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Objectives: In this paper we report the evaluation of a proprietary recall system for promoting compliance with recommended follow-up in high-risk patients. Methods: We conducted a retrospective chart review for patients of an active private colon and rectal surgery practice having colonoscopy in 2006. Patients selected were <80 years of age and assessed to be high-risk by findings at exam or personal/family history of colorectal neoplasm with a recommendation for follow-up surveillance colonoscopy ranging from months to 5 years. Up to 6 months from recommendation was considered to be within compliance. Results: A total of 795 patients met the inclusion criteria, with average age of 63.2 years, 422 (53.1%) being men. Compliance with surveillance colonoscopy recommendations was 62.5%. The recall system impacted patient behavior with compliant patients being sent a median of one letter (average, 1.5) and late or no follow-up patients being sent a median of 4 letters (average, 3.9). Conclusions: Multiple contacts with patients are required to improve compliance with surveillance. Our findings support at least 4 to 5 efforts to remind patients of the importance to schedule a colonoscopy is necessary to optimize compliance. [ABSTRACT FROM AUTHOR]

Objectives: In this study, we examined the role of plate size in an individual's ability to draw what they had for dinner the previous evening. Methods: A sample of 199 students at one US university were given large pieces of paper with the image of a plate printed on them and asked to make an accurate drawing on the plate of what they had for dinner the previous evening once per week for 10 weeks. The sizes of the printed plates either stayed constant at 10.5 inches or 8.5 inches or started at 10.5 inches and decreased in small weekly increments to 8.5 inches. We hypothesized that participants given the changing size plates would unknowingly alter their drawn meal sizes in relation to the size of the plate offered. Results: Participants drew more food on larger plates than smaller plates. Participants given plates that decreased in size also decreased the size of their drawings and reported consuming a total of 69 square inches less food on the decreasing than the large plates. Conclusion: These findings suggest that changes in plate size may be useful in influencing food portion sizes over time when the size of the plates is decreased incrementally. [ABSTRACT FROM AUTHOR]

Objectives: In this study, we examined sex and racial/ethnic differences in the prevalence and predictors of suicide consideration and attempts among US college students. Methods: We used multivariable logistic regression to investigate suicide consideration and attempts by sex and race/ethnicity among students (N = 319,342) who completed the American College Health Association- National College Health Assessment from fall 2011 to spring 2015. Results: Overall, the prevalence of suicide consideration and attempts was higher in spring 2015 than fall 2011 (p < .05). Men had higher odds of suicide consideration and attempts than women (p < .001). Blacks, Hispanics, and Asians had higher odds of suicide consideration and attempts compared with Whites (p < .001). Weight-related problems (unhealthy weight, body weight overestimation, and lack of physical activity), sleep problems (insufficient sleep and sleep difficulties), and lower levels of academic performance were associated with both suicide consideration and attempts (p < .05). Conclusions: Our findings indicate a need for sex- and race/ethnicity-specific suicide prevention strategies for college students, specifically men and racial/ethnic minority groups. Furthermore, appropriate weight and sleep management could be considered to help prevent suicide among US college students. [ABSTRACT FROM AUTHOR]

Objectives: We investigated whether the Short Grit Scale (Grit-S) predicted odds of food insecurity (FI) among adults and their children. Methods: A cross-sectional panel of parent-child dyads completed an online questionnaire. Eligible dyads included parents with household income below the 2015 median ($52,250 USD/year) and their self-selected household child between the ages of 13 to 17 years. An online questionnaire assessed: (1) FI using the 18-item Household Food Security Survey Module and the Food Security Survey Module for Youth; (2) perseverance and determination using the validated 8-item Grit-S; and (3) sociodemographic FI predictors. Logit regression models estimated the relationship between odds of FI and predictors among parents and children, separately. Results: Among 252 parents, 61.1% reported household FI. Parents' Grit-S score (N = 179) was associated with a significantly lower odds of household FI (OR= 0.4; 95%CI= 0.2, 0.8; p < .01) while adjusting for established predictors. Mean (±SD) Grit-S was 3.1 (±0.7). Children's Grit-S score (N = 178) was associated with a significantly lower odds of child FI (OR= 0.6; 95%CI= 0.4, 0.9; p < .05) while adjusting for established predictors. Conclusions: Perseverance and determination, also known as "grit," may be one further explanation for why some poor households are food secure. [ABSTRACT FROM AUTHOR]

