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Purpose: To summarize the evidence on associations of adiposity and cardiorespiratory fitness (CRF) with arterial structure and function in nonclinical children and adolescents. Methods: Two researchers conducted a search in 5 electronic databases in April 2022 to find studies in nonclinical youth (age 5–17.9 y) reporting multivariable associations. Studies were eligible if adiposity and/or CRF were used as the predictor and arterial structure and/or function was the outcome. The Quality Assessment Tool for Quantitative Studies was used to assess methodological quality for experimental studies, and a modified version was used for observational studies. Results: Ninety-nine studies (72.7% cross-sectional) were included. Ninety-four assessed associations between adiposity and arterial outcomes, most using overall body proportion (n = 71), abdominal (n = 52), or whole-body adiposity (n = 40). Most evidence was inconsistent or nonsignificant, but 59 studies suggested higher abdominal adiposity and worse body proportion were associated with adverse arterial outcomes. Twenty-one assessed associations between CRF and arterial outcomes, with findings inconsistent. Most evidence was rated weak in quality. Conclusion: While high adiposity may contribute to poor arterial outcomes, evidence is limited regarding CRF. Future studies should disentangle these associations by studying youth with healthy adiposity but poor CRF, or vice versa, using longitudinal or experimental study designs.

U.S. Latinos are 1.5 times more likely to develop Alzheimer’s disease (AD) than non-Latino Whites. To raise awareness of and action around this rising public health issue, Salud America!, a nationa...

In response to coronavirus disease (COVID-19) in 2020, the national Salud America! Latino health equity program at University of Texas Health San Antonio applied its digital content curation model to create and communicate culturally relevant news, stories, and data to raise immediate awareness and generate action against the pandemic’s inequitable impacts on U.S. Latinos. Digital content curation is an emerging public health communication strategy using a systematic, refined process to create tailored online and social health messages and prevent mixed messaging and information overload for an audience. Salud America! curated culturally relevant digital content to raise awareness of the pandemic’s inequitable impact on Latinos and promote solutions for health equity, with a unique combination of website blog posts exploring pandemic effects on Latinos, peer-modeled stories of people responding meaningfully to the crisis, podcast episodes and Tweetchats engaging people in COVID-19 solutions for Latinos, action tools and campaigns equipping school leaders to make grassroots changes, and supplying advocates with a local data tool on health equity identification. The digital health promotion intervention produced curated content that spiked program website traffic to record highs, revealing the model’s effectiveness in increasing exposure to culturally relevant and action-oriented information for a novel topic.

Background and Purpose: Activity trackers have grown increasingly popular, yet research grade accelerometers, like Actigraph, are still very expensive and must be worn on the waist. This study correlated the low-cost wrist-worn SQORD band to the Actigraph accelerometer to assess physical activity (PA) in youth from a low-income area. Methods: Forty-one participants (22:19 male:female; mean age= 10.7 years) in an after-school program participated. Participants wore a waist-worn Actigraph accelerometer and a wrist-worn SQORD for seven days. Abdominal, upper and lower body strength and endurance, and aerobic capacity were assessed through FITNESSGRAM tests. Bivariate correlations were used to analyze the relationship between moderate-to-vigorous PA (MVPA) via the Actigraph and SQORD and to examine relationships between physical fitness and MVPA. Results: At 8- and 10-hour wear-time, compliance with wearing the devices was higher with the SQORD than the Actigraph. A correlation was found between MVPA via SQORD and Actigraph (r=0.651). Neither the SQORD or Actigraph was associated with any fitness measures (r = -0.061; – 0.817). Conclusion: The SQORD appears to be successful in tracking MVPA in youth and was worn more than the Actigraph. Wrist-worn, consumer-grade devices may be a cost-effective alternative to traditional accelerometers for physical education programs and research in low-income populations.

