Biomedical subjects

Sara Wilcox

Publications and source records attributed to Sara Wilcox.

At least 37 records · Page 2Linked to original sources

PubMed2003

Recreational physical activity and the risk of breast cancer in postmenopausal women: the Women's Health Initiative Cohort Study.

CONTEXT: Women who are physically active have a decreased risk for breast cancer, but the types, amounts, and timing of activity needed are unknown. OBJECTIVE: To prospectively examine the association between current and past recreational physical activity and incidence of breast cancer in postmenopausal women. DESIGN, SETTING, AND PATIENTS: Prospective cohort study in 74 171 women aged 50 to 79 years who were recruited by 40 US clinical centers from 1993 through 1998. MAIN OUTCOME MEASURE: Incident invasive and in situ breast cancer. RESULTS: We documented 1780 newly diagnosed cases of breast cancer over a mean follow-up of 4.7 years. Compared with less active women, women who engaged in regular strenuous physical activity at age 35 years had a 14% decreased risk of breast cancer (relative risk [RR], 0.86; 95% confidence interval [CI], 0.78-0.95). Similar but attenuated findings were observed for strenuous physical activity at ages 18 years and 50 years. An increasing total current physical activity score was associated with a reduced risk for breast cancer (P =.03 for trend). Women who engaged in the equivalent of 1.25 to 2.5 hours per week of brisk walking had an 18% decreased risk of breast cancer (RR, 0.82; 95% CI, 0.68-0.97) compared with inactive women. Slightly greater reduction in risk was observed for women who engaged in the equivalent of 10 hours or more per week of brisk walking. The effect of exercise was most pronounced in women in the lowest tertile of body mass index (BMI) (<24.1), but also was observed for women in the middle tertile of BMI (24.1-28.4). CONCLUSIONS: These data suggest that increased physical activity is associated with reduced risk for breast cancer in postmenopausal women, longer duration provides most benefit, and that such activity need not be strenuous.

Aged↗

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

Test-retest reliability of a questionnaire on physical activity and its correlates among women from diverse racial and ethnic groups.

BACKGROUND: A better understanding of physical activity and its correlates is needed, especially among diverse populations of women. The objective of this study was to examine the test-retest reliability of a survey designed to measure physical activity and its correlates among women from diverse racial and ethnic groups. METHODS: Test and retest surveys were conducted in person or over the telephone with 344 white, Latina, African-American, and Native American women aged 20 to 50 years living in rural and urban areas of the United States. Reliability of self-reported physical activity and its correlates were determined using intraclass correlation coefficients (ICC) overall and separately by site and race/ethnicity. RESULTS: Of the women responding, 45% of the participants met recommendations for physical activity, 40% were insufficiently active, and 15% were inactive. Reliability for the physical activity measure was 0.69 (95% confidence interval [CI], 0.62-0.74), with an ICC of 0.30 to 0.95 across sites. Overall, the seven items on the physical environment had substantial reliability (ICC=0.64-0.91). The sense of community scale (0.79; 95% CI, 0.74-0.83), social issues (0.68; 95% CI, 0.61-0.74), social roles (0.64; 95% CI, 0.56-0.71), and self-efficacy for exercise (0.72; 95% CI, 0.66-0.77) all had acceptable reliability overall and across most sites. CONCLUSIONS: This study provides psychometric evidence that the questionnaire on physical activity and its correlates is reliable among diverse women aged 20 to 50 years from various racial and ethnic groups. These results suggest that test-retest reliability is not an obstacle to comparison of associations between physical activity and several hypothesized correlates of activity.

Adult↗

PubMed2003

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

BACKGROUND: Little is known about the correlates of physical activity among African-American women living in the southeastern United States. The purpose of this study was to assess the relationship of personal, social, cultural, environmental, and policy variables with physical activity among women in ethnic minority groups. METHODS: The Women and Physical Activity Survey was used in a telephone interview of 917 African-American women living in two counties in South Carolina. The sample of women was selected by random-digit dialing. RESULTS: Approximately one third (34.1%) of the women met current recommendations for moderate or vigorous physical activity, 49.4% were insufficiently active, and 16.5% were inactive. Meeting the recommendations or engaging in insufficient activity (versus inactive) was related to attaining higher educational levels, being married or with a partner; being in excellent or very good health, having greater self-efficacy, seeing people exercise in the neighborhood, having more favorable ratings of women who exercise (social issues score), having lower social role strain, and reporting the presence of sidewalks or lighter traffic in the neighborhood. CONCLUSION: Multiple factors influence physical activity. Interventions to increase physical activity should use multilevel approaches that incorporate the personal, social environmental, and physical environmental factors related to participation in physical activity.

