
Donald HedekerUniversity of Chicago | UC · Department of Public Health Sciences
Donald Hedeker
PhD
About
432
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25,092
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Additional affiliations
September 2014 - present
August 1993 - August 2014
Education
September 1981 - March 1989
September 1976 - June 1980
Publications
Publications (432)
Stepped-care obesity treatments aim to improve efficiency by early identification of non-responders and adjusting interventions but lack validated models. We trained a random forest classifier to improve the predictive utility of a clinical decision rule (>0.5 lb weight loss/week) that identifies non-responders in the first 2 weeks of a stepped-car...
Background:
Research investigating the psychological determinants of physical activity (PA) tends to conceptualize determinants as stable, trait-like factors. Growing evidence suggests that people and the processes that regulate people's behavior fluctuate over short timescales (eg, hours and days). This study explores the extent to which subject-...
Introduction
Menthol cigarettes are associated with experimentation and progression to regular use. Although reinforcement processes likely underlie menthol’s appeal, the reinforcing value of menthol cigarettes remains unknown.
Aims and Methods
This study examined the relative reinforcing value (RRV) of menthol versus nonmenthol cigarettes in youn...
Purpose:
To (1) describe secular trends in gross motor coordination (GMC) scores by sex and age; (2) investigate GMC trends adjusted for concomitant secular trends in height, weight, and overall physical fitness; and (3) examine trends in children's frequencies within different GMC categories.
Method:
The sample comprises 1562 Peruvian children...
Objective
To evaluate whether the neighborhood social and built environment moderates response to a mobile health multiple health behavior change intervention targeting fruit/vegetable intake, sedentary behavior, and physical activity.
Methods
Participants were 156 Chicago-residing adults with unhealthy lifestyle behaviors. Using linear mixed mode...
Background
Individuals who have metastatic cancer experience substantial physical and psychological distress (e.g., pain, depression, anxiety) from their disease and its treatment compared to patients with less advanced disease. As the burden of symptoms varies over time, ecological momentary assessment (EMA) may be used to better understand patien...
Objective
To investigate the relationship of biological characteristics (age, sex, and obesity), movement behaviors (physical activity and sedentary time), and family socioeconomic status with fundamental movement skills (FMS) in primary school children.
Methods
This cross‐sectional study sampled 1014 children (537 girls) aged 6 to 10 years from 2...
Introduction
Subjective experience of e-cigarettes may be an important factor in helping people who use combustible cigarettes switch completely to e-cigarettes to reduce harm from smoking. This paper describes a novel two-stage analysis using pleasure and satisfaction responses from ecological momentary assessments (EMA) of both cigarette and e-ci...
Importance
Lifestyle interventions for weight loss are difficult to implement in clinical practice. Self-managed mobile health implementations without or with added support after unsuccessful weight loss attempts could offer effective population-level obesity management.
Objective
To test whether a wireless feedback system (WFS) yields noninferior...
Objectives
To examine whether long-term air pollution exposure is associated with central hemodynamic and brachial artery stiffness parameters.
Methods
We assessed central hemodynamic parameters including central blood pressure, cardiac parameters, systemic vascular compliance and resistance, and brachial artery stiffness measures [including brach...
Objective: The present study probes into the association between children’s fundamental movement skills (FMS) and moderate-to-vigorous physical activity (MVPA) during weekdays and weekends.
Methods: This cross-sectional sample included 1014 children aged 6-10 years from the REACT project. Physical activity was assessed with accelerometry, and five...
Objective
The aim was to (1) estimate the relationship between physical fitness (PF) and object control fundamental movement skills (FMS), (2) identify child characteristics that relate with PF and FMS, and (3) examine associations between the school environment, PF, and FMS.
Methods
The sample included 1014 Portuguese children aged 6–10 years fro...
Hypofractionated whole-breast irradiation (HF-WBI), a radiotherapy with a larger dose per fraction and a shorter schedule for early-stage breast cancer patients post breast-conserving surgery, shows equivalent safety and efficacy compared to conventionally fractionated whole-breast irradiation (CF-WBI) regarding local recurrence and disease-free su...
Objective
This paper examines the relationship between body mass index (BMI) and cardiorespiratory fitness (CRF) using a multivariate multilevel approach and investigates the links between individual and school‐related correlates with children's BMI and CRF.
