Greg S. Dana

Weather factor impacts on commuting to work by bicycle

OBJECTIVE Quantify the impact of weather conditions on individual decisions to commute to work by bicycle among a diverse panel of adults who commute ≥2 miles each way. METHOD Working adults (n=163) in a northern U.S. state reported transportation mode for four seven-day periods in 2009-2010 that maximized seasonal weather variations. Personal characteristics, trip to work distances, and commuting mode data were linked to location- and time-specific weather data and daylight hours. Analyses focused on effect of weather conditions on reports of commuting by bicycle. RESULTS Participants were diverse in age, gender and bicycle use, but were relatively well-educated; they traveled to work by bicycle on 34.5% of the logged commuting days. Modeling indicated that the likelihood of bicycle commuting increased in the absence of rain (odds ratio=1.91; 95% confidence interval 1.42, 2.57) and with higher temperatures (1.03; 1.02, 1.04), and decreased with snow (0.90; 0.84, 0.98) and wind (0.95; 0.92, 0.97). Independent effects also were found for bicycle commuting distance, gender, and age, but not for daylight hours. CONCLUSION Precipitation, temperature, wind and snow conditions had significant and substantial independent effects on the odds of travel to work by bicycle among a diverse panel of adult bicycle commuters.

Primary care physicians' use of family history for cancer risk assessment

BackgroundFamily history (FH) assessment is useful in identifying and managing patients at increased risk for cancer. This study assessed reported FH quality and associations with physician perceptions.MethodsPrimary care physicians practicing in two northeastern U.S. states were surveyed (n = 880; 70% response rate). Outcome measures of FH quality were extent of FH taken and ascertaining age at cancer diagnosis for affected family members. Predictors of quality measured in this survey included: perceived advantages and disadvantages of collecting FH information, knowledge of management options, access to supportive resources, and confidence in ability to interpret FH.ResultsReported collection of information regarding second degree blood relatives and age of diagnosis among affected relatives was low. All hypothesized predictors were associated with measures of FH quality, but not all were consistent independent predictors. Perceived advantages of taking a family history, access to supportive resources, and confidence in ability to identify and manage higher risk patients were independent predictors of both FH quality measures. Perceived disadvantages of taking a family history was independently associated one measure of FH quality. Knowledge of management options was not independently associated with either quality measure.ConclusionsModifiable perception and resource factors were independently associated with quality of FH taking in a large and diverse sample of primary care physicians. Improving FH quality for identification of high risk individuals will require multi-faceted interventions.

Increasing patient/physician communications about colorectal cancer screening in rural primary care practices.

Background:Rural populations as well as less educated people in the United States are less likely to receive colorectal cancer (CRC) screening than people living in urban areas and more educated people. Methods:We tested a computer tablet, Patient/Provider Communication Assistant (PPCA), which collected data, educated patients, and printed personalized notes to patients and providers encouraging conversation about CRC screening. Mixed model analyses using a prepost quasi-experimental design compared patient results during the comparison and intervention periods in 5 rural primary care practices on provider discussion about CRC screening, provider recommendation, and patient intention to be screened. Models including age, education, and literacy measures as covariates were examined. Results:Providers talked with patients about CRC screening in general, and colonoscopy specifically more frequently after the PPCA than with the comparison group (P values = 0.04 and 0.01, respectively). Providers recommended CRC screening more often to patients in the intervention group than to the comparison group (P = 0.02). Patients planned to be screened, specifically with colonoscopy, more frequently after the intervention than in the comparison group (P = 0.003). There were no interactions between group and any of the covariates. Ninety-five percent of the patients, regardless of age or education, found the PPCA easy to use. Conclusions:Results indicated increased provider discussion and recommendation, and patients’ intentions to obtain CRC screening, and in particular colonoscopy, for patients exposed to the intervention, regardless of the patients’ age or literacy levels. The PPCA is a promising intervention method that is acceptable to rural patients.

State Legislators’ Beliefs About Legislation That Restricts Youth Access to Tobacco Products

Better understanding of the cognitive framework for decision making among legislators is important for advocacy of health-promoting legislation. In 1994, the authors surveyed state legislators from North Carolina, Texas, and Vermont concerning their beliefs and intentions related to voting for a hypothetical measure to enforce legislation preventing the sale of tobacco to minors, using scales based on the theory of planned behavior. Attitude (importance), subjective norm (whether most people important to you would say you should or should not vote for the law), perceived behavioral control (ability to cast one’s vote for the law), and home state were independently and significantly related to intention to vote for the law’s enforcement. The results, including descriptive data concerning individual beliefs, suggest specific public health strategies to increase legislative support for passing legislation to restrict youth tobacco sales and, more generally, a framework for studying policy making and advocacy.

To Bike or Not to Bike: Seasonal Factors for Bicycle Commuting

Research with a panel of working adults in northern communities was conducted to assess the impact of weather on commuting to work by bicycle. Participants commuted at least 2 mi each way and commuted by bike more than twice annually. Transportation mode was recorded for four 7-day periods in 2009 and 2010 (one sampling period per season). Mode, personal characteristics, and commute length were linked to location- and time-specific weather conditions and to daylight hours on commuting days. Analyses focused on the effects of season, weather, and other factors to develop binary models for commuting by bicycle. The likelihood of bike commuting increased 3% with every 1°F increase in morning temperature and decreased by 5% with a 1 mph increase in wind speed. Likelihood of biking to work was more than double on days with no morning precipitation. Hours of daylight had no discernible effect, although study participants cited this as a barrier in the baseline survey. Distance to work negatively affected the likelihood of bike commuting. Men were nearly twice as likely to bike commute on a given day as were women. Separate models for men and women suggested that these groups responded similarly to adverse weather conditions, although some effects were less pronounced among women because of a smaller sample size. An appreciable portion of participants biked to work throughout the year in a variety of weather conditions, a result that suggested that a northern climate might not necessarily preclude year-round bike commuting. Multimodal commuting was prevalent in the sample: on 20% of the days that participants reported biking to work, they reported returning home by another mode. Helping cyclists learn to deal safely with cold and dark conditions and facilitation of multimodal bicycle commuting may promote wider use of bicycle commuting and extend the northern bicycle commute season.