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↗

PubMed2003

The effects of widowhood on physical and mental health, health behaviors, and health outcomes: The Women's Health Initiative.

This study examined whether widowhood was associated with physical and mental health, health behaviors, and health outcomes using a cross-sectional (N=72,247) and prospective (N=55,724) design in women aged 50-79 years participating in the Women's Health Initiative observational study (85.4% White). At baseline, married women reported better physical and mental health and generally better health behaviors than widowed women. Whereas women who remained married over the 3-year period showed stability in mental health, recent widows experienced marked impairments and longer term widows showed stability or slight improvements. Both groups of widows reported more unintentional weight loss over the 3-year period. Changes in physical health and health behaviors were inconsistent, with generally small effect sizes. Findings underscore the resilience of older women and their capacity to reestablish connections, but point to the need for services that strengthen social support among women who have difficulty during this transition.

Aged↗

PubMed2003

Psychosocial and perceived environmental correlates of physical activity in rural and older african american and white women.

African American and rural older women are among the least active segments of the population. This study, guided by social cognitive theory, examined the correlates of physical activity (PA) in 102 rural older women (41% African American; 70.6 +/- 9.2 years). In bivariate associations, education, marital status, self-efficacy, greater pros than cons, perceived stress, social support, and perceived neighborhood safety were positively associated with PA; age, depressive symptoms, perceived sidewalks, health care provider discussion of PA, and perceived traffic were negatively associated with PA. In a hierarchical regression analysis, the sociodemographic (R(2) = 23%), psychological (IR(2) = 9%), social (IR(2) = 6%), and perceived physical environmental (IR(2) = 9%) sets of variables were significant (p <.05) predictors of PA (model R(2) = 47%). In response to open-ended questions, most women cited individual and social factors as PA barriers and motivators; falls, injuries, and heart attacks were identified most often as risks. These findings support the importance of multilevel influences on PA in older rural women and are useful for informing PA interventions.

Black or African American↗

PubMed2002

Vigorous leisure activity through women's adult life: the Women's Health Initiative Observational Cohort Study.

This study described differences in vigorous activity participation recalled across the life span, assessed whether reports of past vigorous activity were associated with current participation, and examined factors associated with participation in current vigorous activity among women. After the exclusion of women aged 50-54 years, the study population included 71,837 multiethnic postmenopausal women aged 55-79 years who were participating in the Women's Health Initiative Observational Cohort Study, 1993-1998. Vigorous activity was assessed retrospectively for ages 18, 35, and 50 years and currently at enrollment into the study (median age, 65 years). Current participation in vigorous activity (>3 days/week) was low and consistent across racial/ethnic groups (13-16%). The prevalence of vigorous activity declined with age, with the largest decrease in vigorous activity occurring after age 50 years for all racial/ethnic groups. Current vigorous activity was generally higher among women with a lower body mass index, not currently smoking, in excellent general health, and of higher socioeconomic status across racial/ethnic groups. These data suggest that a lower prevalence of vigorous activity in the postmenopausal period is part of a complex of health-related attitudes and behaviors that transcends race/ethnicity. The perimenopausal period may be a critical juncture at which targeted and tailored interventions may help to achieve maintenance of physical activity into the postmenopausal period.

Adolescent↗

PubMed2002

Correlates of physical activity among women from diverse racial/ethnic groups.

OBJECTIVE: Women have lower rates of participation in leisure time physical activity than men and have been studied to a lesser extent than men. Because physical activity plays a vital role in overall health, it is important to identify factors than can help increase physical activity rates for women. METHODS: Defining and understanding correlates of physical activity is critical for at-risk populations and for planning effective interventions. This paper reviews research conducted in the past two decades on correlates of physical activity in women. An ecological model with an added physical environment component was used to organize the correlates. Studies conducted among adult white, black, American Indian, Asian, and Hispanic women are included. A total of 91 studies were reviewed. Many studies included white women, fewer studies included black and Hispanic women, and even fewer included American Indian women, and only 3 studies included Asian women. RESULTS: The correlates most studied are sociodemographic variables, with nonwhite race, lower educational levels, and older age most consistently associated with lower levels of physical activity. Few studies focused on environmental and policy correlates. Social support was an overwhelmingly positive determinant of physical activity for all groups of women. CONCLUSIONS: Based on these findings, we recommend that future research include more diverse groups of women and evaluate modifiable factors, such as psychological, interpersonal, and environmental correlates. Future research also should include more intervention and longitudinal studies.

