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Background: HPV vaccination is recommended for female and male adolescents in the U.S. to prevent HPV-related cancer, yet the uptake remains suboptimal nationwide. Asian American female adolescents have the lowest HPV vaccine rates. Successful HPV vaccine depends heavily on parents' attitudes, perceptions, and willingness to have their adolescents vaccinated. Objective: This study was designed to test the feasibility and outcomes of a provider-based culturally tailored intervention among Asian American parents and their eligible adolescents. Methods: Asian American parents (n=120) who had adolescent girls and boys aged 11 to 18 (n=170) were recruited from a primary-care community health center. The primary outcome was first and second shots of HPV vaccination uptake 6 months following the intervention. Secondary outcomes included third shot of HPV vaccine at 6 months after the intervention for adolescents over the age of 12, increase in knowledge and belief in HPV vaccine, and engagement of adolescents in decision-making at post intervention. Results: Among 170 adolescents, 68% of them received first and second shots of HPV vaccine (73% for girls vs 63% for boys). Among 81 adolescents over the age of 12, 63% of them received third shot (63% for girls vs 76% for boys). Parents' (n=120) knowledge and belief in HPV vaccine and engagement of adolescents in decision-making have significantly increased from baseline to post intervention (p Conclusion: A culturally tailored pilot intervention in a clinical setting demonstrated promising effects, which can potentially yield significant increase in HPV vaccine uptake among Asian American and other underserved ethnic minority female and male adolescents to prevent cancer. Citation Format: Grace X. Ma, Yin Tan, Shumenghui Zhai, Philip Siu, Sarah Lai, Lin Zhu, Adeodat Ilboudo, Min Qi Wang. Promising effects of a culturally tailored pilot intervention to increase HPV vaccination uptake among female and male adolescents [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr B14.

Objectives: Given the substantial disparity in hepatitis B virus (HBV) infection among Vietnamese Americans, it is important to understand what intervention components facilitate behavioral change. In this study, we evaluated the influence of psychosocial factors on HBV screening. Methods: The study sample consists of 1,716 Vietnamese participants in our HBV intervention trial, recruited from 36 community-based organizations in Pennsylvania, New Jersey, and New York City between 2009 and 2014. Using Health Belief Model and Social Cognitive Theory, we measured self-efficacy, knowledge, perceived barriers, perceived benefits, perceived severity, and risk susceptibility. Analysis of covariance (ANCOVA) was used to compare pre- and post-intervention changes of psychosocial variables. Structural equation modeling (SEM) 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, with knowledge having 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. Conclusions: To promote HBV screening among Vietnamese Americans, intervention efforts should focus on increasing knowledge, self-efficacy, and perceived benefits; decreasing perceived barriers; and account for the dynamic cognitive processing. Citation Format: Minsun Lee, Lin Zhu, Min Qi Wang, Zhengyu Wei, Yin Tan, Minhhuyen Nguyen, Olorunseun O. Ogunwobi, Grace X. Ma. The role of psychosocial predictors in HBV screening behavior among Vietnamese Americans [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr C60.

The purpose of this study was to determine (a) the effects of strength training (ST) on physical function and (b) the influence of strength, power, muscle volume (MV), and body composition on physical function. Healthy, inactive adults (n = 50) aged 65 years and older underwent strength, power, total body composition (% fat and fat free mass [FFM]), and physical function testing before and after 22 weeks of ST. Physical function testing consisted of tasks designed to mimic common physical activities of daily living (ADL). To improve internal validity of the assessment of mid-thigh intermuscular fat, subcutaneous fat, and knee extensors MV, a 10-week unilateral ST program using the untrained leg as an internal control preceded 12 weeks of whole-body ST. Strength, power, and FFM increased significantly with ST (all p < 0.05), whereas rapid walk, 5 chair stands, and get up and go time decreased significantly with ST in the overall group (all p < 0.05). Women improved significantly in both walking test times (both p < 0.05) but not in the stair climb test, whereas men improved in the stair climb test (p < 0.05) but not in walking test times. Multiple regression analysis revealed the highest R2 (0.28) for the change in chair stands time, followed by stair climb and usual walk at 0.27 and 0.21, respectively. ST improves performance in functional tasks important for ADLs. Changes in strength, power, and FFM are predictors of ST-induced improvements in these tasks.

INTRODUCTION: The purpose of this investigation was to compare the results of a web-based and a telephone interview survey measuring driver concerns about a variety of traffic safety issues, their beliefs, and specific driving behaviors. METHOD: State-wide, annual random digit-dial telephone surveys and web-based surveys were conducted in Maryland. A total of 1,700 drivers were surveyed by telephone and 6,806 took a web survey. RESULTS: Telephone respondents were more likely to be female and older. Web respondents were more likely to be white and not Latino/Hispanic. After controlling for demographic differences, telephone survey respondents were more likely to be concerned about traffic safety. They were more likely to believe that sobriety checkpoints reduce drunk driving (OR=2.18, 95% CI 1.94, 2.45), they would be ticketed for not wearing a seat belt (OR=1.26, 95% CI 1.12, 1.43), and they would be stopped by the police if they drove after drinking too much (OR=1.17, 95% CI 1.03, 1.32). They were less likely to report a variety of risky behaviors including using a cell phone while driving (OR=.54, 95% CI .48, .61) and driving 10+ mph over the speed limit (OR=.81, 95% CI .72, .91), but were more likely to report having been ticketed for a moving violation in the last month (OR=2.22, 95% CI 1.70, 2.90). Suggestions are offered for overcoming potential sources of sampling bias. IMPACT ON INDUSTRY: Web-based surveys produce substantially different results than random-digit-dial telephone surveys, when used for public assessments of traffic safety concerns and behaviors. Language: en

