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Objectives Genome-wide association studies (GWAS) of lung cancer have identified regions of common genetic variation with lung cancer risk in Europeans who smoke and never-smoking Asian women. This study aimed to conduct a GWAS in African Americans, who have higher rates of lung cancer despite smoking fewer cigarettes per day when compared with Caucasians. This population provides a different genetic architecture based on underlying African ancestry allowing the identification of new regions and exploration of known regions for finer mapping. Materials and methods We genotyped 1,024,001 SNPs in 1737 cases and 3602 controls in stage 1, followed by a replication phase of 20 SNPs ( p −5 ) in an independent set of 866 cases and 796 controls in stage 2. Results and conclusion In the combined analysis, we confirmed two loci to be associated with lung cancer that achieved the threshold of genome-wide significance: 15q25.1 marked by rs2036527 ( p =1.3×10 −9 ; OR=1.32; 95% CI=1.20–1.44) near CHRNA5 , and 5p15.33 marked by rs2853677 ( p =2.8×10 −9 ; OR=1.28; 95% CI=1.18–1.39) near TERT . The association with rs2853677 is driven by the adenocarcinoma subtype of lung cancer ( p =1.3×10 −8 ; OR=1.37; 95% CI=1.23–1.54). No SNPs reached genome-wide significance for either of the main effect models examining smoking − cigarettes per day and current or former smoker. Our study was powered to identify strong risk loci for lung cancer in African Americans; we confirmed results previously reported in African Americans and other populations for two loci near plausible candidate genes, CHRNA5 and TERT , on 15q25.1 and 5p15.33 respectively, are associated with lung cancer. Additional work is required to map and understand the biological underpinnings of the strong association of these loci with lung cancer risk in African Americans.

We examined cross-sectional associations of health literacy (HL) with smoking and other established health indicators among 1,467 African American adults. Data emanated from a longitudinal cohort study designed to investigate cancer risk factors among church-going African American adults. We conducted linear and logistic regression analyses to assess associations between HL and health indicators. HL was assessed using an established single-item screening question. Outcomes included indicators of poor physical health (cigarette smoking, self-rated general and physical health) and mental health (self-rated mental health, depressive symptoms, perceived stress). Nearly 19% of participants had low HL. Low HL was significantly associated with current smoking, poorer self-rated general and physical health, and higher perceived stress (ps

Analyses of genome-wide association study (GWAS) data have revealed that detectable genetic mosaicism involving large (>2 Mb) structural autosomal alterations occurs in a fraction of individuals. We present results for a set of 24,849 genotyped individuals (total GWAS set II [TGSII]) in whom 341 large autosomal abnormalities were observed in 168 (0.68%) individuals. Merging data from the new TGSII set with data from two prior reports (the Gene-Environment Association Studies and the total GWAS set I) generated a large dataset of 127,179 individuals; we then conducted a meta-analysis to investigate the patterns of detectable autosomal mosaicism (n = 1,315 events in 925 [0.73%] individuals). Restricting to events >2 Mb in size, we observed an increase in event frequency as event size decreased. The combined results underscore that the rate of detectable mosaicism increases with age (p value = 5.5 × 10(-31)) and is higher in men (p value = 0.002) but lower in participants of African ancestry (p value = 0.003). In a subset of 47 individuals from whom serial samples were collected up to 6 years apart, complex changes were noted over time and showed an overall increase in the proportion of mosaic cells as age increased. Our large combined sample allowed for a unique ability to characterize detectable genetic mosaicism involving large structural events and strengthens the emerging evidence of non-random erosion of the genome in the aging population. Some individuals, studies, and centers received individual support. The grant numbers are: Addiction (U01HG004422, NIAAA: U10AA008401, NCI: P01CA089392, NIDA: R01DA013423, R01DA019963); Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study (U.S. Public Health Service contracts: N01-CN-45165, N01-RC-45035, N01-RC-37004, NCI contract: HHSN261201000006C); Birth weight (U01HG004415); Blood clotting (R37 HL 039693); Broad Center for Genotyping and Analysis (U01HG04424); Cancer Prevention Study-II (American Cancer Society); Center for Inherited Disease Research (U01HG004438, HHSN268200782096C); Cleft lip/palate (NIDCR: U01DE018993 and R01DE016148, NIH contract: HHSN268200782096C); Dental Caries (NIDCR:U01DE018903 and R01DE014899, NIH CIDR contract: HHSN268200-782096C); Endometrial cancer (R01 CA134958); Fudan Lung Cancer Study (Ministry of Health (201002007); Ministry of Science and Technology (2011BAI09B00); National S&T Major Special Project (2011ZX09102-010-01); China National High-Tech Research and Development Program (2012AA02A517, 2012AA02A518); National Science Foundation of China (30890034); National Basic Research Program (2012CB944600); Scientific and Technological Support Plans from Jiangsu Province (BE2010715)); Gene-Environment Association Studies (Coordinating Center :U01 HG004446, Manuscript preparation: P01-GM099568); Genes and Environment in Lung Cancer, Singapore Study (National Medical Research Council Singapore grant (NMRC/0897/2004, NMRC/1075/2006); Agency for Science, Technology and Research (A*STAR) of Singapore); Genetic Epidemiological Study of Lung Adenocarcinoma (National Research Program on Genomic Medicine in Taiwan (DOH98-TD-G-111-015); National Research Program for Biopharmaceuticals in Taiwan (DOH 100-TD-PB-111-TM013); National Science Council,Taiwan (NSC 100-2319-B-400-001)); Glaucoma (NHGRI: U01HG004728, NEI: R01EY015473, NEI: R01EY015872, Harvard Medical School Distinguished Ophthalmology Scholar Award: Louis Pasquale); Guangdong Study (Foundation of Guangdong Science and Technology Department (2006B60101010, 2007A032000002, 2011A030400010); Guangzhou Science and Information Technology Bureau (2011Y2-00014); Chinese Lung Cancer Research Foundation; National Natural Science Foundation of China (81101549); Natural Science Foundation of Guangdong Province (S2011010000792)); Health Professionals Follow-up Study (UM1 CA167552, R01 HL35464); Hong Kong Study (General Research Fund of Research Grant Council, Hong Kong (781511M)); Intramural Research Program of the Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH; Intramural Research Program of the NIH, National Library of Medicine; Intramural Research Program of the National Institute for Occupational Safety and Health; Japanese Female Lung Cancer Collaborative Study (Grants-in-Aid from the Ministry of Health, Labor, and Welfare for Research on Applying Health Technology and for the 3rd-term Comprehensive 10-year Strategy for Cancer Control; National Cancer Center Research and Development Fund; Grant-in-Aid for Scientific Research on Priority Areas and on Innovative Area from the Ministry of Education, Science, Sports, Culture and Technology of Japan; NCI (R01-CA121210)); Lung cancer (Z01CP010200); Lung health (U01HG004738); Ministry of Health (201002007); Ministry of Science and Technology (2011BAI09B00); Melanoma (NCI R29CA70334, R01CA100264, P50CA093459); NLCS (China National High-Tech Research and Development Program Grant (2009AA022705); Priority Academic Program Development of Jiangsu Higher Education Institution; National Key Basic Research Program Grant (2011CB503805)); Nurses’ Health Study (P01 CA87969, R01 CA49449); Nurses’ Health Study II (UM1 CA176726, R01, 67262); OpPancreatic cancer (Mayo Clinic SPORE in Pancreatic Cancer: P50CA102701); Prematurity (U01HG004423); Prostate cancer (U01HG004726, NCI: CA63464, CA54281, CA1326792, RC2 CA148085); Shanghai Women’s Health Cohort Study (National Institutes of Health (R37 CA70867); National Cancer Institute intramural research program; NCI Intramural Research Program contract (N02 CP1101066)); Shenyang Lung Cancer Study (National Nature Science Foundation of China (81102194); Liaoning Provincial Department of Education (LS2010168); China Medical Board (00726)); Singapore Chinese Health Study (NIH grants: NCI R01 CA55069, R35 CA53890, R01 CA80205, and R01 CA144034); South Korea Multi-Center Lung Cancer Study (National Research Foundation of Korea (NRF) grant funded by the Korea government (MEST) (2011-0016106); National R&D Program for Cancer Control, Ministry of Health &Welfare, Republic of Korea (0720550-2); (A010250)); Tianjin Lung Cancer Study (Program for Changjiang Scholars and Innovative Research Team in University (PCSIRT); China (IRT1076), Tianjin Cancer Institute and Hospital, National Foundation for Cancer Research US); Venous thromboembolism (U01HG004735); Wuhan lung cancer study (National Key Basic Research and Development Program (2011CB503800)) and Yunnan Lung Cancer Study (Intramural program of U.S. National Institutes of Health; National Cancer Institute). Additionally, K.C.B. was supported in part by the Mary Beryl Patch Turnbull Scholar Program. The GENEVA consortium thanks the participants and the staff of all GENEVA studies for their important contributions. Support for the GENEVA genome-wide association studies was provided through the NIH Genes, Environment and Health Initiative (GEI).