Methods
This cross‐sectional sample included 1014 children (6–10 years) from 25 Portuguese...
Purpose
We aimed to assess geographic and physician-level variation for hypofractionated whole-breast irradiation (HF-WBI) use for early-stage breast cancer patients in the United States. We further evaluated the association between HF-WBI use and demographic factors after accounting for these variations.
Methods and Materials
We performed a retro...
Conceptualizing tobacco dependence as a chronic relapsing condition suggests the need to use analytic strategies that reflect that premise. However, clinical trials for smoking cessation typically define the primary endpoint as a measure of abstinence at a single timepoint distal to the intervention, typically 3-12 months. This reinforces the conce...
Background
Walking cadence has been suggested as a measure of activity intensity; however, it remains uncertain if prefrail and frail older adults can increase their walking cadence and if doing so leads to improvements in functional capacity. We aimed to determine if cadence can be increased and if this leads to improvement in functional capacity...
Objective
Whether sleep is related to fundamental movement skills (FMS) in the pediatric population is largely unknown. The objective of this study was to examine the association between sleep characteristics (duration, efficiency, regularity) and FMS proficiency levels in school‐aged children.
Methods
This cross‐sectional study included 996 child...
Objectives
The REACT project was designed around two main aims: (1) to assess children's growth and motor development after the COVID‐19 pandemic and (2) to follow their fundamental movement skills' developmental trajectories over 18 months using a novel technological device (Meu Educativo®) in their physical education classes. In this article, our...
Abstract
Objectives: There is evidence showing that children's proficiency in fundamental movement skills (FMS) is positively related to weight status, physical
activity, fitness levels, cognitive development, as well as academic performance. Yet, the feasibility of FMS assessment is challenging, especially with
relatively large samples of children...
Background
Collection of intensive longitudinal health outcomes allows joint modeling of their mean (location) and variability (scale). Focusing on the location of the outcome, measures to detect influential subjects in longitudinal data using standard mixed-effects regression models (MRMs) have been widely discussed. However, no existing approach...
Physical activity (PA) guidelines recommend that PA be accumulated in bouts of 10 minutes or more in duration. Recently, researchers have sought to better understand how participants in PA interventions increase their activity. Participants can increase their daily PA by increasing the number of PA bouts per day while keeping the duration of the bo...
Objectives
The REACT project was designed around two main aims: (1) to assess children's growth and motor development after the COVID-19 pandemic and (2) to follow their fundamental movement skills' developmental trajectories over 18 months using a novel technological device (Meu Educativo®) in their physical education classes. In this introductor...
Objectives
To examine whether air pollution exposure is associated with central hemodynamic and brachial artery stiffness parameters.
Methods
We assessed central hemodynamic parameters, brachial artery stiffness measures [including brachial artery distensibility (BAD), compliance (BAC), and resistance (BAR)] using waveform analysis of the arterial...
Background:
Co-use of cannabis and tobacco has become increasingly popular among young adults. Interactive voice response (IVR) based ecological momentary assessment (EMA) allows for measurement of behavior in or near real-time, but has limitations including non-compliance, missing data, and potential for reactivity (e.g., behavior change) from fr...
Objectives:
Overeating interventions and research often focus on single determinants and use subjective or nonpersonalized measures. We aim to (1) identify automatically detectable features that predict overeating and (2) build clusters of eating episodes that identify theoretically meaningful and clinically known problematic overeating behaviors...
Objective:
Differences in the subjective effects of alcohol in different social contexts have been well documented, but little research examines affect during drinking in real-world social contexts. This study examined differences by social context in negative affect (NA) and positive affect (PA) during alcohol consumption. We hypothesized that NA...
Physical activity is associated with a host of positive health outcomes and is shaped by both genetic and environmental factors. We aim to: (1) estimate sibling resemblance in two physical activity phenotypes [total number of steps∙day−1 and minutes for moderate steps per day (min∙day−1)]; and (2) investigate the joint associations of individual ch...
The physical fitness of children is an important marker of health, and monitoring its temporal changes provides important information for developing interventions. We aimed to: (1) describe secular trends in physical fitness across age, within each sex, in Peruvian schoolchildren; and (2) verify if these trends are also present when adjusted for ch...
