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Biomedical subjects

J L Forster

Publications and source records attributed to J L Forster.

At least 19 recordsLinked to original sources
PubMed1992

Availability of cigarettes to underage youth in three communities.

BACKGROUND: Underage youth report that they primarily obtain cigarettes from commercial sources. Thus policies that effectively prevent purchase by minors could have an effect on the prevalence of young people's cigarette use. METHODS: In this study, 12- to 15-year-old male and female confederates attempted to purchase cigarettes from all cigarette outlets in three communities. RESULTS: A success rate of 53% over the counter and 79% from vending machines was achieved. These results show that minors can purchase cigarettes in all types of businesses, even those characterized as "adult" locations. Boys in this study had more difficulty than girls in purchasing cigarettes over the counter, and younger individuals had more difficulty than 15-year-olds. However, these differences were not found in vending machine sales. Similarly, over-the-counter sales of cigarettes were significantly reduced following a state-wide increase in the penalty for tobacco sales to minors, but vending machine sales were not affected. CONCLUSIONS: These results support stringent and universal controls over the sale of cigarettes as an essential part of any tobacco use prevention strategy.

Adolescent↗
PubMed1992

Locking devices on cigarette vending machines: evaluation of a city ordinance.

OBJECTIVES: Policymakers, researchers, and citizens are beginning to recognize the need to limit minors' access to tobacco by restricting the sale of cigarettes through vending machines. One policy alternative that has been proposed by the tobacco industry is a requirement that vending machines be fitted with electronic locking devices. This study evaluates such a policy as enacted in St. Paul, Minn. METHODS: A random sample of vending machine locations was selected for cigarette purchase attempts conducted before implementation and at 3 and 12 months postimplementation. RESULTS: The rate of noncompliance by merchants was 34% after 3 months and 30% after 1 year. The effect of the law was to reduce the ability of a minor to purchase cigarettes from locations originally selling cigarettes through vending machines from 86% at baseline to 36% at 3 months. The purchase rate at these locations rose to 48% at 1 year. CONCLUSIONS: Our results suggest that cigarette vending machine locking devices may not be as effective as vending machine bans and require additional enforcement to ensure compliance with the law.

Adolescent↗
PubMed1991

Prevalence of dieting among working men and women: the healthy worker project.

Examined dieting to lose weight in a population of 2,107 men and 2,540 women employed in 32 worksites in the upper Midwest. Lifetime prevalence of this behavior was estimated to be 47% in men and 75% in women, and point prevalence was reported as 13% and 25% in men and women, respectively. Lifetime prevalence of participation in organized weight-loss programs was 6% in men and 31% in women; current prevalence was 1% in men and 6% in women. The strongest correlate of dieting behavior was relative body weight. In logistic regression analyses, dieting tended to be associated positively with education and occupational status and, in men only, was more prevalent among those with a history of hypertension. Dieters reported lower food intakes than nondieters, but the two groups did not differ consistently in reported physical activity. Overall, dieting appears to be a pervasive behavioral U.S. phenomenon that may contribute in part to population differences in the prevalence of obesity.

Adult↗
PubMed1991

Use of carbon monoxide breath validation in assessing exposure to cigarette smoke in a worksite population.

Assessed the usefulness of carbon monoxide (CO) breath validation of self-reported smoking status in a large worksite population (N = 4,647). CO assessment was performed as part of a baseline survey procedure. CO levels differed substantially in relation to self-reported smoking status and amount smoked. Correcting for ambient exposure (estimated by mean CO levels among never smokers) produced more satisfactory results than uncorrected CO levels. Striking company differences were observed in mean CO exposures among self-reported never smokers. An unexpected finding was that 17.1% of current smokers reported smoking less than daily. Although the CO measure was excellent in detecting moderate and heavy smokers, it was inadequate in detecting occasional and light smokers. If detection of occasional or lighter smoking is critical to the purposes of the study, the more expensive (but more accurate) cotinine measure is preferred.

Adult↗
PubMed1991

Socioeconomic status differences in health behaviors related to obesity: the Healthy Worker Project.