Objective Ecologic frameworks account for multilevel factors related to physical activity (PA) and may be used to develop effective interventions for women. The purpose of this study was to examine the influence of individual, social and environmental factors on PA among African American and Hispanic women using structural equation modeling. Methods Overweight and obese women (N = 164, 65.9% African American) completed a 7-day accelerometer protocol, a physical assessment, and questionnaires on body image, self-efficacy, motivational readiness, social support, home environment for physical activity and perceived environment. Trained assessors evaluated each participant's neighborhood and collected objective measures of physical activity resources and the pedestrian environment. Assessments were completed between 2006 and 2008. Results Structural model fit was acceptable (RMSEA = .030). Body composition and image was negatively associated with PA, and motivational readiness had an indirect effect on PA through body composition and image. PA resources and the pedestrian environment operated through the perceived environment to positively influence neighborhood cohesion, which was positively associated with body composition and image. Conclusion PA is more heavily influenced by intrapersonal factors related to weight. Improving intrapersonal factors related to weight and perceptions of the environment may lead to increased PA in African American and Hispanic women., Highlights • Physical inactivity contributes to health disparities among ethnic minority women. • Individual factors directly and indirectly influence physical activity. • The physical environment influences individual factors via the social environment.

Background Physical activity (PA) public health programming has been widely used in Mexico; however, few studies have documented individual and organizational factors that might be used to evaluate their public health impact. The RE-AIM framework is an evaluation tool that examines individual and organizational factors of public health programs. The purpose of this study was to use the RE-AIM framework to determine the degree to which PA programs in Mexico reported individual and organizational factors and to investigate whether reporting differed by the program’s funding source. Methods Public health programs promoting PA were systematically identified during 2008–2013 and had to have an active program website. Initial searches produced 23 possible programs with 12 meeting inclusion criteria. A coding sheet was developed to capture behavioral, outcome and RE-AIM indicators from program websites. Results In addition to targeting PA, five (42%) programs also targeted dietary habits and the most commonly reported outcome was change in body composition (58%). Programs reported an average of 11.1 (±3.9) RE-AIM indicator items (out of 27 total). On average, 45% reported reach indicators, 34% reported efficacy/effectiveness indicators, 60% reported adoption indicators, 40% reported implementation indicators, and 35% reported maintenance indicators. The proportion of RE-AIM indicators reported did not differ significantly for programs that were government supported (M = 10, SD = 3.1) and programs that were partially or wholly privately or corporately supported (M = 12.0, SD = 4.4). Conclusion While reach and adoption of these programs were most commonly reported, there is a need for stronger evaluation of behavioral and health outcomes before the public health impact of these programs can be established. Electronic supplementary material The online version of this article (doi:10.1186/s12889-015-1474-2) contains supplementary material, which is available to authorized users.