This study models children's musculoskeletal fitness (MSF) developmental trajectories and identifies individual differences related to effects of time-invariant, as well as time-varying covariates. A total of 348 Portuguese children (177 girls) from six age cohorts were followed for three years. MSF tests (handgrip strength, standing long jump and...
As a result of advances in data collection technology and study design, modern longitudinal datasets can be much larger than they historically have been. Such “intensive" longitudinal datasets are rich enough to allow for detailed modeling of the variance of a response as well as the mean, and a flexible class of models called mixed‐effects locatio...
Background:
Patients who have received mechanical ventilation can have prolonged cognitive impairment for which there is no known treatment. We aimed to establish whether early mobilisation could reduce the rates of cognitive impairment and other aspects of disability 1 year after critical illness.
Methods:
In this single-centre, parallel, rando...
Background
Little is known about the factors that bias event-based (i.e., self-initiated) reporting of health behaviors in ecological momentary assessment (EMA) due to the difficulty inherent to tracking failures to self-initiate reports.
Purpose
To introduce a real-time method for identifying the predictors of noncompliance with event-based repor...
Background:
Cannabis use is rising globally, underscoring the importance of understanding contextual factors related to cannabis use. Although much work has retrospectively examined cannabis use patterns and effects, fewer studies have evaluated cannabis use in natural environments.
Methods:
The present study used ecological momentary assessment...
Many preventive trials randomize individuals to intervention condition which is then delivered in a group setting. Other trials randomize higher levels, say organizations, and then use learning collaboratives comprised of multiple organizations to support improved implementation or sustainment. Other trials randomize or expand existing social netwo...
Background:
Compared to the effects of stress on hunger, the temporal effect of hunger on stress levels is less understood, especially in the context of everyday lives of vulnerable populations with unstable access to food.
Objective:
Our objective was to examine the effects of food insecurity and momentary hunger on momentary stress and stress...
Background
Tobacco use is the leading cause of preventable morbidity and mortality. Adults with low income and members of certain racial and ethnic minority groups are less likely to quit, and therefore, they experience profound tobacco-related health disparities. Mindfulness training can increase the rates of smoking cessation and lapse recovery,...
Ecological momentary assessment and other modern data collection technologies facilitate research on both within‐subject and between‐subject variability of health outcomes and behaviors. For such intensively measured longitudinal data, Hedeker et al extended the usual two‐level mixed‐effects model to a two‐level mixed‐effects location scale (MELS)...
Objective: PA habits reflect stable, consistent patterns in behaviours that are performed automatically in response to temporal or contextual cues. Mothers face multiple demands and complex schedules related to parenting. This study examined how subject-level mean, variability, and slopes in device-measured moderate-to-vigorous physical activity (M...
Research examined how acute affect dynamics, including stability and context-dependency, contribute to changes in children’s physical activity levels as they transition from late-childhood to early-adolescence. Children (N = 151) (ages 8–12 years at baseline) participated in an ecological momentary assessment and accelerometry study with six semi-a...
A polygenic risk score (PRS) for attention-deficit/hyperactivity disorder (ADHD) has been found to be associated with ADHD in multiple studies, but also with many other dimensions of problems. Little is known, however, about the processes underlying these transdiagnostic associations. Using data from the baseline and 1-year follow-up assessments of...
We estimated sibling resemblance in health-related physical fitness (PF) and examined how individual characteristics and shared natural environment accounted for sibling similarities. The sample comprised 656 sibling pairs and 102 triplets (6–15 years of age), from three geographical areas of Peru. PF components included morphological (waist circum...
Introduction:
Although the Food and Drug Administration banned other characterising flavours in cigarettes, menthol cigarettes are still available to consumers. Young adult new smokers are initiating with menthol cigarettes, such that the prevalence of young adults menthol versus non-menthol smokers is increasing. Experimentation with menthol ciga...
Background: Cardiovascular disease (CVD) persists as the leading preventable cause of death in the US and worldwide. The American Heart Association (AHA) defines ideal cardiovascular health as the presence of: non-smoking, normal weight, adequate physical activity, healthy diet, normal blood pressure, normal fasting plasma glucose, and normal chole...
