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Background: The gateway behavior hypothesis posits that change in a health behavior targeted for modification may promote positive changes in other untargeted health behaviors; however, previous studies have shown inconsistent results. Aims: To examine the patterns and predictors of change in untargeted health behaviors in a large health behavior change trial. Method: Using repeated-measures latent class analysis, this study explored patterns of change in untargeted physical activity, alcohol consumption, and smoking behavior during the first year of the Women's Health Initiative dietary modification trial that targeted total fat reduction to 20% kcal and targeted increased fruit and vegetable intake. Participants were healthy postmenopausal women who were randomly assigned to either the low-fat dietary change intervention (n = 8,193) or a control (n = 12,187) arm. Results: Although there were increases in untargeted physical activity and decreases in alcohol consumption and smoking in the first year, these changes were not consistently associated with study arm. Moreover, although the results of the repeated-measures latent class analysis identified three unique subgroups of participants with similar patterns of untargeted health behaviors, none of the subgroups showed substantial change in the probability of engagement in any of the behaviors over 1 year, and the study arms had nearly identical latent class solutions. Discussion and Conclusion: These findings suggest that the dietary intervention did not act as a gateway behavior for change in the untargeted behaviors and that researchers interested in changing multiple health behaviors may need to deliberately target additional behaviors.

BackgroundAlthough epidemiologic studies have shown associations between sedentary behavior and mortality, few have focused on older women with adequate minority representation and few have controlled for both physical activity and functional status.PurposeThe objective of this study was to determine the relationship between sedentary time and total; cardiovascular disease (CVD); coronary heart disease (CHD); and cancer mortality in a prospective, multiethnic cohort of postmenopausal women.MethodsThe study population included 92,234 women aged 50-79 years at baseline (1993-1998) who participated in the Women's Health Initiative Observational Study through September 2010. Self-reported sedentary time was assessed by questionnaire and examined in 4 categories (≤4, >4-8, ≥8-11, >11 hours). Mortality risks were examined using Cox proportional hazard models adjusting for confounders. Models were also stratified by age, race/ethnicity, body mass index, physical activity, physical function, and chronic disease to examine possible effect modification. Analyses were conducted in 2012-2013.ResultsThe mean follow-up period was 12 years. Compared with women who reported the least sedentary time, women reporting the highest sedentary time had increased risk of all-cause mortality in the multivariate model (HR=1.12, 95% CI=1.05, 1.21). Results comparing the highest versus lowest categories for CVD, CHD, and cancer mortality were as follows: HR=1.13, 95% CI=0.99, 1.29; HR=1.27, 95% CI=1.04, 1.55; and HR=1.21, 95% CI=1.07, 1.37, respectively. For all mortality outcomes, there were significant linear tests for trend.ConclusionsThere was a linear relationship between greater amounts of sedentary time and mortality risk after controlling for multiple potential confounders.

A study of the direct and interactive effects of social support, social burden, education, and income on repeated use of breast cancer screening among a large national sample of postmenopausal women participating in the Women's Health Initiative is presented. The results of the interactive effects show that emotional/informational but not tangible support is associated with repeated mammography and clinical breast examination.

Understanding risk perceptions for breast cancer among women smokers is important because smokers tend to underutilize breast cancer screening. Perceptions of the relative importance of a variety of factors which may increase breast cancer risk and the benefits/barriers of mammography, were examined among women who were current (n = 185), ex- (n = 632) and never (n = 623) smokers. Participants were a subset of women taking part in a project to increase mammography utilization among women aged 50 and over. Current smokers, but not ex-smokers, were significantly less likely than never smokers to agree that health risk behaviors most frequently seen in smokers (e.g., smoking cigarettes, high-fat diet, low intake of fruits and vegetables, physical inactivity, drinking alcohol) may increase risk for breast cancer. Current smokers, but not ex-smokers, perceived more barriers and fewer benefits of mammography, than never smokers. KEYWORDS. Smoking, women, attitudes, health risks, mammography screening

Objective To examine the relationship between parents' attitudes toward nutrition and plasma lipid levels of their children. Design Parents' nutrition attitudes were assessed with the Nutritional Attitude Scale, a self-report questionnaire measuring attitudes toward the adoption of a low-fat, low-cholesterol diet. Parents' and children's plasma lipid and lipoprotein levels were obtained. Data were collected during the baseline period and a 1-year follow-up of the Family Heart Study, a small community study of cholesterol-lowering via dietary change. Participants/setting Participants were 33 girls and 34 boys (aged 6 to 13 years), and their parents. They were a subsample of European-American, middle-class, Portland, Ore, families participating in the Family Heart Study. Statistical analyses Associations between parents' nutrition attitudes and plasma lipid levels of their children were evaluated using multiple linear regression analyses, controlling for the contribution of parents' lipid levels to those of their children. Results Mothers' nutrition attitudes interacted with their daughters' ages, accounting for 14% of the variance in plasma total cholesterol level and 11% in low-density lipoprotein cholesterol level in their daughters. Mothers' unhealthful nutrition attitudes were associated with elevated levels of plasma total and low-density lipoprotein cholesterol levels among older daughters, but not among younger daughters nor their sons. Fathers' nutrition attitudes were unrelated to their children's plasma lipid levels, Mothers' nutrition attitudes assessed at baseline remained a significant predictor of their daughters' lipid levels measured 1 year later. Applications/Conclusions The previously reported relationships between adults' unhealthful nutrition attitudes and their own elevated plasma lipid levels appear to extend to that of their children. The association between mothers' nutrition attitudes and their daughters' lipid levels highlights the importance of focusing on nutrition attitudes when designing intervention programs to reduce plasma lipids and lipoproteins via dietary changes in the family. J Am Diet Assoc. 2002;102:678-682., Coronary heart disease (CHD) remains a primary health concern in the United States and other industrialized countries (1). The risk for developing CHD increases as levels of plasma total cholesterol [...]

For protection against invasive pneumococcal disease, the Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices recommends use of the 23-valent pneumococcal polysaccharide vaccine (PPV) for people […]

Chinese American women have lower rates of mammography screening compared with non-Hispanic White women. Although the extent of perceived barriers, as conceptualized by the Health Belief Model, have been shown to distinguish between currently non-adherent Chinese American women who have ever and never had a mammogram, it is less clear which types of perceived barriers differentiate them. One hundred twenty-eight Chinese American women in the New York metropolitan area who had not had a mammogram in the past year completed baseline assessments for a mammography framing intervention study. Demographics, medical access variables, and perceived barriers to mammography (lack of access, lack of need for screening, and modesty) were used to predict mammography history (ever versus never screened). Fifty-five women (43%) reported having been screened at least once. A sequential logistic regression showed that English speaking ability and having health insurance significantly predicted mammography history. However, these control variables became non-significant when the three barrier factors were included in the final model. Women who reported a greater lack of access (OR = 0.36, p <.05) and greater lack of need (OR = 0.27, p <.01) were less likely to be ever screeners. Unexpectedly, women who reported greater modesty were more likely to be ever screeners (OR = 4.78, p <.001). The results suggest that interventions for Chinese American women should identify and target specific perceived barriers with consideration of previous adherence. [ABSTRACT FROM AUTHOR]