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Background: This study examined the moderating role of social support in the acculturation-obesity/central obesity relationship in Mexican American (MA) men and women. Methods: Data from NHANES 1999-2008 were used. Acculturation derived from language use, country of birth and length of residence in the U.S. Social support assessed emotional and financial support. BMI (≥30) and waist circumference (≥88 cm for women; ≥102 cm for men) measured obesity and central obesity, respectively. Weighted multivariate logistic regression models were used to describe associations. Results: Compared to less acculturation, more acculturation was associated with higher odds of obesity (ORs 2.48; 95% CI 1.06-5.83) and central obesity (2.90; 1.39-6.08) among MA men with low/no social support, but not among MA men reporting high social support. The modifying effects was not observed among women. Conclusion: Higher amounts of social support appeared to attenuate the risk of obesity/central obesity associated with acculturation. Interventions enhancing social support maybe effective among acculturated MAs, particularly among men.

Age and acculturation may play a role in diet quality among Mexican Americans. This study examined diet quality in Mexican Americans by age and whether acculturation influences diet quality across different age groups, using data from the National Health and Nutrition Examination Survey (NHANES). Diet quality, measured by the Healthy Eating Index 2010, improved with age except in categories of dairy, sodium, and refined grains. More acculturation was associated with lower scores in overall diet quality and categories of vegetables, fruits, and sodium and empty calories across almost all ages, but higher scores in grain categories, especially in younger groups. A diet rich in fruits and vegetables but low in fat and sodium should be promoted among more acculturated Mexican Americans, and whole-grain foods should be promoted among young but less acculturated Mexican Americans.

Research shows aconsistent racial disparity in obesity between white and black adults in the United States. Accounting for the disparity is a challenge given the variety of the contributing factors, the nature of the association, and the multilevel relationships among the factors. We used the multivariable mediation analysis (MMA) method to explore the racial disparity in obesity considering not only the individual behavior but also geospatially derived environmental risk factors. Results from generalized linear models (GLM) were compared with those from multiple additive regression trees (MART) which allow for hierarchical data structure, and fitting of nonlinear and complex interactive relationships. As results, both individual and geographically defined factors contributed to the racial disparity in obesity. MART performed better than GLM models in that MART explained a larger proportion of the racial disparity in obesity. However, there remained disparities that cannot be explained by factors collected in this study.

ObjectiveUsing the Healthy Eating Index-2010 (HEI-2010), the present study aimed to examine diet quality and the impact of overall diet quality and its components on central obesity among Mexican-American men and women.DesignCross-sectional data from NHANES 1999-2012 were used. The HEI-2010 data, including twelve components for a total score of 100, were collected with a 24 h recall interview. Central obesity was defined as a waist circumference of ≥88 cm for women and ≥102 cm for men. Weighted logistic regressions were performed to assess associations between HEI-2010 scores and central obesity.SettingNational Health and Nutrition Examination Survey (NHANES) 1999-2012.SubjectsA total of 6847 Mexican Americans aged ≥20 years with reliable dietary recall status and non-pregnancy status.ResultsHigher HEI-2010 total score was associated with lower odds of central obesity in Mexican-American men (OR; 95 % CI=0·98; 0·98, 1·00). Among all Mexican Americans, one-unit higher score of total fruit and sodium (i.e. lower level of intake) was associated with 4 % (0·96; 0·93, 0·99) and 2 % (0·98; 0·96, 0·99) lower odds of central obesity, respectively. However, a higher total proteins score was associated with higher odds of central obesity (1·08; 1·00, 1·16). In gender-specific analyses, a higher whole fruit or sodium score was inversely associated with central obesity in men but not in women.ConclusionsHEI-2010 scores of total fruit and sodium were inversely associated with central obesity among all Mexican Americans. However, total proteins score and central obesity was positively associated. In Mexican-American men, HEI-2010 total and whole fruit scores were inversely associated with central obesity.

Objectives. We explored the relationship between boarded-up housing and rates of gonorrhea and premature mortality.Methods. In this ecological study of 107 US cities, we developed several models predicting rates of gonorrhea and premature death before age 65 from all causes and from specific causes. We controlled for race, poverty, education, population change, and health insurance coverage.Results. Boarded-up housing remained a predictor of gonorrhea rates, all-cause premature mortality, and premature mortality due to malignant neoplasms, diabetes, homicide, and suicide after control for sociodemographic factors.Conclusions. Boarded-up housing may be related to mortality risk because of its potential adverse impact on social relationships and opportunities to engage in healthful behaviors. Neighborhood physical conditions deserve further consideration as a potential global factor influencing health and well-being.