We address the issue of (non‐) responsivity of self‐initiated assessments in Ecological Momentary Assessment (EMA) or other mobile health (mHealth) studies, where subjects are instructed to self‐initiate reports when experiencing defined events, for example, smoking. Since such reports are self‐initiated, the frequency and determinants of nonrespon...
Background:
Black men are more likely than Non-Hispanic White (NHW) men to be diagnosed with high-risk prostate cancer (PCa). We examined the extent to which social factors were associated with differences in PCa risk profiles between Black men and NHW men (using a modification to the original D'Amico risk groups based on prostate specific antigen...
Introduction
A large body of literature indicates that nicotine results in an acute mood “boost,” including increased positive affect and decreased negative affect. Young adults frequently engage in polysubstance use of cigarettes with cannabis and alcohol—a trend that is likely to accelerate with the expanding legalization of cannabis. However, li...
The topic of centering in multilevel modeling (MLM) has received substantial attention from methodologists, as different centering choices for lower-level predictors present important ramifications for the estimation and interpretation of model parameters. However, the centering literature has focused almost exclusively on continuous predictors, wi...
Background
Longitudinal assessments of usage are often conducted for multiple substances (e.g., cigarettes, alcohol and marijuana) and research interests are often focused on the inter-substance association. We propose a multivariate longitudinal modeling approach for jointly analyzing the ordinal multivariate substance use data.
Methods
We descri...
This study investigates trajectories of racial discrimination, racial and ethnic socialization (RES), and their interaction effects with social positions (nativity and gender) on mental health. A longitudinal study of 786 Filipino American (FA) and Korean American (KA) youth from the Midwestern United States (Mage.Wave1 = 15) confirmed that discrim...
This study investigated the associations between biological and environmental factors and gross-motor coordination (GMC) in Peruvian children and adolescents. The sample comprised 7401 boys and girls, aged 6–14 years, recruited from three geographical regions: sea-level, Amazon and high-altitude. Biological variables included age, sex, height, BMI,...
Introduction
Maternal smoking is a well-known risk factor for youth smoking, yet whether this relationship is causal remains unresolved. This study utilizes propensity score methods for causal inference to robustly account for shared risk factors between maternal and offspring smoking.
Methods
An 8-year longitudinal cohort of 900 adolescents in th...
Introduction
Maternal smoking is a risk factor for offspring smoking. Lifetime maternal smoking vs. prenatal tobacco exposure (PTE) appear to act through different mechanisms. This study tested the hypothesis that maternal smoking measures’ effects on offspring smoking could be attributable to hereditary mechanisms: personality traits (novelty-seek...
This study investigates the interplay between individual and natural environments, as well as the effects of school characteristics, on Peruvian children and adolescents’ gross motor coordination (GMC) problems. The sample comprises 7401 participants (4121 girls) aged 6–14 years from three geographical regions: sea-level, Amazon and high-altitude....
Objective: While the U.S. adult smoking rate has declined, Black smokers disproportionately face more barriers to accessing brief effective tobacco cessation treatments compared with other racial groups. This study developed and tested the effects of a novel, evidence-based, brief smoking intervention culturally targeted for disadvantaged Black smo...
Objective:
We applied the ORBIT model to digitally define dynamic treatment pathways whereby intervention improves multiple risk behaviors. We hypothesized that effective intervention improves the frequency and consistency of targeted health behaviors and that both correlate with automaticity (habit) and self-efficacy (self-regulation).
Method:...
Purpose
To evaluate weight change patterns over time following the diagnosis of breast cancer and to examine the association of post-diagnosis weight change and survival outcomes in Black and White patients.
Methods
The study included 2888 women diagnosed with non-metastatic breast cancer in 2000–2017 in Chicago. Longitudinal repeated measures of...
In their letter, Ebrahimi Kalan et al.¹ support the need to assess nicotine dependence (ND) separately for combustible cigarettes and electronic nicotine delivery systems (ENDS) among dual users of these products, as we concluded in our study² evaluating whether there was one common ND factor underlying the use of these two products. As Ebrahimi Ka...
Hidden Markov models (HMM) presents an attractive analytical framework for capturing the state-switching process for auto-correlated data. These models have been extended to longitudinal data setting where simultaneous multiple processes are observed by including subject specific random effects. However, application of HMMs for intensive longitudin...
