Dennis Tolsma

TAILORING A FRUIT AND VEGETABLE INTERVENTION ON ETHNIC IDENTITY: RESULTS OF A RANDOMIZED STUDY

OBJECTIVE Many targeted interventions have been developed and tested with African Americans (AA); however, AAs are a highly heterogeneous group. One characteristic that varies across AAs is Ethnic Identity (EI). Little research has been conducted on how to incorporate EI into the design of health messages and programs. DESIGN We tested whether tailoring a print-based fruit and vegetable (F & V) intervention on EI would enhance program impact. AA adults were recruited from two integrated healthcare delivery systems and then randomized to receive three newsletters focused on F & V behavior change over three months. One set of newsletters was tailored only on demographic and social cognitive variables (control condition), whereas the other (experimental condition) was additionally tailored on EI. MAIN OUTCOME MEASURES The primary outcome for the study was F & V intake, assessed at baseline and three months later using the composite of two brief self-report frequency measures. RESULTS A total of 560 eligible participants were enrolled, of which 468 provided complete 3-month follow-up data. The experimental group increased their daily mean F & V intake by 1.1 servings compared to .8 servings in the control group (p = .13). Afrocentric experimental group participants showed a 1.4 increase in F & V servings per day compared to a .43 servings per day increase among Afrocentric controls (p < .05). CONCLUSIONS Although the overall between-group effects were not significant, tailoring dietary messages on ethnic identity may improve intervention impact for some AA subgroups.

A Randomized Clinical Trial Evaluating Online Interventions to Improve Fruit and Vegetable Consumption

OBJECTIVES We assessed change in fruit and vegetable intake in a population-based sample, comparing an online untailored program (arm 1) with a tailored behavioral intervention (arm 2) and with a tailored behavioral intervention plus motivational interviewing-based counseling via e-mail (arm 3). METHODS We conducted a randomized controlled intervention trial, enrolling members aged 21 to 65 years from 5 health plans in Seattle, Washington; Denver, Colorado; Minneapolis, Minnesota; Detroit, Michigan; and Atlanta, Georgia. Participants reported fruit and vegetable intake at baseline and at 3, 6, and 12 months. We assessed mean change in fruit and vegetable servings per day at 12 months after baseline, using a validated self-report fruit and vegetable food frequency questionnaire. RESULTS Of 2540 trial participants, 80% were followed up at 12 months. Overall baseline mean fruit and vegetable intake was 4.4 servings per day. Average servings increased by more than 2 servings across all study arms (P<.001), with the greatest increase (+2.8 servings) among participants of arm 3 (P=.05, compared with control). Overall program satisfaction was high. CONCLUSIONS This online nutritional intervention was well received, convenient, easy to disseminate, and associated with sustained dietary change. Such programs have promise as population-based dietary interventions.

Effect of incentives and mailing features on online health program enrollment.

BACKGROUND With the growing use of Internet-based interventions, strategies are needed to encourage broader participation. This study examined the effects of combinations of monetary incentives and mailing characteristics on enrollment, retention, and cost effectiveness for an online health program. METHODS In 2004, a recruitment letter was mailed to randomly selected Midwestern integrated health system members aged 21-65 and stratified by gender and race/ethnicity; recipients were randomly pre-assigned to one of 24 combinations of incentives and various mailing characteristics. Enrollment and 3-month retention rates were measured by completion of online surveys. Analysis, completed in 2005, compared enrollment and retention factors using t tests and chi-square tests. Multivariate logistic regression modeling assessed the probability of enrollment and retention. RESULTS Of 12,289 subjects, 531 (4.3%) enrolled online, ranging from 1% to 11% by incentive combination. Highest enrollment occurred with unconditional incentives, and responses varied by gender. Retention rates ranged from 0% to 100%, with highest retention linked to higher-value incentives. The combination of a

Associations and Lags between Air Pollution and Acute Respiratory Visits in an Ambulatory Care Setting: 25-Month Results from the Aerosol Research and Inhalation Epidemiological Study

2 bill prepaid incentive and the promise of

Is vaginal douching associated with preterm delivery

20 for retention (10% enrollment and 71% retention) was optimal, considering per-subject recruitment costs (

Methods for Characterizing Fine Particulate Matter Using Ground Observations and Remotely Sensed Data: Potential Use for Environmental Public Health Surveillance

32 enrollment,

Gender differences in asthma experience and disease care in a managed care organization.

70 retention) and equivalent enrollment by gender and race/ethnicity. CONCLUSIONS Cash incentives improved enrollment in an online health program. Men and women responded differently to mailing characteristics and incentives. Including a small prepaid monetary incentive (

A Two-Time-Period Comparison of the Effects of Ambient Air Pollution on Outpatient Visits for Acute Respiratory Illnesses

2 or

Ethnic Identity predicts loss-to-follow-up in a health promotion trial.

5) and revealing the higher promised-retention incentive was cost effective and boosted enrollment.

Cohort profile: Study of Transition, Outcomes and Gender (STRONG) to assess health status of transgender people

Abstract Particulate matter (PM) has been associated with adverse respiratory outcomes in numerous studies that utilized data from emergency room visits, hospital admissions, and mortality records. This study is unique in its investigation of associations of air pollution measures, including components of PM, with health outcomes in an ambulatory-care setting. Visit data were collected from Kaiser Permanente, a not-for-profit health maintenance organization in the metropolitan Atlanta, GA, area. Kaiser Permanente collaborated on the Aerosol Research Inhalation Epidemiological Study (ARIES), which provided detailed information on the characteristics of air pollutants. The Kaiser Permanente study was a time-series investigation of the possible associations between daily levels of suspended PM, inorganic gases, and polar volatile organic compounds and ambulatory care acute visit rates during the 25-month period from August 1, 1998, to August 31, 2000. For this interim analysis, the a priori 0–2 days lagged moving average, as well as the 3–5 days and 6–8 days lagged moving averages, of air quality measures were investigated. Single-pollutant Poisson general linear modeling was used to model daily visit counts for asthma and upper and lower respiratory infections (URI and LRI) by selected air quality metrics, controlling for temporal trends and meteorological variables. Most of the statistically significant positive associations were for the 3–5 days lagged air quality metrics with child asthma and LRI.