Objective: The authors aimed to replicate previous findings on social capital and harmful alcohol outcomes in the college setting and to ascertain the protective effects of additional indicators of social capital. Methods: Over 4 years (2000-2004), the authors conducted annual cross-sectional, random-sample student surveys at 32 US institutions of higher education (N = 15,875) and constructed multilevel models to examine the association between individual- and campus-level participation in campus activities and harmful drinking outcomes. Results: At the individual level, community volunteerism was protective against harmful drinking outcomes. In contrast to past research, campus-level volunteerism was not significantly associated with the outcome measures. At both the individual and campus levels, participation in a religious organization was protective. Greek membership and varsity athletic participation were risk factors at the individual level. Conclusions: Results did not corroborate previous findings and revealed mixed results for other measures of participation at the campus level. The influence of social capital on college alcohol consumption deserves further attention. (Contains 3 tables.)

Objective: Evaluations of social norms marketing campaigns to reduce college student drinking have produced conflicting results. This study examines whether the effectiveness of such campaigns may be moderated by on-premise alcohol outlet density in the surrounding community. Method: Multilevel analyses were conducted of student survey responses (N = 19,838) from 32 U.S. colleges that took part in one of two 4-year randomized, controlled trials completed for the Social Norms Marketing Research Project (SNMRP). In the models, students by year were nested within treatment (n = 16) and control group (n = 16) campuses, which were characterized by the on-premise outlet density in their surrounding community. The moderating effect of outlet density was introduced into the models as an interaction between the treatment effect (i.e., the effect of the social norms marketing campaigns over time) and outlet density. The models were also stratified by campus alcohol outlet density (high vs. low) to examine the effect of the intervention in each type of setting. Results: There was a significant interaction between the treatment effect and on-premise alcohol outlet density for one of the drinking outcomes targeted by the SNMRP intervention, the number of drinks when partying, and marginal evidence of interaction effects for two other outcomes, maximum recent consumption and a composite drinking scale. In stratified analyses, an intervention effect was observed for three of the four outcomes among students from campuses with lower on-premise alcohol outlet density, whereas no intervention effect was observed among students from campuses with higher on-premise alcohol outlet density. Conclusions: The findings suggest that the campus alcohol environment moderates the effect of social norms marketing interventions. Social norms marketing intervention may be less effective on campuses with higher densities of on-sale alcohol outlets. (J. Stud. Alcohol Drugs. 72. 232-239, 2011), COLLEGE STUDENTS HAVE inflated perceptions of how much alcohol their peers drink (Borsari and Carey, 2001; Perkins and Berkowitz, 1986). Some prevention experts have called for widespread campus-based social norms [...]

Objective: This article extends the compartmental model previously developed by Scribner et al. in the context of college drinking to a mathematical model of the consequences of lowering the legal drinking age. Method: Using data available from 32 U.S. campuses, the analyses separate underage and legal age drinking groups into an eight-compartment model with different alcohol availability (wetness) for the underage and legal age groups. The model evaluates the likelihood that underage students will incorrectly perceive normative drinking levels to be higher than they actually are (i.e., misperception) and adjust their drinking accordingly by varying the interaction between underage students in social and heavy episodic drinking compartments. Results: The results evaluate the total heavy episodic drinker population and its dependence on the difference in misperception, as well as its dependence on underage wetness, legal age wetness, and drinking age. Conclusions: Results suggest that an unrealistically extreme combination of high wetness and low enforcement would be needed for the policies related to lowering the drinking age to be effective. (J Stud, Alcohol Drugs. 72. 15-23, 2011), ALCOHOL USE ON COLLEGE CAMPUSES continues to be a subject of concern both in terms of health consequences and social costs (National Institute of Alcohol Abuse and Alcoholism, 2002). Alcohol-related [...]

It has been widely recognized that an epidemiological study limited to individual risk factors will not be adequate to address the current public health challenges of human immunodeficiency virus (HIV)/acquired [...]

