Predictors of Moderate-to-Vigorous Physical Activity (MVPA) in African American Young Adolescents

Background

African American adolescents residing in the South are at increased risk for obesity and physical inactivity, yet our understanding of potential influences is limited.

Purpose

Using an ecological framework, this study explored multilevel predictors (individual, family, home, and neighborhood environment) of moderate-to-vigorous physical activity (MVPA) among 116 African American adolescents (ages 12–16).

Methods

Adolescents and their parents completed self-report surveys for hypothesized predictors. Youth physical activity was measured using accelerometry.

Results

In multiple regression models, decreased daily MVPA was associated with female sex (β?=??24.27, p?<?0.0001). Family social support (β?=?1.07, p?=?0.004) and adolescent self efficacy for PA (β?=?6.89, p?=?0.054) were positively associated with daily MVPA.

Conclusions

Adolescent demographics along with family social support and self-efficacy influence younger African American adolescent physical activity. Further exploration of the complex interaction of multiple levels of influence is needed to develop appropriate interventions for this vulnerable group.

     

The Perceived and Built Environment Surrounding Urban Schools and Physical Activity Among Adolescent Girls

Background

Neighborhood perceived/built environment and physical activity (PA) associations have been examined for adolescents around homes, but not surrounding schools.

Purpose

The purpose of this paper is to examine if positive perceptions/built environment in neighborhoods surrounding schools predict PA among low-income, urban adolescent girls.

Methods

Measures include: minutes in moderate-vigorous PA (MVPA, ankle accelerometry), perceptions of the school environment (questionnaire), built environment (neighborhood audit). Analyses include multi-level models.

Results

Two hundred twenty-four sixth and seventh grade girls [mean(sd) age?=?12.1(0.7)?years] from 12 schools serving low-income, primarily African American communities; mean MVPA 35.4 min (mean days assessed?=?5.8). Girls in schools with more positive perceptions of the neighborhood environment surrounding the school were less active (β?=?7.2, p?=?0.043). Having “places to go within walking distance” (perceptions) and number of food stores near school (built environment) positively relate to MVPA (β?=?5.5, p?=?0.042 and β?=?0.59, p?=?0.047).

Conclusions

Among neighborhoods surrounding urban schools, positive perceptions do not predict PA; accessibility, via both perceived and built environment, support PA.

     

A controlled evaluation of a brief parenting psychoeducation intervention in Burundi

Purpose

Conduct problems and emotional distress have been identified as key problems among children and adolescents in post-war Burundi. This pilot study aims to evaluate the impact of a brief parenting psychoeducation intervention on children’s mental health.

Methods

This study employs a controlled pre and post evaluation design. The two-session psychoeducation intervention was offered to groups of parents of children (mean age 12.3 years, 60.8 % female) who had been screened for elevated psychosocial distress. Children in the intervention group (n = 58) were compared to a waitlist control group (n = 62). Outcome indicators included child-reported levels of aggression (using the Aggression Questionnaire), depression symptoms (using the Depression Self Rating Scale) and perceived family social support.

Results

The intervention had a beneficial effect on reducing conduct problems compared to the control condition (Cohen d = 0.60), especially among boys, while not showing impact on depression symptoms or family social support. Parents evaluated the intervention positively, with increased awareness of positive parenting strategies and appropriate disciplinary techniques reported as the most common learning points.

Conclusion

A brief parenting psychoeducation intervention conducted by lay community counselors is a promising public health strategy in dealing with widespread conduct problems in boys living in violence-affected settings and not so for social and emotional indicators and for girls. An efficacy study is warranted to confirm these preliminary findings.     

The Dynamic Relationship Between Social Support and HIV-Related Stigma in Rural Uganda

Background

Cross-sectional studies show that human immunodeficiency virus (HIV) stigma is negatively correlated with social support.

Purpose

The purpose of this study is to examine the bidirectional relationship between social support and HIV stigma.

Methods

We collected quarterly data from a cohort of 422 people living with HIV in Uganda, followed for a median of 2.1 years. We used multilevel regression to model the contemporaneous and 3-month-lagged associations between social support and both enacted and internalized stigma.