Obesity and health behaviors that influence energy balance (diet, exercise, and dieting to lose weight) were examined in a population of 2108 and 2539 working men and women in relation to socioeconomic status (SES). The hypothesis investigated was that the inverse relationship between SES and obesity observed in a number of studies is due to the fact that the distribution of obesity relevant health behaviors differs by social class. Body mass index (BMI), as expected, was found to be inversely related to SES. Higher SES was also associated with several behaviors that contribute importantly to energy balance. High SES respondents reported a lower fat diet, more exercise, and a higher prevalence of dieting to control weight. However, lower smoking rates were observed in upper SES men and women and higher alcohol consumption was reported in upper SES women. Both of these associations appear to be inconsistent with the hypothesis that the inverse association between SES and obesity is caused by differences in health behaviors. In multiple regression analyses, SES remained a significant predictor of BMI after controlling for all measured health behaviors. Weaknesses in the methodologies for measuring health behaviors and possible effects of obesity itself on social mobility are suggested as possible explanations for the residual association between obesity and SES.

Adult↗
PubMed1990

Hypertension prevention trial: do 24-h food records capture usual eating behavior in a dietary change study?

The Hypertension Prevention Trial (HPT) was a randomized unmasked multicenter trial designed to address questions concerning the feasibility and efficacy of dietary intervention in the primary prevention of hypertension. Participants in the diet treatments were given counseling to achieve and sustain changes in calorie, sodium, and/or potassium intake. Diet composition, sodium and potassium excretion, and body weight were assessed for all participants at 6-mo intervals over 3 y. This paper provides information about extent and possible sources of bias in the dietary assessment methodology used in the HPT. Estimates of nutrient intake were derived from food records, urinalysis, and measurement of body weight. Reported potassium intake increased and sodium intake declined to a greater degree during the study than did potassium and sodium excretion. Our results indicate that repeated assessments of diet, which depend upon participant recording, may not accurately represent usual diet in a dietary trial.

Adult↗
PubMed1990

Public support for policy initiatives regulating alcohol use in Minnesota: a multi-community survey.

Public support for policies to control alcohol sales and consumption was surveyed in seven Minnesota communities. A total of 438 women and 383 men were asked to indicate their level of support of or opposition to nine different proposals designed to regulate alcohol. There was general support for all policies, which was strongly related to characteristics of respondents and type of policy proposed. Women were significantly more supportive of all items than were men. Marriage, older age and low alcohol consumption were also associated with support. Education and voter status generally were not. Policies and activities that serve primarily to protect youth received the strongest support. Restrictions and prohibitions such as limiting advertisements were less popular. The least support was expressed for increases in taxes on alcohol and for measures that would eliminate an existing practice such as prohibiting wine-cooler sales at convenience stores. The majority of respondents also indicated that they felt the individual, as opposed to the manufacturer or retailer, was responsible for problems associated with alcohol and should be the focus of intervention. Strategies for shifting the focus from the individual to environmental and regulatory control are discussed.

Adolescent↗
PubMed1989

Public support for policy initiatives regulating high-fat food use in Minnesota: a multicommunity survey.

Public support of eight policies to regulate the sale and consumption of high-fat food was evaluated in a survey of 438 women and 383 men in seven Minnesota communities. The survey was part of the ongoing activities of the Minnesota Heart Health Program (MHHP). Respondents, when asked to indicate their level of support or opposition to each of eight policies, expressed general support for all but two. Women were consistently more supportive than men. Other sociodemographic characteristics and reported use of food and other substances were generally not predictive of support. Policies that would control conditions of sale or information about the product were the most strongly supported. Taxation as an incentive to food producers to provide alternatives to high-fat food or as a disincentive to consumers to purchase these foods was moderately supported. A proposal to limit sale of high-fat food to children was the most strongly opposed. The majority of respondents indicated that they felt the individual consumer, as opposed to the producer or retailer, is most responsible for problems associated with high-fat food use. The three communities which had received MHHP health promotion activities were significantly more supportive than the comparison communities on two of the eight proposals. There is a moderate level of support in the general public for additional policies to regulate the sale and consumption of high-fat foods. These policy level interventions, similar to policies common in the regulation of alcohol and tobacco use, may be a feasible strategy to help moderate use of potentially health-compromising food products.

