Wura Jacobs

Influence of the Home Food Environment on Children’s Fruit and Vegetable Consumption A Study of Rural Low-Income Families

Background. This investigation sought to identify micro-level built and sociocultural characteristics of a home food environment that have been theoretically linked with fruit and vegetable (F&V) consumption. Method. We examined rural families (n = 298) from the southeastern United States. Hierarchical multiple regression analyses determined the association between the outcome variable (F&V consumption) and micro-level built and sociocultural characteristics of a home food environment. Results. Demographic characteristics were entered at Step 1, explaining 14% of variance in vegetable consumption and 9% in fruit consumption. After entry of sociocultural factors in the home food environment, such as parenting styles and so on, in Block 2, the total variance explained increased by 25% for vegetable consumption and 12% for fruit consumption. Micro-level built environmental factors such as the availability of F&V in the home was entered at Block 3, total variance explained by the model for vegetable consumption was 67%, F(17, 111) = 13.5, p < .001, and for fruit consumption was 57%, F(17, 160) = 12.5, p < .001. Conclusion. F&V availability was the most important variable influencing a child’s consumption of F&V. There are modifiable factors within the rural low-income home that could serve as priorities for intervention to improve F&V consumption.

Coverage and determinants of childhood immunization in Nigeria: A systematic review and meta-analysis

INTRODUCTION The proportion of fully immunized children in Nigeria is reportedly low. There are concerns over national immunization data quality, with this possibly limiting country-wide response. We reviewed publicly available evidence on routine immunization across Nigeria to estimate national and zonal coverage of childhood immunization and associated determinants. METHODS A systematic search of Medline, EMBASE, Global Health and African Journals Online (AJOL) was conducted. We included population-based studies on childhood immunization in Nigeria. A random effects meta-analysis was conducted on extracted crude rates to arrive at national and zonal pooled estimates for the country. RESULTS Our search returned 646 hits. 21 studies covering 25 sites and 26,960 children were selected. The estimated proportion of fully immunized children in Nigeria was 34.4% (95% confidence interval [CI]: 27.0-41.9), with South-south zone having the highest at 51.5% (95% CI: 20.5-82.6), and North-west the lowest at 9.5% (95% CI: 4.6-14.4). Mothers social engagements (OR=4.0, 95% CI: 1.9-8.1) and vaccines unavailability (OR=3.9, 95% CI: 1.2-12.3) were mostly reported for low coverage. Other leading determinants were vaccine safety concerns (OR=3.0, 95% CI: 0.9-9.4), mothers low education (OR=2.5, 95% CI: 1.8-3.6) and poor information (OR=2.0, 95% CI: 0.8-4.7). CONCLUSION Our study suggests a low coverage of childhood immunization in Nigeria. Due to the paucity of data in the Northern states, we are still uncertain of the quality of evidence presented. It is hoped that this study will prompt the needed research, public health and policy changes toward increased evenly-spread coverage of childhood immunization in the country.

Gender Differences in Type 2 Diabetes Risk Perception, Attitude, and Protective Health Behaviors: A Study of Overweight and Obese College Students

Background: Obesity prevalence among children and adolescents has dramatically increased in the past decade and has resulted in higher rates of type 2 diabetes mellitus (T2DM) among adolescents. Purpose: To examine whether there are gender differences in T2DM risk perception, attitude toward T2DM protective behaviors, physical activity, and meeting the recommended fruit and vegetable daily intake among adolescents at risk for T2DM. Methods: Overweight and obese students were included in this study (n = 319). Linear regression analyses were used for all models. Analyses were carried out using SPSS (Ver 20.0). Gender differences in the regression models were considered statistically significant at P < .05. Results: Females showed significantly higher positive attitudes toward eating healthy foods such as fruits and vegetables (B = 9.089, β = 0.337, P = .000). Females were more likely to consume more cups of fruit and vegetables than males (B = 1.650, β = 0.118, P = .036) and more likely to use calorie information when ordering/buying food compared to males (B = .765, β = 0.245, P = .000). However, males were more likely to engage in moderate physical activity (PA; B = − 22.076, β = − 0.110, P = .050) and vigorous PA (B = − 45.145, β = − 0.235, P = .000) compared to females). Conclusion: To effectively develop health promotion initiatives for students/adolescents, it is important to examine gender differences and factors that influence them. Translation to Health Education Practice: Findings from this study suggest the need for Health Education Specialists to consider gender variations when developing and evaluating T2DM prevention health programs for youth.