Objective We examined the within-person longitudinal and bidirectional associations between patterns of sedentary time accumulation [alpha (sedentary bout duration/length), sedentary breaks (number of breaks in sedentary bouts)], and symptoms of major depressive disorder and generalized anxiety disorder. Methods Children [N = 167, 10.1(0.9) years old, 54.5% female, 59.3% Hispanic, 35.9% overweight/obese at baseline] participated in a 3-year longitudinal study that consisted of assessments of sedentary time, and depressive and anxiety symptoms. At each assessment, participants wore accelerometers and completed the Revised Child Anxiety and Depression Scale. Separate random intercept cross-lagged panel models estimated the within-person longitudinal and bidirectional associations between alpha, sedentary breaks, and symptoms of major depressive disorder and generalized anxiety disorder across chronological age intervals. Results Having greater than one’s own usual depressive symptoms at age 11 was associated with fewer sedentary breaks 1 year later. Having greater than one’s own usual generalized anxiety symptoms at age 11 was associated with longer sedentary bouts and fewer sedentary breaks 1 year later. In contrast, having greater than one’s own usual sedentary breaks at age 10 was associated with fewer generalized anxiety symptoms 1 year later. All other associations, including at younger ages, were null. Conclusion Deviations from one’s usual levels of depressive or anxiety symptoms may be important for how sedentary time is subsequently accumulated. Intraindividual processes appear to be at play, therefore more within-person research is needed. Intervention strategies for promoting a healthier accumulation of sedentary time may consider targeting occasions when depressive and anxiety symptoms are greater than usual.

Given how smart phones, internet services, and social media have shown great potential for assisting smoking cessation, we constructed a Facebook chat application based on our previous work with SMS texting services. This report summarizes findings from 2,364 Spanish-speaking young adults recruited through Facebook advertising in South Texas during the 2020 New Year holiday season. Among these service users, 926 (39%) were ready to make a quit attempt, and 26 (3.1%) of those users reported that they were tobacco free 1 month later. There were no responses to a chat question survey 72 days after the dates selected for quitting. Although more research with longer follow up is needed, these findings show that social media chat applications may be helpful for at least prompting quit attempts and short-term cessation among young adult Spanish-speaking smokers. There is no evidence of an impact on long-term cessation, and more research is clearly needed.

Promoting coronavirus vaccination is deterred by misinformation, ranging from elaborate conspiracy theories about sinister purposes to exaggeration of side effects, largely promulgated by social media. In this pilot study, we tested the effects of different messages on actions leading to vaccination. Two theory-based advertisements were produced for Facebook, which provided video testimonials from peer role models recommending vaccination and its benefits while providing psychological inoculation through the models’ acknowledging misinformation, rejecting it and receiving the vaccine. These ads were paid to appear on Facebook users’ feeds in rural counties in South Texas, along with a generic vaccine promotion ad from the CDC without peer models or psychological inoculation. Ad viewers could click a link to ‘find a vaccine near you’; these responses served as the outcome variable for assessing experimental effects. Ads featuring peer modeling with psychological inoculation yielded a significantly higher rate of positive responses than CDC ads (30.5 versus14.9/1000 people reached in English and 49.7 versus 31.5/1000 in Spanish; P

This study investigated the cross-sectional and longitudinal associations of the substitution of non-school time light physical activity (LPA), moderate-to-vigorous physical activity (MVPA), and sedentary time (ST) with adiposity in boys and girls. Boys (n = 65, baseline Mage= 9.93 ± 0.86 years) and girls (n = 77, baseline Mage = 10.17 ± 0.95 years) wore waist-worn accelerometers (ActiGraph GT3X) at baseline and at a 30-month follow-up, from which non-school time LPA, MVPA, ST, and total device wear were quantified. Body mass index (BMI) and waist-to-height-ratio (WHR) were measured at baseline and follow-up. Body fat percent (BF%) was obtained at follow-up only. Isotemporal substitution models assessed the cross-sectional and longitudinal associations of reallocating non-school time activity with BMI, WHR and BF%. In boys, replacing 30 min/day of LPA with MVPA was cross-sectionally (β = −8.26, p &lt, 0.05) associated with a lower BF%. Replacing 30 min/day of ST with MVPA was cross-sectionally (β = −6.02, p &lt, 0.05) associated with a lower BF% in boys. Longitudinally in boys, replacing 30 min of change in LPA with MVPA (β = −7.42, p &lt, 0.10) and replacing 30 min of change in MVPA with ST (β = 5.78, p &lt, 0.10) over 30 months was marginally associated with less BF%. Associations were null in girls (p &gt, 0.05). These results may support targeting activity reallocation during non-school time for the purposes of adiposity improvement in boys. A multi-behavioral approach may be more appropriate for girls, as non-school time activity may not be driving adiposity status.