The purpose of this study was to determine factors associated with cervical cancer screening compliance and noncompliance among Chinese, Korean, Vietnamese, and Cambodian women aged 18 years and older.A cross-sectional design was used. The sample consisted of 1049 women aged 18 or older, of whom 37.94% reported never having been screened for cervical cancer, 23.55% reported noncompliance, and 38.51% were in compliance with screening guidelines. The sample was comprised of Chinese, 50.58%; Koreans, 17.50%; Vietnamese, 16.15%; and Cambodians, 15.77%.Education was significantly associated with never having been screened for cervical cancer for Cambodians. Low income ($10000) was significantly associated with never having been screened for Cambodian and Chinese women. Not having health insurance was significantly correlated with not getting screened for all ethnic groups. Age and living in the United States less than 15 years were significantly correlated with never having been screened for Vietnamese, Korean, and Chinese women. Marital status was significantly correlated with not getting screened for Korean and Chinese women. English fluency was significantly associated with screening for Cambodians, Koreans, and Chinese. Barriers associated with women who were never screened compared to those barriers for women who were screened and were compliant included lack of knowledge, psychosocial, no insurance, language, transportation, and lack of time, but these barriers were different among the 4 ethnic groups.Compliance with cervical cancer screening guidelines among Asian American women can be enhanced significantly by providing culturally and linguistically appropriate educational and early intervention programs.

Given the history of vulnerability of women of childbearing age to medical treatments that have caused injury, for example, diethylstilbestrol (DES) and thalidomide, it is surprising that, to date, little research has directly examined attitudes of the general public regarding the vulnerability of women when they participate in biomedical research studies.We asked three questions about beliefs of women as biomedical research subjects of 623 white, 353 black, and 157 Hispanic people in four U.S. cities: (1) Do you believe that women are more likely to be "taken advantage of" when they become subjects in a medical research project as compared to men? (2) Do you believe that women of childbearing age (15-45-year-olds) should become study participants in medical research projects? and, if the response was no or don't know/not sure, (3) Would you still say no or don't know/not sure to question 2 even if it meant that we would not know anything about the health and medical treatments for women aged 15-45 years?Overall, women were 60% more likely than men to state that women were more likely than men to be "taken advantage of," even when controlling for potential confounders, and both black and Hispanic participants were much more likely than white participants to state that this was the case. The majority of respondents (57.4%) said that women of childbearing age should not be research subjects; among women, both black and Hispanic people were less likely than white people to change their minds when prompted that this might mean that "nothing would be known about the health and medical treatments for women aged 15-45 years."A substantial proportion of the participants reported knowledge of historical events, and this knowledge was related, particularly in black participants, to attitudes toward vulnerability of women as biomedical research subjects.

Background: This analysis was conducted to determine whether there is a difference among blacks, Hispanics, and whites in their perception of risks associated with participating in either a biomedical study or a cancer screening. Methods: The Tuskegee Legacy Project Questionnaire, which focused on research subject participation, was administered in two different surveys (1999-2000 and 2003) in seven cities. The Cancer Screening Questionnaire was administered in 2003 in three cities. Results: The study sample across the three surveys consisted of 1,064 blacks, 781 Hispanics, and 1,598 non-Hispanic whites. Response rates ranged from 44% to 70% by city. Logistic regression analyses, adjusted for age, sex, education, income, and city, revealed that blacks and Hispanics each self-reported that minorities, compared with whites, are more likely to be "taken advantage of" in biomedical studies and much less likely to get a "thorough and careful examination" in a cancer screening (odds ratios ranged from 3.6 to 14.2). Conclusions: Blacks and Hispanics perceive equally high levels of risk for participating in cancer screening examinations and for volunteering to become research subjects in biomedical studies. This perception provides a strong message about the need to overtly address this critical health disparities issue.

Background: In the United States, blacks and Hispanics have lower cancer screening rates than whites have. Studies on the screening behaviors of minorities are increasing, but few focus on the factors that contribute to this discrepancy. This study presents the self-reported willingness by blacks, Puerto Rican Hispanics, and non-Hispanic whites to participate in cancer screenings in differing cancer screening situations. Methods: The Cancer Screening Questionnaire (CSQ), a 60-item questionnaire, was administered via random-digit-dial telephone interviews to adults in three cities: Baltimore, Maryland; New York, New York; and, San Juan, Puerto Rico. Results: The 1,148 participants in the CSQ study sample consisted of 355 blacks, 311 Puerto Rican Hispanics, and 482 non-Hispanic whites. Response rates ranged from 45% to 58% by city. Multivariable logistic regression analyses revealed that blacks and Puerto Ricans were often more likely (OR 2.0‐3.0) and never less likely than whites to self-report willingness to participate in cancer screenings regardless of who conducted the cancer screening, what one was asked to do in the cancer screening, or what type of cancer was involved (with the exception of skin cancer where blacks, compared with whites, had an OR of 0.5). Conclusions: The findings from this study provide evidence that blacks and Hispanics self-report that they are either as willing or more willing than whites to participate in cancer screening programs.