Ethnicity↗

PubMed2002

Effects of moderate-intensity exercise on physiological, behavioral, and emotional responses to family caregiving: a randomized controlled trial.

BACKGROUND: The study objective was to determine the health and quality-of-life effects of moderate-intensity exercise among older women family caregivers. METHODS: This 12-month randomized controlled trial involved a volunteer sample of 100 women aged 49 to 82 years who were sedentary, free of cardiovascular disease, and caring for a relative with dementia. Participants were randomized to 12 months of home-based, telephone-supervised, moderate-intensity exercise training or to an attention-control (nutrition education) program. Exercise consisted of four 30- to 40-minute endurance exercise sessions (brisk walking) prescribed per week at 60% to 75% of heart rate reserve based on peak treadmill exercise heart rate. Main outcomes were stress-induced cardiovascular reactivity levels, rated sleep quality, and reported psychological distress. RESULTS: Compared with nutrition participants (NU), exercise participants (EX) showed significant improvements in the following: total energy expenditure (baseline and post-test means [SD] for EX = 1.4 [1.9] and 2.2 [2.2] kcal/kg/day; for NU = 1.2 [1.7] and 1.2 [1.6] kcal/kg/day; p <.02); stress-induced blood pressure reactivity (baseline and post-test systolic blood pressure reactivity values for EX = 21.6 [12.3] and 12.4 [11.2] mm Hg; for NU = 17.9 [10.2] and 17.7 [13.8] mm Hg; p <.024); and sleep quality (p <.05). NU showed significant improvements in percentages of total calories from fats and saturated fats relative to EX (p values <.01). Both groups reported improvements in psychological distress. Conclusions. Family caregivers can benefit from initiating a regular moderate-intensity exercise program in terms of reductions in stress-induced cardiovascular reactivity and improvements in rated sleep quality.

Athletic Injuries↗

PubMed2002

Factors influencing health-related quality of life in cardiac rehabilitation patients.

Associations of age, gender, cardiac procedure (coronary artery bypass grafting or percutaneous transluminal coronary angioplasty), risk stratification, and number of comorbidities with health-related quality of life (HRQL) were examined among 217 men and 84 women (mean age, 63+/-11 years) consecutively enrolled in a phase II cardiac rehabilitation program. Female gender and high-risk stratification were independently associated with impaired treatment gains in most areas of HRQL. Older age and having a greater number of comorbidities were also associated with impaired gains in specific areas. HRQL was generally lower at baseline but not post-treatment in coronary artery bypass grafting vs. percutaneous transluminal coronary angioplasty patients. Cardiac rehabilitation patients also had lower HRQL scores than an age-matched, normative sample at baseline (most areas) and post-treatment (mainly on role physical). Findings reinforce the need for cardiac rehabilitation programs to tailor assessments and risk factor modification strategies to patient characteristics associated with low levels of HRQL, especially in women and those with higher risk stratification.

Adult↗

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 African American women.

Six focus groups were conducted in South Carolina with African American women (n = 42) aged 19-51 years to identify factors that influence physical activity. Transcripts were analyzed using NUD*IST. Cultural influences were seen as more important in determining the type of physical activity than its level. Barriers to and enablers of physical activity were identified in the social and physical environments, as were policy issues affecting physical activity in the community and at the work site. Potential community and work site interventions were suggested. Child care and monetary costs were frequently cited as barriers to physical activity.

Adult↗

PubMed2002

Worry regarding major diseases among older African-American, Native-American, and Caucasian women.

This study examined worry regarding seven major diseases and their correlates in a sample of African-American (n = 57), Native-American (n = 50), and Caucasian (n = 53) women ages 36 to 91 years. African-American and Native-American women were most worried about developing cancer (44% and 50%, respectively) while Caucasian women were most worried about osteoporosis (37%) and cancer (33%). Women from each ethnic group were more worried about developing cancer than cardiovascular diseases and conditions. African-American and Native-American women were more worried than Caucasian women about developing diabetes and high cholesterol. Body mass index (BMI) was a consistent correlate of worry: heavier women were more worried about developing diseases than were leaner women. Other risk factors (e.g., physical activity, blood pressure), however, were generally not associated with disease worry. In fact, age was inversely associated with worry regarding diabetes, cancer, and osteoporosis. Although women who were more worried about developing cancer were more likely to perform monthly breast self-exams, worry regarding other diseases was not associated with preventive actions. These results are generally consistent with other studies that indicate women are more concerned about cancer than cardiovascular diseases.

Adult↗

PubMed2002

Perceptions of physical activity and personal barriers and enablers in African-American women.

