Gregory W Heath

University of Tennessee at Chattanooga | Chatt · Department of Health and Human Performance

Background Thousands of hospitals worldwide have adopted mobile artificial intelligence (AI)-based stroke care coordination platforms. Studies exploring the benefit of these platforms have been scrutinized due to small sample size, serial cohort design, and measurement of metrics with multiple determinants. In this large multi-center study, we eval...

Background: The benefits of mechanical thrombectomy in low NIHSS score (<6) is unclear and undergoing investigation. Current acute stroke guidelines do not address the utilization of computed tomography angiography (CTA) in low NIHSS largely due to a paucity of data leading to great variation in clinical practice. Understanding the predictive value...

Background Previous studies have shown sex differences in stroke care. Female patients have both lower thrombolytic treatment rates with OR reported as low as 0.57 and worse outcomes. With updated standards of care and improved access to care through telestroke, there is potential to reduce or alleviate these disparities. Methods Acute stroke cons...

Introduction: Previous analyses suggest that ethnic and racial differences exist in acute stroke care including thrombolytic treatment rates. The current study evaluates ethnic or racial differences in acute stroke treatment within a multi-state telestroke program. Methods: Acute telestroke consultations seen in the Emergency Department in 203 f...

Introduction: Multiple clinical trials support an extended treatment window for thrombectomy for large vessel occlusions (LVO) and the treatment of distal occlusions, leading to increased numbers of patients requiring advanced imaging during acute stroke evaluation. Across hospital systems, there is great variation in advanced imaging protocols for...

Introduction: Analyses from early- and late-window thrombectomy trials for acute large vessel occlusion (LVO) stroke have consistently demonstrated a strong time-dependent treatment effect for best outcomes. The utilization of an artificial intelligence (AI)-based care coordination platform to support LVO diagnosis and treatment has the potential t...

Objective: Assess for treatment differences by sex and their potential contributors among telestroke evaluations. Background: Studies have shown sex differences in stroke care. Female patients have both lower thrombolytic treatment rates with OR as low as 0.57 reported and worse outcomes. With improved access to care through telestroke and updated...

Background: Physical activity (PA) surveillance, policy, and research efforts need to be periodically appraised to gain insight into national and global capacities for PA promotion. The aim of this paper was to assess the status and trends in PA surveillance, policy, and research in 164 countries. Methods: We used data from the Global Observator...

Physical activity has become an integral component of public health systems modeling the public health core functions of assessment, policy development, and assurance. However, people with disabilities have often not been included in public health efforts to assess, develop policies, or evaluate the impact of physical activity interventions to prom...

Background: Malaria is a significant cause of morbidity and mortality throughout the world and particularly sub-Saharan Africa. The World Health Organization and many national bodies, including Burundi, recommend artemisinin-based therapy as first-line treatment for uncomplicated and severe malaria. Implementing this recommendation requires health...

Over the past 2 decades, population levels of physical activity (PA) have not substantially improved, especially not in low- and middle-income countries (LMICs). One potential explanation is that, while the epidemiological research on correlates and determinants of PA has grown in recent years, there has been little progress on research on interven...

Introduction The coronavirus disease 2019 (COVID-19) pandemic has significantly impacted acute stroke care globally. Decreased stroke presentations and concern for delays in acute stroke care have been identified. This study evaluated the impact of COVID-19 on the timely treatment of patients with thrombolytics at hospitals utilizing telestroke acu...

Approximately 1·5 billion people worldwide live with a physical, mental, sensory, or intellectual disability, about 80% of which are in low-income and middle-income countries. This Series paper provides a global overview of the prevalence, benefits, and promotion policies for physical activity for people living with disabilities (PLWD). PLWD are 16...

Introduction: The first case of COVID-19 in Chattanooga/Hamilton County, Tennessee (CHC) was identified on March 13, 2020. By early April, 51 RT-PCR confirmed cases were identified, with white, non-Hispanic males and females representing 82% (41/51) of positive cases and remaining cases representing black residents (18%; 9/51). That few people from...