Contents of this article are solely the responsibility of the authors and do not necessarily reflect the opinions, official policy or position of the U.S. Department of Health and Human Services, the Substance Abuse and Mental Health Services Administration or Centers for Mental Health Services and Substance Abuse Prevention.To evaluate an HIV risk profile in sexually active black and Hispanic adolescents using a structural equation model (SEM).Grantees from 15 states and Washington, DC, were selected to participate in the study. Black and Hispanic adolescents (N = 2,371) who completed the baseline instrument were required to have experienced vaginal, oral or anal sex in order to be included in this study. Total minority youths who self-reported as black but not Hispanic were n = 1,455 and for Hispanic n = 916.The hypothesized model fit moderately well (CFI = 0.940, TLI = 0.928, RMSEA = 0.039). The key significant direct effect was found (P0.05) for higher alcohol, tobacco and other drug use related to nonuse of condoms, more sex partners and use of substances before sex.Current findings underscore the need to incorporate culturally sensitive strategies in developing programs for minority youth. However, given that minority group members often report greater experiences of discrimination than whites, future research in this area should also include an examination of the role of other stressors such as racial disparities and their potential cumulative impact on minority youth and their risks for alcohol, tobacco and other drug use and HIV.

Background There is little literature on spatiotemporal trends of AIDS mortality among different race and gender groups. The purpose of the present study is to describe AIDS mortality geographically and temporally, and to determine if detected trends vary by race and gender. Methods The Spatial Scan Statistic was employed to examine the geographic excess of AIDS mortality by race and gender in 24 Maryland jurisdictions between 1987 and 2003. Spatial analysis was conducted to identify clusters of excess mortality. The temporal scan statistic was used to explore time trends of AIDS mortality. Prospective space–time analysis was also conducted to verify if detected clusters persisted into the present. Results Among 10,887 AIDS deaths, 77.5% occurred in African Americans. Geographic excesses of AIDS mortality were detected in Baltimore city, and Howard, Montgomery, Anne Arundel, Prince Georges and Baltimore counties. Over the study period, AIDS mortality peaked in 1995 and then sharply dropped until 1998, when it stabilized. However, the AIDS mortality of African-American women started oscillating upward in 1998. Conclusion This study quantitatively described geographic and temporal variations of AIDS mortality in Maryland by gender and racial groups. The results may inform development of programs to address HIV/AIDS while considering the groups most affected differentially by geographic area.

The phrase, 'legacy of the Tuskegee Syphilis Study', is sometimes used to denote the belief that Blacks are more reluctant than Whites to participate in biomedical research studies because of the infamous study of syphilis in men run by the U.S. Public Health Service from 1932-72. This paper is the first to attempt to assess directly the accuracy of this belief within a multi-city, multi-racial, large-scale, detailed random survey. We administered the Tuskegee Legacy Project (TLP) Questionnaire to 826 Blacks and non-Hispanic White adults in three U.S. cities. While Blacks had higher levels of general awareness of the Tuskegee Syphilis Study, there was no association between either awareness or detailed knowledge of the Tuskegee Syphilis Study and willingness to participate in biomedical research, either for Blacks or Whites observed in our survey. While this study refutes the notion that there is a direct connection between detailed knowledge of the Tuskegee Syphilis Study and willingness to participate in biomedical research, it does not assess the broader question of whether and how historical events influence people's willingness to participate in research. Future studies should explore this.

This 6-week study was conducted to evaluate the effects of seven different levels of dietary chromium (Cr) (0, 75, 150, 300, 450, 600, and 1 200 ppb Cr) in the form of Cr nanoparticle (CrNano) on growth, body composition, serum hormones and tissue Cr in Sprague-Dawley (SD) rats. Seventy male SD rats (average initial body weight of (83.2+/-4.4) g) were randomly assigned to seven dietary treatments (n=10). At the end of the trial, body composition was assessed via dual energy X-ray absorptiometry (DEXA). All rats were then sacrificed to collect samples of blood, organs and tissues for determination of serum hormones and tissue Cr contents. The results indicated that lean body mass was significantly increased (P

The purpose of this study was to test the hypothesis that individuals reporting healthy lifestyle behaviors would also report better self-rated mental health. Logistic regression analyses were conducted utilizing SUDAAN on the Behavioral Risk Factor Surveillance Survey data set. This descriptive analysis suggests that persons reporting poor mental health were more likely to report unhealthy lifestyle behaviors. This set of findings encourages careful design of experimental studies of empirically based associations of mental health and life style, using psychometrically sound measures. Then public health programs focused on change of health-related behaviors might be more suitably devised.

Introduction The purpose of this investigation was to identify risky driving behaviors and dispositions that distinguish drivers who use a cell phone while operating a motor vehicle from non-cell phone using drivers. Method Annual telephone surveys were used to identify drivers who reported using a cell phone while driving in the last month (n = 1803) and were compared to those who said they did not use cell phones while driving (n = 1578). Results Cell phone using drivers were more likely to report driving while drowsy, going 20 mph over the speed limit, driving aggressively, running a stop sign or red light, and driving after having had several drinks. They were also more likely to have had a prior history of citation and crash involvement than non-cell phone using drivers. Cell phone using drivers also reported they were less careful and more in a hurry when they drive than non-cell phone using drivers. Conclusion Cell phone using drivers report engaging in many behaviors that place them at risk for a traffic crash, independent of the specific driving impairments that cell phone usage may produce. Strategies that combine coordinated and sustained enforcement activities along with widespread public awareness campaigns hold promise as effective countermeasures for these drivers, who resemble aggressive drivers in many respects.

