Raheem J. Paxton

Associations among physical activity, body mass index, and health-related quality of life by race/ethnicity in a diverse sample of breast cancer survivors

Health‐related quality of life (HRQOL), body mass index (BMI), and physical activity (PA) levels have all been associated with prognosis following breast cancer and may explain partially the higher mortality for breast cancer in certain racial/ethnic subgroups. In this study, associations between PA, BMI, and HRQOL by race were examined in a sample of breast cancer survivors.

Attraction to Physical Activity Mediates the Relationship between Perceived Competence and Physical Activity in Youth

Although scientists and policy makers have established the importance of physical activity for health and well being across the life span (e.g., Baranowski et al. 2000, u.s. Department ofHealth and Human Services [USDHHS], 2000), youth are not meeting public health physical activity standards (USDHHS, 1997, 2000). And, while physical inactivity is problematic in all areas of the U.S., it is even more problematic in rural areas (citypopulations below 2,500; 37% inactive) when compared to urban areas (27% inactive; Center for Disease Control and Prevention, 1998). Therefore, it is essential to develop interventions that can increase the prevalence and initiation of physical activity among rural youth. Prior to intervention, it is necessary to determine the correlates ofphysical activity-within the specific targeted population-that may be potential mechanisms on which to develop an effective intervention (Baranowski, Andersen, & Carmack, 1998). Two promising social cognitive variables that have been consistently related to youth physical activity are perceived physical competence and attractions to physical activity (Brustad, 1993, 1996; Crocker, Eklund, &Kowalski, 2000). Given the low

Associations between leisure-time physical activity and health-related quality of life among adolescent and adult survivors of childhood cancers

Objective: Survivors of childhood cancer are at an increased risk for reduced quality of life (QOL), yet few studies have explored factors associated with improving health‐related QOL (HRQOL) in this population. We thus explored the relationship between physical activity (PA) and HRQOL among survivors of childhood cancer.

Physical Activity Behaviors and Emotional Self-Efficacy: Is There a Relationship for Adolescents?

BACKGROUND This study explored relationships between physical activity (PA) behaviors and emotional self-efficacy (ESE) in a statewide sample of public high school adolescents in South Carolina (n=3836). METHODS The Center for Disease Control Youth Risk Behavior Survey PA items and an adolescent ESE scale were used. Logistic regression analyses and multivariate models constructed separately, revealed significant race by gender findings. RESULTS Results suggest that reduced vigorous PA (past 7 days), moderate PA (past 7 days), strengthening/toning exercises (past 7 days), and playing on sport teams (past 12 months) were associated (p<or=.05) with reduced ESE for specific race/gender groups. CONCLUSIONS Results have implications for school- and community-based mental health services and PA programs for adolescents. Measures of ESE as a component of comprehensive assessments of adolescent mental health and PA behaviors in fieldwork, research, and program-evaluation efforts should be considered.

Are constructs of the transtheoretical model for physical activity measured equivalently between sexes, age groups, and ethnicities?

Background/PurposeIdentifying mediators of physical activity change requires measurement instruments that are reliable, valid, and generalizable to multiple populations. Despite continued application of the transtheoretical model (TTM) to the study of physical activity, the structural components of the TTM measurement instruments have been understudied in diverse populations.MethodsA multiethnic sample (N = 700, Mage = 47, 63% women, 38% Caucasian) of participants living in Hawaii completed TTM measures. The factor validity and measurement equivalence/invariance (ME/I) of decisional balance, barrier self-efficacy, temptations, and processes of change instruments were explored between men, women, age groups, and ethnicities.Results/ConclusionsMeasurement models of barrier self-efficacy and revised models of temptations and processes of change demonstrated sufficient evidence for ME/I among all subgroups. A revised model of decisional balance demonstrated sufficient evidence for ME/I between genders and among ethnicities, but not among age groups. Future research should examine the stability of these constructs across time.

Health Behaviors and Weight Status of Childhood Cancer Survivors and Their Parents: Similarities and Opportunities for Joint Interventions

Childhood cancer survivors are at increased risk for chronic health conditions that may be influenced by their cancer treatment and unhealthy lifestyle behaviors. Despite the possibility that interventions targeting the survivor-parent dyad may hold promise for this population, a clearer understanding of the role of family factors and the lifestyle behaviors of both survivors and parents is needed. A mailed cross-sectional survey was conducted in 2009 to assess weight status (body mass index), lifestyle behaviors (eg, diet, physical activity), and the quality of the parent-child relationship among 170 childhood cancer survivors who were treated at MD Anderson Cancer Center and 114 of their parents (80% mothers). Survivors were more physically active and consumed more fruits and vegetables than their parents. However, fewer than half of survivors or parents met national guidelines for diet and physical activity, and their weight status and fat intakes were moderately correlated (r=.30-.57; P<0.001). Multilevel models showed that, compared with survivors with better than average relationships, those with poorer than average relationships with their parents were significantly more likely to consume high-fat diets (P<0.05). Survivors and their parents may thus benefit from interventions that address common lifestyle behaviors, as well as issues in the family environment that may contribute to an unhealthy lifestyle.

