Biomedical subjects

Deborah Rohm Young

Publications and source records attributed to Deborah Rohm Young.

At least 19 recordsLinked to original sources

PubMed2006

Associations between family support, family intimacy, and neighborhood violence and physical activity in urban adolescent girls.

We examined the association between various dimensions of the family environment, including family intimacy and involvement in activities, family support for physical activity, and neighborhood violence (perceived and objective) and physical activity among urban, predominantly African American, ninth-grade girls in Baltimore, Md. Greater family intimacy (P = .05) and support (P = .01), but not neighborhood violence, was associated with physical activity. Family factors, including family intimacy and support, are potential targets in physical activity interventions for urban high-school girls.

Adolescent↗

PubMed2006

A description of the social-ecological framework used in the trial of activity for adolescent girls (TAAG).

Social-ecological (SE) models are becoming more widely used in health behavior research. Applying SE models to the design of interventions is challenging because models must be tailor-made for each behavior and population, other theories need to be integrated into multi-level frameworks, and empirical research to guide model development is limited. The purpose of the present paper is to describe a SE framework that guided the intervention and measurement plans for a specific study. The trial of activity for adolescent girls (TAAG) is a multi-center study of interventions to reduce the decline of physical activity in adolescent girls. The TAAG framework incorporates operant learning theory, social cognitive theory, organizational change theory and the diffusion of innovation model in a multi-level model. The explicit and practical model developed for TAAG has already benefited the study and may have elements that can generalize to other health promotion studies.

Adolescent↗

PubMed2006

PREMIER--a trial of lifestyle interventions for blood pressure control: intervention design and rationale.

Interventions encouraging adoption of healthy diets and increased physical activity are needed to achieve national goals for preventing and treating hypertension, cardiovascular disease, diabetes, and other chronic diseases. PREMIER was a multicenter clinical trial testing the effects of two lifestyle interventions on blood pressure control, compared with advice only. Both interventions implemented established national guidelines for blood pressure control (weight loss, reduced sodium and alcohol intake, and increased physical activity), and one intervention also included the Dietary Approaches to Stop Hypertension (DASH) diet. Both interventions focused on behavioral self-management, motivational enhancement, and personalized feedback. This article describes the design and evaluation approaches for these interventions. Evaluation of multicomponent lifestyle change interventions can help us understand the benefits and difficulties of making multiple lifestyle changes concurrently and the effects such changes can have on blood pressure, particularly in minorities at higher risk for hypertension.

Adult↗

PubMed2006

Effects of comprehensive lifestyle modification on diet, weight, physical fitness, and blood pressure control: 18-month results of a randomized trial.

BACKGROUND: The main 6-month results from the PREMIER trial showed that comprehensive behavioral intervention programs improve lifestyle behaviors and lower blood pressure. OBJECTIVE: To compare the 18-month effects of 2 multicomponent behavioral interventions versus advice only on hypertension status, lifestyle changes, and blood pressure. DESIGN: Multicenter, 3-arm, randomized trial conducted from January 2000 through November 2002. SETTING: 4 clinical centers and a coordinating center. PATIENTS: 810 adult volunteers with prehypertension or stage 1 hypertension (systolic blood pressure, 120 to 159 mm Hg; diastolic blood pressure, 80 to 95 mm Hg). INTERVENTIONS: A multicomponent behavioral intervention that implemented long-established recommendations ("established"); a multicomponent behavioral intervention that implemented the established recommendations plus the Dietary Approaches to Stop Hypertension (DASH) diet ("established plus DASH"); and advice only. MEASUREMENTS: Lifestyle variables and blood pressure status. Follow-up for blood pressure measurement at 18 months was 94%. RESULTS: Compared with advice only, both behavioral interventions statistically significantly reduced weight, fat intake, and sodium intake. The established plus DASH intervention also statistically significantly increased fruit, vegetable, dairy, fiber, and mineral intakes. Relative to the advice only group, the odds ratios for hypertension at 18 months were 0.83 (95% CI, 0.67 to 1.04) for the established group and 0.77 (CI, 0.62 to 0.97) for the established plus DASH group. Although reductions in absolute blood pressure at 18 months were greater for participants in the established and the established plus DASH groups than for the advice only group, the differences were not statistically significant. LIMITATIONS: The exclusion criteria and the volunteer nature of this cohort may limit generalizability. Although blood pressure is a well-accepted risk factor for cardiovascular disease, the authors were not able to assess intervention effects on clinical cardiovascular events in this limited time and with this sample size. CONCLUSIONS: Over 18 months, persons with prehypertension and stage 1 hypertension can sustain multiple lifestyle modifications that improve control of blood pressure and could reduce the risk for chronic disease.