A more diverse health science-related workforce including more underrepresented race/ethnic minorities, especially from low socioeconomic backgrounds, is needed to address health disparities in the USA. To increase such diversity, programs must facilitate youth interest in pursuing a health science-related career (HSRC). Minority youth from low socioeconomic families may focus on the secondary gains of careers, such as high income and status, given their low socioeconomic backgrounds. On the other hand, self-determination theory suggests that it is the intrinsic characteristics of careers which are most likely to sustain pursuit of an HSRC and lead to job satisfaction. Intrinsic and extrinsic motivation for pursuing an HSRC (defined in this study as health professional, health scientist, and medical doctor) was examined in a cohort of youth from the 10th to 12th grade from 2011 to 2013. The sample was from low-income area high schools, had a B- or above grade point average at baseline, and was predominantly: African American (65.7 %) or Hispanic (22.9 %), female (70.1 %), and children of foreign-born parents (64.7 %). In longitudinal general estimating equations, intrinsic motivation (but not extrinsic motivation) consistently predicted intention to pursue an HSRC. This finding provides guidance as to which youth and which qualities of HSRCs might deserve particular attention in efforts to increase diversity in the health science-related workforce.

African Americans’ greater access to mobile phones makes short messaging service technology a promising complement to health promotion interventions. Short messaging service text messages were added to the Men’s Prostate Awareness Church Training project, a men’s health intervention for African American men. We report on the feasibility and acceptability of the use of short messaging service text messages in the intervention. Short messaging service text messages served as (1) workshop reminders; (2) post-workshop message reinforcement; (3) spiritual/motivational messages; and (4) participant retention. At workshop 4, over 65 percent of participants wished to continue receiving the messages. While there was an increase in recall over time, more than one-third of the participants did not recall receiving the 53 text messages. However, recall was considerably greater among men who attended the Men’s Prostate Awareness Church Training workshops. Overall, the inclusion of text messages in health promotion interventions targeting mature African American men was found to be feasible and acceptable.

Using 2010 national data, we investigate the relationship between social integration and health insurance for African American adults. During the previous year 21.6% of men and 19.8% of women lacked continuous health insurance. The effect of marital status, income, and employment on insurance coverage differed by age and gender. Additionally, frequency of church attendance was positively associated with continuous health insurance for women aged 51–64. Spiritual/religious identity was marginally associated with insurance status for men aged 36–50. As provisions of the Affordable Care Act take effect, implementation programs should expand enrollment efforts to include the conjugal unit and the church.

Minority populations are underrepresented in fields of science, perhaps limiting scientific perspectives. Informed by recent studies using Social Cognitive Career Theory, this study examined whether three conceptual constructs: self-efficacy, perceived adult support, and perceptions of barriers, as well as several discrete and immutable variables, were associated with intent to pursue college science education in a sample (N = 134) of minority youth (70.1% female and 67.2% African American). A paper-and-pencil survey about pursuit of college science was administered to 10th graders with a B- or better grade point average from six high schools in an underserved community. Results indicated that the three conceptual constructs were bivariate correlates of intent to pursue college science education. Only perceived adult support and knowing whether a parent received college education were significant predictors in multivariate modeling. These results build on previous research and provide further insight into youth decision-making regarding pursuit of college science.

This study examined the relationship between substance use and STD/HIV sexual risk behaviors among sexually active adolescents. Participants included ninth through twelfth grade sexually active youth (N = 7,669) who completed the 1999 national Youth Risk Behavior Survey. Multivariate logistic regression was used to examine all significant independent relationships. Use of cigarettes, cocaine and glue/ inhalants was associated with unprotected sex and multiple sexual partners. Alcohol use, binge drinking and marijuana use were associated with multiple sexual partners. Use of inhalants and glue differentiated youth who engaged in none versus two STD/HIV risk behaviors. Substance use behavior, particularly harder drugs, may place adolescents at increased risk for acquiring an STD or HIV.

This study explored the relationships among a variety of victimization experiences and dissociative symptoms in a community probabilistic household sample (n=891) of youths (11-17 years old) in Puerto Rico. To measure dissociative symptoms, the authors selected eight items from the Adolescent Dissociative Experiences Scale (Armstrong, Putnam, Carlson, Liber, & Smith, 1997) that are indicative of pathological forms of dissociation. Victimization factors associated with dissociation were investigated with bivariate logistic regression followed by multiple logistic regression. The results indicated that 44 (4.9%) youths experienced pathological dissociative symptoms. Forty-three (98%) of those youths experienced victimization. Logistic regression analyses indicated that the risk of pathological dissociation was significant among those participants who reported severe forms of physical abuse and those who were exposed to violence.

The broad goal of the Tuskegee Legacy Project (TLP) study was to address, and understand, a range of issues related to the recruitment and retention of Blacks and other minorities in biomedical research studies. The specific aim of this analysis was to compare the self-reported willingness of Blacks, Hispanics, and Whites to participate as research subjects in biomedical studies, as measured by the Likelihood of Participation (LOP) Scale and the Guinea Pig Fear Factor (GPFF) Scale. The Tuskegee Legacy Project Questionnaire, a 60 item instrument, was administered to 1,133 adult Blacks, Hispanics, and non-Hispanic Whites in 4 U.S. cities. The findings revealed no difference in self-reported willingness to participate in biomedical research, as measured by the LOP Scale, between Blacks, Hispanics, and Whites, despite Blacks being 1.8 times as likely as Whites to have a higher fear of participation in biomedical research on the GPFF Scale.