Physical inactivity is an ongoing challenge in the US that contributes to at least 4 of the leading causes of death: heart disease, stroke, diabetes and cancer.1 Self-report measures suggest that nearly 50% of the adult population fail to meet physical activity recommendations,2 and objective measures suggest that only 5% of adults actually meet aerobic physical activity recommendations of 30 minutes per day on 5 or more days per week.3 Despite increases in physical activity over the past decade,4,5 the majority of Americans still do not meet guideline minimums. The problem is particularly evident among African Americans, or non-Hispanic Blacks, and Hispanics, who are less likely to meet physical activity guidelines and who engage in less physical activity than non-Hispanic Whites do.4,6,7 Thus, in the US and among ethnic minorities, primary prevention efforts aimed at reducing cancer and cardiovascular disease risk have included strategies to increase physical activity adoption and promote physical activity maintenance.8 Although several physical activity interventions have been developed for large population groups, few have succeeded among ethnic minority adults, suggesting a lack of suitability and need to target additional, ethnically relevant correlates related to physical activity.9–11 Theoretical frameworks, such as Social Cognitive Theory and the Transtheoretical Model, have identified intrapersonal factors related to physical activity (eg, biologic and physiologic characteristics, self-efficacy, beliefs, attitudes or knowledge related to physical activity) and interpersonal relationships (eg, support from family and friends to do physical activity regularly) as important correlates of physical activity. Previous research has shown that psychosocial factors, including intrapersonal and interpersonal factors, are related and contribute significantly to behavioral mechanistic pathways for physical activity adoption and maintenance in African Americans and Hispanics.12 Although psychosocial factors related to physical activity often are included as intervention components based on theoretical frameworks, the effectiveness of interventions based on improving psychosocial factors as pathways to physical activity adoption or maintenance remains unclear.13–15 For example, Resnick et al16 found that an intervention which promoted self-efficacy through group exercise sessions, education materials, and discussions led to increased physical activity among older African American women.17 However, other studies in African Americans reported that interventions that included one or more psychosocial factors did not lead to hypothesized increases in physical activity.14,18 Because the reported findings are inconclusive, it is important to understand which psychosocial factors are effective for physical activity adoption and whether these psychosocial factors individually or in combination lead to increases in physical activity adoption in African Americans and Hispanics. Psychosocial factors are usually linked to a particular theory or theory-related construct or to multiple theories and/or constructs; they can vary from study to study and may be included individually or in combination with other psychosocial factors within a study. Because of these variations, a systematic review is needed to improve understanding of the theoretical foundations of interventions and to identify the psychosocial factors that are found to be effective for physical activity engagement in African American and Hispanic adults. Previous systematic reviews that looked at the effectiveness of physical activity interventions in ethnic minority groups mostly focused on environmental interventions versus interventions that included psychosocial factors.19–22 Studies that included psychosocial factors as intervention components looked at them in the context of overall behavior change related to obesity and weight loss and were not specific to physical activity.23 This systematic review goes beyond previous reviews by examining the use of theory in physical activity interventions, focusing on interventions that target psychosocial factors related to physical activity, and synthesizing the results of interventions that address these factors. The purposes of this study were to summarize (1) the results of physical activity interventions that include psychosocial factors to increase physical activity among adult African Americans and Hispanics in randomized controlled trials; and (2) the use of theory and theoretical constructs in physical activity interventions.

Background: Social ecological models suggest that conditions in the social and physical environment, in addition to individual factors, play important roles in health behavior change. Using structural equation modeling, this study tested a theoretically and empirically based explanatory model of physical activity to examine theorized direct and indirect effects of individual (e.g., motivation and self-efficacy), social environmental (e.g., social support), and physical environmental factors (e.g.), neighborhood quality and availability of facilities).Method: A community-based sample of adults (N = 910) was recruited from 2 public health centers (67% female, 43% African American, 43% < $20,000/year, M age = 33 years) and completed a self-administered survey assessing their current physical activity level, intrinsic and extrinsic motivation for physical activity, perceived social support, self-efficacy, and perceptions of the physical environment.Results: Results indicated that (a) perceptions of the physical environment had direct effects on physical activity, (b) both the social and physical environments had indirect effects on physical activity through motivation and self-efficacy, and (c) social support influenced physical activity indirectly through intrinsic and extrinsic motivation. For all forms of activity, self-efficacy was the strongest direct correlate of physical activity, and evidence of a positive dose-response relation emerged between self-efficacy and intensity of physical activity. Conclusions: Findings from this research highlight the interactive role of individual and environmental influences on physical activity.

Cardiovascular disease (CVD) risk factors are prevalent among Black adults. Studies have demonstrated that functional social support buffers CVD risk. The objective of our study is to assess whether specific types of functional social support or their cumulative total buffers CVD risk factors among a convenience sample of Black adults, and whether these associations differ by sex or partner status.Cross-sectional study using self-reported survey data.Large church in Houston, TX.A total of 1,381 Black adults reported their perceived social support using appraisal, belonging, and tangible subscales of the Interpersonal Support Evaluation List-12. A cumulative score was created based on the three subscales. Participants also reported on a number of sociodemographic characteristics.Three self-reported CVD risk factors: diabetes, high blood pressure, and high cholesterol (yes vs no).A series of multivariate logistic regressions controlling for sociodemographic characteristics were used to calculate adjusted odds ratios (aOR) and 95% confidence intervals (CI) for CVD risk factors. Cumulative social support, rather than any specific type of social support, was significantly related to diabetes and high blood pressure. Higher cumulative social support was associated with lower odds of experiencing diabetes (aOR = .97, 95% CI = .94, .99) and high blood pressure (aOR = .98, 95% CI = .95, .99). Neither sex nor partner status moderated associations.In a high risk population for CVD, increasing all types of social support--appraisal, belonging, and tangible--might be useful in preventing or delaying the onset of CVD.

