vigorous physical activity was associated with higher optimism by 0.4 score points [Revised 6-item Life Orientation Test, 95% CI = 0.2, 0.6] and positive affect by 0.6 score points [modified Differential Emotions Scale, 95% CI = 0.2, 0.9]. One-hour increments in light physical activity were associated with higher positive affect [0.2 score points; 95% CI = 0.03, 0.33] while one-hour increments in sedentary behavior patterns were associated with lower positive affect [-0.1 score points; 95% CI = − 0.10, − 0.02). Effect modification by age, race and ethnicity, social support, and number of chronic conditions was not observed. In conclusion, associations between physical behavior with optimism and positive affect were modest but suggest greater activity and less sedentary time are associated with greater psychological well-being in older women. [ABSTRACT FROM AUTHOR]

Background: Aging is generally accompanied by decreasing physical activity (PA), which is associated with a decline in many health parameters, leading to recommendations for older adults to increase or at least maintain PA.Methods: We determined relationships between social connectedness and decreasing or increasing PA levels during the coronavirus disease 2019 pandemic among 41 443 participants of the Women's Health Initiative Extension Study. Outcomes of logistic regression models were decreasing PA activity (reference: maintaining or increasing) and increasing PA activity (reference: maintaining or decreasing). The main predictor was social connectedness as a combined variable: not living alone (reference: living alone) and communicating with others outside the home more than once/week (reference: once/week or less). We adjusted for age, race, ethnicity, body mass index, physical function level, and education.Results: Compared with participants who were not socially connected, socially connected participants had lower odds of decreasing PA (adjusted odds ratio 0.91, 95% confidence interval 0.87-0.95). Odds of increasing PA (vs decreasing or maintaining PA) were not significantly different among socially connected and not socially connected participants. Associations between social connectedness and decreasing PA did not significantly differ by age (<85 vs ≥85 years), race/ethnicity (non-Hispanic White vs other races/ethnicity), education (college vs 75).Conclusion: Social connectedness was associated with lower odds of decreasing PA among older women during the pandemic. These findings could inform the development of future interventions to help older women avoid decreasing PA. [ABSTRACT FROM AUTHOR]

Background: Hip-worn accelerometer cut-points have poor validity for assessing children's sedentary time, which may partly explain the equivocal health associations shown in prior research. Improved processing/classification methods for these monitors would enrich the evidence base and inform the development of more effective public health guidelines. The present study aimed to develop and evaluate a novel computational method (CHAP-child) for classifying sedentary time from hip-worn accelerometer data. Methods: Participants were 278, 8–11-year-olds recruited from nine primary schools in Melbourne, Australia with differing socioeconomic status. Participants concurrently wore a thigh-worn activPAL (ground truth) and hip-worn ActiGraph (test measure) during up to 4 seasonal assessment periods, each lasting up to 8 days. activPAL data were used to train and evaluate the CHAP-child deep learning model to classify each 10-s epoch of raw ActiGraph acceleration data as sitting or non-sitting, creating comparable information from the two monitors. CHAP-child was evaluated alongside the current practice 100 counts per minute (cpm) method for hip-worn ActiGraph monitors. Performance was tested for each 10-s epoch and for participant-season level sedentary time and bout variables (e.g., mean bout duration). Results: Across participant-seasons, CHAP-child correctly classified each epoch as sitting or non-sitting relative to activPAL, with mean balanced accuracy of 87.6% (SD = 5.3%). Sit-to-stand transitions were correctly classified with mean sensitivity of 76.3% (SD = 8.3). For most participant-season level variables, CHAP-child estimates were within ± 11% (mean absolute percent error [MAPE]) of activPAL, and correlations between CHAP-child and activPAL were generally very large (> 0.80). For the current practice 100 cpm method, most MAPEs were greater than ± 30% and most correlations were small or moderate (≤ 0.60) relative to activPAL. Conclusions: There was strong support for the concurrent validity of the CHAP-child classification method, which allows researchers to derive activPAL-equivalent measures of sedentary time, sit-to-stand transitions, and sedentary bout patterns from hip-worn triaxial ActiGraph data. Applying CHAP-child to existing datasets may provide greater insights into the potential impacts and influences of sedentary time in children. [ABSTRACT FROM AUTHOR]