Prostate cancer incidence and mortality are highest among African-American men, and coupled with the controversy around routine prostate cancer screening, reaching African-American men with interventions to help them make an informed decision about whether or not to be screened is critical. This study compares two approaches to delivering a church-based peer community health advisor intervention consisting of a series of four men's health workshops on informed decision-making for prostate cancer screening. In the men-only group, male community health advisors teach group workshops consisting only of men. In the health partner group, male-female pairs of community health advisors teach workshops in a mixed-gender format in which enrolled men are asked to invite a significant woman in their lives (e.g., wife/partner, sister, daughter, friend) with them to the workshops. Eighteen African-American churches were randomized to receive one of the two approaches, and 283 eligible men enrolled in the intervention. Main findings suggested that the workshops had an impact on stage of decision-making, and this increased significantly over time in the health partner group only. The intervention was highly rated by men in both groups, and these ratings increased over time, with some study group differences. Within-workshop study group differences favored the health partner group in some instances; however, men in the men-only groups reported greater increases in their ratings of trust in the workshops over time. The health partner intervention strategy appears to be promising for reaching men of color with health information.

To evaluate the substance use pathways of minority adolescents with a structural equation modeling (SEM) based on the social ecological model.Seven hundred ninety adolescents completed the baseline survey questionnaire for the Center for Substance Abuse Prevention's Mentoring and Family Strengthening Initiative. The exogenous variables were family supervision, family involvement, and social support, whereas self-control, school connectedness, and substance use served as the endogenous variables.The following significant direct effects were found: family involvement to self-control; self-control and social support to school connectedness; school connectedness to substance use.These findings provide empirical evidence that family protective factors can significantly influence adolescents' substance use and should be adopted into substance use prevention interventions.

This study sought to predict the use of dietary supplements marketed to enhance athletic performance among 1,737 adolescent athletes. An anonymous, paper-and-pencil, self-report survey was administered to the participants. Grade level, participation in multiple sports, and scales representing attitudes, subjective norms, and intention were all significant predictors of current dietary supplement use. The results of this study allow for the development of more appropriate prevention and intervention strategies that can target specific groups of adolescent athletes. We recommend that attitudes of adolescent athletes be addressed in interventions and that salient others be included in program planning.

This study assessed the extent to which a belief in fate or destiny might explain certain health behaviors among African Americans. A survey of 1,253 African Americans in Alabama churches was conducted. Fifty-nine percent of the total sample indicated that they believe in fate or destiny. The findings of this study suggest that fate/destiny may influence health decisions. The study found a statistically significant difference between men and women regarding their belief in fate or destiny. Women reported believing in fate and destiny more than men. Surprisingly people with more education (i.e., college or postgraduate) believed in fate and destiny significantly more than high school dropouts and high school graduates. A belief in fate or destiny also varied by income level. Respondents who made more in annual income were more likely to believe in fate and destiny than people who made less. One behavior, breast exam had a statistically significant association with a belief in fate and destiny. Women who reported never having a breast exam were more likely to believe in fate and destiny than women who did not have a belief in fate or destiny. These findings highlight the need for practitioners to examine more closely the definition of fate and destiny and determine how this belief influences or does not influence health behaviors as once believed. The research suggests a closer examination of the role culture plays in health decision making which may be independent of a belief in fate and destiny.

Purpose To determine associations between intakes of the primary food and beverage sources of added sugars and intakes of key nutrients and food pyramid groups among U.S. children aged 6–17 years. Methods The 1994–96 and 1998 U.S. Department of Agriculture (USDA) Continuing Survey of Food Intakes by Individuals (CSFII) were used to examine the diets of U.S. children aged 6–17 years, who provided 2 full days of dietary data. The nationally representative sample (n = 3038) included children age 6–11 (n = 1913) and adolescents age 12–17 (n = 1125). Food codes for sweetened foods and beverages were selected from the USDA Food Coding Scheme and categorized into five food and beverage categories. The Statistical Analysis System software program was used to recode and format the data for statistical analysis and the Survey Data Analysis System was used to apply sample weights and generate statistical procedures. Results The consumption of sweetened dairy products was positively associated with calcium intakes for children and adolescents. Consumption of presweetened cereals increased the likelihood of the children and adolescents meeting recommendations for the essential shortfall micronutrients calcium, folate, and iron, whereas the consumption of sugar-sweetened beverages, sugars and sweets, and sweetened grains decreased the likelihood of meeting the Dietary Reference Intakes (DRI) for these nutrients. Only children who were nonconsumers of sugar-sweetened beverages had a mean calcium intake that met the adequate intakes (AI). Consumption of sweetened dairy products and presweetened cereals was positively associated with the number of dairy servings consumed per day for both age groups. Conclusions On average, consumption of sweetened dairy foods and beverages and presweetened cereals had a positive impact on children and adolescents' diet quality, whereas sugar-sweetened beverages, sugars and sweets, and sweetened grains had a negative impact on their diet quality.