Was race a factor in the outcomes of the Women's Health Eating and Living Study?

The objective of this study was to determine whether women who were participating in the Womens Healthy Eating and Living (WHEL) Study exhibited similar dietary changes, second breast cancer events, and overall survival regardless of race/ethnicity.

Lifestyle Behaviors of African American Breast Cancer Survivors: A Sisters Network, Inc. Study

Introduction African American breast cancer survivors experience poor cancer outcomes that may, in part, be remedied by healthy lifestyle choices. Few studies have evaluated the health and lifestyle behaviors of this population. The purpose of this study was to characterize the health and lifestyle habits of African American breast cancer survivors and evaluate the socio-demographic and medical correlates of these behaviors. Methods A total of 470 African American breast cancer survivors (mean age = 54 years) participated in an online survey. All participants completed measures assessing medical and demographic characteristics, physical activity, and sedentary behavior. Chi-square tests for association, nonparametric tests, and logistic regression models were used to assess associations. All statistical tests were two sided. Results Almost half (47%) of the women met the current guidelines for physical activity, almost half (47%) were obese, and many reported having high blood pressure (53%) or diabetes (21%). The prevalence of high blood pressure, diabetes, and high cholesterol increased by age (P<0.001), and obese women had a higher prevalence of high blood pressure (63% vs. 44%) and diabetes (21% vs. 12%) than did non-obese women (all P<0.05). Obese women participated in significantly fewer total minutes of physical activity per week (100 minutes/week) than did non-obese women (150 minutes/week; P<0.05). The number of comorbid conditions was associated with increased odds for physical inactivity (odds ratio = 1.40) and obesity (odds ratio = 2.22). Conclusion Many African American breast cancer survivors had chronic conditions that may be exacerbated by poor lifestyle choices. Our results also provide evidence that healthy lifestyle interventions among obese African American breast cancer survivors are urgently needed.

Booster Breaks in the workplace: participants’ perspectives on health-promoting work breaks

Increasing sedentary work has been associated with greater cardiovascular and metabolic risk, as well as premature mortality. Interrupting the sedentary workday with health-promoting work breaks can counter these negative health effects. To examine the potential sustainability of work-break programs, we assessed the acceptance of these breaks among participants in a Booster Break program. We analyzed qualitative responses from 35 participants across five worksites where one 15-min physical activity break was taken each workday. Two worksites completed a 1-year intervention and three worksites completed a 6-month intervention. Responses to two open-ended questions about the acceptance and feasibility of Booster Breaks were obtained from a survey administered after the intervention. Three themes for benefits and two themes for barriers were identified. The benefit themes were (i) reduced stress and promoted enjoyment, (ii) increased health awareness and facilitated behavior change, and (iii) enhanced workplace social interaction. The barrier themes were the need for (iv) greater variety in Booster Break routines and (v) greater management support. This study provides empirical support for the acceptance and feasibility of Booster Breaks during the workday. Emphasizing the benefits and minimizing the barriers are strategies that can be used to implement Booster Breaks in other workplaces.

Physical Activity and Quality of Life—The Complementary Influence of Self-Efficacy for Physical Activity and Mental Health Difficulties

BackgroundStudies proposed that the physical activity and quality of life (QoL) relationship may not be entirely direct but mediated through other variables; however, few studies have examined these relationships in diverse population’s older adults.PurposeThis study aims to examine the roles of self-efficacy and mental health difficulties in the physical activity and QoL relationship and to determine if demographic characteristics alter these relationships.MethodsOne hundred ninety-six older adults completed measures of physical activity, self-efficacy, mental health difficulties, and QoL. Two-multilevel structural models were tested to determine the relationship between physical activity and QoL.ResultsBoth structural models suggested that the relationship between physical activity and QoL is indirect, but the models were not significantly different. In model 1, we observed a positive linear relationship between physical activity and self-efficacy. In turn, self-efficacy was negatively associated with poor mental health difficulties and positively associated with QoL. Mental health difficulties were also negatively associated with QoL. In model 2, physical activity was positively associated with self-efficacy and negatively associated with mental health difficulties; in turn, self-efficacy was positively associated with QoL, whereas mental health difficulties were negatively associated with QoL.ConclusionsOverall, our findings suggest that self-efficacy and mental health have intermediary roles in the relationship between physical activity and QoL in a diverse sample of older adults. Prospective studies are needed to determine whether self-efficacy and mental health difficulties are complementary or one or the other accounts for more variance in the relationship between physical activity and QoL.