Results

Lagged enacted stigma was negatively correlated with emotional and instrumental social support, and lagged instrumental social support was negatively correlated with enacted stigma. Internalized stigma and emotional social support had reciprocal lagged associations.

Conclusions

Interventions to reduce enacted stigma may strengthen social support for people living with HIV. Improved social support may in turn have a protective influence against future enacted and internalized stigma.     

Psychosocial Correlates of Atrial Natriuretic Peptide: A Marker of Vascular Health

Background

Psychosocial factors have been associated with cardiovascular outcomes, but few studies have examined the association between psychosocial function and natriuretic peptides.

Purpose

The purpose of this study is to determine the predictive value of hostility, anger, and social support in relation to atrial natriuretic peptide (ANP), a marker of vascular health, among middle-aged men.

Methods

One hundred twenty-one men (mean age?=?39.8 years, SD?=?4.1) underwent assessments of ANP and completed the Cook–Medley Hostility Scale, the Spielberger State–Trait Anger Scale, and the Interview Schedule for Social Interaction.

Results

Higher levels of hostility (β?=?0.22 [95 % CI 0.04, 0.40], P?=?0.032) and trait anger (β?=?0.18 [95 % CI 0.01, 0.37], P?=?0.044) were associated with greater ANP levels. In contrast, higher perceived social support was also associated with lower ANP levels, (β?=??0.19 [95 % CI ?0.05, ?0.41], P?=?0.010).

Conclusions

Psychosocial factors, including hostility, anger, and social support, are associated with varying ANP levels among middle-aged men, independent of cardiovascular and behavioral risk factors.     

Physical Activity in Older Adults: an Ecological Approach

Background

Studies identifying correlates of physical activity (PA) at all levels of the ecological model can provide an empirical basis for designing interventions to increase older adults’ PA.

Purpose

Applying ecological model principles, this study concurrently examined individual, psychosocial, and environmental correlates of older adults’ PA to determine whether built environment factors contribute to PA over and above individual/demographic and psychosocial variables.

Methods

Using a cross-sectional observational design, 726 adults, aged ≥66 years, were recruited from two US regions. Explanatory variables included demographics, self-efficacy, social support, barriers, and environmental variables measured by using geographic information systems (GIS) and self-report. Outcomes included reported walking for errands and leisure/exercise and accelerometer-measured daily moderate to vigorous PA (MVPA). Analyses employed mixed-model regressions with backward elimination.

Results

For daily MVPA, the only significant environmental variable was GIS-based proximity to a park (p < 0.001) after controlling for individual/demographic and psychosocial factors. Walking for errands was positively related to four environmental variables: reported walking/cycling facilities (p < 0.05), GIS-based intersection density (p < 0.01), mixed land use (p < 0.01), and private recreation facilities (p < 0.01). Walking for leisure/exercise was negatively related to GIS-based mixed land use (p < 0.05). Non-Hispanic white race/ethnicity, self-efficacy, and social support positively related to all three PA outcomes (p < 0.05).

Conclusions

Correlates of older adults’ PA were found at all ecological levels, supporting multiple levels of influence and need for multilevel interventions. Environmental correlates varied by PA outcome. Walking for errands exhibited the most environmental associations.

     

Increasing Physical Activity Through Principles of Habit Formation in New Gym Members: a Randomized Controlled Trial

Background

The promotion of physical activity (PA) is paramount to public health, yet interventions in the social cognitive tradition have yielded negligible improvements. The limited progression may be due to an overreliance on intention as the proximal determinant of behavior and a lack of consideration of implicit/automatic processes. The purpose of this study was to examine the impact of a habit formation intervention on PA over 8 weeks in a two-arm parallel design, randomized controlled trial.

Methods

Participants (n = 94) were new gym members with the intention to engage in PA but below international PA guidelines at baseline, who were randomized into a control or habit experimental group. The experimental group attended a workshop (at baseline) and received a follow-up booster phone call at week 4. The primary outcome of the study was minutes of moderate-vigorous intensity PA (MVPA) at week 8. The secondary outcome was a manipulation check to determine if the experimental group effectively incorporated habit-building constructs (cues and practice consistency).