This study assessed psychometrics of an HIV/AIDS knowledge scale and the relation of scores to HIV risk behaviors among African-American women 17 to 44 years of age ( N = 405). Data were collected from five communities located in Atlanta, Georgia. The HIV/AIDS risk-behavior knowledge scale and the HIV risk-behavior factors were collected. Analysis indicated reliability coefficients of the HIV/AIDS knowledge scale were virtually identical for high- and low-risk groups. The high-risk group scored statistically significantly better (76% correct answers) than the low-risk group (67% correct answers) The KR-20 coefficients were identical for both risk groups (.73), suggesting that the AIDS knowledge scale has suitable reliability.

Using a representative sample of the 1999 National School-based Youth Risk Behavior Survey, this study investigated the risky behavior of cigarette, alcohol, and marijuana consumption by underage students. The research analyzes the contemporaneous and intertemporal relationship between the use of these licit and illicit substances. Evidence of a gateway from cigarettes to marijuana was found; however, prior use of alcohol does not significantly increase the likelihood of currently using marijuana.

Although HIV/AIDS education is recommended by health officials and professionals for all school age students, most programs are offered in middle and high schools. This report describes a comprehensive age-appropriate HIV/AIDS Awareness Education Program for kindergarten through fifth grade students. The children receive factual information about HIV disease, as well as a message of hope, understanding, and compassion for people living with the disease. The results of a program evaluation for program-improvement using a pretest post-test design indicated a significant increase in HIV/AIDS knowledge for children in the second through the fifth grade, and a significant increase in comfort levels related to HIV/AIDS for children in kindergarten through the fifth grade.

Objectives. We conducted health literacy environmental scans in 26 Maryland community-based dental clinics to identify institutional characteristics and provider practices that affect dental services access and dental caries education. Methods. In 2011–2012 we assessed user friendliness of the clinics including accessibility, signage, facility navigation, educational materials, and patient forms. We interviewed patients and surveyed dental providers about their knowledge and use of communication techniques. Results. Of 32 clinics, 26 participated. Implementation of the health literacy environmental scan tools was acceptable to the dental directors and provided clinic directors with information to enhance care and outreach. We found considerable variation among clinic facilities, operations, and content of educational materials. There was less variation in types of insurance accepted, no-show rates, methods of communicating with patients, and electronic health records use. Providers who had taken a communication skills course were more likely than those who had not to use recommended communication techniques. Conclusions. Our findings provide insight into the use of health literacy environmental scan tools to identify clinic and provider characteristics and practices that can be used to make dental environments more user friendly and health literate.

This cross-sectional study was designed to identify correlates of blood pressure control behaviors, including participation in physical activity, maintaining a healthy diet, limiting alcohol and tobacco use, discussing blood pressure with a doctor, and getting screened for blood pressure. The study sample included 116 Korean American men and women aged 42 to 77 years ( M = 58.7) who resided in the greater Philadelphia area. Intention to exercise, comfort exercising in the neighborhood, and confidence in the ability to find time to exercise were positively correlated with participating in physical activity. Knowledge about the benefits of a healthy diet and confidence in the ability to maintain a healthy diet were positively correlated with maintaining a healthy diet. Intention to visit a doctor, having a regular doctor, satisfaction with the doctor, having confidence in the doctor, and confidence in the ability to ask doctors about health issues were positively correlated with medical adherence (including adhering to medication regimen and seeing a doctor regularly).

OBJECTIVES: To examine the physical, social and temporal contexts of physical activity, as well as sex variations of the associations among 314 urban adolescents. METHODS: Three-day physical activity recall measured contextual information of physical activities. Logistic regressions and generalized estimating equation models examined associations among physical activity types and contexts, and sex differences. RESULTS: Active transportation was the most common physical activity. Home/neighborhood and school were the most common physical activity locations. School was the main location for organized physical activity. Boys spent more time on recreational physical activity, regardless of the social context, compared to girls. The average physical activity level was significantly lower for girls than for boys after school. CONCLUSIONS: Physical activity promotion interventions need to target physical activity environments and social contexts in a sex-specific manner. Language: en

This study used data from the 1996 National Health Interview Survey to identify families that have full health insurance coverage, have partial coverage, and are uninsured. It examined the socioeconomic and demographic variables that influenced the probability of being in a particular group. The results indicate that the probability of full insurance coverage was positively related to the level of education and age of the reference person, as well as to having children younger than age 6. Families below the poverty level had a lower probability of being fully covered by any type of health insurance compared with other families. A family with a self-employed reference person or living in the South was less likely to have insurance. Implications of the study are discussed.

A selected number of lifestyle and risk behaviors of adolescents in relation to their smoking were studied using both longitudinal and cross-sectional analyses. Data of a national sample of 4,431 nonsmoking adolescents who participated in the 1989 Teenage Attitudes and Practices Survey and were re-interviewed in 1993 were analyzed. Adolescents who engaged in physical fights, engaged in drunk driving, and were risk-takers were more likely to be regular experimental smokers than adolescents who did not exhibit these behaviors. The data suggest that high-risk behaviors may cluster. Interventions may be necessary to target multiple risk behaviors and be more effective in changing adolescents' risk behaviors associated with smoking.

