Sasha A. Fleary

Combined Patterns of Risk for Problem and Obesogenic Behaviors in Adolescents: A Latent Class Analysis Approach.

BACKGROUND Several studies have used latent class analyses to explore obesogenic behaviors and substance use in adolescents independently. We explored a variety of health risks jointly to identify distinct patterns of risk behaviors among adolescents. METHODS Latent class models were estimated using Youth Risk Behavior Surveillance System (YRBSS) 2011 data. Behaviors in the models included substance use, physical fights, physical activity (PA), sedentary activity, sleep, fruit and vegetables (F&V) consumption, and weight-related variables. Models were estimated separately by sex. Constrained and unconstrained models were computed for race. Age and perceived and calculated weight status were compared among emergent latent classes using latent multinomial logistic regressions. RESULTS Four and 5 latent class solutions emerged for boys and girls, respectively. Healthy, sedentary, and physically active (PA) groups were common in both boys and girls. The sample of boys also included a health risk behavior (HRB)/PA group and the sample of girls included HRB and HRB/F&V groups. CONCLUSIONS The results confirm that obesogenic and HRBs should be conceptualized as combined patterns of risk. Health education programming in schools should adopt a multiple health behavior approach to target the continuum of risks adolescents engage in simultaneously.

African American Women’s Involvement in Promoting Informed Decision-Making for Prostate Cancer Screening Among Their Partners/Spouses

Routine prostate cancer screening is not recommended but African American men who are at higher risk for the disease should be offered the opportunity for shared decision-making with their health-care providers. This qualitative study sought to better understand the potential role of women in educating their male spouses/partners about prostate cancer screening. Nine focus groups were conducted (n = 52). Women were recruited from a variety of community venues. Those eligible were African American and married to or in a partnership with an African American male age ≥ 45. Women provide numerous types of support to their male partners in an effort to facilitate participation in preventive health care. While women agreed that they would like to educate their partners about prostate cancer screening, they had little information about screening guidelines or the potential harms and limitations. The current findings suggest that women are eager information-seekers and can disseminate information to men and facilitate their efforts to make more informed decisions about prostate cancer screening. Women should be included in educational interventions for to promote informed decision-making for prostate cancer screening.

The Relationship Between Health Literacy, Cancer Prevention Beliefs, and Cancer Prevention Behaviors

While cancer prevention behaviors have been clearly defined, many people do not engage in these risk-reduction behaviors. Factors such as cancer prevention beliefs and limited health literacy may undermine cancer prevention behavior recommendations. This study explored the relationships between cancer prevention beliefs, health literacy, and cancer prevention behaviors. Data were analyzed from the 2013 Health Information National Trends Survey (n = 1675). Regression analyses for four cancer prevention belief (prevention is not possible, cancer is fatal, there are too many recommendations for prevention, everything causes cancer) statements were modeled, including health literacy and sociodemographic variables as predictors. In addition, separate regression analyses predicted four cancer prevention behaviors (fruit and vegetable consumption, physical activity, cigarette smoking) from cancer prevention beliefs, health literacy, and sociodemographic variables. Participants with low health literacy were more likely to hold fatalistic cancer prevention beliefs than those with higher health literacy. Cancer prevention beliefs were related to less fruit and vegetable consumption, fewer days of physical activity, and with being a nonsmoker after controlling for sociodemographic variables. Health literacy was not a significant predictor of cancer prevention behaviors. Given the relationship between health literacy and cancer prevention beliefs, research is needed to ascertain how to empower patients with low health literacy to have a more realistic understanding of cancer.

Trends in Health Behavior Patterns Among U.S. Adults, 2003–2015

Background Over the last two decades, considerable resources from U.S. federal and philanthropic entities were dedicated to improving preventive and reducing chronic disease risk behaviors. Purpose Given the population health efforts to improve health behaviors in adults, this study explored how health behavior patterns shifted over the years by exploring multiple health behavior patterns. Methods Data were obtained from the odd years between 2002 and 2016 Behavioral Risk Factor Surveillance System. Latent class analyses including fruit and vegetables, physical activity, cigarette smoking, and heavy and binge drinking were conducted for each year. Results Three-class models best fit the data and were most interpretable. Each year included Healthy or Physically Active (preventive behaviors, no risk behaviors), Apathetic (no preventive/risk behaviors), and Binge-drinking groups. Gender and age consistently distinguished the Healthy/Physically Active groups from the Apathetic and Binge-drinking groups across the years. Conclusions This study confirms health behavior clusters exist and have been stable across time. This is encouraging as trends have not gotten worse, but there is room for improvement. Repetition of the groups across years suggests that despite population-level interventions, a large segment of the U.S. population at risk for chronic diseases are not engaging in preventive health.

Increasing active physical education in the Commonwealth of the Northern Mariana Islands: Sports, Play, and Active Recreation for Kids

Objectives: Pacific Islander children’s obesity-risk demands attention, particularly via physical activity (PA). SPARK (Sports, Play, and Active Recreation for Kids) is proven to increase students’ PA, but has limited application with Pacific Islanders. We evaluated the SPARK program implementation in the Commonwealth of the Northern Mariana Islands Public School System (CNMI-PSS). Methods: Fourteen elementary, four junior high, and five senior high schools from CNMI-PSS were invited with 2–5 representatives to SPARK trainings. The System for Observing Fitness Instruction Time was utilized to observe a random sample of classes within a random sample of schools representing each level and was validated with pedometers. Results: Students increased their walking and vigorous activity during PE classes by 10% over the school year. Increases were found for lesson contexts of fitness activities and game play; and teacher interactions of promoting fitness, and managing. Teacher interactions in demonstrating fitness, instructing, and observing decreased. Conclusions: SPARK’s success in changing PE instruction and increasing PA time of CNMI students during the PE highlight suggests SPARK programs should be disseminated to other Pacific Islands and potentially beyond.

Parent and Peer Influence on Recreational Use of Pain Medication: Are Their Influences Similar to That of Marijuana Use?

Parent and peer disapproval were examined as potential predictors of recreational use of over-the-counter (OTC) and prescription pain medication. Risk perception was studied as a potential mediator of the effects of parent and peer disapproval. Four hundred and sixty-five college students (M age = 18.57, SD = 0.86) were recruited between September 2009 and September 2010. Participants completed an online survey about their recreational medication use, other substance use, and correlates of use. Path analyses showed that predictors of OTC and prescription pain medication recreational use are largely similar to predictors of marijuana use in college students such that risk perception mediated both the effect of parent and peer disapproval on dichotomous misuse, and peer disapproval had a significant direct effect on dichotomous misuse. Prevention interventions for recreational use of pain medication should target risk perception and peer disapproval.