Objectives: We examined college students' beliefs and behavior regarding sharing when smoking a hookah, a practice that may involve substantial risk of disease transmission. Methods: We carried out a cross-sectional Web-based survey of undergraduate ever users of hookah (N = 970) at a US university in 2007. Results: Hookah sharing started at initiation of hookah use. The first-time participants smoked hookah, 96.9% shared it, and 97.5% were with friends either in a hookah lounge (59.5%) or at a friend's home (30%). Participants shared a hookah when they first smoked it because sharing was acceptable with friends, family, or trusted others, normative etiquette, not problematic/harmful, cheaper, or the only smoking option. Participants did not use a mouth tip when they first smoked a hookah because it is not necessary with friends/family, there was no tip available, they were unaware of tips, or did not want to use one. Conclusions: Overwhelmingly, hookah sharing started at smoking initiation. Efforts are needed to create an environment in which sharing hookah practices are less acceptable such as increasing awareness of potential health risks of sharing, particularly among youth, and providing disposable hoses, disposable mouth tips, and proper hookah device cleaning practices in private and public hookah venues settings. [ABSTRACT FROM AUTHOR]

Objective: The association between social norms and dietary behaviors is well-documented, but few studies examine the role of race. The aim of this study was to determine the interrelationships among race, social norms, and dietary behaviors. Methods: We used data from the Healthy Friends Network Study (a pilot study of women attending a southern university). Dietary behaviors, social norms, and self-identified race were obtained. Results: African Americans had lower odds of daily vegetable (OR = 0.55, 95% CI = 0.38-0.79) and fruit consumption (OR = 0.45, 95% CI = 0.30-0.67), but no race difference in frequent consumption of fatty/fried/salty/sugary foods was observed in fully adjusted models. Proximal descriptive norms were associated with all dietary behaviors, but distal injunctive social norms were associated with lower odds of frequent unhealthy food consumption (OR = 0.10, 95% CI = 0.05-0.21). Race differences in family descriptive norms were found to mediate race differences in vegetable and fruit consumption by 7%-9%. However, race differences in friend and family injunctive norms mediated 20%-50% of the effects of race on frequent unhealthy food consumption. Conclusions: Proximal injunctive norms account for race differences in unhealthy food consumption. Future studies should further explicate the mechanisms and seek to utilize social norms in behavior change interventions. [ABSTRACT FROM AUTHOR]

Objectives: Learning to swim is recommended for children to prevent drowning and to promote lifelong physical activity. Dissimilar US youth swimming ability rates by demographics have been reported. Our research purpose was to examine youth swimming ability by selected variables, and to compare with similar research in 2010. Methods: USA Swimming Foundation sponsored a cross-sectional study in 5 US cities during 2017. Trained YMCA personnel administered surveys measuring self-reported swimming ability among youth, ages 4-18 (N = 1373). We compared the 2017 results with findings from the 2010 study (N = 1741). Results: In 2017, fewer respondents reported no/low swimming ability. However, groups were identified with a high percentage (greater than 50%) of no/low swimming ability including the following ones; girls, African-American boys and girls, and boys and girls who participate in free or reduced-cost lunch programs. Multivariate analysis showed that significant predictors for lower swimming ability were parent education (less than college education), qualifying for free or reduced-cost lunch programs, and being African-American. Conclusions: No/low swimming ability groups were identified and continue to need support. Interventions should target children who are African-American, qualify for free or reduced-cost lunch, and have parents with lower levels of education. [ABSTRACT FROM AUTHOR]

