Patricia A. Sharpe

Associations of Perceived Social and Physical Environmental Supports With Physical Activity and Walking Behavior

We evaluated perceived social and environmental supports for physical activity and walking using multivariable modeling. Perceptions were obtained on a sample of households in a southeastern county. Respondents were classified according to physical activity levels and walking behaviors. Respondents who had good street lighting; trusted their neighbors; and used private recreational facilities, parks, playgrounds, and sports fields were more likely to be regularly active. Perceiving neighbors as being active, having access to sidewalks, and using malls were associated with regular walking.

Functional health status as a predictor of mortality in men and women over 65

This study evaluated the effect of functional health status on mortality in a sample of community-dwelling older people. White and African-American self-respondents to the 1986 National Health Interview Survey Functional Health Supplement (n = 5, 320) were included in the study. Functional health status was measured by a ten-item unidimensional activities of daily living-instrumental activities of daily living (ADL-IADL) scale and a three-item cognitive ADL scale. Proportional hazards regression was used to evaluate the effect of increasing score on the ten-item ADL-IADL scale on risk of mortality over a 5-year period while controlling for demographic, social, and health status covariates. In both men and women, increasing score on the ADL-IADL scale was predictive of mortality, adjusting for increasing age, poor self-rated health, low body mass index in women, and being an unmarried man. These findings indicate that a unidimensional scale consisting of both ADL and IADL items is useful in predicting mortality, controlling for the effect of covariates in sex-specific models.

The relationship between diet, activity, and other factors, and postpartum weight change by race.

Objective To identify the impact of dietary intake and activity level on postpartum weight change. Methods White (n = 121) and black (n = 224) women, 7–12 months postpartum, participating in the Special Supplemental Feeding Program for Women, Infants, and Children were assessed for dietary intake, activity level, body weight, and other maternal characteristics. Results For both black and white women, the most important variables in predicting postpartum weight loss were pre-pregnancy weight, gestational weight gain, parity, and prenatal exercise. After these factors were controlled, race predicted that black women retained 6.4 lb more than white women. These results may be due to the finding that black women reported significantly higher mean energy intake (2039 versus 1552 kcal, P < .001), higher percent fat in diet (41 versus 38%, P < .001), and significantly lower amounts of prenatal and postpartum activity. Conclusion Higher energy intake and lower activity levels in black postpartum mothers compared with white mothers may contribute to the significantly higher rates of obesity found in black mothers. This study suggests the need for intervention strategies in the prenatal and postpartum periods to help those at risk of retaining weight gained during pregnancy.

Impact of Social Support, Social Cognitive Variables, and Perceived Threat on Depression Among Adults With Diabetes

Tested was a model of social support and cognitive appraisal of self-efficacy, outcome expectancies, and illness threat on depression. Study participants were community-dwelling adults with diabetes who completed a mailed questionnaire (N = 362). Results of structural equation modeling indicated that 52% of the variance in depression was explained by the model--largely by the direct effects of physical functioning, the perceived availability of social support, and the perceived threat of diabetes as well as the indirect paths from perceived support to perceived threat and from physical functioning to perceived support and perceived threat of diabetes. Diabetes-specific social support, self-efficacy, and outcome expectancies were not significant predictors of depression.

Association of Environmental Factors to Meeting Physical Activity Recommendations in Two South Carolina Counties

Purpose. The purpose of the study was to examine associations between environment and policy factors and physical activity. Design. A random-digit-dialed, cross-sectional telephone survey was administered. Setting. The setting was a two-county area of eastern South Carolina. Subjects. Before weighting, the sample included 1936 adults; 36.9% African-American, 63.1% white, and 60.1% women. The age group distribution was 28.8% 55+ years, 39.3% 35–54 years, and 31.9% 18–34 years of age. The response rate was 62.9%. Measures. Six physical activity questions (2001 Behavioral Risk Factor Surveillance Survey [BRFSS]) were used to create a dichotomous variable, “meets/does not meet recommendation for moderate or vigorous physical activity.” Self-report items assessed knowledge, presence, and use of recreational facilities; presence of environmental and worksite supports; perceived safety; condition of sidewalks; and quality of street lighting Results. Linear and logistic regression were used to analyze the data. Unadjusted odds for meeting the recommendation were significantly greater for well-maintained sidewalks (OR = 1.90); safe areas for walking/jogging (OR = 1.39); knowledge of routes for bicycling (OR = 1.38) and walking/jogging (OR = 1.32); and worksites with sports teams (OR = 1.53), exercise facilities (OR = 1.33), flexible time for exercise (OR = 1.33), and preventive checkups (OR = 1.26). Among persons who met the recommendation, means were greater for number of known walking/jogging routes (p = .04); number of known bicycling routes (p < .01); number of days per month uses tracks, trails, routes, pathways (p < .01); and number of days per month uses outdoor recreation areas (p < .01). Conclusion. The results support an association between level of physical activity and environmental and policy factors in two southeastern counties in South Carolina. Limitations of the study include self-reported data and cross-sectional design.