Background Cigarette smoking and alcohol use are well known to be concomitant behaviors, but there is a lack of studies related to recruitment of smokers for mobile cessation services at places where alcohol is consumed, such as bars and clubs. Adapting recruitment strategies to expand the reach of cessation programs to where tobacco users are located may help decrease the health-equity gap in tobacco control by improving reach and enrollment of underserved smokers residing in low-income and rural areas who are not reached by traditional cessation services. Objective The purpose of this exploratory study was to assess the feasibility of direct outreach in bars, clubs, and restaurants to recruit smokers to Quitxt, our mobile smoking cessation service. Quitxt is delivered through SMS text messaging or Facebook Messenger. Methods We collaborated with an advertising agency to conduct in-person recruitment of young adult smokers aged 18-29 years, focusing on urban and rural Spanish-speaking Latino participants, as well as English-speaking rural White and African American participants. Street team members were recruited and trained in a 4-hour session, including a brief introduction to the public health impacts of cigarette smoking and the aims of the project. The street teams made direct, face-to-face contact with smokers in and near smoking areas at 25 bars, clubs, and other venues frequented by young smokers in urban San Antonio and nearby rural areas. Results The 3923 interactions by the street teams produced 335 (8.5%) program enrollments. Most participants were English speakers with a mean age of 29.2 (SD 10.6) years and smoked a mean of 8.5 (SD 6.2) cigarettes per day. Among users who responded to questions on gender and ethnicity, 66% (70/106) were women and 56% (60/107) were Hispanic/Latino. Among users ready to make a quit attempt, 22% (17/77) reported 1 tobacco-free day and 16% (10/62) reported maintaining cessation to achieve 1 week without smoking. The response rate to later follow-up questions was low. Conclusions Direct outreach in bars and clubs is a useful method for connecting young adult cigarette smokers with mobile cessation services. However, further research is needed to learn more about how mobile services can influence long-term smoking cessation among those recruited through direct outreach, as well as to test the use of incentives in obtaining more useful response rates.

BACKGROUND Cigarette smoking and alcohol use are well known to be concomitant behaviors, but there is a lack of studies related to recruitment of smokers for mobile cessation services at places where alcohol is consumed, such as bars and clubs. Adapting recruitment strategies to expand the reach of cessation programs to where tobacco users are located may help decrease the health-equity gap in tobacco control by improving reach and enrollment of underserved smokers residing in low-income and rural areas who are not reached by traditional cessation services. OBJECTIVE The purpose of this exploratory study was to assess the feasibility of direct outreach in bars, clubs, and restaurants to recruit smokers to Quitxt, our mobile smoking cessation service. Quitxt is delivered through SMS text messaging or Facebook Messenger. METHODS We collaborated with an advertising agency to conduct in-person recruitment of young adult smokers aged 18-29 years, focusing on urban and rural Spanish-speaking Latino participants, as well as English-speaking rural White and African American participants. Street team members were recruited and trained in a 4-hour session, including a brief introduction to the public health impacts of cigarette smoking and the aims of the project. The street teams made direct, face-to-face contact with smokers in and near smoking areas at 25 bars, clubs, and other venues frequented by young smokers in urban San Antonio and nearby rural areas. RESULTS The 3923 interactions by the street teams produced 335 (8.5%) program enrollments. Most participants were English speakers with a mean age of 29.2 (SD 10.6) years and smoked a mean of 8.5 (SD 6.2) cigarettes per day. Among users who responded to questions on gender and ethnicity, 66% (70/106) were women and 56% (60/107) were Hispanic/Latino. Among users ready to make a quit attempt, 22% (17/77) reported 1 tobacco-free day and 16% (10/62) reported maintaining cessation to achieve 1 week without smoking. The response rate to later follow-up questions was low. CONCLUSIONS Direct outreach in bars and clubs is a useful method for connecting young adult cigarette smokers with mobile cessation services. However, further research is needed to learn more about how mobile services can influence long-term smoking cessation among those recruited through direct outreach, as well as to test the use of incentives in obtaining more useful response rates.