Innovative and empirically tested strategies are needed to define and understand obesity prevention and reduction in a transcultural society. This manuscript describes the development of Science & Community, a partnership developed over a 3-year period with the end goal of implementing a community-based participatory research (CBPR) trial to reduce and prevent obesity. Outreach strategies focused on promoting the project via existing and new channels and identifying and contacting potential partners using established strategies. Science & Community developed and fostered partnerships by hosting a series of interactive meetings, including three Opportunity Receptions, four Community Open Forum Symposia, and quarterly Community Advisory Board (CAB) meetings. Opportunity Reception ( N = 62) and Symposia attendees ( N = 103) represented the diversity of the community, and participants reported high satisfaction with content and programming. From these events, the CAB was formed and was comprised of 13 community representatives. From these meetings, a Partnership representing 34 organizations and 614 individuals emerged that has helped to guide the development of future proposals and strategies to reduce obesity in Houston/Harris County.

OBJECTIVES To explore relations between loneliness and self-rated health among African-American adults of diverse ages. METHODS Associations between loneliness and self-rated health were investigated using covariate-adjusted linear regression models. Perceived social support was examined as a moderator. The potential indirect effects of stress and/or depressive symptoms were examined using nonparametric bootstrapping procedures. RESULTS Greater loneliness was associated with poorer self-rated health (p = .008), and social support did not moderate. Stress and depressive symptoms yielded significant indirect effects in single and multiple mediator models (p values ≤ .05). CONCLUSIONS Loneliness may contribute to poorer health among African Americans. Results suggest that greater stress and depressive symptoms might underlie these associations, but longitudinal studies are needed to assess causal relations.

Health disparities among Black adults have been an ongoing problem in the United States.1 For example, prevalence and mortality rates are higher among Black adults for heart disease, cancer, and stroke as compared to other ethnic groups.2–4 Blacks also have higher rates of HIV/AIDS than their White counterparts, and 2.3 times the infant mortality rate.4 These health disparities are reflected in perceived health status as well, with Black adults reporting substantially poorer self-reported health when compared to Whites.5 Self-reported health has been consistently linked to premature mortality and chronic conditions such as diabetes and heart disease, which particularly affect Black adults.6,7 Socioeconomic status (SES) has been linked to the health disparities experienced by Blacks. Relative to those at the higher end of the SES spectrum, individuals of lower SES experience comparatively worse health outcomes.8–10 Unfortunately, Blacks may be at particular risk for experiencing the negative ramifications of low SES on health, given that they tend to have lower SES than individuals of other race/ethnicities in this country.11 However, although a few studies have linked low SES with poorer health outcomes and higher mortality rates among Black adults,6,11 there remains debate on exactly how SES affects health. Previous studies have suggested that individuals of low SES may lack sufficient funds to satisfy basic needs and experience decreased access to healthcare and a lower quality of healthcare, potentially as a result of income inadequacy.12,13 Consequently, because income inadequacy may be a mechanism underlying the relations between low SES and negative health outcomes, it is of interest to better understand relations between income inadequacy and health status. Income inadequacy, also known as financial strain, represents an individual’s unfavorable subjective perception of their income to needs ratio.14 As such, perceptions of financial strain can vary widely among individuals of low income (based on their needs), and can be relevant to individuals across the SES spectrum.15 Several studies have examined the relations between financial strain and health. Results indicate that financial strain is positively correlated with poor health outcomes such as early disability, increased psychological stress, chronic health conditions, and even mortality.16,17 For instance, using retrospective data about economic adversities experienced over a lifetime, one study found that long-term financial strain at the poverty level was associated with a variety of negative health outcomes in an older adult and elderly population of 1167 adults, including over 400 Black men and women.17 Another study also found a strong correlation between financial strain at the poverty level and poor health among a sample of 699 middle-aged Black twins.16 A third study found that as exposure to negative financial situations increased, the risk for poor self-rated health increased, as well as the risk for depressed mood, stress, smoking, and drug use in a sample of 1,506 urban emergency department patients, with over 50% of the sample under the age of 35 and overall 39% of whom were Black.18 However, no previous studies have examined the association of financial strain and self-rated health within a large sample of Blacks, with a diverse age range and wide-ranging spectrum of incomes. Since financial strain can be relevant to any period of life, not just older age, understanding more about the association between financial strain and self-rated health in diverse Black samples of adults is important.8 A neo-materialistic perspective suggests that inadequate access to resources accounts for the relation between financial strain and poor health.19–21 This approach posits that the social determinants of health affect one’s living conditions, which in turn influences health. However, conceptual models linking low SES (more generally) to poorer health and less desirable health behaviors have proposed that psychosocial mechanisms such as depression and stress might underlie these relations. For example, Gallo and Matthews reviewed the extant literature and found a correlation between lower SES and negative emotions and attitudes, particularly depressive symptoms.22 Research suggests that these negative emotions in turn have an adverse effect on health outcomes such as cardiovascular morbidity.22 In addition, studies have found that people with low SES face more chronically negative and stressful life events, which are also interpreted more negatively.22 Relevant to financial strain in particular, several studies have argued that those with lower SES have less material and psychological resources to manage these stressors, which may lead to increased susceptibility to future stresses.7,22 Although the aforementioned conceptual models make reference to objective SES indicators such as income, education, and/or occupation, similar pathways have been suggested to underlie relations between financial strain and poor self-rated health.23 This psychosocial perspective suggests that financial strain impacts health over time through chronic over-activation of physiologic systems related to stress (ie, increased allostatic load), which lead to assorted negative systemic effects.16,23,24 However, to the best of our knowledge, no previous studies have addressed the potential indirect effects of stress and depressive symptoms on the association between financial strain and self-rated health among a large sample of Black adults. The purpose of the current study was to examine the relationship between financial strain and self-rated health in a large church-based sample of Black adults, while controlling for several important covariates including age, sex, partner status, income, education, and employment status. A secondary aim of the current study was to assess whether relations between financial strain and self-rated health were mediated by depressive symptoms and/or stress. Although at least one previous study has investigated the association between financial strain and self-rated health among Black adults (among middle-aged twins, in that case),16 more research is needed among Blacks of diverse ages and financial means. Based on the previous literature in this area, we hypothesized that greater financial strain would be associated with worse self-rated health, and that stress and depressive symptoms would underlie this association.

