Terence A. Gerace

The Women's Health Trial Feasibility Study in Minority Populations: Design and baseline descriptions

The Womens Health Trial: Feasibility Study in Minority Populations (WHT:FSMP), a randomized trial of 2208 women, was conducted to investigate three questions. First, can women from minority and low-socioeconomic-status populations be recruited in numbers sufficient to evaluate a dietary intervention designed to lower fat intake. Second, the efficacy of a low fat, increased fruit/vegetable/ grain product intervention for reducing fat consumption. Third, will participation in the intervention lower plasma cholesterol and estradiol levels relative to the controls. The baseline results showed that an adequate number of minority and low SES women could be recruited to test the study hypotheses. A diverse study population of postmenopausal women consuming a high fat diet was recruited: 28% of participants were Black, 16% were Hispanic, 11% had less than a high school level of education, and 15.5% had household incomes of <

Smoking cessation and change in diastolic blood pressure, body weight, and plasma lipids. MRFIT Research Group

15,000.

Cancer incidence in Florida professional firefighters, 1981 to 1999

Cigarette smoking cessation was examined for its impact on diastolic blood pressure, weight, and plasma lipids in 3,470 special intervention males in the Multiple Risk Factor Intervention Trial. Change in smoking status (quitters vs nonquitters) was not independently associated with change in diastolic blood pressure or the subsequent use of antihypertensive medication for smokers who were normotensive at entry. More quitters (35%) became hypertensive than nonquitters (27%, P less than 0.01), although the groups had similar baseline diastolic blood pressure levels. Weight gain subsequent to cessation probably contributed to this excess incidence of hypertension in quitters. Stepped-care antihypertensive therapy lowered diastolic blood pressure similarly for hypertensive quitters and nonquitters. Weight increases of 6 lb or more by the 72-month visit occurred in 47% of quitters vs 25% of nonquitters (P less than 0.01); quitters did not differ from nonquitters in their change in total kilocalories from baseline to the 72-month visit. Quitters who gained 6 lb or more tended to be less obese at baseline, be less physically active, and smoke more cigarettes per day than those who did not gain this amount. Finally, quitters relative to nonquitters experienced an adjusted increase of 2.4 mg/dl high-density lipoprotein cholesterol, but no difference in total or low-density lipoprotein cholesterol. The implications for intervention are discussed as they relate to the common, but not inevitable, increase in weight subsequent to cessation.

Original reportThe Women's Health Trial Feasibility Study in Minority Populations: Design and baseline descriptions☆

Objective: The objective of this study was to examine the cancer risk associated with firefighting. Methods: Standardized incidence ratio analysis (SIR) was used to determine the relative cancer risk for firefighters as compared with the Florida general population. Results: Among 34,796 male (413,022 person-years) and 2,017 female (18,843 person-years) firefighters, 970 male and 52 female cases of cancer were identified. Male firefighters had significantly increased incidence rates of bladder (SIR = 1.29; 95% confidence interval = 1.01–1.62), testicular (1.60; 1.20–2.09), and thyroid cancers (1.77; 1.08–2.73). Female firefighters had significantly increased incidence rates of overall cancer (1.63; 1.22–2.14), cervical (5.24; 2.93–8.65), and thyroid cancer (3.97; 1.45–8.65) and Hodgkin disease (6.25; 1.26–18.26). Conclusions: Firefighting may be associated with an increased risk of selected site-specific cancers in males and females, including an overall increased cancer risk in female firefighters.

Response rates to six recruitment mailing formats and two messages about a nutrition program for women 50–79 years old

The Womens Health Trial: Feasibility Study in Minority Populations (WHT:FSMP), a randomized trial of 2208 women, was conducted to investigate three questions. First, can women from minority and low-socioeconomic-status populations be recruited in numbers sufficient to evaluate a dietary intervention designed to lower fat intake. Second, the efficacy of a low fat, increased fruit/vegetable/ grain product intervention for reducing fat consumption. Third, will participation in the intervention lower plasma cholesterol and estradiol levels relative to the controls. The baseline results showed that an adequate number of minority and low SES women could be recruited to test the study hypotheses. A diverse study population of postmenopausal women consuming a high fat diet was recruited: 28% of participants were Black, 16% were Hispanic, 11% had less than a high school level of education, and 15.5% had household incomes of <

Children's type A interview: interrater, test-retest reliability, and interviewer effect.

15,000.