Introduction. Sedentary behavior (SB) is highly prevalent among older adults, with more than 25% engaging in 6 hours or more of SB daily. SB has been associated with several cardiometabolic biomarkers in younger adults; however, there is a paucity of research in older populations. This study examined associations between patterns of SB and cardiometabolic biomarkers in community-dwelling adults aged 55 years and older. Methods. Data were drawn from a convenience sample of 54 community-dwelling individuals (12 males, 42 females; mean age = 72.6 ± 6.8 years, range = 56–89 years). Cardiometabolic biomarkers assessed included systolic (SBP) and diastolic blood pressure (DBP), body mass index, waist circumference, and fasting blood glucose and cholesterol parameters. SB was assessed via accelerometry over a 7-day period, and measures included daily time in SB, number and length of sedentary bouts, the number and length of breaks between sedentary bouts, moderate-to-vigorous physical activity (MVPA), and light physical activity (LPA). Associations between the SB measures and each cardiometabolic risk factor were examined using separate stepwise multiple regression models, controlling for sex, MVPA, and accelerometer wear time. Isotemporal substitution models were used to examine the change in cardiometabolic outcomes when SB is replaced by an equal duration of either LPA or MVPA. Results. Adjusted regression analyses showed that daily sedentary time was positively associated with DBP (β = 0.052, ∆R2 = 0.112, p=0.022) and inversely associated with HDL cholesterol (β = −0.111, ∆R2 = 0.121, p=0.039). Sedentary bout length was also associated with DBP and HDL cholesterol (β = 0.575, ∆R2 = 0.152, p = 0.007; β = −1.529, ∆R2 = 0.196, p=0.007, respectively). Replacement of 10 minutes of SB a day with LPA was associated with improved DBP and HDL cholesterol (p≤0.05). No other significant associations (p≤0.05) were found. Conclusion. Sitting for prolonged periods of time without interruption is unfavorably associated with DBP and HDL cholesterol. Prospective studies should identify causal relationships and observe specific changes in cardiometabolic profiles in older populations.

In South Texas, smoking rates among young Latino adults aged 18–29 are high (23.2%–25.7%). This is a serious public health problem, yet few are reached by services to help them quit smoking. Cellular phones have an extraordinary potential for assisting smoking cessation by providing access to peer modeling and social reinforcement for behavior change. Quitxt is a bilingual text-messaging and mobile media service designed at UT Health San Antonio to help young adults quit smoking. Text messages include links to web content and YouTube videos with peer modeling of reasons and skills to quit smoking. Quitxt was promoted in South Texas via social media advertising and other recruitment channels. An assessment of the program included 798 participants with a mean age of 29 years; 57% were males and 36% identified themselves as Hispanic or Latino. The mean number of cigarettes consumed per day was 11.5. Abstinence was assessed at 2, 4, and 7 months; at the 7-month follow up, 21% reported abstinence. This is consistent with high success rates found in studies of telephone counseling for young adults and confirms that text messaging services specifically designed for young adults are a feasible and cost-effective way to promote smoking cessation. Young adult smokers in South Texas can be reached via mobile media service. This highly scalable service makes mobile, personalized, smoking-cessation advice/support an affordable approach to reach disadvantaged population groups, affect public health, reduce health service costs, and reduce smoking-related health disparities.