Objectives: Due to growing health disparities, federal and philanthropic agencies have emphasized reducing health disparities in their preventive health efforts. This study determined the status of disparities in health behaviors in the last 13 years in the United States. Methods: Data were obtained from the Behavioral Risk Factor Surveillance Systems in odd years (2003-2015). Health behaviors were dichotomized to reflect met fruit and vegetable (FV) consumption and physical activity (PA) recommendations, non-cigarette smoking, non-heavy drinking, and nonbinge drinking. Overall and sociodemographic characteristic-specific disparities ratios for each behavior were calculated. Linear trend analyses were calculated to determine disparities change across the years. Results: Overall disparities fluctuated across the years. Linear trend analyses confirmed that education-specific and income-specific disparities' contribution to overall disparities increased for all behaviors. Sex-specific disparities' contribution decreased for all behaviors except non-cigarette smoking. Age-specific disparities' contribution decreased for all behaviors except non-binge drinking. Race/ethnicity-specific disparities' contribution to overall disparities increased for FV and non-cigarette smoking, but decreased for the other behaviors. Conclusions: The results suggest health disparities in preventive health behaviors in the last 13 years have not improved. Tailored interventions, systemic and policy changes, and/or inclusive population efforts should be initiated to reduce disparities in preventive health for the mostdivergent groups identified in the results. [ABSTRACT FROM AUTHOR]

Objectives: Lung cancer is the leading cause of cancer death, yet lung screening remains underutilized. Lung cancer screening uncertainty (LCSU), including referral clarity and the perceived accuracy of screening, may hinder utilization and represent an unmet psychosocial need. This study sought to identify correlates of LCSU among lung screening patients. Methods: Current and former smokers (N = 169) completed questionnaires assessing LCSU, sociodemographic variables, objective and subjective numeracy, stress, and anxiety, as part of a cross-sectional study of lung screening patients at an academic hospital. Results: Patients (52% current smokers) reported high clarity about the reason for their lung screening referral. Less clarity was associated with lower education, not receiving Medicare, and greater stress and anxiety. Patients perceived lung screening to be moderately accurate, and levels were inversely related to objective numeracy. Subjective numeracy was higher among former versus current smokers (OR = 2.5), yet was unrelated to LCSU variables. Conclusions: Several sociodemographic, numeracy, and emotional factors were associated with greater LCSU. With multiple policy and clinical guidelines purporting the uptake of annual lung screening, it is important to identify patients with LCSU and tailor shared decision-making to clarify their uncertainties. [ABSTRACT FROM AUTHOR]

Objectives: We determined knowledge of the health benefits of consuming beans, and assessed if awareness varied by acculturation status among Hispanic and non-Hispanic low-income women. Methods: We used a self-administered survey with Iowa women aged 18-65 years who were eligible to receive income-based services through 2 healthcare clinics, a WIC clinic, and Extension Outreach. Chi-square and ANOVA were used to compare bean health benefit knowledge, demographics, health-risk factors, nutrition information seeking, and self-efficacy by acculturation categories. Results: Of the 158 women who completed the survey, 58% were Hispanic, with a mean age of 36 years. In terms of acculturation, 24% were Hispanic-dominant, 30% bicultural, and 46% English dominant. Over 50% of all respondents did not know bean consumption lowered cholesterol, aided blood glucose control, or reduced some cancer risks. Responses for 5 of 7 knowledge statements differed significantly by acculturation. Hispanic-dominant and bicultural women reported significantly better health, higher bean consumption, and less cigarette smoking than English-dominant women. Bicultural and English-dominant women were more likely to use the Internet for nutrition information. Conclusions: There are knowledge gaps about the health benefits of bean consumption among low-income women. Nutrition education to improve their knowledge may lead to increased bean consumption, reducing health disparities and improving nutrition. [ABSTRACT FROM AUTHOR]

