Dorothy W Pekmezi

University of California, San Diego, San Diego, CA, United States

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Publications (12)21.62 Total impact

  • American Journal of Lifestyle Medicine 01/2014;
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    ABSTRACT: Latinas in the U.S. are less physically active than non-Latino white women and also report higher levels of diabetes, obesity, and other conditions related to inactivity. Interventions are needed to address disparities in this high-risk group. To evaluate the efficacy of a culturally adapted, Spanish-language, individually tailored, computer expert system-driven physical activity print-based intervention for adult Latinas. Participants were 266 inactive adult Latinas who participated between 2009 and 2012. Participants were randomized to one of two treatment arms: a 6-month tailored physical activity intervention condition or wellness contact control. For both conditions, print materials were delivered by mail. The main outcome measure was change in weekly moderate-to-vigorous physical activity (MVPA) measured by the 7-Day Physical Activity Recall interview, which was administered at baseline and post-intervention (6 months). Participants also wore accelerometers for a week at baseline and follow-up. Analyses were conducted in 2013. Increases in minutes/week of MVPA measured by the 7-Day PAR were significantly greater in the intervention group compared to the control group (mean difference=41.36, SE=7.93, p<0.01). This difference was corroborated by accelerometer readings (rho=0.44, p<0.01). Further, results indicate that intervention participants had greater increases in self-efficacy, cognitive processes, and behavioral processes at 3 months compared to control paricipants (p's<0.05). The tailored Spanish-language intervention was effective in increasing MVPA among predominantly low-income, less-acculturated Latinas. Such print-based interventions are poised for widespread dissemination, and thus may help address health disparities.
    American journal of preventive medicine 11/2013; 45(5):598-605. · 4.24 Impact Factor
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    ABSTRACT: Physical activity (PA) has been shown to enhance quality of life (QOL) in older adults. Findings from these studies indicate that the relationship between PA and QOL is indirect and likely mediated by variables such as physical self-esteem, exercise self-efficacy, and affect. As PA varies greatly by age, the purpose of the current study is to extend this area of research to young adults and explore the complex relationship between PA and QOL in this target population. Data were collected via anonymous questionnaire from N = 590 undergraduate students. PA was assessed with the Godin Leisure Time Exercise Questionnaire, and QOL was assessed by the Satisfaction with Life Scale. Path analysis was used to test the relationship between PA and QOL, with mediators of exercise self-efficacy, physical self-esteem, and affect. The PA model (RMSEA = .03, CFI = .99) accounted for 25 % of the variance in QOL. PA had positive direct effects on exercise self-efficacy (β = .28, P < .001), physical self-esteem (β = .10, P < .001), positive affect (β = .10, P < .05), and negative affect (β = .08, P < .05). Physical self-esteem was found to be the most powerful mediating variable on QOL (β = .30, P < .001), followed by positive affect (β = .27, P < .001) and negative affect (β = .14, P < .001). Physical self-esteem and, to a lesser extent, positive affect emerged as integral components in the link between PA and QOL. Findings suggest that health education programs designed to promote regular PA and increase physical self-esteem may be effective in improving QOL in young adults.
    Quality of Life Research 08/2013; · 2.86 Impact Factor
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    ABSTRACT: Latinas are the largest, fastest growing female ethnic minority group in the USA, and also report the lowest levels of physical activity. Following the framework of the social ecological model, this review examines unique social and environmental factors that influence physical activity in Latinas. Research shows that Latinas receive little social support for activity despite having large, close-knit social networks. Interventions incorporating social support components are generally efficacious. Latinas also face many environmental barriers, including crime, heat, traffic, lack of facilities and a fear of immigration enforcement, and there have been few attempts to address environmental barriers in Latino communities. Successful future interventions will need to consider unique social and environmental barriers affecting Latinas, and help Latinas learn to incorporate social networks into physical activity participation.
    Women s Health 03/2013; 9(2):201-10.
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    ABSTRACT: African American women report low levels of physical activity (PA) and are disproportionately burdened by related chronic diseases. This pilot study tested a 6-month theory-based (Social Cognitive Theory, SCT) culturally-relevant website intervention to promote PA among African American female college students.
    Journal of health disparities research and practice. 01/2013; 6(2):1-18.