Objective: The primary aim was to assess associations between total steps per day and incident diabetes, whereas the secondary aim was to assess whether the intensity and/or cadence of steps is associated with incident diabetes.Research Design and Methods: Women without physician-diagnosed diabetes (n = 4,838; mean [SD] age 78.9 [6.7] years) were followed up to 6.9 years; 395 developed diabetes. Hip-worn ActiGraph GT3X+ accelerometers worn for 1 week enabled measures of total, light-intensity, and moderate- to vigorous-intensity (MV-intensity) steps per day. Using Cox proportional hazards analysis we modeled adjusted change in the hazard rate for incident diabetes associated with total, light-intensity, and MV-intensity steps per day. We further estimated the proportion of the steps-diabetes association mediated by BMI.Results: On average, participants took 3,729 (SD 2,114) steps/day, of which 1,875 (791) were light-intensity steps and 1,854 ± 1,762 were MV-intensity. More steps per day were associated with a lower hazard rate for incident diabetes. Confounder-adjusted models for a 2,000 steps/day increment yielded hazard ratio (HR) 0.88 (95% CI 0.78-1.00; P = 0.046). After further adjustment for BMI, HR was 0.90 (95% CI 0.80-1.02; P = 0.11). BMI did not significantly mediate the steps-diabetes association (proportion mediated = 17.7% [95% CI -55.0 to 142.0]; P = 0.09]). The relationship between MV-intensity steps per day (HR 0.86 [95% CI 0.74-1.00]; P = 0.04) and incident diabetes was stronger than for light-intensity steps per day (HR 0.97 [95% CI 0.73-1.29]; P = 0.84).Conclusions: These findings suggest that for older adults, more steps per day are associated with lower incident diabetes and MV-intensity steps are most strongly associated with a lower hazard of diabetes. This evidence supports that regular stepping is an important risk factor for type 2 diabetes prevention in older adults. [ABSTRACT FROM AUTHOR]

Background: Recent evidence suggests that prolonged sitting and its adverse impact on glycaemic indicators appear to be proportional to the degree of insulin resistance. To investigate this finding in a free-living context, we aimed to examine associations of device-measured 24-h time-use compositions of sitting, standing, stepping, and sleeping with fasting glucose (FPG) and 2 h post-load glucose (2hPLG) levels, and to examine separately the associations with time-use compositions among those at lower and at higher risk of developing type 2 diabetes. Methods: Cross-sectional analyses examined thigh-worn inclinometer data (activPAL, 7 day, 24 h/day protocol) from 648 participants (aged 36-80 years) at either lower (< 39 mmol/mol; < 5.7% HbA1c) or higher (≥39 mmol/mol; ≥5.7% HbA1c) diabetes risk from the 2011-2012 Australian Diabetes, Obesity and Lifestyle study. Multiple linear regression models were used to examine associations of differing compositions with FPG and 2hPLG, with time spent in each behaviour allowed to vary up to 60 min. Results: In general, the associations with the FPG within the time-use compositions were small, with statistically significant associations observed for sitting and sleeping (in the lower diabetes risk group) and standing (in higher diabetes risk group) only. For 2hPLG, statistically significant associations were observed for stepping only, with findings similar between lower (β = − 0.12 95%CI:−0.22, − 0.02) and higher (β = − 0.13 95%CI:−0.26, − 0.01) risk groups. Varying the composition had minimal impact on FPG; however 1 h less sitting time and equivalent increase in standing time was associated with attenuated FPG levels in higher risk only (Δ FPG% = − 1.5 95%CI: − 2.4, − 0.5). Large differences in 2hPLG were observed for both groups when varying the composition. One hour less sitting with equivalent increase in stepping was associated with attenuated 2hPLG, with estimations similar in lower (Δ 2hPLG% = − 3.8 95%CI: − 7.3, − 0.2) and higher (Δ 2hPLG% = − 5.0 95%CI: − 9.7, − 0.0) risk for diabetes. Conclusions: In middle-aged and older adults, glycaemic control could be improved by reducing daily sitting time and replacing it with stepping. Standing could also be beneficial for those at higher risk of developing type 2 diabetes. [ABSTRACT FROM AUTHOR]