Objectives. Mexico's 2018 Report Card evaluates the opportunities available for Mexican children and youth to reach healthy levels of physical activity, sleep, and sedentary behavior. Methods. The Report Card is a surveillance system that gathers data from national surveys, censuses, government documents, websites, grey literature, and published st...

An understanding of epidemiologic methods is important for the clinical exercise physiologist to assess the complex relationships between physical activity and health and disease. It is essential to the practice of preventive and rehabilitative care to understand the web of causation and complex interactions among agent (exercise), host (individual...

In the past few decades, the field of physical activity has grown and evolved in scope, depth, visibility and impact around the world. Global progress has been observed in research and practice in physical activity regarding surveillance, health outcomes, correlates/determinants, interventions, translation and policy. The 2012 and 2016 Lancet serie...

Purpose A novel automatic discontinuation policy implemented within an antimicrobial stewardship program (ASP) is described, and results of an evaluation of the policy’s effects on antibiotic usage are reported. Methods A retrospective, before-and-after study was conducted at an 800-bed, tertiary care, academic teaching hospital to evaluate select...

Background: There is a paucity of studies, especially among diverse populations, demonstrating the effects of policy and environmental interventions to increase regular physical activity. The Grow Healthy Together Chattanooga project provided the opportunity to assess the impact of physical activity policy and environmental interventions on the ph...

Introduction: Exercise is Medicine (EIM) is an initiative that seeks to integrate physical activity assessment, prescription, and patient referral as a standard in patient care. Methods to assess this integration have lagged behind its implementation. Purpose and objectives: The purpose of this work is to provide a pragmatic framework to guide h...

Background The work of The Global Observatory for Physical Activity-GoPA! is the first global effort to compile standardized country-level surveillance, policy and research data for physical activity in order to better understand how countries and regions address promoting physical activity. GoPA! developed standardized country-specific physical a...

Objectives: Early determination of hospital discharge disposition status at an acute admission is extremely important for stroke management and the eventual outcomes of patients with stroke. We investigated the hospital discharge disposition of patients with stroke residing in Tennessee and developed a predictive tool for clinical adoption. Our in...

Background: The Global Observatory for Physical Activity-GoPA! was launched in response to the physical inactivity pandemic. The aim of this article is to present current information about surveillance, policy, and research on physical activity (PA) and health worldwide. Methods: Information was collected for 217 countries. For 139 of these nati...

Purpose: Develop strategic priorities to guide future physical activity surveillance in the United States. Methods: The Centers for Disease Control and Prevention and the American College of Sports Medicine convened a Scientific Roundtable of physical activity and measurement experts. Participants summarized the current state of aerobic physical...

Purpose Develop strategic priorities to guide future physical activity surveillance in the United States. Methods The Centers for Disease Control and Prevention and the American College of Sports Medicine convened a scientific roundtable of physical activity and measurement experts. Participants summarized the current state of aerobic physical act...

On the eve of the 2012 summer Olympic Games, the first Lancet Series on physical activity established that physical inactivity was a global pandemic, and global public health action was urgently needed. The present paper summarises progress on the topics covered in the first Series. In the past 4 years, more countries have been monitoring the preva...

Worldwide it has been estimated that physical inactivity alone accounts for the premature loss of ∼5.2 million lives per year. Sedentary and inactive people should be given opportunities to become physically active, and those who are minimally active should be supported in doing more. Through community organization physical activity levels can incr...

No abstract available for this article.

Introduction: Exercise is Medicine™ (EIM) is an approach to clinic-based physical activity (PA) promotion. Study aims were to 1) assess the acceptability of current EIM protocols among healthcare providers (providers) and health and fitness professionals (fitness professionals); and 2) pilot test the resultant modified EIM protocols comparing pati...

The promotion of physical activity and healthy eating to prevent obesity among youth is a pressing challenge. The current study examined the feasibility of community health workers (CHWs) con-ducting a physical activity (PA) and healthy eating intervention strategy with links to community supports and programs. Youth aged 10 -18 years were recruite...

Background: Despite overwhelming evidence of the health benefits of physical activity, most American youth are not meeting the 60 minutes per day recommendation for moderate- to vigorous-intensity physical activity (MVPA). Policy changes have the potential to bring about substantial increases in physical activity in youth, within school and commun...