Working to Close the Gap: Identifying Predictors of HPV Vaccine Uptake among Young African American Women

Factors associated with greater likelihood of human papillomavirus (HPV) vaccination among women who experience excess cervical cancer incidence and mortality requires further study. The purpose of this study was to assess factors associated with HPV vaccine uptake among young African American women. Three hundred sixty-three African American women aged 18–26 were recruited from Historically Black Colleges/Universities to complete a questionnaire to assess health beliefs associated with HPV vaccination. Onequarter of participants reported uptake of the HPV vaccine. Women who reported uptake had significantly higher HPV knowledge, lower perceived barriers to vaccination, and were younger (all p<.05). Factors significantly associated with HPV vaccine uptake included HPV knowledge (OR=1.22), perceived severity of health outcomes (OR=0.48), perceived barriers to vaccination (OR=0.49), cues to action (OR=1.94), and age (OR=0.68). Findings can be used to inform the development of targeted HPV vaccine promotion programs for African American women to prevent continued cervical cancer disparities.

An Evaluation of Printed HPV Educational Materials

HPV educationalmaterials should be a viable source of accurate and mean-ingful information for women and should complementclinician counseling to reinforce important HPV informa-tion and to assist women with medical decision making.The purpose of this study was to formally evaluate printedHPV educational materials by determining the readability,suitability, and HPV content of existing, printed HPV edu-cational materials selected by the authors.

Knowledge and Beliefs About Abnormal Pap Test Results and HPV Among Women with High-Risk HPV: Results from In-Depth Interviews

ABSTRACT The purpose of this qualitative study was to explore womens knowledge and understanding of abnormal Pap tests and HPV. Forty-four in-depth interviews were conducted with low-income, high-risk human papillomavirus (HPV) positive women (ages 18–64 years). Major themes regarding abnormal Pap test results were: (a) getting cancer; (b) need for repeat Pap testing; (c) need for additional tests/treatment; (d) low concern; (e) variety of causes; (f) sexual transmission; and (g) connection to HPV/other sexually transmitted disease (STD). Major themes related to HPV were: (a) getting follow-up care and (b) association of HPV with cancer. Findings indicate a need for clear, consistent educational messages.

Association of body mass index to meeting physical activity recommendations

OBJECTIVE To investigate the association between BMI and physical activity based on the CDC-ACSM recommendation and a more demanding standard consistent with the IOM recommendation. METHODS A random-digit-dialed survey (n=1810) used 2001 BRFSS questions to measure physical activity. RESULTS Data revealed a monotonic association between BMI and physical activity level. Lower odds of meeting both recommendations were associated with higher BMI. The proportion meeting the CDC-ACSM recommendation was at least 3 times that of persons meeting the IOM-based recommendation. CONCLUSIONS Meeting either recommendation was associated with BMI; however, a larger proportion of persons were meeting the less demanding CDC-ACSM recommendation.

Do Health Beliefs, Health Care System Distrust, and Racial Pride Influence HPV Vaccine Acceptability among African American College Females?

The promise of human papillomavirus (HPV) vaccines rests with the ability to promote widespread uptake especially among populations at high risk of cervical cancer and other associated disease outcomes. The purpose of this study was to examine health beliefs and culturally specific influences of HPV vaccine acceptability among African American college females. Approximately 76 percent of participants reported HPV vaccine acceptability. Predictors of acceptability included: higher perceived benefit and lower racial pride. Findings can be used to inform development of campus-based HPV educational approaches to promote widespread HPV vaccine acceptability and safer sex practices among African American college females.