National guidelines recommend physically active interruptions to sitting time; however, the characteristics of these interruptions are broadly stated and ill-defined. A robust methodology for population surveillance for such interruptions is needed. Purpose: To describe the frequency and characteristics (i.e. duration, stepping time, and estimated intensity) of all interruptions and physically active interruptions to adults' free-living sitting time (i.e. transitions from sitting to upright posture) across segments of the population. Methods : Australian Diabetes, Obesity and Lifestyle study participants (321 men; 406 women; mean +/- standard deviation, 58.0 +/- 10.3 yr) wore the activPAL3(TM) for >=1 valid day. The characteristics of interruptions from laboratory studies demonstrating health benefits were selected to define active interruptions (>=5 min upright and/or >=2 min stepping) and ambulatory interruptions (>=2 min stepping). The frequency and characteristics of all, active, and ambulatory interruptions were described and compared by age, sex, diabetes status, and body mass index. Results : Adults averaged 55.0 +/- 21.8 interruptions per day, but only 20.3 +/- 6.7 were active and 14.0 +/- 5.4 were ambulatory. Median (25th, 75th percentile) duration was 2.6 min (0.9, 7.8 min), stepping time was 0.8 min (0.3, 2.0 min), and estimated energy expenditure was 4.3 metabolic equivalents (MET)[middle dot]min-1 (1.4, 12.5 MET[middle dot]min-1). Those who were older, had obesity, or had diabetes had significantly (P < 0.05) fewer interruptions of all types and less stepping time during active interruptions than their counterparts (Cohen's d < 0.2). Conclusions : Free-living interruptions were often less active than interruptions performed in effective acute laboratory studies and their content varied widely between population groups. Monitoring all interruptions, as well as those that are more active, is advisable to provide a comprehensive understanding of free-living sedentary behavior. [ABSTRACT FROM AUTHOR]

Introduction: Sitting patterns predict several healthy aging outcomes. These patterns can potentially be measured using hip-worn accelerometers, but current methods are limited by an inability to detect postural transitions. To overcome these limitations, we developed the Convolutional Neural Network Hip Accelerometer Posture (CHAP) classification method. Methods: CHAP was developed on 709 older adults who wore an ActiGraph GT3X+ accelerometer on the hip, with ground-truth sit/stand labels derived from concurrently worn thigh-worn activPAL inclinometers for up to 7 d. The CHAP method was compared with traditional cut-point methods of sitting pattern classification as well as a previous machine-learned algorithm (two-level behavior classification). Results: Forminute-level sitting versus nonsitting classification, CHAP performed better (93% agreement with activPAL) than did other methods (74%-83% agreement). CHAP also outperformed other methods in its sensitivity to detecting sit-to-stand transitions: cut-point (73%), TLBC (26%), andCHAP (83%). CHAP's positive predictive value of capturing sit-to-stand transitions was also superior to other methods: cut-point (30%), TLBC (71%), and CHAP (83%). Day-level sitting pattern metrics, such as mean sitting bout duration, derived from CHAP did not differ significantly from activPAL, whereas other methods did: activPAL (15.4 min of mean sitting bout duration), CHAP (15.7 min), cut-point (9.4 min), and TLBC (49.4 min). Conclusion: CHAP was the most accurate method for classifying sit-tostand transitions and sitting patterns from free-living hip-worn accelerometer data in older adults. This promotes enhanced analysis of older adult movement data, resulting in more accurate measures of sitting patterns and opening the door for large-scale cohort studies into the effects of sitting patterns on healthy aging outcomes. [ABSTRACT FROM AUTHOR]

Abstract: Parental substance use significantly increases risk of child maltreatment, but is often under-identified by child protective services. This study examined how agency use of standardized substance use assessments and child welfare investigative caseworker education, experience, and caseload affected caseworkers'' identification of parental substance abuse treatment needs. Data are from a national probability sample of permanent, primary caregivers involved with child protective services whose children initially remained at home and whose confidential responses on two validated instruments indicated harmful substance use or dependence. Investigative caseworkers reported use of a formal assessment in over two thirds of cases in which substance use was accurately identified. However, weighted logistic regression indicated that agency provision of standardized assessment instruments was not associated with caseworker identification of caregiver needs. Caseworkers were also less likely to identify substance abuse when their caseloads were high and when caregivers were fathers. Implications for agency practice are discussed. [Copyright &y& Elsevier]

