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ABSTRACT: Abstract Purpose . To examine relationships between physical activity (PA) and awareness and treatment status of low bone mineral density (BMD) among adults. Design . Cross-sectional. Setting . Stratified sample of adults living independently in the community. Subjects . A total of 1928 adults aged 50 years and older who participated in the National Health and Nutrition Examination Survey 2005-2006 were included in the analysis. Among those, about 54% were women, 84% were non-Hispanic whites, 65% were married, and 44% were between 50 and 59 years of age. Measures . Objective measures: femoral neck BMD and duration of PA and step counts measured by accelerometers. Self-report: strength exercise, and awareness and treatment of low bone density. Analysis . Multivariate regression analyses using SUDAAN. Results . Despite a high prevalence of low BMD, self-reported awareness, treatment, and PA were very low. After controlling socio-demographic and health-related factors, those who were aware of their low bone density status and who received treatment for it were less physically active than those who were unaware of their bone condition or who did not have any treatment. Conclusions . PA levels are below the recommended level for bone health benefits. Health care providers should consider screening individuals at risk of low bone density and encourage them to implement prevention and treatment regimen including increasing daily levels of PA.
American journal of health promotion: AJHP 09/2012; 27(1):2-9. · 2.37 Impact Factor
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ABSTRACT: Two problems affecting school-aged children in the United States are inadequate sleep and an increased prevalence of obesity. The purpose of this study was to quantify media-related technology use and caffeine consumption in order to assess their potential effects on sleep duration and body mass index (BMI) in children.
The study was a secondary analysis of children 6 to 10 years of age (N = 625) from the National Sleep Foundation's Sleep in America Poll. Regression analysis was used to assess the relationship between caffeine and technology use, sleep variables, and BMI, adjusting for age, race, gender, and general health.
Almost 30% (29.5%) of the children consumed a daily caffeinated beverage, and 42.4% had a television in the bedroom. Children who drank caffeinated beverages had 15 fewer minutes of sleep per night than did children who did not drink such beverages (b = -0.27, p = .002). Children with three technology items in their bedroom received 45 fewer minutes of sleep than did children without these items in their bedroom (b = -0.75, p = .010). Having adjusted for variables, only drinking caffeinated beverages was associated with a BMI z score.
The complex relationships between caffeine intake and the use of technology with shortened periods of sleep and increased BMI need further study. Future research should explore how these risk factors for shortened periods of sleep can be modified in this young population.
Journal of Pediatric Health Care 07/2012; 26(4):276-82. · 1.66 Impact Factor
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ABSTRACT: To investigate (1) weight maintenance among black and white participants and (2) psychosocial correlates (eg, healthy eating barriers, self-efficacy, stress) of weight maintenance 18 months after behavioral weight-loss treatment.
Linear and logistic regression examined weight change and unsuccessful weight maintenance (>5% weight gain) among 107 black and white adults.
After controlling for socio-demographics, differences in weight maintenance between ethnicities were not generally noted. Healthy eating barriers and stressful life events were associated with weight gain, P<.04.
Strategies to cope with stressful events and overcome barriers to eating healthfully are needed for weight maintenance among both ethnicities.
American journal of health behavior 03/2012; 36(3):395-407. · 1.31 Impact Factor
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ABSTRACT: Obesity has been associated with a decreased health-related quality of life (HRQoL); however, the association between weight change and HRQoL is unclear. This secondary analysis of the SMART (Self Monitoring And Recording using Technology) trial, a clinical trial of behavioral weight loss treatment, provides evidence that quality of life improves with weight loss.
