SeungYong Han

Background: Preventing Alzheimer’s disease is a public health priority to address its substantial social and healthcare impacts. Exercise and cognitive training interventions are promising but show mixed effects on cognition in older adults with and without mild cognitive impairment (MCI), which is at least partially attributable to varied quality in trial implementation. The purpose of this study was to evaluate the implementation outcomes of the 3‐site Aerobic exercise and Cognitive training (ACT) trial that tests the cognitive effects and underlying mechanisms.Method: The ACT Trial enrolled 146 older adults with amnestic MCI (aMCI). Participants were randomized equally to ACT, aerobic exercise only, cognitive training only, or attention control ed for six months and followed for another 12 months. Participants completed a 3‐step screening process that included a 30‐minute phone screen (step 1), a 120‐minute in‐person screening (step 2), medical clearance (step 3), and a 60‐minute graded exercise test and MRI (steps 4a & 4b). The implementation outcomes included durations between each screening step, from phone screen to enrollment, from enrollment to the first intervention section. Implementation outcomes were compared across sites using ANOVA.Result: The mean age was 73.57±5.49 years, with 47.95% female, 91.78% white, 91.09% had a college degree or higher, and a mean Montreal Cognitive Assessment (MoCA) score of 23.38±2.16. The duration from step 1 to step 2 was 20.23±31.21 days, step 2 to step 3 was 24.42±41.27 days, step 3 to step 4a was 36.84±76.86 days, step 4a to step 4b was 25.84±60.75 days, and the duration from step 4b to enrollment was 25.60±60.17 days. The duration from step 1 to enrollment is 121.16±109.16 days. ANOVA results indicate no significant differences in implementation outcomes across the three sites.Conclusion: The screening took longer than projected regarding completing a participant’s in‐person screening (step 2) and obtaining medical clearance from the participant’s provider (step 3). The major contributors to longer screen duration were delays in receiving faxed documentation from medical providers. Future trials need to build in adequate screening duration to ensure screening success.

Background: Metabolic diseases, including obesity and type 2 diabetes, are a major health concern for Latina immigrants. Performing regular aerobic physical activity (PA) is a lifestyle behavior associated with the prevention and control of these conditions. However, PA levels of most Latina immigrants are below national guidelines. Neighborhood environmental factors may influence the PA levels of adults, but limited research has explored associations between the neighborhood environment and PA levels among Latina immigrants. Objective: The objective of this study was to explore the PA patterns of first-generation US Latina immigrants and how neighborhood environmental factors are related to those PA patterns. Methods: Using a cross-sectional study design, 50 first-generation Latina immigrants completed the International Physical Activity Questionnaire (IPAQ) and the Neighborhood Scales Questionnaire, which assessed 6 perceived neighborhood factors: (1) walking environment, (2) aesthetic quality, (3) safety, (4) violence, (5) social cohesion, and (6) activities with neighbors. Median self-reported metabolic equivalent (MET)-minutes/week of PA were used to summarize domain-specific (ie, work, domestic/household, leisure, and transportation) and intensity-specific (ie, walking, moderate, vigorous, moderate to vigorous) PA patterns. Logistic regression examined associations between neighborhood factors and engaging in leisure-time PA (ie, dichotomous outcome of some versus no leisure-time PA), transportation PA (ie, dichotomous outcome of some versus no transportation PA), and meeting national PA guidelines (ie, dichotomous outcome of meeting versus not meeting guidelines). Results: Preliminary analyses showed that 10 participants reported excessively high PA levels and 1 participant had incomplete PA data; these women were excluded from analyses based on IPAQ scoring guidelines. The remaining 39 participants (mean age 40.5 years; mean length of US residency 4.6 years) reported a median of 4512 MET-minutes/week of total PA. The majority of PA was acquired through domestic activities (median 2160 MET-minutes/week), followed by leisure-time PA (median 396 MET-minutes/week), transportation PA (median 198 MET-minutes/week), and work PA (0 MET-minutes/week). Intensity-specific PA patterns showed a median of 594 MET-minutes/week of walking activity and 3500 MET-minutes/week of moderate-to-vigorous PA. Logistic regression models indicated that the neighborhood factors of walking environment, aesthetic quality, and safety were positively associated with engaging in leisure-time PA (odds ratios of 5.95, 95% CI 1.49-23.74; 2.45, 95% CI 1.01-5.93; and 3.30, 95% CI 1.26-8.67, respectively) and meeting national PA guidelines (odds ratios of 4.15, 95% CI 1.13-15.18; 6.43, 95% CI 1.45-28.39; and 2.53, 95% CI 1.00-6.36, respectively). The neighborhood factors of violence, social cohesion, and activities with neighbors were not significantly associated with PA outcomes. Conclusions: Although most participants met national PA guidelines (ie, ≥500 MET-minutes/week of moderate-to-vigorous PA), the majority of their PA was achieved through domestic activities, with limited leisure, transportation, and work PA. Given that leisure-time PA in particular plays a significant role in improving health outcomes, findings suggest that many Latina immigrants could benefit from a leisure-time PA intervention. Such interventions should consider neighborhood environmental influences, as these factors may serve as determinants of PA.