Subjective social status (SSS), or an individual’s perception of his or her relative position in the social hierarchy, has been associated with health status[eg,1,2–4] and health behaviors[eg,5–7] independent of objective socioeconomic indicators such as income, education, and employment status. It has been argued that SSS functions as a unique predictor of health-related outcomes over and above objective measures of socioeconomic status (SES) for several reasons. For example, SSS captures the nuances of SES that affect social class (eg, quality of education, job prestige), allows for consideration of rarely assessed socioeconomic components (ie, wealth), includes experiences of societal inequities (eg, discrimination), and incorporates consideration of future prospects.1,4,8–10 Together, these aspects of SSS may uniquely affect health-related outcomes through their associations with the psychological and physiological variables that influence health and health-related behaviors [eg, depression and negative affect (cf.7,11)]. Most research on the relations of SSS with health outcomes has included the use of a single SSS scale, which asks individuals to rank their standing relative to that of others in the United States (or society in some international studies). Known as the SSS-US (or SSS-SES) ladder, directions specify the consideration of relative standing in the United States with regard to, for example, money, education, and occupation.12 A lesser used SSS scale is the SSS-community ladder, which asks individuals to rank how they stand relative to others in their self-defined communities, without reference to SES.12 Research indicates that respondents tend to primarily consider material wealth, occupational status, and education in providing SSS-US rankings, whereas everyday altruistic practices (eg, participation in giving activities such as volunteering or being a good neighbor) were among the highest considerations in providing SSS-community rankings.12 Accordingly, the SSS-US ladder typically demonstrates stronger associations with objective SES indicators than does the SSS-community ladder.5,12 For this reason, the SSS-community ladder may be particularly relevant for individuals of lower SES, who might not rate themselves highly on the SSS-US ladder, but who have important and influential roles in their communities that would elevate their SSS-community rankings. Because the referents and determinants of SSS-US and the SSS-community ladder rankings differ, so too may their associations with health outcomes and behaviors. A greater understanding of the relative associations of these ladders with health behaviors would help inform future research, aid in the identification of individuals or groups at risk for negative health outcomes, and expand our knowledge of how different dimensions of social standing affect health outcomes. The first published study that examined both ladders in their relation to health behaviors was by Ghaed and Gallo, who focused on cardiovascular risk behaviors among a sample of (largely) white women. Results indicated that higher SSS-US endorsements were significantly associated with greater consumption of fruits and vegetables in analyses adjusting for sociodemographics, but this association was not significant with the SSS-community ladder.5 In addition, there were no independently significant relations between either of the ladders and physical activity, body mass index (BMI), or smoking status in adjusted analyses.5 Only a couple of papers published following the Ghaed and Gallo study used both the SSS-US and the SSS-community ladders, but with a focus on different health outcomes or nonadult populations. For example, although not the main objective, one study found that leisure-time exercise among adults was significantly and negatively correlated with the SSS-US ladder, and not associated at all with the SSS-community ladder.13 Another study among Mexican adolescents indicated differing associations with smoking and drinking outcomes for an SSS ladder focused on comparisons with the larger Mexican society (a modified version of the SSS-US ladder) versus the SSS-community ladder. Specifically, this study found negative associations between the SSS-society ladder and smoking and drinking behaviors, but positive associations between the SSS-community ladder and smoking and drinking behaviors.14 Together, these studies seem to suggest that the SSS-US and the SSS-community ladder are distinct from one another in their association with health behaviors, and mixed results suggest the need for additional research in this area. It is also important to note that the influence of SSS on health outcomes may not be the same among different racial/ethnic groups. For example, previous studies found that race/ethnicity moderated relationships between SSS and sleep quality,15 self-rated health,2 and hypertension.10 Specifically, one study found that the SSS-society ladder was related to greater impairment in sleep quality among Asian and African Americans, but was unrelated among whites.15 Another found that, after accounting for the effects of objective SES, ratings on the SSS-US ladder were positively associated with self-rated health among white and Chinese American women, but not African American and Latina women. Another found that ratings on the SSS-US ladder were significantly associated with hypertension among white men and women and African American women in fully adjusted analyses, but there was no relationship between SSS and hypertension among African American men.10 In addition, research suggests that the determinants of SSS may vary by racial/ethnic group. For example, one study found that objective SES measures were not associated with SSS-US ladder rankings as strongly among African American as among white participants.10 Therefore, it seems important to examine the effects of SSS on health outcomes within racial/ethnic groups. To the best of our knowledge, there have been no previous studies comparing the relative associations of the ladders with multiple health behaviors among African American adults. The purpose of the current work was to address this gap in the literature. The current study examined the relative associations of the SSS-US and the SSS-community ladders with multiple health-related behaviors (ie, smoking status, at-risk drinking, fruit and vegetable intake, physical activity, and BMI) in a sample of African American adults enrolled in a church-based longitudinal cohort study. This research builds upon the Ghaed and Gallo study, which examined the relative influence of the SSS ladders on these outcomes while controlling for objective SES indicators,5 and extends it to a large African American sample of men and women. We hypothesized that the SSS-US and the SSS-community ladders would be associated with health-related behaviors, over and above the influence of sociodemographics, but were not more specific in our predictions given the exploratory nature of this study within an African American sample.

Purpose. Few studies have assessed how attributes of neighborhood environments contribute to sedentary, in addition to active, behaviors. This study investigated associations of perceived social and physical aspects of neighborhood environments with television (TV) viewing and physical activity (PA) in African-American adults. Design. Cross-sectional analysis of self-reported survey. Setting. Large mega-church in Houston, Texas. Subjects. A total of 1374 African-American men and women. Measures. Outcomes included log-transformed daily TV viewing and participation in medium/high levels of PA, measured by the short version of the International Physical Activity Questionnaire. Neighborhood perceptions were assessed with the Social Cohesion and Trust and the Neighborhood Problems scales. Analysis. Multivariable models that controlled for clustering within neighborhoods. Results. Reporting more neighborhood problems was significantly associated with greater log-transformed TV viewing in women (β = .017, SE = .006, p = .003), and social cohesion was positively associated with PA in women (odds ratio = 1.06, 95% confidence interval = 1.02, 1.11, p = .006). Concerns about litter and walking after dark and a lack of places to shop were associated with increased TV viewing among women, and concerns about traffic and walking after dark were associated with reduced PA among men. Conclusion. Physical and social neighborhood conditions were associated with TV viewing and PA, particularly in women. Neighborhood-based strategies to reduce sedentary behaviors and enhance PA should include attention to social as well as physical aspects of neighborhood environments.