Time spent sitting is positively correlated with endothelial dysfunction and cardiovascular disease risk. The underlying molecular mechanisms are unknown. MicroRNAs contained in extracellular vesicles (EVs) reflect cell/tissue status and mediate intercellular communication. We explored the association between sitting patterns and microRNAs isolated from endothelial cell (EC)-derived EVs. Using extant actigraphy based sitting behavior data on a cohort of 518 postmenopausal overweight/obese women, we grouped the woman as Interrupted Sitters (IS; N = 18) or Super Sitters (SS; N = 53) if they were in the shortest or longest sitting pattern quartile, respectively. The cargo microRNA in EC-EVs from the IS and SS women were compared. MicroRNA data were weighted by age, physical functioning, MVPA, device wear days, device wear time, waist circumference, and body mass index. Screening of CVD-related microRNAs demonstrated that miR-199a-5p, let-7d-5p, miR-140-5p, miR-142-3p, miR-133b level were significantly elevated in SS compared to IS groups. Group differences in let-7d-5p, miR-133b, and miR-142-3p were validated in expanded groups. Pathway enrichment analyses show that mucin-type O-glycan biosynthesis and cardiomyocyte adrenergic signaling (P < 0.001) are downstream of the three validated microRNAs. This proof-of-concept study supports the possibility that CVD-related microRNAs in EC-EVs may be molecular transducers of sitting pattern-associated CVD risk in overweight postmenopausal women. [ABSTRACT FROM AUTHOR]

Background: National guidelines promote physical activity to prevent cardiovascular disease (CVD), yet no randomized controlled trial has tested whether physical activity reduces CVD.Methods: The Women's Health Initiative (WHI) Strong and Healthy (WHISH) pragmatic trial used a randomized consent design to assign women for whom cardiovascular outcomes were available through WHI data collection (N = 18 985) or linkage to the Centers for Medicare and Medicaid Services (N30 346), to a physical activity intervention or "usual activity" comparison, stratified by ages 68-99 years (in tertiles), U.S. geographic region, and outcomes data source. Women assigned to the intervention could "opt out" after receiving initial physical activity materials. Intervention materials applied evidence-based behavioral science principles to promote current national recommendations for older Americans. The intervention was adapted to participant input regarding preferences, resources, barriers, and motivational drivers and was targeted for 3 categories of women at lower, middle, or higher levels of self-reported physical functioning and physical activity. Physical activity was assessed in both arms through annual questionnaires. The primary outcome is major cardiovascular events, specifically myocardial infarction, stroke, or CVD death; primary safety outcomes are hip fracture and non-CVD death. The trial is monitored annually by an independent Data Safety and Monitoring Board. Final analyses will be based on intention to treat in all randomized participants, regardless of intervention engagement.Results: The 49 331 randomized participants had a mean baseline age of 79.7 years; 84.3% were White, 9.2% Black, 3.3% Hispanic, 1.9% Asian/Pacific Islander, 0.3% Native American, and 1% were of unknown race/ethnicity. The mean baseline RAND-36 physical function score was 71.6 (± 25.2 SD). There were no differences between Intervention (N = 24 657) and Control (N = 24 674) at baseline for age, race/ethnicity, current smoking (2.5%), use of blood pressure or lipid-lowering medications, body mass index, physical function, physical activity, or prior CVD (10.1%).Conclusion: The WHISH trial is rigorously testing whether a physical activity intervention reduces major CV events in a large, diverse cohort of older women. Clinical Trials Registration Number: NCT02425345. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to improve estimates of sitting time from hip-worn accelerometers used in large cohort studies by using machine learning methods developed on free-living activPAL data. Methods: Thirty breast cancer survivors concurrently wore a hip-worn accelerometer and a thigh-worn activPAL for 7 d. A random forest classifier, trained on the activPAL data, was used to detect sitting, standing, and sit–stand transitions in 5-s windows in the hip-worn accelerometer. The classifier estimates were compared with the standard accelerometer cut point, and significant differences across different bout lengths were investigated using mixed-effect models. Results: Overall, the algorithm predicted the postures with moderate accuracy (stepping, 77%; standing, 63%; sitting, 67%; sit-to-stand, 52%; and stand-to-sit, 51%). Daily level analyses indicated that errors in transition estimates were only occurring during sitting bouts of 2 min or less. The standard cut point was significantly different from the activPAL across all bout lengths, overestimating short bouts and underestimating long bouts. Conclusions: This is among the first algorithms for sitting and standing for hip-worn accelerometer data to be trained from entirely free-living activPAL data. The new algorithm detected prolonged sitting, which has been shown to be the most detrimental to health. Further validation and training in larger cohorts is warranted. [ABSTRACT FROM AUTHOR]