Adult↗

PubMed2006

Effects of a life skills intervention for increasing physical activity in adolescent girls.

BACKGROUND: Although adolescence is a time when physical activity levels decline, few interventions have targeted high school-aged girls in the school setting. OBJECTIVE: To evaluate the effects of a life skills-oriented physical activity intervention for increasing overall physical activity in high school-aged girls. DESIGN: Randomized controlled trial. SETTING: Baltimore magnet high school. PARTICIPANTS: A total of 221 ninth-grade girls, 83.0% of whom were African American. Intervention Participants were randomized to an 8-month physical intervention conducted in physical education class or to a standard physical education class (control). MAIN OUTCOME MEASURES: Self-reported estimated daily energy expenditure (physical activity), self-reported sedentary activities (television viewing and computer or Internet use), cardiorespiratory fitness, and selected cardiovascular disease risk factors. RESULTS: Intervention classes spent 46.9% of physical education class time in moderate to vigorous activity compared with 30.5% of time for control classes (P<.001). There were no significant between-treatment group differences for mean daily energy expenditure (P = .93), moderate-intensity energy expenditure (P = .77), or hard to very hard energy expenditure (P = .69). The proportion of participants who spent 3 or more hours viewing television during school days declined from 22.3% to 17.0% in the intervention group, but remained at 26.7% for the control group (P = .03). Both groups improved their cardiorespiratory fitness (P<.001). CONCLUSION: A life skills-oriented physical education curriculum may need to be combined with other approaches to increase the magnitude of effects on physical activity behavior in predominantly African American high school-aged girls.

Adolescent↗

PubMed2006

Physical activity attitudes, preferences, and practices in African American, Hispanic, and Caucasian girls.

Physical activity levels in girls decline dramatically during adolescence, most profoundly among minorities. To explore ethnic and racial variation in attitudes toward physical activity, semistructured interviews (n = 80) and physical activity checklists (n = 130) are conducted with African American, Hispanic, and Caucasian middle school girls in six locations across the United States. Girls from all groups have similar perceptions of the benefits of physical activity, with staying in shape as the most important. Girls have similar negative perceptions of physical activity, including getting hurt, sweating, aggressive players, and embarrassment. Chores, running or jogging, exercises, and dance are common activities for girls regardless of ethnicity. Basketball, swimming, running, and dance are commonly cited favorite activities, although there are slight differences between ethnic groups. The results suggest that factors other than ethnicity contribute to girls' physical activity preferences and that distinct interventions may not be needed for each ethnic group.

Adolescent↗

PubMed2006

Data to action: using formative research to develop intervention programs to increase physical activity in adolescent girls.

Formative research is used to inform intervention development, but the processes of transmitting results to intervention planners and incorporating information into intervention designs are not well documented. The authors describe how formative research results from the Trial of Activity for Adolescent Girls (TAAG) were transferred to planners to guide intervention development. Methods included providing oral and written reports, prioritizing recommendations, and cross-checking recommendations with intervention objectives and implementation strategies. Formative work influenced the intervention in many ways. For example, results indicated that middle schools offered only coeducational physical education and health education classes, so the TAAG intervention was designed to be appropriate for both sexes, and intervention strategies were developed to directly address girls' stated preferences (e.g., enjoyable activities, opportunity to socialize) and barriers (e.g., lack of skills, fear of injury) for physical activity. The challenges of using formative research for intervention development are discussed.