Adolescent↗
PubMed1989

Baseline characteristics in the Hypertension Prevention Trial. Hypertension Prevention Trial Research Group.

The Hypertension Prevention Trial (HPT) was a randomized, controlled, multicenter (four clinics, four resource centers) trial designed to test the feasibility of achieving and sustaining dietary changes in the intake of calories, sodium, and potassium and to assess the effect of those changes on blood pressure in a normotensive population. The trial involved 841 men and women (plus a test cohort of 78) who, at the first baseline (BL) examination were in the age range of 25-49 years and had diastolic pressure (DBP) greater than or equal to 76 but less than 100 mm Hg (average of two readings), and at the examination prior to randomization (BL 2), had DBP greater than or equal to 78 but less than 90 mm Hg (also averaged). Participants were randomly assigned to a control treatment group (no dietary counseling) or to one of four dietary treatment groups involving counseling designed to reduce calorie intake; reduce sodium intake, reduce sodium and calorie intake, and reduce sodium and increase potassium intake. This chapter presents HPT baseline characteristics by weight stratum, clinic, and treatment group for various demographic, medical history, and nutritional characteristics, for several physiologic variables used in monitoring treatment compliance, and for blood pressure. The degree of comparability observed among treatment groups was within the range expected for the randomization procedure used.

Adult↗
PubMed1989

Long-term follow-up of behavioral treatment for obesity: patterns of weight regain among men and women.

Maintenance of weight loss continues to be a critical concern in behavioral treatment programs. Problems with the acquisition and/or application of behavioral skills are a likely contributor to relapse. However, biological models, especially the hypothesis of a body weight setpoint, are being offered increasingly as alternative explanations for maintenance failure. Within the context of these sometimes opposing viewpoints the present study describes long-term weight outcomes for 114 men and 38 women assessed annually for 4 or 5 years following completion of a 15 week behavioral weight loss program. Although significant mean weight loss was evident at long-term follow-up, a negatively accelerating pattern of weight regain was the predominant outcome. Less than 3 percent of the subjects were at or below their posttreatment weight on all follow-up visits. Consistent sex differences were found, with women having better weight loss maintenance than men. Implications and potential future directions are discussed.

Behavior Therapy↗
PubMed1989

The relationship between social status and body mass index in the Minnesota Heart Health Program.

This study investigated relationships between social variables and body mass index (BMI) in 2465 men and 2792 women aged 25 to 74 in six upper midwestern communities. After controlling for age and cigarette smoking status, BMI was significantly related to education, income, occupation, and marital status in both men and women. SES variables tended to be inversely related to BMI, with a steeper gradient for women than for men. A curvilinear trend was noted, however, in that social status tended to be lower at both ends of weight distribution than in the middle. The relationship between marital status and BMI was also found to be curvilinear. Highest rates of marriage were in the middle portion of the weight distribution for both sexes.

Adult↗
PubMed1988

One-year follow-up study to a worksite weight control program.

Follow-up weights were obtained from 149 participants from two worksite weight control programs 1 year after the end of treatment. These participants regained, on average, 75% of the weight they had lost during treatment. Only 21% of this population maintained their post-treatment weight or continued to lose. We conclude that worksites do not appear to offer special advantages over clinic settings in aiding weight-loss maintenance.

Adult↗
PubMed1988

Preventing weight gain in adults: a pound of prevention.

This study evaluated the feasibility and effectiveness of a program for weight gain prevention in normal-weight adults. Two hundred nineteen participants were randomized to either weight gain prevention treatment or no treatment for a period of 12 months. Those in the treatment group received monthly newsletters relating to weight management, participated in a financial incentive system, and were offered an optional four-session education course in the sixth month of the program. Results demonstrated high interest in weight gain prevention among individuals who were not objectively overweight. Participation, as measured by return of postcards sent with each newsletter, was approximately 75%. Results after 1 year showed a net weight loss in the group receiving the program of 1.8 lb compared to those in the control group. Eighty-two percent of program participants maintained or lost weight, compared to 56% of the control group. It is concluded that programs for weight gain prevention are feasible in adults and may be more effective than weight loss treatment programs in addressing the problem of community-wide obesity.