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    ABSTRACT: BACKGROUND: Due to high rates of inactivity and related chronic illnesses among Latinas, the current study examined the feasibility and acceptability of using pedometers as an intervention tool in this underserved population. METHODS: Data were taken from a larger randomized, controlled trial and focused on the subsample of participants (N=43) who were randomly assigned to receive a physical activity intervention with pedometers and instructions to log pedometer use daily and mail completed logs back to the research center each month for six months. RESULTS: Retention (90.7% at six months) and adherence to the pedometer protocol (68.89% returned > 5 of the 6 monthly pedometer logs) were high. Overall, participants reported increased physical activity at six months and credited pedometer use for helping them achieve these gains (75.7%). Participants who completed a high proportion (> 5/6) of pedometer logs reported significantly greater increases in physical activity and related process variables (stages of change, self-efficacy, behavioral processes of change, social support from friends) than those who were less adherent (completed < 5 pedometer logs). CONCLUSIONS: Pedometers constitute a low-cost, useful tool for encouraging self-monitoring of physical activity behavior in this at-risk group.
    Journal of Physical Activity and Health 07/2012; · 1.95 Impact Factor
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    ABSTRACT: Health literacy (HL) is associated with preventive health behaviors. Self-efficacy is a predictor of health behavior, including physical activity (PA); however, causal pathways between HL and self-efficacy for PA are unknown, especially among Latinas who are at risk for chronic disease. To explore this potential relationship, secondary analyses were conducted on data [Shortened Test of Functional Health Literacy in Adults (STOFHLA), PA self-efficacy, and socio-demographics] from a 6-month, randomized controlled trial of a print-based PA intervention (n = 89 Spanish-speaking Latinas). Linear regression models revealed associations between HL and baseline self-efficacy in addition to changes in self-efficacy at 6-months. After controlling for significant covariates, higher HL scores were associated with lower baseline PA self-efficacy. Regardless of treatment assignment, higher HL scores at baseline predicted greater changes in PA self-efficacy at 6-months. HL may contribute to Latinas' improved PA self-efficacy, though further research is warranted.
    Journal of Immigrant and Minority Health 06/2012; · 1.16 Impact Factor
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    Dorothy W Pekmezi, Wendy Demark-Wahnefried
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    ABSTRACT: A growing body of evidence suggests that diet and exercise behaviors and body weight status influence health-related outcomes after a cancer diagnosis. This review synthesizes the recent progress in lifestyle interventions in light of current guidelines put forth by the American Cancer Society (ACS), the World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) and the American College of Sports Medicine (ACSM). The PubMed database was searched for terms of cancer survivor(s) or neoplasms/survivor, cross-referenced with MeSH terms of lifestyle, health behavior, physical activity, exercise, body weight, obesity, weight loss, diet, nutrition, and intervention studies and limited to randomized controlled trials (RCTs) that had retention rates exceeding 75%. There has been an increase in the number and methodological rigor of the studies in this area, with 21 RCTs identified in the past three years. Results suggest that physical activity interventions are safe for cancer survivors and produce improvements in fitness, strength, physical function, and cancer-related psychosocial variables, whereas dietary interventions improve diet quality, nutrition-related biomarkers and body weight. Preliminary evidence also suggests that diet and exercise may positively influence biomarkers associated with progressive disease and overall survival (e.g., insulin levels, oxidative DNA damage, tumor proliferation rates). The evidence base regarding health-related benefits of increased physical activity, an improved diet, and weight control continues to expand. Due to the large (and increasing) number of cancer survivors, more research is needed that tests the impact of lifestyle change on health-related outcomes in this population, especially research that focuses on high-reach, sustainable interventions that recruit diverse, representative samples to help increase the generalizability of findings to the population at large. Concurrent research also needs to address relative benefit in relation to various subpopulations as defined by phenotype, genotype, and/or exposures to treatment, and other lifestyle and environmental factors.
    Acta oncologica (Stockholm, Sweden) 02/2011; 50(2):167-78. · 2.27 Impact Factor
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    ABSTRACT: Cancer coping styles have been associated with several cancer-related outcomes. We examined whether baseline lifestyle behaviors differed between cancer survivors with fatalistic vs fighting-spirit coping styles, and whether there was differential response to two diet-exercise mailed-print interventions, one standardized and another individually tailored. Baseline differences by coping style are presented for 628 breast and prostate cancer survivors who participated in the FRESH START trial, along with multivariable analyses on rates of uptake by coping style and arm assignment for those completing the 2-year trial. At baseline, several differences were observed between fighting-spirits and fatalists, with the former significantly more likely to be white, younger, leaner, more-educated and at risk for depression, and less likely to consume 5+fruits and vegetables (F&V)/day (p-values<0.05). Improvements in physical activity were observed, with fighting-spirits exhibiting the greatest gains from baseline to Year-1, regardless of intervention type; but by Year-2, these differences diminished as fatalists gained ground. Moreover, fatalists who received standardized intervention material also charted steady improvements in F&V intake over the study period; by Year-2, 58.1% of fatalists achieved the 5-a-day goal vs 44.6% of fighting-spirits (p-value<0.05). Lifestyle behaviors and health message uptake differs by cancer coping style. Although tailored interventions appear most effective and minimize differential uptake, standardized interventions also can improve behaviors, though fighting-spirits may require additional boosters to maintain change.