Results

The experimental group showed a significant increase in MVPA after 8 weeks in both accelerometry (d = 0.39, p = .04) and self-report (d = 0.53, p = .01) compared with the control group. The experimental group also showed an increase in use of cues (d = 0.56, p < .001) and practice consistency (d = 0.40, p = .01) at week 8.

Conclusion

The results contribute to the initial validity of increasing PA through a focus on preparation cues and practice consistency. Future research should replicate these findings and extend the duration of assessment to evaluate whether PA changes are sustained. Registered Trial Number NCT02785107

     

Perceived emotional support in remission: results from an 18-month follow-up of patients with early episode psychosis

Purpose

Serious mental illness is known for the damage that it inflicts on the social network and social support of patients. Although many studies have used relapse and rehospitalisation as outcomes, recent research has emphasized the importance of a fuller definition of recovery that includes social function. In this study, our goal is to investigate the association of social support with sustained remission in patients with early episode psychosis.

Methods

A secondary analysis of remission and social support was performed with 123 of 144 patients enrolled in the Lambeth Early Onset randomized clinical trial who ever achieved symptom-free status in 18 months of follow-up. Social support was measured by hours of family contact, perceived support, and network size at 6 months into an early intervention treatment program. Consensus judgments made by clinicians on symptom status at each of 18 months of follow-up were analyzed for consecutive months spent in remission. Direct and mediated effects of social support on remission were calculated using Poisson regression and path analysis, respectively.

Results

114 of 123 patients achieved remission after about 7 months on average [mean 6.81 (SD 4.17)]. In univariate models, perceived emotional support predicted longer time spent in remission, while moderate family contact predicted shorter remission duration. Perceived practical support was not associated with remission. Perceived emotional support mediated the association between family contact and remission and between network size and remission. These results are not totally attributable to a specialized early intervention treatment.

Conclusion

Structural measures of support probably contribute to the maintenance of remission through the patient’s perception of emotional support.     

Physical Activity Disparities in Heterosexual and Sexual Minority Youth Ages 12–22 Years Old: Roles of Childhood Gender Nonconformity and Athletic Self-Esteem

Background

Physical activity is an important health determinant. Little is known about sexual orientation differences in physical activity and their psychosocial determinants.

Purpose

The aim of this study is to examine adolescent and young adult hours/week of moderate/vigorous physical activity (MVPA) and team sports participation by sexual orientation and investigate contributions of gender nonconformity and low athletic self-esteem to possible sexual orientation differences.

Methods

Analysis of data from 5,272 males and 7,507 females from 1999 to 2005 waves of the US Growing Up Today Study (ages 12–22 years).

Results

Sexual minorities (i.e., lesbian, gay, bisexual, mostly heterosexual) reported 1.21–2.62 h/week less MVPA (p?<?0.01) and were 46–76 % less likely to participate in team sports than same-gender heterosexuals. Gender nonconformity and athletic self-esteem accounted for 46–100 % of sexual orientation MVPA differences.

Conclusions

Physical activity contexts should be modified to welcome sexual minority males and females. Targeting intolerance of gender nonconformity and fostering athletic self-esteem may mitigate sexual orientation MVPA disparities.     

Type D Personality Is Associated with the Development of Stress Cardiomyopathy Following Emotional Triggers

Background

Stress cardiomyopathy (SCM) can be triggered by emotional events. Recently, type D personality has been established as an independent predictor of acute cardiac adverse events.

Purpose

We sought to examine whether type D personality can be identified in SCM patients.

Methods

A case–control study with 37 SCM patients, 37 myocardial infarction (AMI) patients, who both experienced emotional triggering, and 37 SCM patients without emotional triggers was performed. The DS14 and Interview for Recent Life Events were administered.

Results

Twenty-eight (76 %) SCM emotional trigger patients were categorized as type D compared with 13 (43 %) SCM patients without emotional trigger and 12 (32 %) AMI patients (p?<?0.001). SCM patients with emotional triggers had higher scores on the social inhibition subscale than the other patient groups.

