Complementary and alternative medicine use and asthma: relation to asthma severity and comorbid chronic disease

Objective: To determine (a) the prevalence of complementary and alternative medicine (CAM) use among people with asthma, and (b) if comorbid chronic disease and asthma severity are associated with CAM use. Methods: This cross-sectional study utilized data from n?=?15?276 adults who participated in the 2009 Behavioral Risk Factor Surveillance System (BRFSS) and the 2009 Asthma Callback Survey (ACBS). Binary Logistic regression was used to determine if comorbid disease and asthma severity were associated with CAM use (yes/no). Model covariates were age, sex, income, and education. Results: About 26% of respondents report using at least one form of CAM. The most frequently reported form of CAM use is breathing exercises (19.8%). The results indicate that neither comorbid cardiovascular disease, diabetes, nor stroke are related to CAM use, but individuals with more severe asthma symptoms were more likely to use CAM (OR?=?1.05, 95% CI 1.04, 1.05). Conclusions: CAM remedies most often reported by people with asthma (breathing techniques, vitamins) are unlikely to pose safety risks. Comorbid chronic disease does not motivate people with asthma to seek unconventional remedies. The increase in CAM use with asthma severity prompts questions about factors that might drive this behavior, such as untreated/inadequately treated disease, or medication side effects.     

The association between diabetes mellitus,sugar-sweetened beverages,and tooth loss in adults: Evidence from 18 states

Background

Sugar-sweetened beverages (SSBs) are dietary sources of sugar that are factors in caries development and tooth loss. Dietary sugar also is linked to diabetes mellitus (DM). There is limited research related to SSBs and tooth loss in people with DM. The authors investigated the association between SSBs and tooth loss as it related to the presence or absence of DM.

Prostate‐specific antigen testing in older men in the USA: data from the behavioral risk factor surveillance system

Study Type – Diagnosis (cohort) Level of Evidence 2a What's known on the subject? and What does the study add? Previous studies from the USA reported that, in recent years, prostate cancer screening with PSA was very common among the elderly men, including those whose life expectancy was substantially limited by advanced age and known comorbidities. In 2008, the US Preventive Services Task Force (USPSTF) recommended against PSA screening after age 75. The purpose of this study was to examine the impact of the USPSTF 2008 recommendation on the frequency of PSA testing among elderly men in the USA. Our findings suggest that the USPSTF recommendation had no major impact on clinical practice.

OBJECTIVE

• ? To examine the frequency of PSA testing in men aged ≥75 years before and after the 2008 US Preventive Services Task Force (USPSTF) recommendation to stop prostate‐specific antigen (PSA) screening at age 75.

MATERIALS AND METHODS

• ? Data were obtained from the Behavioral Risk Factor Surveillance System (BRFSS) surveys completed in 2006, 2008 and 2010.
• ? Men aged ≥ 76 years at the time of survey and without a prostate cancer diagnosis were included in the study.
• ? The percentage of men who had a PSA test in the year before the survey was computed separately for survey years 2006, 2008 and 2010.

RESULTS

• ? The estimated percentages of men with a PSA test in the year before the survey were 60% (95% CI: 58–62%), based on 9033 respondents interviewed in 2006, 63% (95% CI: 62–65%), based on 12 063 respondents interviewed in 2008, and 60% (95% CI: 59–61%), based on 14 782 respondents interviewed in 2010.

CONCLUSION

• ? No substantial reduction in the frequency of PSA testing was observed in the BRFSS 2010 survey data compared with the earlier years, suggesting that the USPSTF 2008 recommendation had no major impact on the frequency of PSA testing in older men in the USA.

     

Characteristics associated with the uptake of influenza vaccination among adults in the United States

Objective

Existing data suggest that influenza vaccination rates among adults in the United States fall far short of the Healthy People 2010 goals and the updated Healthy People 2020 targets. We identified characteristics associated with influenza vaccination that might inform strategies for increasing coverage.

Methods

We used data from the 2009 Behavioral Risk Factor Surveillance System to estimate adjusted prevalence ratios for receiving the influenza vaccine in the past 12 months.

Results

Among 134,101 adults aged ≥ 65 years, the influenza vaccination coverage level was 68.9%. Among 286,867 younger adults aged 18-64 years, coverage was markedly lower: 31.8%. Having health care coverage was the strongest predictor of vaccination in both age groups, after accounting for other sociodemographic characteristics, health behaviors, and health status. Those reporting older age, white race, higher education, non-smoking status, being physically active, or having poor physical health or a personal history of various chronic conditions were also more likely to report having received the influenza vaccine.

Conclusion

Our results show clearly that vaccine uptake in the United States is related to social position as well as other health behaviors. These findings call for renewed attention to vaccination strategies to meet the updated Healthy People 2020 goals.     

Age-, race-, and gender-specific prevalence of diabetes among smokers

A cross-sectional study using the US national 2009 Behavioral-Risk-Factor-Surveillance-System data (n = 425,846) demonstrates that diabetes prevalence was significantly increased after age 35 in ever smokers, irrespective of gender. Diabetes prevalence was significantly increased in white or Hispanic ever smokers after age 25, and in black ever smokers after age 35.     