Adolescent↗

PubMed2006

Does weight status influence perceptions of physical activity barriers among African-American women?

BACKGROUND: Many African-American women fail to participate in regular physical activity. Weight status may influence physical activity barriers. This study examined the frequency and type of barriers. METHODS: Participants in this study were enrolled in Project EXE-L (Exercising Ladies Excel), a six-month, church-based, randomized trial of moderate-intensity physical activity based in Baltimore city and county in Maryland. Participants were composed of African-American women who attended one of the participating churches, had friends who were church members, or who lived in neighborhoods surrounding one of the churches. Individuals who were between the ages of 25 and 70 years, were not regularly physically active (defined as not engaging in moderate-intensity activity more than three times per week), and were able to participate in moderate-intensity activity met eligibility criteria to participate in the trial. Barriers to physical activity were evaluated with the Steinhardt/Dishman Barriers for Habitual Physical Activity Scale at baseline. RESULTS: One hundred twenty women were classified as normal weight (body mass index [BMI]: <25 kg/m2), overweight (BMI: 25-29.9 kg/m2), or obese (BMI: > or = 30 kg/m2). Obese participants were more likely to report "lack of motivation" as a barrier compared with normal-weight participants (63% vs 31%). Normal-weight and overweight participants were more likely to report no barriers compared with the obese (31%, 0%, 5%, respectively, P<.05). CONCLUSIONS: Barriers for African-American women may vary by BMI status. By defining these unique barriers, effective physical activity interventions can be developed.

Adult↗

PubMed2004

Health status among urban African American women: associations among well-being, perceived stress, and demographic factors.

The purpose of this study was to evaluate the associations among health status, well-being, and perceived stress in a sample of urban African American women. African American women (n = 128) (Mean +/- SD, 49.3 +/- 10.5) from Baltimore, Maryland, enrolled in a church-based physical activity randomized trial were included in the analysis. Health status was assessed from the SF-36. Well-being, perceived stress, and demographics were also determined from self-report. Results indicated that the sample reported favorable health status, well-being, and stress levels compared to mean levels reported in the literature. Spearman rank-order correlations indicated that perceived stress score negatively correlated with most health status dimensions and well-being in the present, past, and future. Multiple regression analyses, adjusting for potential demographic confounders, indicated that higher perceived stress was associated with lower health status and well-being. If these results are confirmed in prospective investigations, they suggest that interventions designed to reduce stress may impact health status and future morbidity and mortality.

Adult↗

PubMed2004

Disparities in women's referral to and enrollment in outpatient cardiac rehabilitation.

OBJECTIVE: The purpose of this study was to determine the predictors of referral and enrollment, including racial differences, in phase 2 cardiac rehabilitation programs among African-American and white women who are eligible for such programs. DESIGN: Prospective longitudinal design. SETTING: One large academic medical center and two large community hospitals. PATIENTS: A total of 253 women (108 African American, 145 white) were surveyed within the first month of discharge from the hospital for a percutaneous coronary intervention, coronary artery bypass surgery, or myocardial infarction without revascularization. A total of 234 (99 African American, 135 white) completed the 6-month follow-up. MAIN RESULTS: The rate of referral to outpatient phase 2 cardiac rehabilitation was significantly lower for African-American women compared with white women, 12 (12%) versus 33 (24%) (P=.03). Only 35 (15%) of women in the study reported enrollment in phase 2 cardiac rehabilitation programs, with fewer African-American women reporting enrollment compared with white women, 9 (9%) versus 26 (19%) (P=.03). Controlling for age, education, angina class, and comorbidities, women with annual incomes <20,000 dollars were 66% less likely to be referred to cardiac rehabilitation (P=.01) and 60% less likely to enroll compared to women with incomes >20,000 dollars (P=.01). Although borderline significant, African-American women were 55% less likely to be referred (P=.059) and 58% less likely to enroll (P=.059) than white women. CONCLUSIONS: We found disparities in cardiac rehabilitation program participation, with women with lower incomes less likely to be referred and to have lower enrollment rates in cardiac rehabilitation and a strong trend for African-American women to be less likely to be referred and enroll. Because almost all patients who have had an acute coronary event, with or without revascularization procedures, will benefit from cardiac rehabilitation, automatic referral systems should be considered to increase utilization and reduce disparities.