... the American Heart Association Council on Epidemiology and Prevention Melanie B. Turner Kris-Etherton, Darwin R. Labarthe, Joanne M. Murabito, Ralph L. Sacco, Comilla Sasson and James M. Galloway, David C. Goff, Jr., Gregory W. Heath, Ariel T. Holland Frank , Penny M ...

Background: Studies have individually reported the relationship of age, cardiac risk factors, and history of preexisting coronary artery disease (CAD) for predicting acute coronary syndromes in chest pain patients undergoing cardiac stress testing. In this study, we investigate the interplay of all these factors on the incidence of acute coronary...

Promotion of physical activity is a priority for health agencies. We searched for reviews of physical activity interventions, published between 2000 and 2011, and identified effective, promising, or emerging interventions from around the world. The informational approaches of community-wide and mass media campaigns, and short physical activity mess...

Background: The HEART score uses elements from patient History, Electrocardiogram, Age, Risk Factors, and Troponin to obtain a risk score on a 0- to 10-point scale for predicting acute coronary syndromes (ACS). This investigation seeks to improve on the HEART score by proposing the HEARTS(3) score, which uses likelihood ratio analysis to give appr...

Introduction: Although it is known that urban design and land use at the community level contributes to active living, there remains a paucity of such information among low income and diverse populations affected by such infrastructure. Reconstruction of an inner city community in Chattanooga, Tennessee afforded the opportunity to assess the impact...

LEARNING OBJECTIVES: • Readers will become familiar with various interventions used to promote physical activity in communities as presented in The Guide to Community Preventative Services and understand how the physical activity recommendations in The Guide to Community Preventative Services can be used to guide an intervention for a university se...

Given sparse knowledge on dissemination, this study sought to explore key benefits, barriers and contextual factors that are perceived to be important to the adoption and implementation of the 'Community Guide's' evidence-based physical activity recommendations. We conducted case studies in two states where extensive adoption and implementation of...

In 2000, the Guide to Community Preventive Services (Community Guide) completed a systematic review of the effectiveness of various approaches to increasing physical activity including informational, behavioral and social, and environmental and policy approaches. Among these approaches was the use of signs placed by elevators and escalators to enco...

Regular physical activity has been demonstrated to protect against coronary heart disease, Type 2 diabetes mellitus, selected cancers, hypertension, obesity, and other chronic conditions. Therefore, the public health significance of promoting physical activity and preventing inactivity has become a well-established agenda for public health agencies...

Since overweight (25 < or = BMI < 30) and obesity (BMI > or = 30 Kg/m2) are associated with poor health-related quality of life (HRQOL) and regular physical activity is associated with higher levels of HRQOL, the authors examined the relationship between physical activity and HRQOL among overweight and obese adults (age > or = 18 years) residing in...

The 20(th) century in the United States (U.S.) has experienced a dramatic increase in life expectancy among adult men and women, an increase unprecedented in the history of this country. As a result, the pattern of disease and conditions most responsible for death in the U.S. shifted during the past century from infectious diseases and unintentiona...

Physical inactivity is associated with the increased risk of many chronic diseases. Such risks decrease with increases in physical activity. This study assessed the cost-effectiveness of population-wide strategies to promote physical activity in adults and followed disease incidence over a lifetime. A lifetime cost-effectiveness analysis from a soc...

The purpose of this study was to assess the relative importance of factors associated with total health care costs (THC) among office workers. Biometric and anthropometric values, health-related survey responses, and THC for 214 employees were analyzed. Factors that had a statistically significant (P < 0.05) bivariate correlation with logarithmical...

Introduction: Estimates of participation in physical activity among Latinos are inconsistent across studies. To obtain better estimates and examine possible reasons for inconsistencies we assessed 1) patterns of participation in various categories of physical activity among Latino adults 2) changes in their activity patterns with acculturation, and...

National surveillance data provide population-level estimates of physical activity participation, but generally do not include detailed subgroup analyses, which could provide a better understanding of physical activity among subgroups. This paper presents a descriptive analysis of self-reported regular physical activity among black adults using dat...