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Biomedical subjects

Bernard F Fuemmeler

Publications and source records attributed to Bernard F Fuemmeler.

8 recordsLinked to original sources

Employer and healthcare policy interventions aimed at adult obesity.

BACKGROUND: Increasing rates of obesity in the population have made prevention a high public health priority. Policy strategies for curtailing obesity have been recommended, yet there has been little research on the degree of public support for policy-level interventions. METHODS: Participants for this study included 1139 respondents who were surveyed as part of the Research Triangle Institute Obesity Telephone Survey conducted in September 2004. Participants were asked to indicate to what degree they favor specific healthcare and work policy strategies for treating and preventing adult obesity. Participants were also asked about their beliefs regarding the causes of obesity. RESULTS: A majority (85%) favored a policy change strategy that offered employers tax breaks if they provided adequate exercise facilities in the workplace. Seventy-three percent favored a move by healthcare companies to require obesity treatment and prevention. The same proportion (72%) favored beneficiary discounts by employers or healthcare companies to motivate individuals to maintain or move toward a healthy weight. Majorities endorsed a lack of willpower and the cost of healthy food as causes. Nearly two thirds did not believe genes or lack of knowledge was related to obesity in society, and the sample was split with regard to the belief that obesity is caused by society. CONCLUSIONS: The findings suggest that there is strong support for healthcare and employment policies in obesity prevention and treatment. These findings may be important to policymakers in developing population-based strategies to prevent obesity.

Adolescent↗

Psychosocial mediation of fruit and vegetable consumption in the body and soul effectiveness trial.

In this study the authors examined psychosocial variables as mediators for fruit and vegetable (FV) intake in a clustered, randomized effectiveness trial conducted in African American churches. The study sample included 14 churches (8 intervention and 6 control) with 470 participants from the intervention churches and 285 participants from the control churches. The outcome of FV intake and the proposed mediators were measured at baseline and at 6-month follow-up. Structural equation modeling indicated that the intervention had direct effects on social support, self-efficacy, and autonomous motivation; these variables also had direct effects on FV intake. Applying the M. E. Sobel (1982) formula to test significant mediated effects, the authors confirmed that social support and self-efficacy were significant mediators but that autonomous motivation was not. Social support and self-efficacy partially mediated 20.9% of the total effect of the intervention on changes in FV intake. The results support the use of strategies to increase social support and self-efficacy in dietary intervention programs.

Feeding Behavior↗

Association between smoking and attention-deficit/hyperactivity disorder symptoms in a population-based sample of young adults.

CONTEXT: Attention-deficit/hyperactivity disorder (ADHD) has been associated with increased risk of smoking, and some studies have suggested that inattentive symptoms specifically may underlie this risk. Few studies, however, have examined ADHD symptoms in nonclinical samples to determine the extent to which the number of symptoms-independent of the full diagnosis-confer risk for smoking-related outcomes. OBJECTIVE: To evaluate the relation between smoking-related variables and the number of retrospectively reported ADHD inattentive and hyperactive/impulsive symptoms in a population-based sample of young adults. DESIGN, SETTING, AND PARTICIPANTS: The study population consists of 15 197 eligible participants from wave III of the National Longitudinal Study of Adolescent Health, a nationally representative sample of adolescents followed from 1995 to 2002. MAIN OUTCOME MEASURES: Logistic regression was used to examine the relation between self-reported ADHD symptoms and the lifetime likelihood of being a regular smoker, defined by having smoked at least 1 cigarette a day for 30 days. For individuals reporting regular smoking, we also examined the extent to which ADHD symptoms predicted age at onset of regular smoking and number of cigarettes smoked. RESULTS: A linear relation was identified between the number of self-reported inattentive and hyperactive/impulsive symptoms and smoking outcome measures (P<.001 for each symptom domain). Controlling for demographic and conduct disorder symptoms, each reported inattention and hyperactivity/impulsivity symptom significantly increased the likelihood of ever regular smoking (odds ratio [OR], 1.11; 95% confidence interval [CI], 1.08-1.14 and OR, 1.16; 95% CI, 1.13-1.19, respectively). For those reporting lifetime regular smoking, reported symptoms decreased the estimated age at onset and increased the number of cigarettes smoked. CONCLUSIONS: Self-reported ADHD symptoms were found to be associated with adult smoking outcome variables in this nationally representative sample, providing further evidence of a likely link between ADHD symptoms and risk for tobacco use.

Adolescent↗

Accelerometer data reduction: a comparison of four reduction algorithms on select outcome variables.

PURPOSE: Accelerometers are recognized as a valid and objective tool to assess free-living physical activity. Despite the widespread use of accelerometers, there is no standardized way to process and summarize data from them, which limits our ability to compare results across studies. This paper a) reviews decision rules researchers have used in the past, b) compares the impact of using different decision rules on a common data set, and c) identifies issues to consider for accelerometer data reduction. METHODS: The methods sections of studies published in 2003 and 2004 were reviewed to determine what decision rules previous researchers have used to identify wearing period, minimal wear requirement for a valid day, spurious data, number of days used to calculate the outcome variables, and extract bouts of moderate to vigorous physical activity (MVPA). For this study, four data reduction algorithms that employ different decision rules were used to analyze the same data set. RESULTS: The review showed that among studies that reported their decision rules, much variability was observed. Overall, the analyses suggested that using different algorithms impacted several important outcome variables. The most stringent algorithm yielded significantly lower wearing time, the lowest activity counts per minute and counts per day, and fewer minutes of MVPA per day. An exploratory sensitivity analysis revealed that the most stringent inclusion criterion had an impact on sample size and wearing time, which in turn affected many outcome variables. CONCLUSIONS: These findings suggest that the decision rules employed to process accelerometer data have a significant impact on important outcome variables. Until guidelines are developed, it will remain difficult to compare findings across studies.

Acceleration↗

Diffusion of an integrated health education program in an urban school system: planet health.

OBJECTIVE: Assessed the feasibility, acceptability, and sustainability of Planet Health, an interdisciplinary, integrated health education curriculum implemented in six public middle schools. METHODS: Workshops on Planet Health implementation were attended by 129 teachers (language arts, math, science, and social studies) over three school years (1999-2000, 2000-2001, and 2001-2002). Questionnaires were administered post-implementation and in the fall and spring of each year. Outcomes were dose, acceptability, feasibility, and intent to continue use. RESULTS: The average number of lessons taught per teacher per year was 1.7 to 3.1, compared to a goal of 2 to 3. Each year, teachers reported high acceptability and perceived feasibility of the intervention, and the majority indicated they intended to continue using the curriculum. CONCLUSIONS: Planet Health was feasible and acceptable in a participatory research model involving a public school-university partnership, and it was also sustainable independent of the research effort.

Boston↗

Survivors of childhood brain tumors: behavioral, emotional, and social adjustment.

This paper reviews the literature on the psychological adjustment and quality of life in children who survive brain tumors. A total of 31 studies were reviewed. Findings are discussed in terms of the rates of general psychological adjustment, internalizing behavior problems, externalizing behavior problems, social competence, correlates or predictors of adjustment, and quality of life among survivors. Although these survivors appear to be at risk for compromised social competence and long-term quality of life, reports in the literature on rates of psychological adjustment in this population vary widely. Limitations in the current literature are discussed including inadequate assessment techniques, lack of appropriate comparison groups, and small sample sizes. Directions for future research are offered.

Adaptation, Psychological↗