Adult↗
PubMed1987

Home testing of urine chloride to estimate dietary sodium intake: evaluation of feasibility and accuracy.

To estimate the utility of quantab chloride titrators, a product of Ames Laboratories, in estimating urine and diet sodium, two study populations were examined. The first consisted of 56 normotensive individuals providing timed, overnight, urine collections and 24-hour food records as part of the baseline assessment for a hypertension prevention study. The second group consisted of 19 study employees, who were instructed to maintain a low sodium diet, and to self-assess diet sodium and urine chloride at home. Results showed that urine chloride measured by quantab was highly correlated with urine sodium. Neither urine chloride nor urine sodium correlated highly with the previous day's intake of dietary sodium as measured by food record. It is estimated that five overnight urine samples would be required to estimate food record sodium to within +/- 25 mEq in individuals with relatively stable diets. Home assessment of urine chloride is feasible. It seems likely that clinical procedures which combine self-monitoring of dietary sodium intake by food record and home measurement of urine chloride concentration would be an effective way of providing persons prescribed sodium restricted diets with continuous and convergent feedback about their success in dietary adherence.

Adult↗
PubMed1986

Reproductive history and body mass index in black and white women.

The relationships of timing, spacing, number of births, and demographic variables to body mass index were examined in 844 white and 289 black women. Subjects were interviewed in 1978-1979 as mothers or female guardians of a stratified random sample of all Minneapolis children in grades 1-3. Results indicate that among black and white women, number of births, age at last birth, and years between first and last births were positively associated with body mass index. However, when age, education, and income were included in the regression equation for black women, none of the reproductive variables predicted body mass index. When number of births, age at last birth, and years between first and last birth were included in the same regression for white women, only number of births was independently associated with body mass index.

Adult↗
PubMed1986

Gender differences related to weight history, eating patterns, efficacy expectations, self-esteem, and weight loss among participants in a weight reduction program.

Fifty-five men and 58 women participating in a behavioral weight loss program were studied to determine sex differences in weight history, eating patterns, efficacy expectations, self-esteem, weight loss and maintenance. Weight history, eating patterns, and psychological variables were further analyzed to identify factors associated with weight change. Women reported more previous dieting experience and a higher degree of overweight at age 25 than men. Women also reported more eating in response to mood and lower self-efficacy prior to participation in this program, while men reported more eating in social situations. Women's self-efficacy rose during treatment, but men's did not. Short-term weight loss was not related to sex, but women were more successful in maintaining weight loss. Degree of overweight at age 25 and prior program participation were inversely related to weight loss success. Self-efficacy in social situations was positively associated in men with short-term weight loss. For men, eating frequency in various moods at post-treatment negatively predicted weight maintenance, and self-efficacy in controlling mood-related eating was positively associated with weight maintenance. We conclude that men and women differ importantly along several dimensions with regard to weight history and response to treatment. These differences may have implications for treatment of overweight.

Behavior Therapy↗
PubMed1985

Promoting weight control at the worksite: a pilot program of self-motivation using payroll-based incentives.

Thirty-six individuals participated in a worksite weight-loss program in which the central component was a self-motivation program of biweekly payroll deductions refunded contingent on meeting self-selected weight-loss goals. Half were assigned to early treatment and the remainder to a delayed treatment control group. Nine additional individuals also enrolled at the time of delayed treatment and were included in descriptive analyses of factors associated with weight loss. Results showed low program attrition over 6 months (6%) and mean weight losses (12.3 lb) that are competitive with those obtained in clinical settings. Although not different at baseline, participants in the delayed treatment group lost more than twice as much weight as those in the early treatment condition. This difference was interpreted as either a strong seasonal effect or a critical mass effect related to the proportion of employees at the worksite participating in the program. We conclude that self-motivation programs for health behavior change using the payroll system as an organization framework offer a promising new methodology for promoting healthful behaviors in work settings.

Adult↗