Black or African American↗

PubMed2004

Comparison of two approaches to structured physical activity surveys for adolescents.

PURPOSE: To compare the test-retest reliability, convergent validity, and overall feasibility/ usability of activity-based (AB) and time-based (TB) approaches for obtaining self-reported moderate-to-vigorous physical activity (MVPA) from adolescents. METHODS: Adolescents (206 females and 114 males) completed two 3-d physical activity recalls using the AB and TB surveys, which contained identical lists of physical activities. The participants wore an MTI Actigraph accelerometer for the same period. RESULTS: The TB instrument took about 3 min longer to complete (P = 0.022). Overall 2-d test-retest correlations for MVPA were similar for the two surveys (r = 0.676 and 0.667), but the girls had higher reliability on the AB survey than the boys (girls: r = 0.713; boys: r = 0.568). The overall 3-d correlations for MVPA surveys and Actigraph counts varied by gender (girls: AB = 0.265 vs TB = 0.314; boys: AB = 0.340 vs TB = 0.277). Correlations for vigorous physical activity and Actigraph counts were higher for the AB than for the TB (r = 0.281 vs 0.162). As the interval between completing the surveys and the days being recalled increased, reliability and validity were lower, especially for the AB survey. CONCLUSION: For both genders, either approach is acceptable for obtaining MVPA information on a single day, but the TB approach appears to be slightly favored over the AB approach for obtaining multiple days of MVPA. A 3-d recall period appears to be too long for accurate recall of MVPA information from either instrument. For both genders, the surveys overestimated activity levels; thus, self-reports should be supplemented with objective data.

Adolescent↗

PubMed2003

Quantitative study of correlates of physical activity in women from diverse racial/ethnic groups: Women's Cardiovascular Health Network Project--introduction and methodology.

BACKGROUND: Physical activity is an important aspect of cardiovascular disease prevention. However, data show a high prevalence of physical inactivity among women and ethnic minority and low-income populations. The purpose of this introduction is to describe the Women's Cardiovascular Health Network Project and implementation of the Women and Physical Activity Survey. The goal of the survey was to identify personal, social environmental, and physical environmental factors that are associated with physical activity status among diverse groups of women. METHODS: Seven universities were funded to study factors that influence physical activity among African-American, Native American, Latina, and white women residing in rural, suburban, and urban living environments. An ecologic model was used to design a quantitative questionnaire that was implemented by telephone or face-to-face interviews in seven sites across the United States. RESULTS: The survey was completed by a total 4122 women, with group totals ranging from 300 to 1000. Results from each site are presented in individual articles in this issue. A summary of results that compare and contrast the groups is presented in an additional report. CONCLUSION: This study provides important information on the assessment of physical activity among women. Results can be used to help improve assessments and to develop more effective policies and interventions for unique groups of women.

Cardiovascular Diseases↗

PubMed2003

Personal, social, and environmental correlates of physical activity in urban African-American women.