BACKGROUND Metabolic diseases, including obesity and type 2 diabetes, are a major health concern for Latina immigrants. Performing regular aerobic physical activity (PA) is a lifestyle behavior associated with the prevention and control of these conditions. However, PA levels of most Latina immigrants are below national guidelines. Neighborhood environmental factors may influence the PA levels of adults, but limited research has explored associations between the neighborhood environment and PA levels among Latina immigrants. OBJECTIVE The objective of this study was to explore the PA patterns of first-generation US Latina immigrants and how neighborhood environmental factors are related to those PA patterns. METHODS Using a cross-sectional study design, 50 first-generation Latina immigrants completed the International Physical Activity Questionnaire (IPAQ) and the Neighborhood Scales Questionnaire, which assessed 6 perceived neighborhood factors: (1) walking environment, (2) aesthetic quality, (3) safety, (4) violence, (5) social cohesion, and (6) activities with neighbors. Median self-reported metabolic equivalent (MET)-minutes/week of PA were used to summarize domain-specific (ie, work, domestic/household, leisure, and transportation) and intensity-specific (ie, walking, moderate, vigorous, moderate to vigorous) PA patterns. Logistic regression examined associations between neighborhood factors and engaging in leisure-time PA (ie, dichotomous outcome of some versus no leisure-time PA), transportation PA (ie, dichotomous outcome of some versus no transportation PA), and meeting national PA guidelines (ie, dichotomous outcome of meeting versus not meeting guidelines). RESULTS Preliminary analyses showed that 10 participants reported excessively high PA levels and 1 participant had incomplete PA data; these women were excluded from analyses based on IPAQ scoring guidelines. The remaining 39 participants (mean age 40.5 years; mean length of US residency 4.6 years) reported a median of 4512 MET-minutes/week of total PA. The majority of PA was acquired through domestic activities (median 2160 MET-minutes/week), followed by leisure-time PA (median 396 MET-minutes/week), transportation PA (median 198 MET-minutes/week), and work PA (0 MET-minutes/week). Intensity-specific PA patterns showed a median of 594 MET-minutes/week of walking activity and 3500 MET-minutes/week of moderate-to-vigorous PA. Logistic regression models indicated that the neighborhood factors of walking environment, aesthetic quality, and safety were positively associated with engaging in leisure-time PA (odds ratios of 5.95, 95% CI 1.49-23.74; 2.45, 95% CI 1.01-5.93; and 3.30, 95% CI 1.26-8.67, respectively) and meeting national PA guidelines (odds ratios of 4.15, 95% CI 1.13-15.18; 6.43, 95% CI 1.45-28.39; and 2.53, 95% CI 1.00-6.36, respectively). The neighborhood factors of violence, social cohesion, and activities with neighbors were not significantly associated with PA outcomes. CONCLUSIONS Although most participants met national PA guidelines (ie, ≥500 MET-minutes/week of moderate-to-vigorous PA), the majority of their PA was achieved through domestic activities, with limited leisure, transportation, and work PA. Given that leisure-time PA in particular plays a significant role in improving health outcomes, findings suggest that many Latina immigrants could benefit from a leisure-time PA intervention. Such interventions should consider neighborhood environmental influences, as these factors may serve as determinants of PA.