Applied nursing research: ANR 11/2011; · 0.87 Impact Factor
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ABSTRACT: Teamwork can benefit students, enhancing their ability to think critically, solve problems creatively, and collaborate effectively. We piloted a collaborative learning project with undergraduate community health nursing students (N = 83) that entailed working in teams to explore epidemiologic data, synthesize the literature, and develop an evidence-based plan for nursing intervention and evaluation pertaining to a public health issue. Project evaluation consisted of pre- and post-project surveys by students, peer evaluation, and formative and summative evaluation by faculty. Having students work in teams, while challenging both for faculty and students, may be a viable strategy for preparing the next generation of nurses for inter- and intraprofessional collaboration. Our experience suggests that instituting a collaborative learning experience as part of an undergraduate course in community health nursing can be an effective way to expose students to constructive approaches to teamwork and prepare them for evidence-based nursing practice in the future.
Nurse education in practice 08/2011; 12(2):72-6.
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ABSTRACT: This secondary analysis study examines the relationship between physical activity and symptoms of insomnia among adults with prediabetes (N = 958) from the 2005-2006 National Health and Nutrition Examination Survey (NHANES). The sample of participants were generally obese, middle-aged, and racially diverse. NHANES questions included symptoms of insomnia, sleep duration, and sleep latency. Body mass index (BMI) was calculated from measured height and weight; at least 2 days of ActiGraph activity monitor data determined mean steps walked. Men walked more steps than women; however, women had more insomnia symptoms. There were significant associations between insomnia symptoms and increased sleep latency and decreased sleep duration. Multiple regression analysis showed that younger age, lower BMI, higher self-rated health, high school education, and fewer insomnia symptoms were significantly related to increased steps walked. The findings indicate that insomnia in adults with prediabetes may be a barrier to their adapting an active lifestyle.
Clinical Nursing Research 07/2011; 21(3):294-308. · 0.88 Impact Factor
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ABSTRACT: Lifestyle modification (i.e., weight loss, active lifestyle, healthy diet) is a recommended strategy for the prevention of type 2 diabetes and cardiovascular disease. The purpose of this study was to examine the relationship between receiving a health-care provider's recommendation and adherence to behavioral indicators of adaptation of a healthy lifestyle among adults with prediabetes.
A secondary analysis was conducted using the 2005-2006 National Health and Nutrition Examination Survey (NHANES) data (N=2,853) that included self-reported efforts to improve diet, lose weight, and increase physical activity and objective measures of body mass index, blood tests for lipids, and actigraph data on physical activity.
When demographic variables, metabolic factors, and physical activity level were controlled, central obesity and elevated blood pressure were significantly associated with having prediabetes. Almost 40% of the respondents with prediabetes reported being told by their health-care provider during the previous year to control or lose weight, increase their physical activity, or decrease the fat and calories in their diet. Participants who were counseled to adopt a healthy lifestyle reported high adherence to weight control and diet modification. Selected objective measures supported that the health-care providers' recommendations contributed to improved lifestyle.
These findings indicate that self-reported health-care provider's recommendations for lifestyle modifications are associated with people actually engaging in healthier behavior. The results reinforce the importance of health-care provider's making recommendations to promote adherence to a healthier lifestyle.
Metabolic syndrome and related disorders 03/2011; 9(3):231-7.
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ABSTRACT: Weight loss has been associated with higher physical activity (PA) levels and frequent dietary self-monitoring. Less is known about how PA self-monitoring affects adherence to PA goals, PA levels, and weight change.
The SMART Trial is a clinical weight loss trial in which 210 overweight adults were randomized equally to one of three arms: 1) paper record (PR), 2) personal digital assistant with self-monitoring software (PDA), and 3) PDA with daily tailored feedback message (PDA + FB). PA self-monitoring and adherence to PA goals were based on entries in weekly submitted diaries. PA levels were measured via self-report by the past 6-month Modifiable Activity Questionnaire at baseline and 6 months.
Data are presented on 189 participants with complete 6-month PA data (84% female, 77% white, mean age = 47.3 ± 8.8 yr, mean body mass index = 34.1 ± 4.5 kg·m(-2)). Median PA level was 7.96 MET·h·wk(-1) at baseline and 13.4 MET·h·wk(-1) at 6 months, with significant PA increases in all three arms. PDA + FB arm had a higher mean number of weekly self-monitoring entries than the PR arm (3.4 vs 2.4, P = 0.003) and were more likely to maintain high (i.e., 100%) adherence to PA goals over time than the PDA (P = 0.02) or PR arms (P = 0.0003). Both PA self-monitoring and adherence to PA goals were related to higher PA levels at 6 months. A higher mean rate of PA self-monitoring was associated with a greater percentage of weight decrease (ρ = -0.49, P < 0.0001) at 6 months.