In an analysis of 31,717 cancer cases and 26,136 cancer-free controls from 13 genome-wide association studies, we observed large chromosomal abnormalities in a subset of clones in DNA obtained from blood or buccal samples. We observed mosaic abnormalities, either aneuploidy or copy-neutral loss of heterozygosity, of > 2 Mb in size in autosomes of 517 individuals (0.89%), with abnormal cell proportions of between 7% and 95%. In cancer-free individuals, frequency increased with age, from 0.23% under 50 years to 1.91% between 75 and 79 years (P = 4.8 x 10(-8)). Mosaic abnormalities were more frequent in individuals with solid tumors (0.97% versus 0.74% in cancer-free individuals; odds ratio (OR) = 1.25; P = 0.016), with stronger association with cases who had DNA collected before diagnosis or treatment (OR = 1.45; P = 0.0005). Detectable mosaicism was also more common in individuals for whom DNA was collected at least 1 year before diagnosis with leukemia compared to cancer-free individuals (OR = 35.4; P = 3.8 x 10(-11)). These findings underscore the time-dependent nature of somatic events in the etiology of cancer and potentially other late-onset diseases.

Introduction Walking is the most commonly reported leisure-time activity. Members of racial/ethnic minority groups and people of low socioeconomic status disproportionately live in urban environments that are perceived to be unsafe, thereby reducing opportunities for engaging in walking. We examined the use of walking maps for increasing physical activity (PA) among low-income residents of public housing sites in Boston, Massachusetts. Methods PA facilities, local businesses, and destinations in a walkable half-mile radius of the housing community were identified and plotted on maps by using geographic information systems technology. Four focus groups (n = 24) were conducted to learn how the walking maps were used by the residents and to understand map features that promoted use. Results Maps were used by participants to increase their PA, and use of the maps increased participants' awareness of community resources. Maps changed participants' perception of distances and were discussed as a means of fostering a sense of community. Use of the maps also increased participants' awareness of neighborhood incivilities. Barriers to map use were difficulty in interpreting the maps and lack of access to the maps. Conclusion Walking maps that display PA opportunities and resources may be useful in increasing walking among residents of public housing sites.

Introduction Walking is the most commonly reported leisure-time activity. Members of racial/ethnic minority groups and people of low socioeconomic status disproportionately live in urban environments that are perceived to be unsafe, thereby reducing opportunities for engaging in walking. We examined the use of walking maps for increasing physical activity (PA) among low-income residents of public housing sites in Boston, Massachusetts.

Recombination, together with mutation, gives rise to genetic variation in populations. Here we leverage the recent mixture of people of African and European ancestry in the Americas to build a genetic map measuring the probability of crossing over at each position in the genome, based on about 2.1 million crossovers in 30,000 unrelated African Americans. At intervals of more than three megabases it is nearly identical to a map built in Europeans. At finer scales it differs significantly, and we identify about 2,500 recombination hotspots that are active in people of West African ancestry but nearly inactive in Europeans. The probability of a crossover at these hotspots is almost fully controlled by the alleles an individual carries at PRDM9 (P value

As part of the Harvard Cancer Prevention Program Project, we sought to address disparities reflected in social class and race/ethnicity by developing and testing a behavioral intervention model that targeted fruit and vegetable consumption, red meat consumption, multivitamin intake, and physical activity in working-class, multiethnic populations.This paper examined the associations between change in leisure-time physical activity and individual and social contextual factors in participants employed in small businesses (n = 850) at both baseline and at 18-month final.In bivariate analyses, age, language acculturation, social ties, and workplace social capital were significantly associated with physical activity at final. In multivariable analyses, being younger and having high language acculturation were significantly associated with greater leisure-time physical activity at final; high workplace social capital was significantly associated with a decline in physical activity at final.These findings have implications for understanding factors that are integral to promoting change in physical activity among working-class, multiethnic populations.

Compared measures of physical activity and dietary habits used in the Health Is Power (HIP) study, and described the associations of physical activity and dietary habits among African American and Hispanic or Latino women, adjusted for weight status. Cross-sectional baseline data were compared for community dwelling, healthy African American (N = 262) and Hispanic or Latina women (N = 148) who participated in HIP. Physical activity was measured using the International Physical Activity Questionnaire (IPAQ) long form, the Check And Line Questionnaire (CALQ) log and accelerometry. Dietary habits were measured using NCI 24-h recall screeners, vegetable and fruit (VF) logs and the NCI Diet History Questionnaire (DHQ). Differences in physical activity and dietary habits were assessed using simultaneous 2 (ethnicity) × 3 (weight status) ANCOVAs adjusted for age and socioeconomic status. Women (M age = 44.4 ± 10.9 years) were obese (M = 34.0 ± 9.7 kg/m2), did not meet physical activity guidelines as measured by accelerometry (M = 19.4 ± 19.1 min MVPA/day) and ate few VF (M = 2.8 ± 2.7 servings/day). DHQ variables differed by weight status. IPAQ was associated with CALQ, and CALQ with accelerometry (P < .05). IPAQ was not associated with accelerometry. Regardless of ethnicity, normal weight women did more physical activity, reported more VF consumption, and consumed more fat calories than overweight and obese women (Ps < .05). African American women did more MVPA than Hispanic or Latino women (P < .001). Relationships between behaviors and weight status suggest accelerometry and DHQ are preferable, regardless of ethnicity; and studies may capture different domains of physical activity and dietary habits depending on measure used.