Validity of the miami structured interview-1 for assessing type a behavior, competitiveness, and aggression in children

Recruiting participants for large prevention trials is time consuming and costly. In order to test various recruitment techniques, we conducted two studies of response rates to recruitment mailings for the Womens Health Trial. The potential participants, 50- to 79-year-old women, were requested to return an enclosed postcard to learn more about the trial. In the first study, we sent at random either a short or a long message to a group of University of Miami personnel (N = 862) and a Dade County cohort (N = 2964). More university women responded to the short message than to the long message (22.4% vs 16.4%, p = 0.024). Similarly, more of the Dade County cohort replied to the short message than to the long one (12.1% vs 9.6%, p = 0.027). The long message listed details of the intervention (e.g., modifying recipes) that some women may have used to decide they were not interested in participating. In the second study, we examined response rates to two different ways of addressing the mailing, i.e., handwritten envelopes and machine-printed labels; we also evaluated three methods for delivering the short message: (1) formal invitation, (2) business letter with an inside name and address of the recipient, and (3) business letter without the recipients name and address. Response rates were similar between the methods of addressing envelopes and among the three vehicles for the message, suggesting that the least costly method of mailing should be used.

Miami Multiple Risk Factor Intervention Trial(MRFIT)

The Miami Structured Interview--1 was developed to assess Type A behavior in preadolescents and adolescents in the United States and Greece. This report describes the interrater and test-retest reliability of the Miami Structured Interview--1, and the effect of different interviewers on the assessment process. Interrater agreements on the A vs not A scale were 73% for Greek American (k = 0.49, p less than 0.01, n = 88), 80% for Mixed American (k = 0.61, p less than 0.01, n = 69), and 88% for Native Greek interviews (k = 0.76, p less than 0.01, n = 65). Exact agreements on a five-point scale were 48% (weighted k = 0.73, p less than 0.01), 42% (weighted k = 0.70, p less than 0.01), and 48% (weighted k = 0.80, p less than 0.01), respectively. Although levels of agreement were all greater than chance, rater bias was observed. Test-retest administrations within 10 min showed 91% agreement (k = 0.82, p less than 0.01) on the A vs not A scale. Analyses suggest interviewers can affect the assessment of Type A behavior. These findings indicate the Miami Structured Interview--1 can (1) reach acceptable levels of interrater reliability, (2) is susceptible to rater bias, (3) has sufficient test-retest reliability for use in longitudinal studies, and (4) must be presented in a standardized way before ratings from interviews conducted by different interviewers can be combined or compared. The strengths and limitations of the Miami Structured Interview-1 are discussed.

THE MRFIT BEHAVIOR PATTERN STUDY II. TYPE A BEHAVIOR AND INCIDENCE OF CORONARY HEART DISEASE

The validity of the Miami Structured Interview-1 for measuring Type A behavior in children was examined in 122 boys 8 to 16 years old. We assessed the relationship between interview ratings and Type A and factor analytically derived Type A component scores from the Matthews Youth Test for Health (MYTH), a teacher rating scale. The validity of interview ratings was initially supported by significant correlations with MYTH Type A scores for preadolescents rated by English teachers and adolescents rated by English and mathematics teachers. Principal-components analyses of the MYTH items revealed components we labeled “competitiveness-leadership” and “impatience-aggression.” Interview ratings were related to the competitiveness-leadership component from English and mathematics teachers of both age groups but not the impatience-aggression component. The implications of these findings and the strengths and limitations of the Miami Structured Interview-1 for preadolscents and adolescents are discussed.

Predictors of Weight Increases over 7 Years in Fire Fighters and Paramedics

In 1971 a Task Force on Atherosclerosis appointed by the National Heart and Lung Institute recommended the development and support of a preventive trial in men with multiple coronary heart disease risk factors.1 Previous studies in the United States and abroad have shown that elevated serum cholesterol, hypertension and cigarette smoking are clearly associated with a high incidence of coronary disease.2 The Multiple Risk Factor Intervention Trial (MRFIT) was therefore initiated to test the hypothesis that significant reduction of these three key variables through an intervention program would be associated with decreased morbidity and mortahty from coronary heart disease. From 1972 to 1974, 20 clinical centers were selected to participate.3 The Dade County Department of Pubhc Health in Miami was one of these centers and the only county health department to be included in the national program. In 1976 the Miami MRFIT also became associated with the Nutrition Division of the Department of Epidemiology and Public Health at the University of Miami School of Medicine.