Objectives. We evaluated the combined impact of community-level environmental and socioeconomic factors on the risk of campylobacteriosis. Methods. We obtained Campylobacter case data (2002–2010; n = 3694) from the Maryland Foodborne Diseases Active Surveillance Network. We obtained community-level socioeconomic and environmental data from the 2000 US Census and the 2007 US Census of Agriculture. We linked data by zip code. We derived incidence rate ratios by Poisson regressions. We mapped a subset of zip code–level characteristics. Results. In zip codes that were 100% rural, incidence rate ratios (IRRs) of campylobacteriosis were 6 times (IRR = 6.18; 95% confidence interval [CI] = 3.19, 11.97) greater than those in urban zip codes. In zip codes with broiler chicken operations, incidence rates were 1.45 times greater than those in zip codes without broilers (IRR = 1.45; 95% CI = 1.34, 1.58). We also observed higher rates in zip codes whose populations were predominantly White and had high median incomes. Conclusions. The community and environment in which one lives may significantly influence the risk of campylobacteriosis.

The study examined and contrasted the extent that peer influence and self-selection for smoking peers may affect acquisition of smoking by adolescents. Data for a U.S. national cohort sample of adolescents ( N = 4,444) who were nonsmokers in the 1989 Teenage Attitudes and Practices Surveys and were re-interviewed in 1993 were included. The information included measures of smoking behavior and smoking status of both boys’ and girls’ best friends. Analysis demonstrated that, although the effects of both peer influence and self-selection of smoking friends occurred, self-selection may play a greater role in adolescents’ beginning to smoke. This implies that, while teaching adolescents to resist peer pressure may be necessary, it is perhaps more important to identify factors that influence adolescents’ decisions in choosing friends who smoke. This could lead to more effective preventive strategies.

Background Our street outreach project investigated the relationship between use of noninjecting drugs (alcohol, marijuana, cocaine) and human immunodeficiency virus (HIV) risk-related sex behaviors of black adults. The study focused on three HIV-related risks: multiple sex partners, unprotected sex, and drugs during sex. Methods Data for this study were collected in a street outreach community survey for a drug abuse and HIV intervention study in Birmingham, Ala. A total of 780 black men and women completed the survey. Results High-risk sex behaviors were far more prevalent among cocaine users than marijuana or alcohol users. A greater number of cocaine users reported having multiple sex partners, not using condoms, and using drugs during sex. Female cocaine users showed the same risk level for HIV infection as male cocaine users. Conclusions Increased risk of HIV infection through sexual transmission is associated with use of noninjecting cocaine for both men and women. Condom use should be considered as a major component of HIV prevention programs.

The Street Outreach to Drug Abusers—Community AIDS Prevention (SODA—CAP) Project implemented and evaluated an HIV-prevention intervention aimed at current drug users. The intervention was developed using social cognitive theory and the transtheoretical model of change. The outreach team assessed individuals’ stages of change for the target behaviors and they were given stage-appropriate role-model stories. The program effects were evaluated using a quasi-experimental design with a repeated, cross-sectional sampling method in which community surveys were administered at baseline, 12 and 22 months. Multivariate statistical models were developed for four outcomes (condom use with main and other partners, treatment entry, and stopping all drug and alcohol use). Exposure to intervention was a significant predictor for condom use with other partners and for stopping drug and alcohol use.

Purpose: To evaluate the ability of social-psychological risk factors to predict adolescent smoking behavior. Methods: Nonsmoking adolescents (n = 4032) who participated in the 1989 and 1993 Teenage Attitudes and Practices Surveys (TAPS I) were selected for analyses. Four multivariate logistic models were used to examine (a) adolescents’ smoking initiation, (b) adults’ smoking initiation, (c) adolescents’ progression to regular smok-ing, and (d) adults’ progression to regular smoking. A series of social-psychological variables were measured. Results: All four models were significant. However, no social-psychological factors were consistently significant in all four models, except white ethnicity. Data showed that social-psychological factors are less able to predict the transition from nonsmoking to experimental smoking than that from nonsmoking to regular smoking. Conclusions: Future prospective studies should measure both social-psychological and smoking acquisition factors at closer intervals to more accurately examine potential relationships.

This article examines sociodemographic risk and smoking and smokeless tobacco use among a national sample of school-based adolescents who participated in the 1993 Teenage Attitudes and Practices Survey. Findings show that six sociodemographic factors (age, gender, ethnicity, income, type of urban area, and region) were significantly associated with cigarette smoking and smokeless tobacco use. Of all smokeless tobacco users, 71.5 percent were also regular smokers or experimental smokers. This article highlights the need to provide comprehensive tobacco use prevention programs that focus on both cigarette and smokeless tobacco use among school adolescents.

BACKGROUND: Older women are considered at risk for hip fracture; fracture rates are highest in the southern region of the United States. The purpose of this study was to develop a predictive model for osteoporotic hip fracture among a national sample of southern women aged 50 years and older. METHODS: Subjects were participants in the Third National Health and Nutritional Examination Survey, Phase 1. Data were collected by the National Center for Health Statistics. Predictors examined included age, race, heredity, body mass index, physical activity, smoking status, alcohol use, and dairy product use. RESULTS: The sample consisted of 953 women aged 50 years and older. The predictive model included older age, black race, Hispanic race, and low body mass index. CONCLUSIONS: Recommendations emphasize weight gain for underweight women and promotion of healthy body weights for women of all ages. Language: en

BACKGROUND This study examined the relationship between depressive symptoms and polydrug use (alcohol, marijuana, and cocaine) among blacks in a high-risk community. METHODS A street sample (N = 570) from four high-risk communities in Birmingham, Alabama, was collected through personal interviews. Interviewers asked respondents about their drug use behavior during the past 30 days, as well as about their depressive symptoms during the past week. RESULTS Odds ratios and logistic regressions, adjusted for age and sex, were used to assess the relationship between depressive symptoms and drug and polydrug use (drug use involving cocaine). Results showed that depressive symptoms are significantly associated with polydrug use. However, depressive symptoms were not associated with alcohol use or with the combination of alcohol and marijuana use. CONCLUSIONS Depressive symptoms are related to polydrug use involving cocaine, though the causal relationship is uncertain. Previous reports on depressive symptoms and alcohol or marijuana may be inconclusive.