Objectives: To prospectively examine associations between accelerometer‐measured physical activity (PA) and mortality in older women, with an emphasis on light‐intensity PA. Design: Prospective cohort study with baseline data collection between March 2012 and April 2014. Setting: Women's Health Initiative cohort in the United States. Participants: Community‐dwelling women aged 63 to 99 (N = 6,382). Measurements: Minutes per day of usual PA measured using hip‐worn triaxial accelerometers, physical functioning measured using the Short Physical Performance Battery, mortality follow‐up for a mean 3.1 years through September 2016 (450 deaths). Results: When adjusted for accelerometer wear time, age, race‐ethnicity, education, smoking, alcohol, self‐rated health, and comorbidities, relative risks (95% confidence intervals) for all‐cause mortality across PA tertiles were 1.00 (referent), 0.86 (0.69, 1.08), 0.80 (0.62, 1.03) trend P = .07, for low light; 1.00, 0.57 (0.45, 0.71), 0.47 (0.35, 0.61) trend P < .001, for high light; and, 1.00, 0.63 (0.50, 0.79), 0.42 (0.30, 0.57) trend P < .001, for moderate‐to‐vigorous PA (MVPA). Associations remained significant for high light‐intensity PA and MVPA (P < .001) after further adjustment for physical function. Each 30‐min/d increment in light‐intensity (low and high combined) PA and MVPA was associated, on average, with multivariable relative risk reductions of 12% and 39%, respectively (P < .01). After further simultaneous adjusting for light intensity and MVPA, the inverse associations remained significant (light‐intensity PA: RR = 0.93, 95% CI = 0.89–0.97; MVPA: RR = 0.67, 95% CI = 0.58–0.78). These relative risks did not differ between subgroups for age or race and ethnicity (interaction, P ≥ .14, all). Conclusion: When measured using accelerometers, light‐intensity and MVPA are associated with lower mortality in older women. These findings suggest that replacing sedentary time with light‐intensity PA is a public health strategy that could benefit an aging society and warrants further investigation. [ABSTRACT FROM AUTHOR]

Background: Limited evidence exists to inform physical activity (PA) and sedentary behavior guidelines for older people, especially women. Rigorous evidence on the amounts, intensities, and movement patterns associated with better health in later life is needed.Methods/design: The Objective PA and Cardiovascular Health (OPACH) Study is an ancillary study to the Women's Health Initiative (WHI) Program that examines associations of accelerometer-assessed PA and sedentary behavior with cardiovascular and fall events. Between 2012 and 2014, 7048 women aged 63-99 were provided with an ActiGraph GT3X+ (Pensacola, Florida) triaxial accelerometer, a sleep log, and an OPACH PA Questionnaire; 6489 have accelerometer data. Most women were in their 70s (40%) or 80s (46%), while approximately 10% were in their 60s and 4% were age 90 years or older. Non-Hispanic Black or Hispanic/Latina women comprise half of the cohort. Follow-up includes 1-year of falls surveillance with monthly calendars and telephone interviews of fallers, and annual follow-up for outcomes with adjudication of incident cardiovascular disease (CVD) events through 2020. Over 63,600 months of calendar pages were returned by 5,776 women, who reported 5,980 falls. Telephone interviews were completed for 1,492 women to ascertain the circumstances, injuries and medical care associated with falling. The dataset contains extensive information on phenotypes related to healthy aging, including inflammatory and CVD biomarkers, breast and colon cancer, hip and other fractures, diabetes, and physical disability.Discussion: This paper describes the study design, methods, and baseline data for a diverse cohort of postmenopausal women who wore accelerometers under free-living conditions as part of the OPACH Study. By using accelerometers to collect more precise and complete data on PA and sedentary behavior in a large cohort of older women, this study will contribute crucial new evidence about how much, how vigorous, and what patterns of PA are necessary to maintain optimal cardiovascular health and to avoid falls in later life.Clinical Trials Registration: ClinicalTrials.gov identifier NCT00000611 . Registered 27 October 1999. [ABSTRACT FROM AUTHOR]

