Carol Macera

Carol Macera
San Diego State University | SDSU · Graduate School of Public Health

Ph.D.

About

356
Publications
55,296
Reads
How we measure 'reads'
A 'read' is counted each time someone views a publication summary (such as the title, abstract, and list of authors), clicks on a figure, or views or downloads the full-text. Learn more
46,136
Citations
Citations since 2016
17 Research Items
11218 Citations
201620172018201920202021202205001,0001,5002,000
201620172018201920202021202205001,0001,5002,000
201620172018201920202021202205001,0001,5002,000
201620172018201920202021202205001,0001,5002,000
Additional affiliations
January 2012 - present
Naval Health Research Center
Position
  • HIV in Foreign Militaries
May 2002 - January 2012
Naval Health Research Center
Position
  • Injuries, Posttraumatic Stress, Traumatic Brain Injury
August 2001 - present
San Diego State University
Education
August 1978 - June 1982
University of California, Berkeley
Field of study
  • Epidemiology

Publications

Publications (356)
Article
1 Background With suicide rising in the United States, identifying and preventing suicides is increasingly important. To provide a valuable step toward achieving effective suicide risk assessment, this study examines the agreement between self‐report measures and psychiatrist documentation of suicidal ideation and behaviors (SI) at a Veterans Admin...
Article
Introduction: To determine the association between four measures of kyphosis and incident and injurious falls in older persons. Methods: Community-dwelling adults aged 65 and older (n = 72) residing in southern California were invited to participate in a prospective cohort study. Participants had kyphosis assessed four ways. Two standing measure...
Article
Background: Hypertensive disorders of pregnancy are among the leading causes of maternal morbidity and mortality. Studies suggest that the use of folic acid may lower the risk of hypertensive disorders in pregnant women. Aim: The aim of this study was to assess the effects of timing and duration of folic acid-containing supplement use on the ris...
Article
Background: Characterizing HIV infection and associated risk behaviors within military populations is critical for understanding the epidemic and informing prevention activities. However, the prevalence of HIV and related risk behaviors is often unknown. Further, militaries may not have the systems in place or the staff expertise to conduct HIV su...
Article
Introduction: Strong scientific evidence supports voluntary medical male circumcision as part of an overall HIV prevention strategy, but self-report information on circumcision status may be inaccurate. The study objectives were to obtain estimates of male circumcision within the Rwanda Defense Force (RDF), to assess the ability of soldiers to cor...
Article
Background: Compared with the general population in low- and middle-income countries, military members tend to be male, young, travel more frequently away from their main sexual partners, drink more alcohol and have a consistent source of income. All of these factors may lead to an increased risk of contracting HIV. Objective: In response, the D...
Article
Background: Military HIV prevention programs and healthy living programs were developed in the mid-1980s to manage and support newly HIV-positive military personnel in the US military. Since then, a program developed by the Centers for Disease Control and Prevention with support from the Department of Defense HIV/AIDS Prevention Program (DHAPP), ca...
Article
Background: Shortened leukocyte telomere length (LTL), a purported marker of cellular aging, is associated with morbidity and mortality. However, the association of physical activity, a modifiable lifestyle behavior, with LTL has not been adequately studied among older adults. Methods: In this cross-sectional study, we examined associations of v...
Article
Full-text available
Few studies have assessed the association of sedentary time with leukocyte telomere length (LTL). In a cross-sectional study conducted in 2012–2013, we examined associations of accelerometer-measured and self-reported sedentary time with LTL in a sample of 1,481 older white and African-American women from the Women's Health Initiative and determine...
Article
Full-text available
PurposeThis study aimed to examine the association between discontinued and continued use of antidepressants and risk for gestational hypertension (GH) and preeclampsia (PE). Methods Data from the MotherToBaby pregnancy studies from 2004 to 2014 were analyzed to compare women who discontinued antidepressant use ˂20 weeks of gestation (discontinuers...
Article
Full-text available
Objectives: To examine associations of maternal age at childbirth and parity with survival to age 90 years (longevity). Methods: We performed a prospective study among a multiethnic cohort of postmenopausal US women in the Women's Health Initiative recruited from 1993 to 1998 and followed through August 29, 2014. We adjusted associations with lo...
Article
Full-text available
Background No study has evaluated whether genetic factors are associated with longevity in African Americans or Hispanics, and it is unclear whether genetic factors are associated with healthy aging. Methods In this prospective study, we determined whether 14 genetic variants previously associated with longevity in genome-wide association studies...