Introduction A unique population of Nigerian children, aged 1–5 years, never receive any of the recommended childhood vaccines. However, the characteristics of this population has not been previously described. Given Nigeria’s historically poor childhood immunization coverage and high child mortality rates, it was imperative we investigate the prevalence and correlates of never-vacccination among Nigerian children. Methods We conducted secondary analysis of the 2013 Nigeria Demographic Health Survey data of Nigerian children, aged 12–59 months (n = 20,586). Weighted multivariate logistic regressions were used to examine the relationship between socio-demographic factors and never-vaccination of Nigerian children. Further regression analysis was conducted after stratifying by Northern and Southern regions. Results About twenty one percent of study sample, had never been vaccinated. Over eighty percent of the never-vaccinated children in our study resided in the Northern geopolitical zones of Nigeria. Child never-vaccination was found to be significantly associated with key socio-demographic characteristics. Children born into poor households, with mothers who are unemployed and uneducation, were more likely to be never-vaccinated. Unique predictors of child never-vaccination specific to Northern Nigeria were identified. Islam (aOR: 1.56, 95% CI: 1.11–2.17) and lack of access to Television or Radio (aOR: 1.49, 95% CI: 1.22–1.81) promoted never-vaccination, while increasing maternal age and rural residence (aOR: 0.63, 95% CI: 0.42–0.95) were associated with lower odds of never-vaccination. Conclusion Socio-demographic factors are predictors of child never-vaccination in Nigeria. Further investigations are needed to better understand the underlying contexts that conribute to child never-vaccination in populations identified in this study. More so, it is important to examine the mechanism through which predictors that are region-speific, culminate in child never-vaccination.

Background: The objective of this study was to examine the associations between adiposity, metabolic syndrome (MetS), cytokines and moderate-to-vigorous physical activity (MVPA) in youth with Prader-Willi syndrome (PWS) and non-syndromic obesity (OB). Methods: Twenty-one youth with PWS and 34 with OB aged 8–15 years participated. Measurements included body composition, blood pressure, fasting blood markers for glucose control, lipids and inflammation and MVPA. Group differences for adiposity, MetS, blood parameters and MVPA were determined using independent t-tests and chi-square (χ2) analyses. Bivariate correlations and analysis of variance (ANOVA) examined the associations between adiposity, MetS severity, cytokines and MVPA. Results: PWS presented similar percentage of body fat (%), lower body mass index (BMI) z-scores, insulin resistance, triglycerides, MetS severity, C-reactive protein (CRP), tumor necrosis factor-α (TNF-α) and MVPA and higher high-density lipoprotein (HDL) and adiponectin (ADP) than OB. Fewer PWS presented MetS based on BMI z-score (61.9% vs. 91.2%) and glucose (14.3% vs. 44.1%) compared to OB. In all youth, MetS severity was significantly associated with body fat %, ADP, interleukin-6 (IL-6) and TNF-α and also with CRP in PWS, but associations became non-significant for CRP and IL-6 when controlling for body fat %. In PWS, those with low MVPA had significantly higher TNF-α than those with high MVPA (1.80±0.45 vs. 1.39±0.26 pg/mL). Conclusions: Although PWS presented better cardiometabolic profiles than OB and lower MetS risk, associations between body fat, MetS and cytokines were somewhat similar for both groups, with the exception of CRP. Results suggest a potential role for MVPA related to MetS and inflammation and extend associations shown in OB to PWS.

To realize the promising potential of services delivered via smart phones to help young adults quit smoking at a high level of cost-efficiency, we constructed a texting and mobile media system that was promoted in South Texas via social media advertising and other recruitment channels. During the 6-month service period described here, enrollments were achieved for 798 participants with a mean age of 29.3 years. Seven-month texted follow-up found that 21% (171) of the enrollees reported abstinence at that point. This is consistent with high rates of success found in studies of telephone counseling for young adults and confirms that text and mobile media service specifically designed for young adults provide a feasible and potentially cost-effective approach to promoting cessation.

Measures of correlates of youth smoking should be invariant. We examined the measurement invariance of smoking-related self-efficacy, beliefs, and intention across gender, race (White vs. Black), ethnicity (non-Hispanic vs. Hispanic), and grade level (9th/10th vs. 11th/12th grade) for 2767 high school current smokers. Strong factorial invariance was found in the factors across gender (NNFI:0.959; CFI:0.959; RMSEA:0.085), grade (NNFI:0.962; CFI:0.962; RMSEA: 0.079), race (NNFI: 0.967; CFI: 0.967; RMSEA: 0.074), and ethnicity (NNFI: 0.965; CFI: 0.965; RMSEA: 0.078). Smoking-related self-efficacy, beliefs, and intention measures may be confidently used to understand attitudinal differences across gender, race, ethnicity, and grade level for youth smokers.