PA self-monitoring and adherence to PA goals were more likely in participants in the PDA + FB arm and in turn predicted higher PA levels and weight loss.
Medicine and science in sports and exercise 12/2010; 43(8):1568-74. · 3.71 Impact Factor
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ABSTRACT: The 2007 Sleep in America poll, a random-sample telephone survey, provided data for this study of sleep in community-dwelling women aged 40 to 60 years. The majority of the respondents were post- or perimenopausal, overweight, married or living with someone, and reported good health. A subsample (20%) reported sleepiness that consistently interfered with daily life; the sleepy subsample reported more symptoms of insomnia, restless legs syndrome, obstructive sleep apnea, depression and anxiety, as well as more problems with health-promoting behaviors, drowsy driving, job performance, household duties, and personal relationships. Hierarchical regression showed that sleepiness along with depressive symptoms, medical comorbidities, obesity, and lower education were associated with poor self-rated health, whereas menopause status (pre-, peri- or post-) was not. These results suggest that sleep disruptions and daytime sleepiness negatively affect the daily life of midlife women.
Behavioral Sleep Medicine 07/2010; 8(3):157-71. · 1.55 Impact Factor
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ABSTRACT: Few studies have reported longitudinal relationships between physical activity (PA) and cardiometabolic risk factors over time using repeated assessments in overweight or obese adults. We conducted a longitudinal study in 127 participants (81% with body mass index > 30 kg/m(2)) who completed a 12-month behavioral intervention for weight loss between 2003 and 2005 in Pittsburgh, PA, USA. Using absolute change scores from baseline to each time point (i.e., 6 and 12 months) for all studied variables (Delta = time point - baseline), we performed mixed effects modeling to examine relationships between PA and cardiometabolic risk factors, after adjusting for body weight, energy intake and other covariates (i.e., age, gender, and ethnicity). PA was assessed as energy expenditure (kcal/week) using the Paffenbarger activity questionnaire. Over the 12-month period, energy expenditure increased (Delta1,370 kcal/week at 6 months vs. Delta886 kcal/week at 12 months); body weight decreased (Delta8.9 kg at 6 months vs. Delta8.4 kg at 12 months). The average increase in energy expenditure over 12 months was significantly and independently related to reductions in total cholesterol (F = 6.25, p = 0.013), low-density lipoprotein cholesterol (LDL-C) (F = 5.08, p = 0.025) and fasting blood glucose (F = 5.10, p = 0.025), but not to other risk factors (i.e., fasting insulin, high-density lipoprotein cholesterol, triglycerides, and waist circumference). In conclusion, among overweight and obese adults undergoing a weight loss intervention, increased energy expenditure over 12 months may improve total cholesterol and LDL-C, important coronary risk factors, and fasting blood glucose, a metabolic risk factor.
Arbeitsphysiologie 10/2009; 108(2):329-36. · 2.15 Impact Factor
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ABSTRACT: Various modes of physical activity, combined with dieting, have been widely recommended to prevent or delay type 2 diabetes. Among these, yoga holds promise for reducing risk factors for type 2 diabetes by promoting weight loss, improving glucose levels and reducing blood pressure and lipid levels. This pilot study aimed to assess the feasibility of implementing a 12-week yoga program among adults at high risk for type 2 diabetes. Twenty-three adults (19 Whites and 4 non-Whites) were randomly assigned to the yoga intervention group or the educational group. The yoga group participated in a 3-month yoga intervention with sessions twice per week and the educational group received general health educational materials every 2 weeks. All participants completed questionnaires and had blood tests at baseline and at the end of 3 months. Effect sizes were reported to summarize the efficacy of the intervention. All participants assigned to the yoga intervention completed the yoga program without complication and expressed high satisfaction with the program (99.2%). Their yoga session attendance ranged from 58.3 to 100%. Compared with the education group, the yoga group experienced improvements in weight, blood pressure, insulin, triglycerides and exercise self-efficacy indicated by small to large effect sizes. This preliminary study indicates that a yoga program would be a possible risk reduction option for adults at high risk for type 2 diabetes. In addition, yoga holds promise as an approach to reducing cardiometabolic risk factors and increasing exercise self-efficacy for this group.