BACKGROUND: African-American women are at risk of chronic diseases for which regular physical activity can provide benefits. This group, however, remains predominantly sedentary. Little research has been undertaken to elucidate the multiple factors that influence their physical activity levels. This study was designed to determine associations among personal, social environmental, and physical environmental factors with physical activity level in urban African-American women. METHODS: The Women and Physical Activity Survey, an interviewer-administered survey consisting of demographic, personal, and social and physical environmental factors, was given to 234 African-American women living in Baltimore, Maryland. Physical activity level was determined from the Behavioral Risk Factor Surveillance System survey. Women were divided into three groups: meeting current recommendations for moderate or vigorous physical activity, insufficiently active, and inactive. Comparisons were made between the group of women that met recommendations versus women who did not, and women who reported any activity versus women who were inactive. RESULTS: Twenty-one percent (48) of women met recommendations for physical activity, 61% (143) were insufficiently active, and 18% (43) were inactive. Women who had a partner or who had no children were less likely to engage in some physical activity. Inactive women were more likely than women who participated in some physical activity to know people who exercised. Women who belonged to community groups were more likely to be inactive than women who met current recommendations for physical activity. Women with fewer social roles were more likely to meet current recommendations. Physical environment factors were not associated with physical activity level. CONCLUSIONS: Further exploration is needed to determine how personal and social environmental and physical environmental factors relate to physical activity in African-American women.

Adult↗

PubMed2003

Personal, social, and physical environmental correlates of physical activity levels in urban Latinas.

BACKGROUND: Nationwide, Hispanic women report low levels of physical activity and bear excess health risk associated with inactivity. This study investigated the relationship between physical activity levels and sociodemographic, social environmental, and physical environmental factors. DESIGN: A cross-sectional, community-based convenience sample of 285 Hispanic/Latino women completed a face-to-face survey administered in Spanish. MAIN OUTCOME MEASURES: The following categories of physical activity were used in analyses: "meets current national recommendations," which includes women who reported engaging in moderate activity at least 5 days per week for at least 30 minutes or who engaged in vigorous activity at least 3 days per week for at least 20 minutes; "insufficiently active" for women not meeting moderate or vigorous objectives; and "inactive" for women who report no moderate or vigorous physical activity. RESULTS: The majority of women (46%) were aged 20 to 29 years, 48% have less than or equal to a high school education, 72% are employed, 43% speak Spanish, and 76% are from Central or South America. A total of 37% of the women met physical activity recommendations, 23% were inactive, and 40% were insufficiently active. Personal and physical environmental factors were not statistically significant correlates of activity level comparison groups; however, most indicated trends in the hypothesized direction. Social environmental factors that showed statistically significant relationships with various physical activity comparison groups included the following: Women were significantly less likely to be active if they reported knowing people who exercise (odds ratio [OR]=0.42; 95% confidence interval [CI], 0.23-0.76), reported that there are people in the neighborhood who exercise (adjusted OR=0.19; 95% CI, 0.09-0.42), belonged to community groups (OR=0.32; 95% CI, 0.15-0.69), or attended religious services (OR=0.41; 95% CI, 0.41-0.72). CONCLUSION: Social environmental factors appeared to be the most important factors related to physical activity in this group of Latino women. Physical environment and personal factors, although not statistically significant, showed trends in expected directions and should be explored further.

Adult↗

PubMed2003

Quantitative study of correlates of physical activity in women from diverse racial/ethnic groups: The Women's Cardiovascular Health Network Project--summary and conclusions.

BACKGROUND: Physical activity is an important aspect of cardiovascular disease prevention. However, the populations that show high risk of cardiovascular disease also have high rates of physical inactivity. The purpose of this article was to summarize findings from the Women and Physical Activity Survey, part of the Women's Cardiovascular Health Network Project. The goal of the survey was to identify personal, social environmental, cultural, and physical environmental factors that are associated with physical activity status among a diverse group of women. METHODS: Seven universities were funded to study factors that influence physical activity among white, African American, Latina, and Native American women residing in rural, suburban, and urban living environments. An ecologic model and qualitative data from these population groups were used to design a quantitative questionnaire. The survey was implemented by telephone and face-to-face interviews in seven sites across the United States. RESULTS: Younger age, good general health, and high self-efficacy were the most consistent personal correlates associated with physical activity. Knowing people who exercise and attending religious services were the only social environmental factors with significant associations across population groups. With the exception of safety from crime, no physical environmental factors were consistently related to physical activity. Most groups had intervention suggestions that included access to facilities. CONCLUSION: This study identifies pertinent factors related to physical activity in women and addresses the differences in assessment among the groups. Because each group may have unique characteristics, it is important to assess all levels that could influence physical activity such as personal, social, environmental, and policy. The information can then be used to tailor interventions for the various groups.