Objective: The purpose of this study was to assess the relationships among campus violence, student drinking levels, and the physical availability of alcohol at off-campus outlets in a multi-site design. Method: An ecological analysis of on-campus violence was conducted at 32 U.S. colleges. Dependent variables included campus-reported rates of rape, robbery, assault, and burglary obtained from a U.S. Department of Education online database for the years 2000-2004. Measures of student alcohol use and demographics were obtained from student surveys conducted for the Social Norms Marketing Research Project from 2000 to 2004. Measures of alcohol-outlet density within 3 miles of each campus were obtained from state alcohol-licensing authorities for 2004. Results: Both on- and off-premise alcohol-outlet densities were associated with the campus rape-offense rate but not with the assault or robbery rates. Student drinking level was associated with both campus rape and assault rates but not with the campus robbery rate. The apparent effect of on-premise outlet density on campus rape-offense rates was reduced when student drinking level was included in the model, suggesting that the effect of on-premise outlet density may be mediated by student drinking level. Separate analyses revealed a similar mediational role for off-premise outlet density. Conclusions: These findings demonstrate that there is a campus-level association between sexual violence and the campus-community alcohol environment. (J. Stud. Alcohol Drugs, 71, 184-191, 2010), ATTENTION TO THE ISSUE of campus violence was sparked by the 1986 rape and murder of Jeanne Clery, a 19-year-old woman at Lehigh University. Jeanne Clery's parents campaigned for greater [...]

Objective: The misuse and abuse of alcohol among college students remain persistent problems. Using a systems approach to understand the dynamics of student drinking behavior and thus forecasting the impact of campus policy to address the problem represents a novel approach. Toward this end, the successful development of a predictive mathematical model of college drinking would represent a significant advance for prevention efforts. Method: A deterministic, compartmental model of college drinking was developed, incorporating three processes: (1) individual factors, (2) social interactions, and (3) social norms. The model quantifies these processes in terms of the movement of students between drinking compartments characterized by five styles of college drinking: abstainers, light drinkers, moderate drinkers, problem drinkers, and heavy episodic drinkers. Predictions from the model were first compared with actual campus-level data and then used to predict the effects of several simulated interventions to address heavy episodic drinking. Results: First, the model provides a reasonable fit of actual drinking styles of students attending Social Norms Marketing Research Project campuses varying by 'wetness' and by drinking styles of matriculating students. Second, the model predicts that a combination of simulated interventions targeting heavy episodic drinkers at a moderately 'dry' campus would extinguish heavy episodic drinkers, replacing them with light and moderate drinkers. Instituting the same combination of simulated interventions at a moderately 'wet' campus would result in only a moderate reduction in heavy episodic drinkers (i.e., 50% to 35%). Conclusions: A simple, five-state compartmental model adequately predicted the actual drinking patterns of students from a variety of campuses surveyed in the Social Norms Marketing Research Project study. The model predicted the impact on drinking patterns of several simulated interventions to address heavy episodic drinking on various types of campuses., COLLEGE DRINKING IS RECOGNIZED as a major problem at institutions of higher learning across the United States (Task Force of the National Advisory Council on Alcohol Abuse and Alcoholism, 2002). [...]

The objective of the study is to examine the relationship between the physical availability of off-campus alcohol and drinking outcomes among college students. Method: A multilevel analysis of students (N = 17,051) nested within college campuses (N = 32) was conducted. Four problem-drinking-related outcomes (i.e., average number of drinks when partying, frequency of drunkenness in past 2 weeks, 30-day frequency of drinking, and greatest number of drinks in one sitting) along with individual level covariates of drinking were introduced at the student level. The physical availability of alcohol was assessed as the number of on-premise and off-premise alcohol outlets within 3 miles of campus per 1,000 students enrolled. Results: Higher densities of on-premise alcohol outlets were strongly related to drinking outcomes even after controlling for individual predictors of college drinking. The association indicated that the campus means for the average number of drinks when partying and the number of drinking occasions in the past 30 days were, respectively, 1.13 drinks and 1.32 occasions greater when the outlet density was 2 SDs higher. Conclusions: Off-campus, on-premise outlet density is strongly associated with college-drinking outcomes. Given the limited number of modifiable factors that affect college drinking, on-premise outlet density represents a potential modifiable means of addressing the problem., ALCOHOL-RELATED PROBLEMS AMONG college students represent a serious threat to American higher education. In 2002, a task force of the National Institute on Alcohol Abuse and Alcoholism (NIAAA) issued recommendations [...]