Conclusions

The present study highlights the possible link between type D, with a specific key role for social inhibition component, and increased biological reactivity to acute emotional stress.     

Neighborhood disadvantage in context: the influence of urbanicity on the association between neighborhood disadvantage and adolescent emotional disorders

Purpose

Inconsistent evidence of a relationship between neighborhood disadvantage and adolescent mental health may be, in part, attributable to heterogeneity based on urban or rural residence. Using the largest nationally representative survey of US adolescent mental health available, we estimated the association between neighborhood disadvantage and adolescent emotional disorders and the extent to which urbanicity modified this association.

Methods

The National Comorbidity Survey Replication Adolescent Supplement (NCS-A) sampled adolescents aged 13–17 years (N = 10,123). Households were geocoded to Census tracts. Using a propensity score approach that addresses bias from non-random selection of individuals into neighborhoods, logistic regression models were used to estimate the relative odds of having a DSM-IV emotional disorder (any past-year anxiety disorder, major depressive disorder or dysthymia) comparing similar adolescents living in disadvantaged versus non-disadvantaged neighborhoods in urban center, urban fringe, and non-urban areas.

Results

The association between neighborhood disadvantage and emotional disorder was more than twice as large for adolescents living in urban centers versus non-urban areas. In urban centers, living in a disadvantaged neighborhood was associated with 59 % (95 % confidence interval 25–103) increased adjusted odds of emotional disorder.

Conclusions

Urbanicity modifies the relationship between neighborhood disadvantage and emotional disorder in adolescents. This effect modification may explain why evidence of a relationship between neighborhood disadvantage and adolescent mental health has been inconsistent. Recognizing the joint influence of neighborhood socioeconomic context and urbanicity may improve specificity in identifying relevant neighborhood processes.     

Classifying the Reasons Men Consider to be Important in Prostate-Specific Antigen (PSA) Testing Decisions: Evaluating Risks, Lay Beliefs, and Informed Decisions

Background

Despite uncertainty regarding the benefits of prostate cancer screening, many men have had a prostate-specific antigen (PSA) test.

Purpose

This study aims to identify classes of reasons guiding men’s decisions about prostate cancer screening and predict reasoning approaches by family history and prior screening behaviour.

Methods

First-degree relatives of men with prostate cancer (n?=?207) and men from the general population (n?=?239) of Australia listed reasons they considered when deciding whether to have a PSA test.

Results

Responses were coded into 31 distinct categories. Latent class analysis identified three classes. The evaluation of risk information cues class (20.9 %) contained a greater number of men with a family history (compared with control and overcome cancer/risk class; 52.7 %). Informed decisions and health system class (26.5 %) included a lower proportion of men who had had a PSA test and greater proportions of highly educated and married men.

Conclusion

Understanding the reasons underlying men’s screening decisions may lead to a more effective information provision and decision support.     

Self-reported social anxiety symptoms and correlates in a clinical (CAP) and a community (Young-HUNT) adolescent sample

Purpose

The frequencies of social anxiety symptoms in a mental health clinical and a community sample of adolescents are compared. Also, we explore if adolescents can be classified in subgroups based on social anxiety symptoms. Associations between social anxiety symptoms and coexisting problems and sociodemographic characteristics are examined.

Methods

Adolescent participants, aged 13–18, in two large Norwegian studies, consisting of a clinical (n = 694, 42.1 % participation rate, 55 % girls, mean age = 15.6) and a community (n = 7,694, 73.1 % participation rate, 51 % girls, mean age = 15.8) sample completed identical self-report questionnaires measuring social anxiety and related variables.

Results

Median sum scores (interquartile range) of social anxiety symptoms were higher among girls than boys and in the clinical [girls = 16 (12–22); boys = 12 (9–16)] compared to the community sample [girls = 12 (9–15); boys = 10 (7–12)] (p < 0.001). Latent profile analysis revealed two classes of adolescents based on social anxiety profiles. Adolescents scoring high on social anxiety symptoms, which ranged from 16 % (boys in community sample) to 40 % (girls in clinical sample), had significantly more coexisting problems than those scoring low. Social anxiety symptoms were associated with academic school problems, bullying, eating problems, acne, and general anxiety and depression in both samples.