OBJECTIVE: To examine perceptions of physical activity and physical activity barriers and enablers in African-American women. DESIGN AND METHODS: Six focus groups were conducted with 42 African-American women, aged 19-51 years, who resided in South Carolina. Transcripts were coded and analyzed using NUD*IST. RESULTS: Women initially thought of physical activity in terms of structured exercise but identified lifestyle physical activities when prompted. Participants held strong negative views of sedentary African-American women, and strong positive views of active African-American women. However, women cited several undesirable outcomes that could result from physical activity, including appearing too masculine. Body weight and physical activity were generally viewed as independent: participants stressed that one could be both fit and heavy. As a result, women believed the physical and mental health benefits of physical activity should be emphasized over weight-related outcomes in physical activity interventions. Factors found to be correlates of physical activity in adults in general were also cited by this population, including attitudes, perceived benefits and barriers, knowledge, self-motivation, and enjoyment. Additional themes included the priority placed on the needs of the family at the expense of one's own needs, the positive association between a healthy diet and being physically active, and equating being "busy" with being active. CONCLUSIONS: Physical activity interventions with African-American women may benefit from targeting correlates that are well-established with other populations, as well as correlates that appear unique to this population.

Adult↗

PubMed2002

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

Ethnic minority and low-income populations have the highest rates of cardiovascular disease and the lowest rates of leisure-time physical activity. Because physical activity reduces the risk of premature death and disability from cardiovascular disease, researching correlates to such activity in these populations is an important aspect of health promotion in the US. To identify environmental, policy, and cultural barriers to physical activity in women, The Women's Cardiovascular Health Network Project conducted focus groups with White, African American, Latina, and American Indian women aged 20-50 years. The focus groups were audiotaped, transcribed, and analyzed with QSR NUD*IST qualitative software using a set of codes developed a priori by the research team. Family priorities were a main barrier to physical activity in all the groups. Having multiple roles as wife, mother, daughter, and as an active community member was mentioned as time-consuming and difficult, leaving little time or energy for exercise. Cultural barriers, which varied among the groups, included acculturation issues, lack of community support, and lack of past experience with exercise. Physical activity interventions suggested involved work programs, family-friendly programs, increased social support, and the availability of safer places to exercise such as parks, well-lit walking trails, and recreation centers. Many of the barriers were common to all groups (e.g., family priority) while some were unique (e.g., lack of community support). Assessing and addressing the issues raised should be considered when planning physical activity-interventions for these populations.

Adult↗

PubMedDate not supplied

In their own voices: definitions and interpretations of physical activity.

Terms such as physical activity, exercise, and leisure are perceived and interpreted differently by people differing in gender, class, and sociocultural factors. We accessed multiple diverse data sources (including qualitative data recently collected in research and evaluation studies) to explore African-American and American Indian women's (age 40+) definitions, meanings, and interpretations of "physical activity". These women reported that physical activity is typically considered to be structured "exercise" and not incidental activities of daily life. The term "leisure" was interpreted from a cultural perspective as being lazy. These women also had difficulty understanding the meaning of "intensity" (e.g., "moderate", "vigorous"). Researchers must acknowledge and understand inconsistencies that arise and how these might influence design of, and responses to, self-report assessment of physical activity.

Adult↗

PubMedDate not supplied

An exercise program for women who are caring for relatives with dementia.

OBJECTIVE: This study describes factors related to retention and adherence to an exercise program for women caregivers. METHODS: One hundred sedentary women (average age = 62 years) caring for relatives with dementia were randomly assigned to an exercise program or an attention control (nutrition education) condition. Participants in the exercise condition received 12 months of home-based exercise counseling to achieve at least four exercise sessions per week, for at least 30 minutes per session. Adherence was tracked through monthly exercise logs, validated in a subsample by ambulatory heart rate and motion monitors. Participants also completed a psychosocial questionnaire battery at baseline and 12 months after randomization. RESULTS: Participants achieved a 12-month average exercise adherence rate of 74% (ie, three exercise sessions per week) with an average of 35 minutes per session. At 12 months, the exercise condition demonstrated increased knowledge of the benefits of exercise and increased motivational readiness for exercise compared with the nutrition education condition. Both groups significantly improved in perceived stress, burden, and depression from baseline to posttest. Women who were older, less depressed, and more anxious at baseline showed better program retention, and lower baseline depression was associated with better exercise adherence. CONCLUSIONS: This study demonstrates the feasibility and success of delivering home-based health promotion counseling for improving physical activity levels in a highly stressed and burdened population. Given the independent risk factors of caregiving and physical inactivity on mortality, programs to improve healthful behaviors are needed to preserve the health of caregivers as they undertake this important familial and societal role.

Aged↗