Estimating the incidence of breast cancer in Africa: a systematic review and meta-analysis

Background Breast cancer is estimated to be the most common cancer worldwide. We sought to assemble publicly available data from Africa to provide estimates of the incidence of breast cancer on the continent. Methods A systematic search of Medline, EMBASE, Global Health and African Journals Online (AJOL) was conducted. We included population- or hospital-based registry studies on breast cancer conducted in Africa, and providing estimates of the crude incidence of breast cancer among women. A random effects meta-analysis was employed to determine the pooled incidence of breast cancer across studies. Results The literature search returned 4648 records, with 41 studies conducted across 54 study sites in 22 African countries selected. We observed important variations in reported cancer incidence between population- and hospital-based cancer registries. The overall pooled crude incidence of breast cancer from population-based registries was 24.5 per 100 000 person years (95% confidence interval (CI) 20.1-28.9). The incidence in North Africa was higher at 29.3 per 100 000 (95% CI 20.0-38.7) than Sub-Saharan Africa (SSA) at 22.4 per 100 000 (95% CI 17.2-28.0). In hospital-based registries, the overall pooled crude incidence rate was estimated at 23.6 per 100 000 (95% CI 18.5-28.7). SSA and Northern Africa had relatively comparable rates at 24.0 per 100 000 (95% CI 17.5-30.4) and 23.2 per 100 000 (95% CI 6.6-39.7), respectively. Across both registries, incidence rates increased considerably between 2000 and 2015. Conclusions The available evidence suggests a growing incidence of breast cancer in Africa. The representativeness of these estimates is uncertain due to the paucity of data in several countries and calendar years, as well as inconsistency in data collation and quality across existing cancer registries.

An Examination of Family, Healthcare Professionals, and Peer Advice on Physical Activity Behaviors among Adolescents at High Risk for Type 2 Diabetes

ABSTRACT Studies have shown that many college students do not meet the recommended daily physical activity (PA) levels, and about 22% of these students are overweight. Given that engaging in PA is a protective behavior against many chronic conditions, it is imperative to understand what sources of information/advice to engage in PA is most influential. Hence, the purpose of this study was to examine the relative impact of different sources of advice regarding exercise and PA on actual PA engagement among obese/overweight adolescents. Using data from 319 overweight/obese college students, multivariate regression analyses were conducted to examine which source of advice (from parents, peers, or healthcare provider) to engage in PA was associated with PA behavior among these adolescents. Influence of type 2 diabetes (T2D) family history on PA behavior was also examined. Moderate and vigorous PA behavior was more likely among obese/overweight adolescents who received advice to exercise or engage in PA from their peers (B = 200.85, β = 0.193, p = 0.001; B = 121.19, β = 0.145, p = 0.014). Overweight/obese adolescents with a T2D family history were more likely to walk compared with those without a T2D family history (χ2 = 12.97, p = 0.000). Findings suggest that although healthcare professionals advise obese/overweight adolescents, those who received advice regarding PA behavior from their peers were more likely to heed the advice and exercise/engage in PA. In essence, intervention efforts should focus on employing peer ambassadors to counsel other adolescents on the importance of PA.

Number and Severity of Type 2 Diabetes among Family Members Are Associated with Nutrition and Physical Activity Behaviors

Aim A binary measurement of type 2 diabetes (T2D) has been found not to influence behaviors. We aimed to examine the influence of other measures of family history such as number of relatives, genetic closeness of relatives, and severity of T2D of family members on nutrition and physical activity behaviors among college students. Methods Students across four colleges in Texas were sampled. Multiple linear regression models, controlling for covariates, were used to model results. Cross-sectional data were used. Results More number of relatives with T2D was associated with vegetable consumption (β = 0.131, p = 0.007) and exercise (β = 0.129, p = 0.037). Having relatives with severe T2D was associated with vegetable consumption (β = 0.157, p = 0.002) and exercise (β = 106, p = 0.027). Closer genetic relationship with someone with T2D was associated with increased vegetable consumption (β = 0.107, p = 0.023) and exercise (β = 0.096, p = 0.047). Conclusion It is likely that the severe complications that may accompany the relatives T2D or having an immediate family member living with T2D may in fact motivate other family members without T2D to modify their attitudes, beliefs, and knowledge about T2D, thus encourage health-protective behaviors.

What’s love got to do with it? Adolescent romantic networks and substance use

Abstract This study examined how romantic aspiration network characteristics at the individual level (in-degree and out-degree) are associated with substance use (i.e. smoking and drinking) among a cross-sectional sample of US adolescents (10th grade, n = 1523) from 4 high schools in Los Angeles. Findings highlighted that, with an increase in out-degree (romantic aspiration nominations made), adolescents in our sample were less likely (OR = .824, CI = .688–.986, p < .05) to report smoking in the past 30 days. Additionally, with an increase in in-degree (romantic aspiration nominations received), adolescents were more likely (OR = 1.186, CI = 1.04–1.36, p < .05) to report drinking in the past 30 days. We conclude that romantic aspirations/relations influence adolescents’ substance use behaviour (i.e. smoking and drinking alcohol), particularly because of the intensity of such relationships and the desire to please or be acceptable to the other person. Moreover, understanding adolescents’ aspirations/relations can be useful for the development of intervention/prevention programmes to target adolescents’ substance use.