Conclusion

Social anxiety symptoms were commonly reported by adolescents, in both clinical and community settings. These symptoms were associated with a broad spectrum of coexisting problems, which can be used to detect adolescents struggling with social anxiety. Adolescent, family, peer, school, and community interventions targeting these associated problems may contribute to prevent and alleviate social anxiety symptoms.     

Structural Stigma and Cigarette Smoking in a Prospective Cohort Study of Sexual Minority and Heterosexual Youth

Background

Sexual minority youth are more likely to smoke cigarettes than heterosexuals, but research into the determinants of these disparities is lacking.

Purpose

This study aimed to examine whether exposure to structural stigma predicts cigarette smoking in sexual minority youth.

Methods

Prospective data from adolescents participating in the Growing Up Today Study (2000–2005) were utilized.

Results

Among sexual minority youth, living in low structural stigma states (e.g., states with non-discrimination policies inclusive of sexual orientation) was associated with a lower risk of cigarette smoking after adjustment for individual-level risk factors (relative risk [RR]?=?0.97; 95 % confidence interval [CI], 0.96, 0.99; p?=?0.02). This association was marginally significant after additional controls for potential state-level confounders (RR?=?0.97; 95 % CI, 0.93, 1.00; p?=?0.06). In contrast, among heterosexual youth, structural stigma was not associated with past-year smoking rates, documenting specificity of these effects to sexual minority youth.

Conclusions

Structural stigma represents a potential risk factor for cigarette smoking among sexual minority adolescents.     

Physical activity and depression in adolescents: cross-sectional findings from the ALSPAC cohort

Purpose

Few studies have examined the association between physical activity (PA), measured objectively, and adolescent depressive symptoms. The aim of this study was to determine whether there is an association between objective measures of PA (total PA and time spent in moderate and vigorous PA (MVPA)) and adolescent depressive symptoms.

Methods

Data on 2,951 adolescents participating in ALSPAC were used. Depressive symptoms were measured using the self-report Mood and Feelings Questionnaire (MFQ) (short version). Measures of PA were based on accelerometry. The association between PA and MFQ scores was modelled using ordinal regression.

Results

Adolescents who were more physically active (total PA or minutes of MVPA) had a reduced odds of depressive symptoms [OR_adj total PA (tertiles): medium 0.82 (95% CI: 0.69, 0.97); high 0.69 (95% CI: 0.57, 0.83)]; OR_adj per 15?min MVPA: 0.92 (95% CI: 0.86, 0.98). In a multivariable model including both total PA and the percentage of time spent in MVPA, total PA was associated with depressive symptoms (OR_adj total PA (tertiles): medium 0.82 (95% CI: 0.70, 0.98); high 0.70 (95% CI: 0.58, 0.85) but the percentage of time spent in MVPA was not independently associated with depressive symptoms [OR_adj MVPA (tertiles) medium 1.05 (95% CI: 0.88, 1.24), high 0.91 (95% CI: 0.77, 1.09)].

Conclusions

The total amount of PA undertaken was associated with adolescent depressive symptoms, but the amount of time spent in MVPA, once total PA was accounted for, was not. If confirmed in longitudinal studies and randomised controlled trials, this would have important implications for public health messages.     

Personality, physical activity, and symptoms of anxiety and depression: the HUNT study

Purpose

To analyze the association between physical activity (PA), symptoms of depression and anxiety, and personality traits.

Methods

Cross-sectional study from a Norwegian population-based survey conducted in the period 2006–2008. The sample consisted of a total of 38,743 subjects aged ≥19 years, 56.1 % women and 43.9 % men. Demographic variables, PA, depression and anxiety (The Hospital Anxiety and Depression Scale), and personality (Eysenck Personality Questionnaire) were assessed by self-reporting measurements.

Results

Individuals who reported moderate and high PA had significantly lower scores on depression and anxiety compared with less physically active individuals (p < 0.05). Significantly lower risk of HADS-defined depression and anxiety was associated with frequency, duration, and intensity of activity among women (p < 0.05), and significantly lower risk of HADS-defined depression was associated with frequency, duration, and intensity of activity among men (p < 0.05). There was a significant linear trend between extroversion and levels of PA (p < 0.01) and between neuroticism and PA (p < 0.01).