This study investigates the effect of the Tuskegee Syphilis Experiment (TSE) on participation in health promotion activities and research studies by African Americans. Random-digit dialing was used to interview 421 adults with telephones living in households in Jefferson County, Alabama in the summer of 1994. Respondents were asked if they had ever heard of the TSE and, if yes, because they knew about the experiment, were they less interested in participating in health promotion or research activities. The primary results were that African Americans, in general, reported less interest in participating in health promotion and research because of their knowledge of the TSE. African American males in particular reported a high degree of resistance because of knowledge of the TSE. These results may have implications for practitioners and researchers recruiting African American subjects for research studies and participation in health promotion and health education programs. It may be necessary to dis...

The purpose of this study was to examine social factors that predicted adolescent smoking transition to more advanced stages of smoking behavior during a 3-year span. A national cohort sample of adolescents (N = 2,099) who participated in the 1989 and 1993 Teenage Attitudes and Practices Survey (TAPS I and TAPS II, respectively) was used for this study. The information obtained from this survey included measurements of smoking behavior and a series of factors related to smoking models in the respondents' social environment, such as smoking behavior of parents, siblings, and best friends. Results showed that the smoking behavior of an adolescent's best male friend was consistently associated with transition from nonsmoking to regular smoking and from experimental smoking to regular smoking. The most surprising finding was that the study showed no relationship between social influence and transition from nonsmoking to experimental smoking.

Since Komaki et al.'s (1978) pioneering work of applying behavioral analysis for industrial safety, several researchers reported successful applications of behavioral safety programs in different work situations. However, most of these programs consisted of a number of components, e.g., safety training, safety performance feedback, goal setting, incentives to performance safety, (e.g., praise, coupons, T-shirts, etc.), consolidated into a single treatment. Although these programs led to improvements in safety behavior of workers, and in a few instances to lower accident rates during the program, it is not clear which components of the safety programs contributed most to the improvement. The present study was conducted to assess the individual effectiveness of training, performance feedback, and goal setting on the safe behavior of workers in an industrial setting. Two groups of workers performing similar operations were selected for the experiment. While the experimental group was treated with safety training, feedback, and goal setting, the control group continued working without any treatment. The safety performance index (SI), a ratio of number of observations safe divided by the numbers safe and unsafe, (Komaki et al., 1978) was used to measure the status of safety on the shop floor. The experimental group did not show any significant change in the safety behavior until safety performance feedback was introduced. This observation indicates that training alone may not be adequate to ensure safe behavior in a workplace. The safety performance index improved further with the introduction of goal setting for the performance. The improvement was significant indicating that feedback with goal setting may begin to maximize the effectiveness of a behavioral safety program in the workplace. The study will be useful in allocating resources to improve safety in the workplace.

The purpose of this study was to determine dental hygienists' use of recommended techniques to communicate science-based information for intervention and prevention of oral disease.A 30-item survey containing 18 communication techniques representing 5 domains including 7 basic skills were mailed to a random sample of 1,258 Maryland dental hygienists to determine their use of recommended communication techniques.The response rate was 43% (n = 540). Nearly all were females (98%) and 58% practiced in solo settings. About half of respondents used 6 of the 18 techniques routinely. Approximately three-quarters of respondents reported they rarely or never used 3 of the 7 basic recommended techniques. Only one basic technique (use of simple language) was used by over 90%. Respondents who had taken a communications course other than in dental hygiene school were significantly more likely to use communication techniques on a routine basis than those who had not (p0.01).Dental hygienists and their patients would benefit from using the recommended communication tools and techniques to address individual patient needs. To improve oral health outcomes, dental hygiene education must strengthen health literacy knowledge and communication skills in dental hygiene education programs and through continuing education courses for practicing hygienists.

Objective: The purpose of this study was to validate a Sociocultural Health Behavior Model using a structural equation analysis to determine the direction and magnitude of the interdependence of model components in relation to health behavior associated with colorectal cancer (CRC) screening among Chinese Americans. Methods: A cross-sectional design included a sample of 311 Chinese American men and women age 50 and older. The initial step involved use of confirmatory factor analysis which included the following variables: access/satisfaction with health care, enabling, predisposing, cultural, and health belief factors. Structural equation modeling analyses were conducted on factors for CRC screening. Results: Education and health insurance status were significantly related to CRC screening. Those with less than a high school education and without health insurance were more likely to be “never screened” for CRC than those having more education and health insurance. The path analysis findings also lend support for components of the Sociocultural Health Belief Model and indicated that there was a positive and significant relationship between CRC screening and the enabling factors, between cultural factors and predisposing, enabling, and access/satisfaction with health care factors and between enabling factors and access/satisfaction with health care. Conclusions: The model highlights the significance that sociocultural factors play in relation to CRC screening and reinforced the need to assist Chinese with poor English proficiency in translation and awareness of the importance of CRC screening. The use of community organizations may play a role in assisting Chinese to enhance colorectal cancer screening rates.