Evidence-based Complementary and Alternative Medicine 09/2009; 2011:257891. · 4.77 Impact Factor
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ABSTRACT: The purpose of this study was to examine the association between cardiovascular risk factors and the presence of diabetes in a large population-level dataset.
A secondary analysis was conducted using data from the 2007 Behavioral Risk Factor Surveillance System, a population-based survey (n = 403,137) conducted in the United States.
The majority of the respondents were middle-aged and overweight. Approximately half of the sample reported little or no physical activity. Estimates from a logistic regression model for a weighted sample of white, black, and Hispanic adults revealed that having hypertension or elevated cholesterol was a strong predictor of diabetes even when controlling for age, gender, race, education, income, body mass index, smoking status, and physical activity.
The results confirmed the importance of diabetes educators counseling patients with hypertension or hypercholesterolemia about their increased risk for developing diabetes.
The Diabetes Educator 07/2009; 35(5):770-7. · 1.96 Impact Factor
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ABSTRACT: To promote healthy lifestyles and prevent youth obesity, school nurses collaborate with teachers and other professionals to implement effective health promotion activities (e.g., physical fitness initiatives and nutrition education). Critical appraisal of relevant, published literature is an essential competency for school nurses engaged in health promotion within their schools. A 1-day continuing education workshop was conducted to enhance literature appraisal skills needed for evidence-based practice among school nurses employed within one urban school district. Forty-six school nurses, students, and other professionals attended this workshop and participated in appraisals of selected research articles. Although the attendees rated the faculty and content highly, their intent to apply the findings to practice was limited. Applying a critical appraisal approach to the literature focused on youth obesity prevention and health promotion was innovative for educating school nurses in this process while helping them choose whether and how existing literature may be applied to their practice. Nurse educators and faculty may replicate this process with school nurses or other nursing specialties.
The Journal of Continuing Education in Nursing 11/2008; 39(10):461-7. · 1.05 Impact Factor
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Kyeongra Yang
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ABSTRACT: Yoga, a form of physical activity, is rapidly gaining in popularity and has many health benefits. Yet healthcare providers have been slow to recognize yoga for its ability to improve health conditions, and few interventions have been developed that take full advantage of its benefits. The purpose of this article is to review published studies using yoga programs and to determine the effect of yoga interventions on common risk factors of chronic diseases (overweight, hypertension, high glucose level and high cholesterol). A systematic search yielded 32 articles published between 1980 and April 2007. The studies found that yoga interventions are generally effective in reducing body weight, blood pressure, glucose level and high cholesterol, but only a few studies examined long-term adherence. Additionally, not enough studies included diverse populations at high risk for diabetes and its related common health problems.
Evidence-based Complementary and Alternative Medicine 01/2008; 4(4):487-91. · 4.77 Impact Factor
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ABSTRACT: The purpose of the study was to investigate the level of leisure-time physical activity (LTPA) among midlife Korean American women and to determine the relationships of LTPA with individual characteristics and behavior-specific cognition and affects. A cross-sectional descriptive study of 152 middle-aged Korean American women in Central Texas was conducted using a health-promotion model of physical activity adapted from Pender's Health Promotion Model. The results showed that 32% of the participants were not engaged in any form of exercise. The level of acculturation was not significantly related to the amount of physical activity. After age, level of acculturation, education, income, and marital status were controlled, LTPA was significantly associated with perceived benefits and barriers and social support. Physical inactivity, which was common in this group of immigrant women, warrants further rigorous investigation to determine the dynamics of the women's involvement in more physical activity.