Adult↗

PubMed2002

Nurse case management of hypercholesterolemia in patients with coronary heart disease: results of a randomized clinical trial.

BACKGROUND: Despite the large body of evidence confirming the effectiveness of lipid lowering for the secondary prevention of coronary heart disease (CHD) events, undertreatment of hyperlipidemia is common. This study tested the effectiveness of a nurse case management program to lower blood lipids in patients with CHD. METHODS: A total of 228 consecutive, eligible adults with hypercholesterolemia and CHD were recruited during hospitalization after coronary revascularization. Patients were randomized to receive lipid management, including individualized lifestyle modification and pharmacologic intervention, from a nurse practitioner for 1 year after discharge in addition to their usual care (NURS), or to usual care enhanced with feedback on lipids to their primary provider and/or cardiologist (EUC). RESULTS: Significantly more patients in the NURS group than in the EUC group achieved low-density lipoprotein cholesterol (LDL-C) levels <2.59 mmol/dL (100 mg/dL, 65% vs 35%, P =.0001). Favorable changes in lipids and lipoproteins were accompanied by significant improvements in dietary and exercise patterns in the NURS group. In a multivariate analysis adjusting for other covariates, being assigned to the NURS group (P =.0001) and being on a lipid-lowering medication (P =.001) were significant independent predictors of LDL-C level. CONCLUSIONS: Control of hypercholesterolemia in patients who have undergone coronary revascularization can be improved by a nurse case-management program. Because the National Cholesterol Education Program Adult Treatment Panel III guidelines have broadened the definition of high-risk populations that warrant aggressive treatment, nurse case-management programs may offer key opportunities to enhance appropriate application of new treatment paradigms.

Algorithms↗

PubMed2002

Environmental, policy, and cultural factors related to physical activity in a diverse sample of women: the Women's Cardiovascular Health Network Project--introduction and methodology.

Ethnic minority and low-income populations have some of the highest rates of cardiovascular disease (CVD) and the highest rates of physical inactivity, an independent risk factor for CVD. Ethnic minority and low-income women are especially at risk. Because programs designed to increase physical activity have the potential to reduce CVD rates in specific populations, research in this area is expanding. As part of the Women's Cardiovascular Health Network funded by the Centers for Disease Control and Prevention, the goal of this multi-site project is to identify factors, particularly environmental, policy, and cultural factors, that may influence physical activity among ethnic minority and low-income women ages 20-50 years. To achieve this goal, 42 focus groups were conducted in various locations throughout the United States with African American, American Indian, Latina and White women. Groups represented both urban and rural living environments. This article explains the basis for this project and the methodology used. Other articles in this series explain the results from the focus groups in detail.

Adult↗

PubMed2002

Environmental, policy, and cultural factors related to physical activity in well-educated urban African American women.

The purpose of this qualitative study was to identify environmental, policy, and cultural predictors of physical activity in urban African American women living in Baltimore, MD. Thirty-nine mostly well-educated women participated in eight focus group discussions, five for women aged 36 to 50 years and three for women 20 to 35 years of age. Transcripts were analyzed using QSR NUD*IST qualitative software, and themes were identified. The discussions identified numerous opportunities and barriers for physical activity. The women reported being aware of physical activity resources and facilities available to them, but they lacked time and motivation to participate. Family responsibilities and duties unique to African American women were cited often. The results suggest that providing more environmental facilities may not be sufficient to increase physical activity in well-educated urban African American women. Intervention strategies that place value on family and cultural responsibilities should be considered.

Adult↗