Article
Full-text available
Objective: The aim of the present study was to investigate associations between reproductive factors and survival to age 90 years. Methods: This was a prospective study of postmenopausal women from the Women's Health Initiative recruited from 1993 to 1998 and followed until the last outcomes evaluation on August 29, 2014. Participants included 1...
Article
This study describes the prevalence and factors of depressive symptoms among a sample of persons who inject drugs (PWID) with a history of deportation from the US in Tijuana, Mexico. In 2014, 132 deported PWID completed a structured questionnaire. Depressive symptoms were measured using the Center for Epidemiologic Studies Short Depression Scale (C...
Article
Objective: Problematic policing practices are an important driver of HIV infection among persons who inject drugs (PWID) in the U.S.-Mexico border region. This study identifies factors associated with recent (i.e., past 6 months) police victimization (e.g., extortion, physical and sexual violence) in the border city of Tijuana, Mexico. Method: F...
Article
Physical activity is an important component of a healthy lifestyle for all adults and especially for older adults. Using information from the updated 2008 Physical Activity Guidelines, 3 dimensions of physical activity are identified for older adults. These include increasing aerobic activity, increasing muscle-strengthening activity, and reducing...
Article
We examined human papillomavirus (HPV) vaccine awareness and acceptance between United States-born and US foreign-born women by utilizing California Health Interview Survey data from 1,672 women (age:18-27) and 2,994 mothers (age:28-65). Foreign-born women and mothers had lower vaccine awareness. Foreign-born young adult Latinas had greater vaccine...
Article
Suicide prevention in the clinical setting is focused on evaluating risk in the coming hours to days, yet little is known about which factors increase acute risk. To determine the prevalence of factors that may serve as warnings of heightened acute risk. Veterans attending an urgent care psychiatric clinic (n=473) completed a survey on suicidal ide...
Article
The association between self-reported smoking and overuse injury in a cohort of young men (n=900) and women (n=597) undergoing 12 weeks of standardized military instruction, after adjustment for physical activity, health history, and incoming fitness tests was examined. The outcome includes all International Classification of Diseases, 9th Revision...
Article
Full-text available
Background: As more women are deployed into combat environments, preliminary findings have been inconsistent regarding gender differences in symptoms of posttraumatic stress disorder (PTSD) following deployment. Very little is known about the experiences of Navy and Marine Corps personnel deployed to combat zones. Methods: The study population c...
Article
This study evaluated whether obese patients who lost weight before their total joint replacement and kept it off post-operatively were at lower risk of surgical site infection (SSI) and re-admission compared with those who remained the same weight. We reviewed 444 patients who underwent a total hip replacement and 937 with a total knee replacement...
Article
Context: Although prevalence of obesity and incidence of total joint arthroplasty (TJA) have dramatically increased over the last two decades in the U.S., little is known of the preoperative and postoperative weight patterns of patients undergoing TJA. Objective: To describe the preoperative and postoperative weight patterns of patients undergoi...
Article
Objective: To empirically identify latent classes of service members according to persistent postconcussive symptom patterns and to characterize the identified classes relative to other postdeployment variables including posttraumatic stress disorder (PTSD) and mild traumatic brain injury (TBI) screening results. Such comparisons may directly info...
Article
To investigate geographical and socioeconomic variation in performance of lymph node dissection for the evaluation of patients with early-stage epithelial ovarian cancer. A population-based, retrospective cohort study was conducted using data from the National Cancer Institute's SEER Program for 15 geographic registries and county-level measures. W...
Article
This study characterized a cohort of obese total hip arthroplasty (THA) and total knee arthroplasty (TKA) patients (1/1/2008-12/31/2010) and evaluated whether a clinically significant amount of pre-operative weight loss (5% decrease in body weight) is associated with a decreased risk of surgical site infections (SSI) and readmissions post-surgery....
Article
Background: Less nocturnal blood pressure (BP) dipping has been associated with greater odds for the metabolic syndrome (MetS), a constellation of risk factors associated with cardiovascular disease (CVD). Little work has examined this association in Hispanics, who have elevated rates of MetS, or investigated differences in this relationship by le...
Article
Full-text available
Servicemembers with combat-related limb loss often require substantial rehabilitative care. The prevalence of traumatic brain injury (TBI), which may impair cognitive and functional abilities, among servicemembers has increased. The primary objectives of this study were to determine the frequency of TBI among servicemembers with traumatic amputatio...