BackgroundOver the last two decades, body dissatisfaction appears to have increased globally, particularly concerns about being “fat”. These increasingly negative large-body norms reflect the intersections of complex socio-cultural phenomena. A range of anthropological theories derived from ethnographic observations across the globe have posited that both changing socioeconomics and internet exposures have increasingly commodified the value of the body in social advancement – especially for women. MethodsUsing demographic data, here we provide a first attempt to explore the sheer effects of individual (i.e., age) and contextual factors (i.e., period and cohort) on body dissatisfaction by using the Hierarchical Age-Period-Cohort (HAPC-CCREM) approach, with a particular emphasis on period effects of internet expansion and macro-economic shifts. The data are drawn from the Korean National Health and Nutrition Examination Survey (KNHANES) collected repeatedly over the period of 2001 to 2017. ResultsThe results show a higher level of body dissatisfaction among Korean women compared to men. Overall period effects indicate a significant increase in the level of body dissatisfaction in the early 2000s, particularly related to increased social media exposure. Although no overall cohort effect was found, early cohorts tend to have a substantial gap in body dissatisfaction levels when examined by socioeconomic status: those with high SES (people with college education and high household income) exhibit a high level of body dissatisfaction and those with low SES exhibit a low level of body dissatisfaction, but over time these begin to converge. ConclusionsThe results suggest a particular role for internet exposure, rather than labor market shifts, in increasing negative classifications of the person’s own body as unacceptably big.

Although substance use and violent behaviors often emerge together in adolescence, and both have similar widely cited causes and negative consequences for development, it remains unclear whether and how they may be linked causally. This study of early adolescents in Mexico’s three largest cities tested whether alcohol use and violence perpetration are temporally related, whether their relationship is unidirectional or reciprocal, and whether the relationship differs by gender and the type of violence. The study employed longitudinal data from seventh grade students (N = 4830; M age = 12.0, range 11–15; 49% female) in 18 public middle schools in Mexico City, Guadalajara and Monterrey. Students completed questionnaires at the beginning, middle, and end of the 2014–2015 academic year. Students’ responses to a multi-dimensional violence assessment emerged in two distinct patterns: criminally violent acts, and bullying/aggression. Although males engaged in both types of violence more frequently than females at all three time points, they used alcohol more frequently than females only at the first survey, after which the gender gap disappeared. Cross-lagged multi-group path models showed that, for both males and females, more frequent alcohol use predicted subsequent increases in criminally violent behavior, and bullying/aggression predicted later increases in alcohol use. Reciprocal associations varied by gender and type of violence: Alcohol use was reciprocally linked to criminally violent behavior among males only, and reciprocally linked to bullying-aggression among females alone. The results are interpreted in the context of sharply increasing rates of violence in Mexico and changing gender norms, with implications for youth prevention programs.

The purpose of this study was to assess the combined effectiveness of a parenting intervention, Families Preparing the New Generation (FPNG), and a youth curriculum, keepin’ it REAL (kiR), on substance use prevention for middle school students in a large urban metro area of the southwest USA. The study aimed to generate usable knowledge on what works in adolescent substance use prevention and how it works best—a combined parent and youth programming or parent-only programming. A total of 532 adolescents in the 7th grade from 19 participating middle schools were randomly assigned into three intervention conditions: parent-youth (PY), parent-only (PO), and comparison (C). This article focuses on the comparison between PY and PO in order to determine which intervention strategy works best to reduce adolescent substance use including alcohol, inhalant, cigarette, and marijuana uses. A generalized estimating equation (GEE) model examined the longitudinal data. The results for alcohol use show that PO yielded better results than PY and that PY outperformed C after 20 months. Further, PO showed a decreasing trajectory in any substance use over time since the implementation of the intervention. The effect sizes based on Cohen’s h indicate small effects in any substance use and alcohol use for PO condition and smaller effects for the PY condition. These findings have implications for the design of future culturally specific parenting and youth prevention interventions with Latino families.

People living with severe obesity report high levels of weight-related stigma. Theoretically, this stigma undermines weight loss efforts. The objective of this study is to test one proposed mechanism to explain why weight loss is so difficult once an individual becomes obese: that weight-related stigma inhibits physical activity via demotivation to exercise. The study focused on individuals who had bariatric surgery within the past 5 years (N = 298) and who report a post-surgical body mass index (BMI) ranging from 16 to 70. Exercise avoidance motivation (EAM) and physical activity (PA) were modeled as latent variables using structural equation modeling. Two measures of weight stigma, the Stigmatizing Situations Inventory (SSI) and the Weight Bias Internalization Scale (WBIS) were modified for people with a long history of extreme obesity for use as observed predictors. Exercise avoidance motivation (EAM) significantly mediated the association between both experienced (SSI) and internalized (WBIS) weight stigma and physical activity (PA) in this population. Exercise avoidance motivation, influenced by weight stigma, may be a significant factor explaining the positive relationship between higher body weights with lower levels of physical activity.