Biomedical subjects

D M Murray

Publications and source records attributed to D M Murray.

154 records · Page 9Linked to original sources

PubMedDate not supplied

Measurement of alcohol and tobacco availability to underage students.

Communities Mobilizing for Change on Alcohol (CMCA) and Tobacco Policy Options for Prevention (TPOP) are randomized multicommunity trials designed to reduce the availability of alcohol (CMCA) and tobacco (TPOP) products to underage youth. We assessed the test-retest reliability and internal consistency of perceived availability measures developed for surveys of middle and high school students. Two questionnaires were administered twice, each to separate student populations (CMCA: 9th graders; TPOP; 8th graders) 21 to 26 days apart. A total of 111 (CMCA) and 70 (TPOP) subjects participated at both times (participation rate of 93.3% and 84.3%, respectively). There were no statistically significant differences in the distribution of demographic variables, alcohol or tobacco use variables, or availability variables across administrations. The scales assessing perceived access to alcohol or tobacco had high internal consistency (Cronbach's alpha of 0.84 for alcohol and 0.77 for tobacco), but moderate to low test-retest correlations (0.58 and 0.13, respectively). Single-item measures of sources of alcohol and tobacco and reported buy attempts also had moderate to low test-retest correlates (0.10-0.65). We recommend that items assessing tobacco and alcohol availability to underage youth be further developed.

Adolescent↗

PubMedDate not supplied

Intraclass correlation among measures related to tobacco use by adolescents: estimates, correlates, and applications in intervention studies.

Tobacco intervention studies that employ a community trial design require adjustment to the usual analytic methods to account for the allocation of intact social groups to study conditions and the positive intraclass correlation (p) that is inevitable in such a design. In the absence of valid estimates of the relevant p, investigators seeking to establish an appropriate sample size could only guess about the magnitude of the problem. We recently published estimates of p for common measures of adolescent tobacco use, but those estimates were unadjusted for potential covariates and so represented an upper limit on the magnitude of p. This report demonstrates how estimates of intraclass correlation may be substantially reduced through regression adjustment for easily measured covariates. Results show that both the p and the residual variance can be reduced, by an average of 20 and 11%, respectively, offering greater efficiency for investigators who plan future studies and who are able to measure those covariates in their studies. Future work should seek both to replicate this work and to extend it; for example, to cohort designs where the improvements might be even greater.

Adolescent↗

PubMedDate not supplied

Perceptions of the family mealtime environment and adolescent mealtime behavior: do adults and adolescents agree?

The family mealtime environment has great potential to affect the eating behaviors of youth in the family. It is difficult to determine the important elements of a healthy mealtime environment because a valid assessment of the family environment is so difficult to obtain.The objective of this study is to examine the level of agreement between adult and adolescent perceptions of the family mealtime environment and adolescent mealtime behavior.A telephone survey was used to query adult and adolescent family members about how they perceive the family mealtime environment and the adolescent's mealtime behavior. A convenience sample of 282 adult/adolescent pairs from four schools in the Minneapolis/St. Paul area completed the telephone surveys. Frequencies of responses and the associations between the adult and adolescent responses are presented. Pearson correlations and regression were used to examine the level of association between adult and adolescent responses. Mixed-model regression was used for the continuous variables, and mixed-model logistic regression was used for the dichotomous variables. This study showed very little concordance between adolescent and adult responses. Only one question regarding arguments about eating during mealtime showed concordance. Adults and adolescents living in the same household seem to have different perceptions of the family mealtime environment and adolescent eating patterns. Researchers need to be aware of and concerned with the validity of the use of self-report for descriptions of family mealtime. They also need to be aware of the difference in adult and adolescent perceptions and consider these differences when designing messages for the family.

Adolescent↗

PubMedDate not supplied

Intraclass correlation for measures from a worksite health promotion study: estimates, correlates, and applications.

Intervention trials that employ a group-randomized trial design require an adaptation of the usual analytic methods to account for the randomization of intact economic/social groups to study conditions and the positive ICC that is implied by such a design. In the absence of valid estimates of the ICCs for the outcomes of interest, investigators designing trials could only guess at how large a problem they faced and how much they would need to increase sample size to compensate. Aside from this paper, we are aware of only one other publication that provides such estimates, and that study provides estimates for only a handful of outcomes. Our purpose here has been to provide a replication and extension of those findings to a broader array of outcomes. The results presented here suggest that worksite-level ICCs for a variety of smoking and health-related outcomes are generally small and that these ICCs can generally be reduced by adjustment for individual-level characteristics. We have demonstrated how information about these ICCs can be incorporated in sample size calculations to avoid designing "underpowered" studies. Our results should assist investigators in planning studies to evaluate the effectiveness of worksite-based health promotion efforts.

Adult↗

PubMedDate not supplied

Seasonal variation in plasma cholesterol distributions: implications for screening and referral.