Objective: We conducted a cluster-randomized trial evaluating an intervention that trained Chinese-American primary care physicians to increase their Chinese patients' colorectal cancer (CRC) screening. Methods: Twenty-five physicians (13 randomized to the intervention arm and 12 to the control arm) and 479 of their patients (aged 50-75 and nonadherent to CRC screening guidelines) were enrolled. The intervention, guided by Social Cognitive Theory, included a communication guide and 2 in-office training sessions to enhance physicians' efficacy in communicating CRC screening with patients. Patients' CRC screening rates (trial outcome) and rating of physician communication before intervention and at 12-month follow-up were assessed. Intention- to-treat analysis for outcome evaluation was conducted. Results: Screening rates were slightly higher in the intervention vs. the control arm (24.4% vs. 17.7%, p = .24). In post hoc analyses, intervention arm patients who perceived better communication were more likely to be screened than those who did not (OR = 1.09, 95% CI: 1.03, 1.15). This relationship was not seen in the control arm. Conclusions: This physician-focused intervention had small, non-significant effects in increasing Chinese patients' CRC screening rates. Physician communication appeared to explain intervention efficacy. More intensive interventions are needed to enhance Chinese patients' CRC screening. [ABSTRACT FROM AUTHOR]

Objective: We evaluated the influence of psychosocial factors on HBV screening. Methods: Sample consisted of 1716 Vietnamese participants in our previous HBV intervention trial, recruited from 36 community-based organizations in Pennsylvania, New Jersey, and New York City between 2009 and 2014. Using the Health Belief Model and Social Cognitive Theory, we measured self-efficacy, knowledge, perceived barriers, perceived benefits, perceived severity, and risk susceptibility. Analysis of covariance was used to compare pre- and post-intervention changes of psychosocial variables. Structural equation modeling was used to explore the direct and indirect effects of the psychosocial variables on HBV screening. Results: Knowledge, self-efficacy, perceived benefits, and perceived barriers were directly associated with HBV screening; knowledge had the strongest effect. Perceived severity and risk susceptibility had indirect association with HBV screening through other variables. Indirect paths among the 6 psychosocial variables were also identified. Conclusion: To promote HBV screening among Vietnamese Americans, intervention efforts should focus on increasing knowledge, self-efficacy, and perceived benefits, decreasing perceived barriers, and accounting for the dynamic cognitive processing. [ABSTRACT FROM AUTHOR]

Objectives: We aimed to determine whether the prevalence of current use of smokeless tobacco products (STPs) changed during 2014-2016 and examine factors associated with use among adults in the United States (US). Methods: Data were obtained from Tobacco Products and Risk Perceptions Surveys of probability samples representative of US adults in 2014, 2015, and 2016. Change over time in current (past 30 day) STP use was examined using pairwise comparisons of proportions and multivariable logistic regression. Associated factors were examined using Rao-Scott χ 2 and multivariable logistic regression. Results: The prevalence of current STP use was higher in 2015 (3.6%) than in 2014 (2.3%, p < .001) and 2016 (2.7%, p = .018) among US adults. In 2016, current STP use was associated with being male, under age 60, currently using hookah or e-cigarettes, and having less than a college degree. Rates of use did not vary by cigarette smoking status, race/ethnicity, income, or metropolitan statistical area (MSA). Conclusions: The prevalence of current STP use peaked in 2015. In 2016, current STP use was more prevalent among males and adults with lower education. Continuous monitoring of STP use is needed, particularly non-cigarette tobacco product users. [ABSTRACT FROM AUTHOR]

The article discusses research regarding youth weight perceptions and weight-control intention in America, and it mentions the impacts of sex and body mass index (BMI) on perception and intention. The COMPASS study, which collects from students in grades 9 through 12 and their secondary schools in Ontario and Alberta, Canada, is examined. It states that accurate perceptions about weight were more likely once students' BMI levels reached the obese range.

The articles presents a study on the effects of long-term medical marijuana legalization on cigarette co-use in a sample of adult smokers. It discusses the implication of medical marijuana legalization to cigarette co-use amid the correlation between marijuana and cigarette co-use, the marijuana use as well as nicotine dependence among adult cigarette smokers and the social norms about marijuana.