Journal of Immigrant and Minority Health 11/2007; 9(4):291-8. · 1.16 Impact Factor
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ABSTRACT: The purpose of the study was to explore gender differences in knowledge and attitudes towards menstruation among Taiwanese adolescents. This study was a secondary data analysis of a cross-sectional comparison study conducted in Taiwan. A total of 287 female and 269 male students at a junior high school participated in the study. The results showed that almost all the students had heard about menstruation and most of them had received menstrual information at school. However, their knowledge about menstruation was not accurate. Moreover, the male students expressed more negative attitudes towards menstruation than the female students. Taboos were heard by most students and, although many female students doubted the reality of the taboos they had heard, they observed them anyway. The study calls for an evaluation of sex education and suggests more open discussions about menstruation among young people in those education sessions. In addition, school nurses and obstetrical/gynecological nurses should be involved more in adolescents' sexual education.
Nursing and Health Sciences 07/2007; 9(2):127-34. · 0.68 Impact Factor
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Kyeongra Yang
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ABSTRACT: The purpose of this study was twofold: to discover how Korean immigrant women perceived their health and to identify associations between social indicators and the health of Korean immigrant women. Participants in the study comprised a nonprobability sample of 137 Korean immigrant women living in the United States who submitted questionnaires about their health to the researcher by U.S. mail in 2004. Approximately 49% of the participants perceived their health as fair or poor. After age, income, education, marital status, and occupational status were controlled, the significant predictors of self-assessed health were involvement in exercise and length of residency in the United States. In future studies, the relationships between perception of health related to acculturation and self-rating health should be investigated.
Health Care For Women International 05/2007; 28(4):329-38. · 0.63 Impact Factor
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ABSTRACT: Our purpose in this article is to review theories critically that have been used to explain immigrant women's health based on 4 case studies of Korean immigrant women's experiences in the United States and suggest directions for future development of theories on immigrant women's health. First, 3 existing theories on immigration and health (selective migration, negative effect of immigration, and acculturation) are concisely described. Then, the daily experiences of 4 low-income Korean immigrant women are described in a narrative mode, and the 3 existing theories are critiqued in terms of how they can explain the women's narratives. Finally, implications for future theory development on immigrant women's health experience are proposed based on the discussion.
Health Care For Women International 10/2006; 27(8):666-81. · 0.63 Impact Factor
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ABSTRACT: The purpose of the study was to examine the factors associated with hormone therapy (HT) use among women with mobility impairments. A non-probability sample of 188 menopausal women (average age = 53 years) from 38 states was recruited in 2004 for the study. Twenty-two percent of participants were currently taking HT; 33% were past users. Using multinomial logistic regression, this study found that those most likely to be taking HT now or in the past were older women, knowledgeable about HT, had had a hysterectomy, had bone loss, and had their provider's encouragement. Implications for health care providers are discussed.
Women & Health 02/2006; 43(1):19-36. · 1.00 Impact Factor
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ABSTRACT: Junior faculty have multiple roles and need to participate in a variety of activities that increase their likelihood of achieving promotion and tenure. Yet, these faculty often struggle when deciding how and when to expend effort along their career trajectory. In response to the need for structured guidance when setting priorities and making decisions about time management, faculty from a school of nursing at a research university have developed and begun to use a faculty progression tool. Introduced during orientation, this tool helps junior faculty weigh the relative importance of engaging in specific activities by offering a time frame and suggestions for prioritizing and pacing efforts to accomplish critical milestones. Although primarily aimed at tenure stream faculty in a research-intensive environment, this faculty progression tool serves as a model that may be modified for environments with less focus on research. Likewise, it may provide a foundation for development of a similar tool for nontenure stream faculty.
Journal of professional nursing: official journal of the American Association of Colleges of Nursing 26(4):207-13. · 0.76 Impact Factor