Article
Full-text available
The purpose of this study was to describe career performance outcomes after combat blast injury and to examine the relationship between the injury severity and type of military discharge. A retrospective cohort study of 4,255 male servicemembers injured in a combat blast as a part of Operation Iraqi Freedom was completed. In the total sample, 37.8%...
Article
Assessment of acute mild traumatic brain injury (mTBI) symptoms after a combat blast could aid diagnosis and guide follow-up care. Our objective was to document acute mTBI symptoms following a combat blast and to examine associations between acute symptoms and mental health and service discharge outcomes. A retrospective cohort study was conducted...
Article
Full-text available
This prospective study evaluated the association of self-reported health habits and behaviors in 2,930 Navy recruits with poor training outcomes, defined as graduating late or separating from training. Although 17% of the men and 21% of the women had a poor training outcome, results suggest that some self-reported measures were associated with poor...
Article
Purpose: The objective of this study was to ascertain whether a relationship exists between pre-diagnostic serum levels of 25-hydroxyvitamin D (25(OH)D) and risk of breast cancer in young women. Methods: About 600 incident cases of breast cancer were matched to 600 controls as part of a nested case-control study that utilized pre-diagnostic sera...
Article
Military members screening positive for blast-related traumatic brain injury (TBI) may subsequently screen positive for posttraumatic stress disorder (PTSD) or depression. The role of sleep as a mediating factor in the development of mental health symptoms was explored. Prospective study with symptoms evaluated at two time points. Postdeployment se...
Article
Full-text available
In Operation Iraqi Freedom and Operation Enduring Freedom, blast-related injuries associated with combat are frequent and can result in traumatic brain injury (TBI) symptoms that may be difficult to distinguish from psychological problems. Using data from the Post-Deployment Health Assessment and Reassessment, we identified 12,046 male U.S. Navy sa...
Conference Paper
Breast cancer (BC) is the most common cancer and the second leading cause of cancer-related deaths in women. However, a disproportionate number of BC deaths occur among minorities. To date, the majority of BC disparity studies have focused on African-American women. Fewer have looked directly at BC survival in US Hispanics and of these studies, the...
Article
Full-text available
Objectives: To target improvement in older adult sexuality by understanding how a myriad of partnered and individual physical and mental health factors, often associated with aging, affect sexual unwellness. Method: Data from the Wisconsin Longitudinal Study were used to conduct a case-control study on the risk factors for sexual unwellness (i.e...
Article
Research supports the favorable effects of exercise on physical and psychosocial outcomes in those with arthritis. Few easily disseminated, multi-component, arthritis-specific programs have been evaluated using both physical function and psychosocial measures. Fitness and Exercise for People with Arthritis (FEPA) is a new community-based, 3-month,...
Article
Full-text available
A wide range of epidemiologic and laboratory studies combined provide compelling evidence of a protective role of vitamin D on risk of breast cancer. This review evaluates the scientific evidence for such a role in the context of the A.B. Hill criteria for causality, in order to assess the presence of a causal, inverse relationship, between vitamin...
Conference Paper
Background: Built environment attributes are associated with physical activity and obesity, but their association with other outcomes is less clear. Neighborhood satisfaction has been found to be correlated with mental health and quality of life. Therefore, it is worthwhile to better understand the relationship between the environment and satisfact...
Article
Low serum levels of 25-hydroxyvitamin D [25(OH)D] have been associated with a high risk of breast cancer. Since publication of the most current meta-analysis of 25(OH)D and breast cancer risk, two new nested case-control studies have emerged. A PubMed search for all case-control studies on risk of breast cancer by 25(OH)D concentration identified 1...
Article
To examine whether dietary self-monitoring is related to weight loss in overweight children and whether perceived social support or dietary self-efficacy affects this relation. Design. Longitudinal, behavioral intervention study. The study population included 153 children, aged 7-12 years, with daily food records from a 20-week weight loss program...
Article
Full-text available
Cigarette smoking has been reported to be higher among deployed military men than among similarly aged civilian or nondeployed men, but the short-term effect of smoking on physical fitness among these young healthy men is unclear. This study examined self-reported smoking status and change in objectively measured fitness over 1-4 years while contro...
Article
Full-text available
The objective of this study was to identify changes in weight that occurred during deployment to Iraq or Kuwait between 2005 and 2008. Data on length and type of deployment among 16,365 male U.S. Navy personnel were combined with weight measurements before and after deployment from the Physical Readiness Information Management System. Weight measur...