To investigate Hmong- American immigrant women's utilization of cervical cancer screening, including the impact of cultural health beliefs on screening use. Methods: Overall, 164 Hmong-American immigrant women 21 to 65 years of age were recruited from a large metropolitan area in the Midwest. We used logistic regression, guided by Andersen's Behavior Model, to examine factors associated with the receipt of Pap test. Results: About 67.1% had received a Pap test within the last 3 years. Fatalism, modesty, education, and marital status were significantly correlated with receiving a Pap test. Conclusion: The provision of cervical cancer literacy education and related preventive guidelines to this population are urgently needed to reduce cancer-screening disparity. [ABSTRACT FROM AUTHOR]

The article discusses a study which examined the relationship between obesity and mental health disorders (MHD) such as serious psychological distress (SPD), anxiety and depression in active duty personnel in the U.S. Army, Navy and Marine Corps. It describes how the study was conducted and the use of the 2005 U.S. Department of Defense Health Related Behaviors Survey. It also mentions the need for personnel screening to identify MHD risk elements.

Objectives: To examine beliefs, prior use, and interest in using pharmacother­apy among people living with HIV/AIDS (PLWHA). Methods: Cross-sectional survey of smokers in a midwestern HIV clinic. Results: The sample (N = 146) included 69% men, 82% African Americans, 45% were in precontemplation for quitting, and 46% were interested in using pharmacotherapy. Primary reasons for non-use included cost and a belief that they would be able to quit on their own. Physician assistance was the strongest correlate of prior use. Perceived benefits and self-efficacy were the strongest correlates of willingness to use pharmaco­therapy. Conclusions: Future interventions should address misconceptions, perceived benefits, and self-efficacy for using cessation aids. Physicians should offer pharmacotherapy to all smokers. [ABSTRACT FROM AUTHOR]

Objective: To compare the breast cancer screening practices and related factors between Asian Americans and Pacific Islanders (PIs) and non-Hispanic whites. Methods: Using 2008 Behavioral Risk Factor Surveillance System data, reported mammogram usage among women aged 40+ were compared. Covariates included demographics, risk behaviors, health perception, care access, and general health practice behavior. Results: PIs had higher rates of screening mammogram usage than did Asian Americans. Most covariates had different levels of influence on mammogram screening for the 2 groups, with a few in opposite directions. Conclusion: Understanding the magnitude and predictors of these disparities for racial/ethnic groups can help inform targeted interventions. [ABSTRACT FROM AUTHOR]

Objective: To describe acculturation, food patterns, overweight, and gender differences among Korean immigrants in the United States. Methods: A cross-sectional exploratory survey assessed acculturation, food frequencies, and weight status of 195 Korean immigrants. Results: Acculturated Korean immigrants (score ≥2.5) were more likely to consume both healthy and unhealthy US foods. Acculturation was not associated with overweight. Men were more likely to be acculturated (OR=2.46; CI=1.26-4.79) and overweight (OR=5.08; CI=2.37- 10.90) than women. Moreover, overweight men reported more frequent consumption of fast foods, hot dogs (OR=2.92;CI=1.18-7.22), and tacos (OR=4.12;CI=1.60-10.62) than did nonoverweight men. Conclusion: Dietary interventions in Korean immigrants should take gender differences in acculturation and food patterns into account. [ABSTRACT FROM AUTHOR]

Objectives: To examine how the relationship between parental-related youth assets and youth sexual activity differed by race/ethnicity. Methods: A random sample of 976 youth and their parents living in a Midwestern city participated in the study. Multivariate logistic regression analyses were conducted for 3 major ethnic groups controlling for the other demographics. Results: Parental monitoring had the strongest association with sexual abstinence for all 3 ethnic/racial groups. Family communication and relationship with mother were also important for white and black youth respectively. Conclusions: Parental youth assets, especially parental monitoring, can be important in the decision to delay sexual intercourse. [ABSTRACT FROM AUTHOR]

Objective: To examine the mechanisms linking health literacy to physical activity and self-reported health. Methods: From 2005-2007, patients (N=330) with hypertension were recruited from safety net clinics. Pathanalytic models tested the pathways linking health literacy to physical activity and self-reported health. Results: There were significant paths from health literacy to knowledge (r=0.22, P<0.001), knowledge to self-efficacy (r=0.13, P<0.01), self-efficacy to physical activity (r=0.17, P<0.01), and physical activity to health status (r=0.17, P<0.01). Conclusions: Health education interventions should be literacy sensitive and aim to enhance patient health knowledge and self-efficacy to promote self-care behavior and desirable health outcomes. [ABSTRACT FROM AUTHOR]