Objectives. We sought to examine the association between structural, functional, and normative social factors and physical activity among urban, low-income, racially/ethnically diverse adults. Methods. We conducted a baseline cross-sectional survey among residents of 12 low-income housing communities in metropolitan Boston, Massachusetts. Participants were also asked to wear a pedometer for 5 days. We analyzed complete data from 1112 residents (weighted n = 1635). Results. Residents with smaller social networks were significantly less physically active than were residents with larger social networks (b = −1503.7; P = .01) and residents with conflicting demands were more active than were residents with none (b = 601.6; P = .01), when we controlled for employment status, gender, poverty level, current health status, age, and perceived safety. Social networks were most strongly associated with physical activity among Hispanics and younger residents (aged 18–35 years). Conclusions. These findings indicate that social factors, including social networks and role-related conflicting demands, may be important drivers of physical activity among low-income populations. Researchers and practitioners should consider social factors in developing multilevel physical activity interventions for this population.

Physical inactivity, poor dietary habits, and obesity are vexing problems among minorities. SAving Lives, Staying Active (SALSA) was an 8-week randomized controlled crossover design, pilot study to promote regular physical activity (PA) and fruit and vegetable (FV) consumption as a means to preventing weight gain among women of color. Participants completed measures of demographics, PA, and dietary habits. Women ( 𝑁 = 5 0 ; 𝑀 = 4 2 years) who participated were overweight ( 𝑀 B M I = 2 9 . 7 kg/m 2; 𝑀 b o d y f a t = 3 8 . 5 % ) and reported low levels of leisure time PA ( 𝑀 = 1 0 . 7 MET-min/wk) and FV consumption ( 𝑀 = 4 . 2 servings/day). All were randomized to a four-week (1) semiweekly Latin dance group or (2) internet-based dietary education group. All participants reported a significant increase in weekly leisure time PA from baseline ( 𝑀 = 1 0 . 7 MET-min/wk) to follow up ( 𝑀 = 3 4 . 0 MET-min/wk, 𝑃 . 0 0 1 ), and FV consumption increased over time by group ( 𝑃 = . 0 2 ). Data suggest that Latin dance interventions to improve PA and web-based interventions to improve dietary habits show promise for improving health among women of color.

To determine whether self-reported discretionary time was associated with physical activity and uptake of a physical activity promotion intervention in a multi-ethnic urban sample.We examined the association of self-reported discretionary time with hours/week of leisure-time physical activity at baseline and physical activity intervention uptake.Low levels of discretionary time were significantly (P0.01) associated with fewer hours/week (beta=-0.78, 95%CI=-1.34, -0.22) of physical activity at baseline. Discretionary time was not associated with physical activity intervention uptake.Lack of discretionary time may serve as barrier to physical activity, but its importance on intervention uptake is less clear.

Background As advances in computer access continue to be made, there is a need to better understand the challenges of increasing access for racial/ethnic minorities, particularly among those with lower incomes. Larger social contextual factors, such as social networks and neighborhood factors, may influence computer ownership and the number of places where individuals have access to computers. ObjectivesWe examined the associations of sociodemographic and social contextual factors with computer ownership and frequency of use among 1554 adults living in urban public housing. MethodsBivariate associations between dependent variables (computer ownership and regular computer use) and independent variables were used to build multivariable logistic models adjusted for age and site clusters. ResultsParticipants (N = total weighted size of 2270) were on average 51.0 (± 21.4) years old, primarily African American or Hispanic, and earned less than US $20000 per year. More than half owned a computer, and 42% were regular computer users. Reporting computer ownership was more likely if participants lived above the poverty level (OR = 1.78, 95% CI = 1.39-2.29), completed high school (OR = 2.46, 95% CI = 1.70-3.55), were in financial hardship (OR = 1.38, 95% CI = 1.06-1.81), were employed and supervised others (OR = 1.94, 95% CI = 1.08-3.46), and had multiple role responsibilities (OR = 2.18, 95% CI = 1.31-3.61). Regular computer use was more likely if participants were non-Hispanic (OR = 1.94, 95% CI = 1.30-2.91), lived above the poverty level (OR = 2.84, 95% CI = 1.90-4.24), completed high school (OR = 4.43, 95% CI = 3.04-6.46), were employed and supervised others (OR = 2.41, 95% CI = 1.37-4.22), felt safe in their neighborhood (OR = 1.57, 95% CI = 1.08-2.30), and had greater social network ties (OR = 3.09, 95% CI = 1.26-7.59). ConclusionsDisparities in computer ownership and use are narrowing, even among those with very low incomes; however, identifying factors that contribute to disparities in access for these groups will be necessary to ensure the efficacy of future technology-based interventions. A unique finding of our study is that it may be equally as important to consider specific social contextual factors when trying to increase access and use among low-income minorities, such as social network ties, household responsibilities, and neighborhood safety.