In 3,377 men and 3,900 women who participated in a community-based plasma cholesterol screening program, we found a significant cyclic time-trend in cholesterol levels, with maximum peak in January. The 95% confidence interval (CI) of the peak to trough distance was 5.8-13.8 mg/dL (0.15-0.36 mmol/L) in men, corresponding to 2.6%-6.3% of the average cholesterol level. Corresponding figures for women were 2.0-9.3 mg/dL (0.05-0.24 mmol/L) or 1.0%-4.6%. Applying the cutoff level for high cholesterol risk proposed by the National Cholesterol Education Program (< or = 240 mg/dL [6.21 mmol/L]) to sex-specific bimonthly distributions, we found a statistically significant variation in prevalence, attributable to seasonal trends, in men (P < .01), but not in women. In men, the age-adjusted prevalence in winter (25.4%) was double that in the summer (13.5%). Seasonal variation is an important determinant of the prevalence of hypercholesterolemia in men and should be considered in patient follow-up and screening.

Age Factors↗

PubMedDate not supplied

Estimated distributions for total body surface area of men and women in the United States.

For the U.S. population in the age range 18 to 74 years, we estimated distributions for total body surface area for men and women using Monte Carlo simulations based on estimated bivariate distributions for height and weight. Surface area is well fit by individual lognormal distributions for men and women. These distributions are appropriate for use in public health risk assessments. We also examined the effect of the correlation between height and weight on the surface area distributions.

Adult↗

PubMedDate not supplied

Population screening and referral for hypercholesterolemia.

To determine the potential effect of screening on referral patterns, an adult population sample (4,404 men, 5,164 women, 20-69 years of age) was systematically recruited and screened for hypercholesterolemia and then analyzed by different cholesterol referral recommendations. Using levels suggested by the Lipid Research Clinics Coronary Primary Prevention Trial (greater than or equal to 265 mg/dL), 7.3% of men and 5.8% of women would be referred for follow-up. With the suggested recommendations of the National Cholesterol Education Program (NCEP), (greater than or equal to 200 mg/dL), 49.2% of men and 40.2% of women would be referred. The use of age-related definitions of the NIH Consensus Conference on Lipid Lowering results in 28.0% referrals in men and 21.8% in women. From this population, hypercholesterolemia subjects (greater than or equal to 265 mg/dL at screening; n = 624) were invited for a second cholesterol determination (58% returned), which found 36% below the 265 mg/dL level. Population screening for cholesterol is likely to produce large numbers of patients for follow-up, with the actual numbers strongly dependent on cutoff levels and age-sex distributions. Referral and follow-up of these patients may place a significant load on an unprepared health care community.

Adult↗

PubMedDate not supplied

Direct mail as a prompt for follow-up care among persons at risk for hypertension.

We undertook a direct mail campaign to urge persons identified as being at risk for hypertension to seek medical advice. Those who received a single mailing displayed a 28% increase in the proportion who subsequently discussed their blood pressure with a physician and a 12% increase in the proportion who had their blood pressure rechecked, while those persons who received six mailings reported an equivalent increase in physician discussions but a smaller increase in rechecking their blood pressure. These results support the use of inexpensive social marketing strategies as follow-up methods for blood pressure screening programs.

Adult↗

PubMedDate not supplied

Characteristics of participants and nonparticipants in a community cardiovascular disease risk factor screening: the Minnesota Heart Health Program.

This research attempts to characterize participants and nonparticipants in a cardiovascular risk screening and education program in terms of their beliefs about personal susceptibility to heart disease, integration into the community, and general pattern of health-promoting behaviors. Telephone surveys were conducted with 76 participants and 76 nonparticipants in the risk factor screening. Participation was strongly related to several health-promoting behaviors (dental checkups and seat belt use) and several measures of integration into the community. Health beliefs (in personal threat, susceptibility to disease, and the efficacy of preventive action) were not related to participation. Future research in the area of program participation may need to move beyond the model of disease-specific health beliefs to the realms of social pressures to participate and general health values.

Age Factors↗

PubMedDate not supplied

Perceived and measured availability of tobacco to youths in 14 Minnesota communities: the TPOP Study. Tobacco Policy Options for Prevention.

INTRODUCTION: Availability of tobacco to young people is believed to be an important factor in the onset of tobacco use. We still do not have a complete picture of how tobacco is obtained by youths or how access can be curtailed. DESIGN: This article describes tobacco availability to youths in 14 communities that are part of a randomized trial, known as TPOP (Tobacco Policy Options for Prevention). The data reported here were obtained from student surveys and tobacco-purchase attempts by underage confederates. RESULTS: Students who have smoked at least once were likely to cite social sources for cigarettes. However, more than half of weekly smokers and almost one third of tenth-grade ever smokers reported purchasing cigarettes in the last 30 days. Tobacco-purchase attempts by confederate buyers at all outlets resulted in an overall success rate of 40.8%, lower than previously reported for urban communities. Fifty-five percent of the over-the-counter outlets had no self-service displays of tobacco at baseline. Store factors that predicted purchase success include tobacco location; purchase success was lower when all tobacco was locked or behind a service counter. The percentage of smokers who reported purchasing their own tobacco soon after starting to smoke was highest in towns where purchase success by teenage study confederates was highest. CONCLUSIONS: These results suggest that sources of cigarettes shift from social to commercial with age and that sources of cigarettes for rural youths may be different than for urban youths.

Adolescent↗