Monitoring healthy people 2010 arthritis management objectives: education and clinician counseling for weight loss and exercise

PURPOSE Our goal was to monitor the progress of 3 Healthy People 2010 (HP2010) objectives encouraging self-management education and clinician counseling for weight loss and physical activity among adults with doctor-diagnosed arthritis.METHODS Using the national 2002 and 2006 National Health Interview Survey (NHIS) and state-based 2003 and 2007 Behavioral Risk Factor Surveillance System (BRFSS), we estimated the change in proportion of persons counseled for each objective, overall and by selected characteristics.RESULTS Nationally, the proportion of overweight and obese adults with doctor-diagnosed arthritis who were counseled by their clinician to lose weight to lessen their arthritis symptoms increased significantly from 35.0% (95% confidence interval [CI], 32.8%–37.2%) in 2002 to 41.3% (95% CI, 38.7%–44.0%) in 2006 but have yet to reach the 2010 target of 46%. There was no change in the proportion of adults with doctor-diagnosed arthritis who had ever taken a self-management education class (approximately 11%) or who had been counseled to engage in physical activity (approximately 52%), whose targets for 2010 are 13% and 67%, respectively. States had variable findings.CONCLUSIONS Nationally, significant progress has been made by clinicians for weight counseling of overweight and obese adults with doctor-diagnosed arthritis but not for the other 2 arthritis management objectives. Because clinician counseling can have important effects on the latter, this discrepancy suggests a need to focus on barriers to physician counseling for these outcomes.     

Explained and unexplained racial and regional inequality in obesity prevalence in the United States

ABSTRACT

Objective: There are substantial racial and regional disparities in obesity prevalence in the United States. This study partitioned the mean Body Mass Index (BMI) and obesity prevalence rate gaps between non-Hispanic blacks and non-Hispanic whites into the portion attributable to observable obesity risk factors and the remaining portion attributable to unobservable factors at the national and the state levels in the United States (U.S.) in 2010.

Design: This study used a simulated micro-population dataset combining common information from the Behavioral Risk Factor Surveillance System and the U.S. Census data to obtain a reliable, large sample representing the adult populations at the national and state levels. It then applied a reweighting decomposition method to decompose the black-white mean BMI and obesity prevalence disparities at the national and state levels into the portion attributable to the differences in distribution of observable obesity risk factors and the remaining portion unexplainable with risk factors.

Results: We found that the observable differences in distribution of known obesity risk factors explain 18.5% of the mean BMI difference and 20.6% of obesity prevalence disparities between non-Hispanic blacks and non-Hispanic whites. There were substantial variations in how much the differences in distribution of known obesity risk factors can explain black-white gaps in mean BMI (?67.7% to 833.6%) and obesity prevalence (?278.5% to 340.3%) at the state level.

Conclusion: The results from this study demonstrate that known obesity risk factors explain a small proportion of the racial, ethnic and between-state disparities in obesity prevalence in the United States. Future etiologic studies are required to further understand the causal factors underlying obesity and racial, ethnic and geographic disparities.     

Mode of physical activity participation by body mass index: 2015 behavioural risk factor surveillance system

Body mass index (BMI) continues to be used as a marker of health due its strong correlation with adiposity and health. Physical activity (PA) has been shown to be favourably associated with a desirable BMI. Few studies have examined mode of PA participation across BMI indices with a mutually exclusive underweight BMI range. The purpose of this study was to examine the relationship between modes of PA and BMI. Data from the 2015 Behavioral Risk Factor Surveillance System was analysed.

Underweight, overweight, and obese BMI categories possessed 35, 20, and 46% lower odds of meeting current PA guidelines. The obese BMI group was found to have lower odds of meeting the aerobic only and strength only guidelines. Underweight, overweight, and obese groups possessed 63, 18, and 76% greater odds of meeting neither PA guideline, respectively.     

The development of a Chinese version of the tobacco use subscale of the behavioral risk factor surveillance system (BRFSS)

OBJECTIVES: To provide a culturally and linguistically specific survey instrument for tobacco consumption in Taiwan, we evaluated the reliability and validity of a Chinese translation of the 1993 US Tobacco Use Subscale of Behavioral Risk Factor Surveillance System (TU-BRFSS). METHODS: An integrative translation was followed by a pilot study of 100 randomly selected adults from throughout Taiwan. Telephone interviews took place in July, 2004. Validity was assessed by Content Validity Index (CVI) computed on the basis of expert review and the averaged scores of back-translation. RESULTS: Of 29 questions, 25 met the CVI criteria for retention in the instrument. In the back-translation assessment, 85% of the average scores taken from the expert evaluations were above 4 (scale of 1-5). Three of four percent agreements between the referent question and 4 other questions were 100%. CONCLUSIONS: The Chinese version of the TU-BRFSS, with appropriate content, semantics, and conceptual equivalence, appears valid and reliable for future surveillance and research in Taiwan and other Chinese populations.