Article
Full-text available
To explore the cross-sectional association of nutrient intake with adiponectin in Filipino-American women who had completed a validated food frequency questionnaire. One hundred and sixty-one Filipino women aged 40 to 82 years were recruited from the University of California, San Diego Filipino Women's Health Study. Dietary information was assessed...
Article
Full-text available
Nomograms are tools used in clinical practice to predict cancer outcomes and to help make decisions regarding management of disease. Since its conception, utility of the prostate cancer nomogram has more than tripled. Limited information is available on the relation between the nomograms' predicted probabilities and obesity. The purpose of this stu...
Article
Full-text available
Although Korean American women show high levels of involvement in religious practices and high prevalence of alcohol consumption, no studies have assessed the association between religious denomination and alcohol intake among this group of women. This cross-sectional study examined the associations of religious denomination and religious commitmen...
Article
Full-text available
To determine the associations between deployment in support of the wars in Iraq and Afghanistan and sleep quantity and quality. Longitudinal cohort study The Millennium Cohort Study survey is administered via a secure website or US mail. Data were from 41,225 Millennium Cohort members who completed baseline (2001-2003) and follow-up (2004-2006) sur...
Conference Paper
While physical activity is useful in improving function, maintaining joint health, and reducing the co-morbidities associated with inactivity in individuals with arthritis, the prevalence of regular exercisers among this population is lower than people without arthritis. This 2007 study examined the effects of a community-based exercise program on...
Article
Full-text available
This prospective study determined whether selected anatomic measures identified women at increased risk of patellofemoral pain syndrome (PFPS) and shin splints (SS). Ten anatomic measures were performed on 748 women before basic training at the Marine Corps Recruit Depot (MCRD), Parris Island, South Carolina. Recruits were then followed throughout...
Article
Self-rated health (SRH) is a predictor of several clinical outcomes, including mortality. Physical activity is associated with SRH; however, the specific role that resistance training (RT) plays in this relationship is unknown. We explored the independent association between self-reported RT and SRH in a cross-sectional survey (National Physical Ac...
Article
Full-text available
Infants in utero during the terrorist attacks of September 11, 2001 may have been negatively affected by maternal stress. Studies to date have produced contradictory results. Data for this retrospective cohort study were obtained from the Department of Defense Birth and Infant Health Registry and included up to 164,743 infants born to active-duty m...
Article
It is a public health recommendation to accumulate at least 150 minutes per week of moderate intensity physical activity. Although pedometers are widely used as a physical activity-monitoring tool, they are unable to measure activity intensity. Translating current physical activity recommendations into a pedometer-based guideline could increase the...
Article
Research into the accuracy of self-reported measures used to quantify physical inactivity has been limited. The purposes of the current report were to examine the reliability of a survey question assessing time spent watching television and to describe associations between television watching and physical activity and health risk factors. Data from...
Article
The association of overall obesity and abdominal adiposity in predicting risk of all-cause mortality in white and black adults was compared. This prospective study included a national sample of 3219 non-Hispanic white and 2,561 non-Hispanic black adults 30 to 64 years of age enrolled in the third National Health and Nutrition Examination Survey dur...
Article
Results of studies comparing overall obesity and abdominal adiposity or body fat distribution with risk of mortality have varied considerably. We compared the relative importance and joint association of overall obesity and body fat distribution in predicting risk of mortality. Participants included 5,799 men and 6,429 women aged 30-102 years enrol...
Conference Paper
According to the National Osteoporosis Foundation, 5% of African American women over 50 years of age have osteoporosis and an additional 35% have osteopenia, which puts them at risk for osteoporosis and fractures. Weight-bearing exercise has been shown to maintain bone mineral density (BMD) in white women, but little research has been reported in A...
Article
The stress of military deployment may compound occupational stress experienced in the military and manifest in maladaptive coping behaviors such as cigarette smoking. The current study describes new smoking among never-smokers, smoking recidivism among past smokers, and change in daily smoking among smokers in relation to military deployment. The M...
Article
Previous studies of leptin with cardiovascular disease (CVD) risk factors have been limited by clinical samples or lack of representation of the general population. This cross-sectional study, designed to examine whether leptin or insulin may mediate the endogenous relation of obesity with metabolic, inflammatory, and thrombogenic cardiovascular ri...