Richard E.C. White

Coronary disease risk factor reduction and behavior modification in minority adolescents: The PATH program

PURPOSE To evaluate the impact of a unique school-based program of exercise, health education, and behavior modification on health knowledge, health behaviors, coronary risk factors, and cardiovascular fitness in minority adolescents. METHODS A total of 346 students from an inner-city public high school participated in health promotion intervention or regular physical education volleyball classes. Subjects were African-American (47%), Asian-American (9%), Hispanic (21%), white (3%), and other (19%). The health promotion curriculum consisted of 11 weeks of daily circuit training exercise and health lecture-discussions. RESULTS The groups were similar in age, height, weight, ethnicity, and socioeconomic status. Following intervention both boys (P < .001) and girls (P < .006) significantly improved health knowledge test scores. Significant benefits for girls included improved dietary habits (P < .05), reduced cholesterol (P < .004), and higher estimated V(O2)max (P < .0001). There were no other significant changes in boys. CONCLUSIONS The results suggest that a school-based health promotion program of exercise and health lecture-discussion is beneficial for multiethnic, inner-city adolescents, especially females.

Health Promotion in Minority Adolescents: A Healthy People 2000 Pilot Study

PURPOSE The purpose was to evaluate the effects of a health promotion curriculum on health knowledge, behavior, cardiovascular fitness, and cardiovascular risk factors. METHODS A multi-ethnic, multi-cultural sample (n = 54) of 10th grade males and females participated in a study of cardiovascular health promotion and coronary risk factor reduction. The sample was comprised of Asian-Americans (39%), blacks (33%), Hispanics (11%), whites (2%), and others (15%). Intervention consisted of a 10-week health promotion curriculum of classroom education modules in physical activity, nutrition, smoking cessation, stress management and personal problem solving, and an exercise program of walking and running. A nonintervention control group served as a basis for comparison. Classroom and exercise sessions met on alternate days. RESULTS Following intervention, a significant treatment effect (P = .007) was observed in lowered total cholesterol, and significant within group improvements (P < .01) were observed in diet habits, percent body fat, and cardiovascular health knowledge. Comparisons of knowledge and social effects revealed higher cardiovascular health knowledge (P < .05) in subjects of nonsmoking compared to smoking parents, higher self-perception of health (P < .01) in more active vs less active subjects and better dietary habits (P < .07) in children whose parents were college educated compared to parents who did not attend college. CONCLUSIONS Preliminary findings suggest that a health promotion curriculum consisting of health education, behavior modification, and regular aerobic exercise lowers cholesterol, improves health behavior and increases health knowledge.

Effects of Graded Levels of Physical Similarity and Density on Visual Selective Attention in Patients With Alzheimer's Disease

A multitarget visual cancellation test was administered to patients with Alzheimers disease (AD) and age-matched healthy controls (HC). Attentional loads--physical similarity (number of features shared by target and distractors; 3 levels) and density (number of items per page; 3 levels)--were varied systematically. As physical similarity increased, both groups slowed their search, but whereas the HC group maintained accuracy, the AD group increased commission errors and tended to miss more targets. Increased density yielded slower search and more target omissions in the AD group. Commission errors are additional indicators of higher order attentional deficits, especially in early disease. The findings suggest that patients with AD may rely increasingly on physical features of stimuli during a search, leading to inefficient bottom-up processing strategies.

P4-315: Impaired attentional refractory period in Alzheimer's disease

impairment and the pattern of neuropsychiatric symptoms (NPS) in AD has been generally characterized. Better understanding of this relationship could help predict NPS symptom targets as well as their potential responsiveness to treatment intervention. The objective of these analyses was to investigate a novel analytical technique relating NPS across individual strata of MMSE scores in patients with AD treated with placebo or donepezil. Methods: Data were pooled from 1106 patients with mild to severe AD (MMSE: 5-26) who were enrolled in 5 randomized, double-blind, placebo-controlled studies of donepezil and who had available data collected using the 10/12-item Neuropsychiatric Inventory (NPI). Bubble matrices were generated for the placebo and donepezil groups by plotting individual baseline MMSE scores (y-axis) against the 12 NPI items (x-axis). A bubble was fitted into each matrix cell with the size of bubble representing the magnitude of effect size (NPI raw mean change/SD at week 24 for corresponding NPI item and MMSE score). Treatment effects were then analyzed by evaluating differences between the placebo and donepezil matrices and measuring the number and magnitude of positive and negative changes. Statistical analyses were performed using the McNemar and Wilcoxon Signed-Rank tests. Results: Comparing overall bubble patterns between placebo and donepezil (N 241 pairs) showed a significant donepezil treatment effect (57% of bubble cells showed a positive change, P 0.024). Changes between the placebo and donepezil matrices were predominantly positive for 10 of the 12 NPI items. When the magnitude of positive and negative changes was analyzed, an overall positive treatment effect was observed (P 0.049). Nine of the 12 NPI items showed an overall positive change in item score. Conclusions: Using this bubble plot analytic technique, it is possible to evaluate an overall effect on individual NPS at each level of MMSE score, as well as evaluate each individual item in a novel way. This approach may assist in the challenge of identifying target symptoms and evaluating their responsiveness to treatment intervention.