Objective: Neighborhoods represent a unique level of analysis where social and material determinants of social capital may be lodged. The 1992 civil unrest in Los Angeles following the Rodney King verdict provided an opportunity to determine if a change in the material environment (i.e., the loss of off-sale alcohol outlets) resulted in a subsequent change in a potential indicator of social capital--civic engagement--as measured by voting rates. Method: Longitudinal analyses of voting rates between 1990 and 1996 for the 480 census tracts affected by the civil unrest were conducted. Tracts that lost and did not lose off-sale alcohol outlets were compared using piecewise hierarchical models that accounted for both time-varying and census-tract-level confounders, as well as for spatial autocorrelation. Results: In the postunrest period, the increase in voting was significantly greater in tracts where there was a loss of alcohol outlets (β = 0.393, p < .05). Findings remained after taking into account time-varying effects of the changes in ethnicity, gender, and age; and baseline effects of voting, potential for social organization, outlet density, and deprivation. The loss of alcohol outlets was associated with an average 3.0% increase in voting rate in the postunrest period, translating into an average increase of 50-212 voters per tract, depending on the size of the tract. Conclusions: Loss of off-sale alcohol outlets in the 1992 civil unrest was associated with increased voting at the census tract level. Findings support the concept that loss of alcohol outlets in the neighborhood environment may contribute to the development of social capital, possibly through social network expansion. (J Stud. Alcohol Drugs 68: 934-943, 2007), SOCIAL CAPITAL REMAINS AN IMPORTANT concept in understanding health disparities among poor and minority populations, albeit one whose operationalization varies across researchers (Baum, 2000; Carpiano, 2006; Muntaner and Lynch, 2002; [...]

Objective: An 18-site randomized trial was conducted to determine the effectiveness of social norms marketing (SNM) campaigns in reducing college student drinking. The SNM campaigns are intended to correct misperceptions of subjective drinking norms and thereby drive down alcohol consumption. Method: Institutions of higher education were randomly assigned to treatment and control groups. At the treatment group institutions, SNM campaigns delivered school-specific, data-driven messages through a mix of campus media venues. Cross-sectional student surveys were conducted by mail at baseline (n = 2,771) and at posttest 3 years later (n = 2,939). Hierarchical linear modeling was applied to examine multiple drinking outcomes, taking intraclass correlation into account. Results: Controlling for other predictors, having an SNM campaign was significantly associated with lower perceptions of student drinking levels and lower alcohol consumption, as measured by a composite drinking scale, recent maximum consumption, blood alcohol concentration for recent maximum consumption, drinks consumed when partying, and drinks consumed per week. A moderate mediating effect of normative perceptions on student drinking was demonstrated by an attenuation of the Experimental Group x Time interaction, ranging from 16.4% to 39.5% across measures. Additional models that took into account the intensity of SNM campaign activity at the treatment institutions suggested that there was a dose-response relationship. Conclusions: This study is the most rigorous evaluation of SNM campaigns conducted to date. Analysis revealed that students attending institutions that implemented an SNM campaign had a lower relative risk of alcohol consumption than students attending control group institutions., RESEARCHERS HAVE SHOWN THAT COLLEGE students greatly overestimate the percentage of their peers who drink heavily (Baer et al., 1991; Borsari and Carey, 2003; Perkins and Berkowitz, 1986). A recent [...]

This study tests the effect of neighborhood changes on gonorrhea rates. Prior studies that indicate gonorrhea rates are associated with alcohol outlet density and neighborhood deterioration have been cross-sectional and cannot establish causality. After the 1992 Civil Unrest in Los Angeles, 270 alcohol outlets surrendered their licenses due to arson and vandalism thus providing a natural experiment. We geocoded all reported gonorrhea cases from 1988 to 1996 in LA County, all annually licensed alcohol outlets, and all properties damaged as a result of the civil unrest. We ran individual growth models to examine the independent effects of changes in alcohol outlets and damaged buildings on gonorrhea. The individual growth model explained over 90% of the residual variance in census tract gonorrhea rates. After the civil unrest, a unit decrease in the number of alcohol outlets per mile of roadway was associated with 21 fewer gonorrhea cases per 100,000 (p< .01) in tracts affected by the Unrest compared to those not affected. Neighborhood alcohol outlets appear to be significantly associated with changes in gonorrhea rates. The findings suggest that efforts to control sexually transmitted diseases, including gonorrhea and HIV, should address contextual factors that facilitate high-risk behaviors and disease transmission Keywords: Gonorrhea; Alcohol outlets; Civil unrest; 'Broken windows'; GIS; Los Angeles; Growth model

The aim of this paper is to evaluate the effectiveness of an intervention to deter underage alcohol sales by targeting alcohol retailers instead of underage youth. A quasi-experiment using a repeated-intervention design was conducted for a random sample (n = 143) of off-sale alcohol outlets from across New Orleans. Compliance checks of off-sale outlets were conducted at baseline, two months after the intervention, and eight months after the intervention. At baseline, only 11.2% (16/143) of outlets were compliant. Following the intervention, compliance increased to 39.9% (p