Conclusions

Subjects reporting regular leisure-time PA were less likely to report symptoms of HADS-defined depression and anxiety. Personality may be an underlying factor in explaining this association.     

Resilience, lifestyle and symptoms of anxiety and depression in adolescence: the Young-HUNT study

Purpose

This study investigated the symptoms of anxiety and depression in adolescence, their associations with lifestyle and resilience and the possibility that resilience factors can attenuate the associations between unhealthy lifestyle and symptoms of anxiety and depression.

Methods

Adolescents (n = 7,639) aged 13–18 years completed a questionnaire regarding lifestyle and health. Symptoms of anxiety and depression were measured by the SCL-5, a five-item shortened version of the Hopkins Symptom Checklist. Resilience factors included questions on friends and family relations and two sub-scales of the Resilience Scale for Adolescents; Family cohesion and Social competence.

Results

Of the total population, 13 % reported symptoms of anxiety and depression. Resilience characteristics were associated with lower symptom levels (ORs ranging from 0.2 to 0.6), and substance use and infrequent physical activity with higher symptom levels (ORs ranging from 2.1 to 4.0). The associations with substance use were strengthened by social competence, but attenuated by family cohesion. The association with physical activity was attenuated by both social competence and family cohesion.

Conclusion

Symptoms of anxiety and depression were frequent in adolescents and were associated with unhealthy lifestyle factors as substance use and low physical activity. Resilience characteristics seemed to protect against symptoms and markedly influenced the associations between lifestyle factors and symptoms of anxiety and depression. The importance of family and other supportive relationships should be emphasized in treatment and prevention of anxiety and depression in adolescence.     

Effects of a Multiple Health Behavior Change Intervention for Colorectal Cancer Survivors on Psychosocial Outcomes and Quality of Life: a Randomized Controlled Trial

Background

Multiple health behavior change can ameliorate adverse effects of cancer.

Purpose

The purpose of this study was to determine the effects of a multiple health behavior change intervention (CanChange) for colorectal cancer survivors on psychosocial outcomes and quality of life.

Methods

A total of 410 colorectal cancer survivors were randomized to a 6-month telephone-based health coaching intervention (11 sessions using acceptance and commitment therapy strategies focusing on physical activity, weight management, diet, alcohol, and smoking) or usual care. Posttraumatic growth, spirituality, acceptance, mindfulness, distress, and quality of life were assessed at baseline, 6 and 12 months.

Results

Significant intervention effects were observed for posttraumatic growth at 6 (7.5, p?p?=?0.033), spirituality at 6 months (1.8, p?=?0.011), acceptance at 6 months (0.2, p?=?0.005), and quality of life at 6 (0.8, p?=?0.049) and 12 months (0.9, p?=?0.037).

Conclusions

The intervention improved psychosocial outcomes and quality of life (physical well-being) at 6 months with most effects still present at 12 months. (Trial Registration Number: ACTRN12608000399392).     

Impact of Baseline Weight on Smoking Cessation and Weight Gain in Quitlines

Background

The use and effectiveness of tobacco quitlines by weight is still unknown.

Purpose

This study aims to determine if baseline weight is associated with treatment engagement, cessation, or weight gain following quitline treatment.

Methods

Quitline participants (n?=?595) were surveyed at baseline, 3 and 6 months.

Results

Baseline weight was not associated with treatment engagement. In unadjusted analyses, overweight smokers reported higher quit rates and were more likely to gain weight after quitting than obese or normal weight smokers. At 3 months, 40 % of overweight vs. 25 % of normal weight or obese smokers quit smoking (p?=?0.01); 42 % of overweight, 32 % of normal weight, and 33 % of obese quitters gained weight (p?=?0.05). After adjusting for covariates, weight was not significantly related to cessation (approaching significance at 6 months, p?=?0.06) or weight gain.

Conclusions

In the first quitline study of this kind, we found no consistent patterns of association between baseline weight and treatment engagement, cessation, or weight gain.