Purpose: The vast majority of long-term cancer survivors are insufficiently active, and breast cancer survivors are more likely to report being physically inactive and sedentary than prostate or colorectal cancer survivors. Social cognitive theory (SCT) has been used to understand physical activity adoption and maintenance in the general adult population and among breast cancer survivors, but no study to date has explored SCT influences on physical activity exclusively among Hispanic cancer survivors, who are at greater risk of not meeting leisure-time physical activity guidelines and disproportionately suffer from comorbidities, such as cardiovascular disease and diabetes. Thus, the purpose of this study was to determine the effect of a culturally-tailored exercise intervention on physical activity and sedentary behavior in Hispanic breast cancer survivors and to determine whether intervention effects were mediated by changes in SCT variables, including exercise self-efficacy, barriers self-efficacy, social modeling and social support. Method: Project VIVA! was a 16-week randomized controlled trial to test the effectiveness and feasibility of a culturally tailored exercise intervention for Mexican American and Puerto Rican breast cancer survivors in Houston, Texas and San Juan, Puerto Rico. Eligible women (N=93) who self-identified as Mexican American residing in Houston, TX or Puerto-Rican residing in San Juan, PR were randomized to a 16-week culturally-tailored (n=30) or standard (n=31) exercise intervention or a wait-list control (n=32) group. Women completed questionnaires on social cognitive influences, physical activity and sedentary behavior and completed a 7-day accelerometer protocol at baseline and post-intervention. Paired sample t-tests were used to assess changes in physical activity, sedentary behavior, and SCT variables over time across groups, and repeated measures analyses were used to assess changes over time by group. Mediation analyses were used to determine whether intervention effects on physical activity and sedentary behavior were mediated by changes in exercise self-efficacy, barriers self-efficacy, social modeling and social support after controlling for age and education. Results: On average, participants were middle-aged (M age=55.5 years, SD=9.9) and most (52.1%) had completed some college or more. At baseline, women reported doing roughly 11.6 minutes of physical activity and walking per day and were sedentary over 6 hours per day. Across groups, women reported increases in vigorous (t=2.7, p=.008), moderate (t=2.6, p=.011) and total (t=2.7, p=.008) physical activity and exercise self-efficacy (t=3.2, p=.002) from baseline to post-intervention. There were no significant differences in changes in physical activity or SCT variables over time by group. Although the intervention did not have a direct effect on physical activity or sedentary behavior, it had an indirect effect on sedentary behavior. Increases in social modeling significantly mediated the association between intervention group assignment and decreases in sedentary behavior (Indirect effect=4.5, 95% CI: 0.4, 12.4) among Hispanic breast cancer survivors, controlling for age and education. Conclusions: Results suggest that Hispanic survivors may benefit the most from exercise interventions that focus on increasing social norms for physical activity and social modeling from friends and family members. Future interventions should include friends and family members of Hispanic breast cancer survivors to support them to be active and less sedentary and to be physically active with them. Further research is needed to explore additional mediators of change in physical activity and sedentary behavior in Hispanic breast cancer survivors in an effort to reduce health disparities and decrease risk of cancer recurrence and comorbidities. Citation Format: Scherezade K. Mama, Lorna H. McNeill, Alexis Ortiz, Maribel Tirado-Gomez, Cristina Palacios, Daniel C. Hughes, Karen Basen-Engquist. Mediated effects of social cognitive theory variables on physical activity in Hispanic breast cancer survivors. [abstract]. In: Proceedings of the Seventh AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 9-12, 2014; San Antonio, TX. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2015;24(10 Suppl):Abstract nr B69.

Background: Early screening and treatment advances have resulted in an overall decline in cancer death rates over the past two decades in the United States (US). However, considerable ethnic disparities still exist in terms of which groups most benefit from these trends. Cancer statistics (2013) suggest that overall cancer incidence and death rates are higher among African Americans as compared to Whites for several cancer sites. Modifiable risk behaviors (smoking, heavy alcohol use, insufficient physical activity, poor diet) and associated outcomes (overweight/obesity) have been causally linked to cancer incidence and related mortality among adults of all ethnicities. However, even after accounting for differences in risk behavior prevalence, African Americans tend to disproportionately suffer from the adverse consequences of behavior risk factors for cancer relative to other ethnic groups. Social determinants, including socioeconomic influences, have been cited as factors contributing to these disparities. There has been recent interest in how financial strain, or an unfavorable income to needs ratio, might uniquely contribute to engagement in modifiable behavioral risk factors for cancer over and above other socioeconomic indicators, but these relations have not been previously examined among African Americans. The current study addressed this gap. Objectives: To examine associations between financial strain and multiple modifiable behavioral risk factors for cancer (smoking, heavy alcohol use, insufficient physical activity, insufficient fruit and vegetable intake, overweight/obesity, and multiple risk factors) among 1278 African American adults (age=46.5+12.6, 77% female), and explore potential mediators (stress and depressive symptoms) of those associations. Methods: A series of regression models were used to examine associations between financial strain and cancer risk factors. All analyses were adjusted for age, sex, partner status, total annual household income, educational level, and employment status. Analyses involving overweight/obesity status additionally controlled for fruit and vegetable intake and physical activity. Statistical significance was set at p Results: Greater financial strain was associated with greater odds of insufficient physical activity (p Conclusions: Financial strain may contribute to higher cancer risk among African Americans through associations with insufficient physical activity, smoking, and multiple behavioral risk factors for cancer. Greater stress and depressive symptoms may lie along the causal pathway. Future interventions aimed at reducing cancer disparities need to focus on African Americans experiencing higher financial strain while addressing their stress and depressive symptoms. Although additional studies with longitudinal designs are needed to confirm these results, potential theoretical, intervention, and policy implications are discussed. This abstract is also presented as Poster B1. Citation Format: Pragati Advani, Lorraine Reitzel, Nga Nguyen, Felicia Fisher, Elaine Savoy, Adolfo Cuevas, David Wetter, Lorna McNeill. Financial strain and cancer risk factors among African American adults. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr PR1. doi:10.1158/1538-7755.DISP13-PR1

Background This paper presents the study design, intervention components, and baseline data from Open Doors to Health, a study designed to address social contextual factors in colorectal cancer (CRC) prevention for low-income, racial/ethnic minority populations. Methods A cluster randomized design with 12 housing sites as the primary sampling units was used: 6 sites were assigned to a "Peer-led plus Screening Access" (PL) condition, and 6 were assigned to "Screening Access only" (SCR) condition. Study-related outcomes were CRC screening, physical activity (measured as mean steps/day), and multivitamin use. Results At baseline (unweighted sample size = 1554), two-thirds self-reported that they were current with screening recommendations for CRC (corrected for medical records validation, prevalence was 52%), with half having received a colonoscopy (54%); 96% had health insurance. Mean steps per day was 5648 (se mean = 224), and on average 28% of the sample reported regular multivitamin use. Residents reported high levels of social support [mean = 4.40 (se = .03)] and moderately extensive social networks [mean = 2.66 (se = .02)]. Conclusion Few studies have conducted community-based studies in public housing communities; these data suggest areas for improvement and future opportunities for intervention development and dissemination. Findings from the randomized trial will determine the effectiveness of the intervention on our health-related outcomes as well as inform future avenues of research.