Background: Few studies characterize older adult physical activity and sitting patterns using accurate accelerometer and concurrent posture measures. In this descriptive paper, we report accelerometer data collection protocols, consent rates, and physical behavior measures from a population-based cohort study (Adult Changes in Thought, ACT).Methods: The ACT study holds enrollment steady at approximately 2000 members of Kaiser Permanente Washington aged 65+ without dementia undergoing detailed biennial assessments. In 2016 the ACT-Activity Monitor (ACT-AM) sub-study was initiated to obtain data from wearing activPAL and ActiGraph devices for 7 days following regular biennial visits. We describe the methods protocol of ACT-AM and present characteristics of people who did and did not consent to wear devices. We compute inverse probability of response weights and incorporate these weights in linear regression models to estimate means and 95% confidence intervals (CI) of device-based pattern metrics, adjusted for wear time and demographic factors, and weighted to account for potential selection bias due to device-wear consent.Results: Among 1885 eligible ACT participants, 56% agreed to wear both devices (mean age 77 years, 56% female, 89% non-Hispanic white, 91% with post-secondary education). On average, those who agreed to wear devices were younger and healthier. Estimated mean (95% CI) activPAL-derived sitting, standing, and stepping times were 10.2 h/day (603-618 min/day), 3.9 h/day (226-239 min/day), and 1.4 h/day (79-84 min/day), respectively. Estimated mean ActiGraph derived sedentary (Vector Magnitude [VM] < =18 counts/15 s), light intensity (VM 19-518 counts/15 s), and moderate-to-vigorous intensity (VM > 518 counts/15 s) physical activity durations were 9.5 h/day (565-577 min/day), 4.5 h/day (267-276 min/day), and 1.0 h/day (59-64 min/day). Participants who were older, had chronic conditions, and were unable to walk a half-mile had higher sedentary time and less physical activity.Conclusions: Our recruitment rate demonstrates the feasibility of cohort participants to wear two devices that measure sedentary time and physical activity. Data indicate high levels of sitting time in older adults but also high levels of physical activity using cut-points developed for older adults. These data will help researchers test hypotheses related to physical behavior and health in older adults in the future. [ABSTRACT FROM AUTHOR]

Interventions are needed to protect the health of children who live with smokers. We pilot-tested a real-time intervention for promoting behavior change in homes that reduces second hand tobacco smoke (SHS) levels. The intervention uses a monitor and feedback system to provide immediate auditory and visual signals triggered at defined thresholds of fine particle concentration. Dynamic graphs of real-time particle levels are also shown on a computer screen. We experimentally evaluated the system, field-tested it in homes with smokers, and conducted focus groups to obtain general opinions. Laboratory tests of the monitor demonstrated SHS sensitivity, stability, precision equivalent to at least 1 µg/m3, and low noise. A linear relationship (R2 = 0.98) was observed between the monitor and average SHS mass concentrations up to 150 µg/m3. Focus groups and interviews with intervention participants showed in-home use to be acceptable and feasible. The intervention was evaluated in 3 homes with combined baseline and intervention periods lasting 9 to 15 full days. Two families modified their behavior by opening windows or doors, smoking outdoors, or smoking less. We observed evidence of lower SHS levels in these homes. The remaining household voiced reluctance to changing their smoking activity and did not exhibit lower SHS levels in main smoking areas or clear behavior change; however, family members expressed receptivity to smoking outdoors. This study established the feasibility of the real-time intervention, laying the groundwork for controlled trials with larger sample sizes. Visual and auditory cues may prompt family members to take immediate action to reduce SHS levels. Dynamic graphs of SHS levels may help families make decisions about specific mitigation approaches. [ABSTRACT FROM AUTHOR]