    Psycho-Oncology 11/2010; 21(1):108-13. · 3.51 Impact Factor
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    ABSTRACT: Computer-tailored and Internet-based interventions to promote physical activity behavior have shown some promise, but only few have been tested among African Americans. We examined the feasibility and efficacy of three 1-year, multiple contact physical activity interventions (Tailored Internet, Tailored Print, Standard Internet) in a subsample of African American participants (n = 38) enrolled in a randomized controlled trial. Participants randomly assigned to Tailored Internet and Print programs received individually tailored computer expert system feedback delivered via Internet or print. Participants in the Standard Internet program received access to six currently available physical activity Web sites. Self-reported physical activity was assessed at baseline and 6 and 12 months with the 7-Day Physical Activity Recall. Across all participants, physical activity changed from 17.24 min/week (standard deviation [SD] = 20.72) at baseline to 139.44 min/week (SD = 99.20) at 6 months, to 104.26 min/week (SD = 129.14) at 12 months. According to available consumer satisfaction data (n = 30), 70% reported reading most or all of the physical activity information received by Internet or mail. Most participants described the Internet- and print-based physical activity programs as "somewhat" or "very" helpful (80%) and enjoyable (87%). These findings suggest that computer-tailored and Internet-based interventions are able to produce long-term increases in physical activity and associated process variables among African American participants. Future studies with larger numbers of African American participants are needed to determine which of the programs (Tailored Print, Tailored Internet, Standard Internet) are more effective and what program modifications might be helpful in assisting this population in becoming more active.
    Telemedicine and e-Health 05/2010; 16(4):498-503. · 1.40 Impact Factor
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    ABSTRACT: In the U.S., Latinos report particularly high levels of inactivity and related chronic illnesses and are in need of intervention. Thus, the purpose of the current study was to culturally and linguistically adapt an empirically supported, individually tailored physical activity print intervention for Latinos and then conduct an RCT of the modified program. An RCT was conducted. The sample included 93 overweight/obese (80%) Latinas with low income and acculturation. Data were collected in 2007-2008 and analyzed by intent-to-treat in 2009. Participants were randomly assigned to either (1) a culturally and linguistically adapted physical activity intervention (Seamos Activas) or (2) a wellness contact control condition. Self-report physical activity, as measured pre- and post-intervention (6 months, 87% retention) by the 7-Day Physical Activity Recall. Moderate-intensity (or greater) physical activity increased from an average of 16.56 minutes/week (SD=25.76) at baseline to 147.27 (SD=241.55) at 6 months in the intervention arm (n=45), and from 11.88 minutes/week (SD=21.99) to 96.79 (SD=118.49) in the wellness contact control arm (n=48). No between-group differences were seen in overall physical activity. Intervention participants reported significantly greater increases in cognitive (F[1, 91]=9.53, p=0.003) and behavioral processes of change (F[1, 91]=8.37, p=0.005) and available physical activity supplies and equipment at home (F[1, 91]=4.17, p=0.04) than control participants. Results supported the hypothesized feasibility, acceptability, and preliminary efficacy of individually tailored physical activity print interventions among Latinas. Although more research is needed to corroborate these findings, such high-reach, low-cost approaches have great potential to positively affect public health. NCT00724165.
    American journal of preventive medicine 12/2009; 37(6):495-500. · 4.24 Impact Factor
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    ABSTRACT: This article provides a comprehensive review of Internet- and Website-based physical activity interventions targeting adult populations. Search procedures identified 72 unique Internet-based physical activity interventions published in peer-reviewed journals. Participants of the studies were predominately White, middle-aged (mean age = 43.3 years), and female (65.9%). Intervention durations ranged from 2 weeks to 13 months (median = 12 weeks). Forty-six of the studies were randomized controlled trials, 21 were randomized trials without a control condition, 2 were non-randomized controlled trials, and 3 used a single-group design. The majority of studies (n = 68) assessed outcomes immediately following the end of the intervention period, and 16 studies provided delayed postintervention assessments. Forty-four of the 72 studies (61.1%) reported significant increases in physical activity. Future directions for Internet-based physical activity interventions include increasing representation of minority and male populations in Internet-based efforts, conducting delayed postintervention follow-up assessments, and incorporating emerging technologies (ie, cellular and Smartphones) into Internet-based physical activity efforts.
    American Journal of Lifestyle Medicine 8(1):42-68.

Publication Stats

81 Citations
21.62 Total Impact Points

Institutions

  • 2013
    • University of California, San Diego
      • Department of Family and Preventive Medicine
      San Diego, CA, United States
  • 2009–2013
    • University of Alabama at Birmingham
      • Department of Health Behavior
      Birmingham, Alabama, United States
  • 2012
    • University of Delaware
      • Department of Behavioral Health and Nutrition
      Newark, DE, United States