Ecological Momentary Assessment (EMA) studies aim to explore the interaction between subjects’ psychological states and real environmental factors. During the EMA studies, participants can receive prompted assessments intensively across days and within each day, which results in three-level longitudinal data, e.g., subject-level (level-3), day-leve...
People differ from each other to the extent to which momentary factors, such as context, mood, and cognitions, influence momentary health behaviors. However, statistical models to date are limited in their ability to test whether the association between two momentary variables (i.e., subject-level slopes) predicts a subject-level outcome. This stud...
Background
Executive functions (EF) are important partly because they are associated with risk for psychopathology and substance use problems. Because EF has been linked to white matter microstructure, we tested the prediction that fractional anisotropy (FA) and mean diffusivity (MD) in white matter tracts are associated with EF and dimensions of p...
Background
Screening for colorectal cancer (CRC) not only detects disease early when treatment is more effective but also prevents cancer by finding and removing precancerous polyps. Because many of our nation’s most disadvantaged and vulnerable individuals obtain health care at federally qualified health centers, these centers play a significant r...
We use a multivariate multilevel model to study the links between physical fitness (PF) and gross motor coordination (GMC) and investigate the influence of predictors affecting their levels across age. We sampled 7918 Peruvians, aged 6‐15 yrs, from sea‐level, Amazon region and high‐altitude. Composite markers of GMC and PF were derived (GMCz and PF...
Introduction
In a sample of dual users of cigarettes and electronic nicotine delivery systems (ENDS; e-cigarettes), we evaluated psychometric properties of ENDS versions of the Nicotine Dependence Syndrome Scale (NDSS), the brief Wisconsin Inventory of Smoking Dependence Motives (WISDM), and the Fagerstrom Test of Nicotine Dependence (FTND). Using...
Background:
Frailty is associated with lower mean activity; however, hourly activity is highly variable among older individuals. We aimed to relate frailty to hourly activity variance beyond frailty's association with mean activity.
Methods:
Using the 2010-2011 National Social Life, Health and Aging Project wrist accelerometry data (n=647), we e...
Background:
Cardiovascular disease (CVD) remains the leading cause of death globally. Seven health factors are associated with ideal cardiovascular health: being a non-smoker; not overweight; physically active; having a healthy diet; and normal blood pressure; fasting plasma glucose and cholesterol. Whereas approximately half of U.S. youth have id...
Reports an error in "Criterion validity and relationships between alternative hierarchical dimensional models of general and specific psychopathology" by Tyler M. Moore, Antonia N. Kaczkurkin, E. Leighton Durham, Hee Jung Jeong, Malerie G. McDowell, Randolph M. Dupont, Brooks Applegate, Jennifer L. Tackett, Carlos Cardenas-Iniguez, Omid Kardan, Gab...
Purpose: To evaluate weight change patterns over time following the diagnosis of breast cancer, and to examine the association of post-diagnosis weight change and survival outcomes in Black and White patients.
Methods: The study included 2,888 women diagnosed with non-metastatic breast cancer in 2000-2017 in Chicago. Longitudinal repeated measures...
Purpose: To evaluate weight change patterns over time following the diagnosis of breast cancer, and to examine the association of post-diagnosis weight change and survival outcomes in Black and White patients.
Methods: The study included 2,888 women diagnosed with non-metastatic breast cancer in 2000-2017 in Chicago. Longitudinal repeated measures...
RationaleLittle is known about relapse among non-daily, intermittent smokers (ITS), who have difficulty quitting, despite a lack of dependence.Objectives
To analyze situations associated with temptations to smoke and smoking lapses among ITS trying to maintain abstinence.Methods
Participants were 130 initially abstinent ITS in the placebo arm of a...
African American (AA) men experience more than twice the prostate cancer mortality as White men yet are under-represented in academic research involving prostate-specific antigen (PSA), a biomarker of prostate cancer aggressiveness. We examined the impact of self-reported tobacco (cigarette pack-years and current tobacco use including e-cigarettes)...
Psychopathology can be viewed as a hierarchy of correlated dimensions. Many studies have supported this conceptualization, but they have used alternative statistical models with differing interpretations. In bifactor models, every symptom loads on both the general factor and 1 specific factor (e.g., internalizing), which partitions the total explai...