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ABSTRACT BACKGROUND Adolescent overweight and obesity are serious health risks, with prevalence varying by sociodemographic group. Studies link children's weight status and sex/race-ethnic differences with meeting recommendations for physical activity and diet. But, research examining the intersection of sociodemographic characteristics, behavior, and weight status is limited. This paper aims to identify sociodemographic differences in the association between adolescent weight status and meeting 6 national obesity-related recommendations. METHODS In 2011-2012, the Healthy Kids Colorado Survey was administered to all Denver high school students. Using descriptive and multivariate modeling, we examined subgroup associations between students' self-reported weight status and physical activity and diet. RESULTS Students (N = 6652) who met at least 1 recommendation were less likely to be at an unhealthy weight (OR = 0.87); also true for students who met at least 1 physical activity recommendation (OR = 0.80). However, the association varied across subgroups. The association between weight status and meeting at least 1 nutritional recommendation (OR = 0.91) was inconsistent across subgroups. Unexpected patterns also emerged in subgroup associations between meeting specific recommendations and weight status. CONCLUSIONS Identifying subgroup differences in meeting recommendations and the association with weight status is important in identifying high risk groups and improving policy and programs that target childhood obesity prevention. [ABSTRACT FROM AUTHOR]

Socially isolated aging adults are at risk of poor health and well-being. Occupational therapy can help address this issue; however, information is needed to guide such work. National surveys characterize social isolation in populations of aging adults but fail to provide meaningful information at a community level. The objective of this study is to describe multiple dimensions of social isolation and related factors among aging adults in diverse urban neighborhoods. Community-based participatory research involving a door-to-door survey of adults 50 years and older was used. Participants (N = 161) reported social isolation in terms of small social networks (24%) and wanting more social engagement (43%). Participants aged 50 to 64 years reported the highest levels of isolation in most dimensions. Low income, poor health, lack of transportation, and infrequent information access appeared linked to social isolation. Occupational therapists can address social isolation in similar urban communities through policy and practice that facilitate social engagement and network building. [ABSTRACT FROM AUTHOR]

This paper examines predictors of cancer-specific distress among posttreatment adult leukemia and lymphoma survivors (LLS). Using a survey mailed to LLS in the Colorado Central Cancer Registry (N = 477), the authors developed a multivariable risk profile for distress. Thirty one percent of LLS reported indicators of distress. Significantly higher distress was associated with younger age (p < 0.001) in bivariate analyses. The risk profile included fear of recurrence, financial burden, and younger age. Distress did not attenuate based on time since treatment completion and may persist up to 4 years posttreatment, suggesting a need for intervention, particularly among high-risk LLS. [ABSTRACT FROM PUBLISHER]

Using in-depth interviews, this paper explores the nature and sources of cancer-specific distress among 51 posttreatment adult leukemia and lymphoma survivors (LLS), focusing on the role of lifespan stage in shaping reported stressors. LLS (all ages) reported physical aftereffects of cancer treatment, with reported sources of emotional and financial distress varying by lifespan stage. Young adult survivors (18–39) reported a greater number of distress sources. Distress may persist up to 4 years posttreatment, particularly among younger LLS, who appear to be at greater risk of distress in multiple domains. [ABSTRACT FROM PUBLISHER]

The article describes the results of a survey on the use of community-based participatory research among practice-based research networks (PBRN) in the United States. Twenty-four PBRN said that they have some mechanism to involve community members and/or patients in their research. No respondents reported using full participatory methods. The survey also reveals active involvement by community members to offer research ideas, review research protocols, interpret results and disseminate findings.

OBJECTIVE — To describe decisions made by primary care providers on elevated HbA[sub 1c] results and their reasons for not intensifying therapy. RESEARCH DESIGN AND METHODS — In this cross-sectional study, a provider survey was administered in two practice-based research networks when HbA[sub 1c] results were reviewed on all nonpregnant patients >18 years old with type 2 diabetes. Univariate and Mantel Hantel analyses assessed associations between patient characteristics and clinical decisions. RESULTS — A total of 483 surveys were completed by at least 88 providers at 19 clinics. Most patients were female (62.5%), mean age was 60 years, and 28.6% were Hispanic. The overall action rate on HbA[sub 1c], results ≥7% (n = 294) was 70.7%. Patients who were black or had Medicare without medication insurance had lower rates of action on HbA[sup 1c] ≥7 and ≥8%, respectively (P < 0.05). The most common reasons providers reported for inaction were "patient improving/doing well," "competing demands," and "hypoglycemic risk." CONCLUSIONS — Primary care providers generally adhere to national glycemic control guidelines, although there may be disparities in black patients and patients without medication insurance coverage. A variety of reasons were given when control was not intensified. [ABSTRACT FROM AUTHOR]

OBJECTIVES: The purpose of our study was to determine the frequency of smoking cessation counseling in relation to insurance status in a practice-based research network. STUDY DESIGN: We administered a modified National Ambulatory Medical Care Survey (NAMCS), with an additional payment category to identify uninsured patients, quarterly to 100 random patients at each practice site for 1 year. POPULATION: The study population included the patients at the 7 practices within the Colorado Research Network (CaReNet), associated with the Department of Family Medicine, University of Colorado Health Science Center. OUTCOMES MEASURED: We measured the prevalence of smoking and the frequency of cessation counseling. RESULTS: Of 2773 visits analyzed, 1443 were made by adults who were either was uninsured (39%), had Medicaid (22%), or had private or a health maintenance organization insurance (private/HMO; 40%). Smoking prevalence was significantly greater in uninsured patients (30%) and Medicaid patients (31%), compared with private/HMO patients (22%) (P =.008). However, those smokers with private/HMO insurance were more likely to receive tobacco counseling (50%) than Medicaid (41%) and uninsured (25%) patients (P <.001). After controlling for potential confounders, this difference remained significant. CONCLUSIONS: Although smoking is more common among Medicaid and uninsured patients, these smokers are less likely to receive counseling. Possible explanations for this disparity include lack of access to cessation interventions or lower quality of care for underserved patients. This finding may have implications for achieving national public health goals on smoking cessation. [ABSTRACT FROM AUTHOR]