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Biomedical subjects

Louise C Mâsse

Publications and source records attributed to Louise C Mâsse.

18 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↗

Factorial and construct validity of the athletic identity questionnaire for adolescents.

PURPOSE: This research describes the development of a measure of the general attribute of "athletic" in adolescents, encompassing exercise, sport, and physical activity. Based on a theoretical model supported in adults, the 40-item Athletic Identity Questionnaire (AIQ) for adolescents assesses four dimensions: appearance, competence, importance of activity, and encouragement from three sources: parents, friends, and teachers/other adults. METHODS: Structural equation modeling was used to evaluate the hypothesized four-factor model in a development sample of 408 adolescents in eighth grade (mean age 13.4 yr). A separate sample (N = 1586) was used to cross-validate the final model. Construct validity was examined by testing the model's relationship to self-reported (Modifiable Activity Questionnaire-Adolescent, Previous Day Physical Activity Recall, Youth Risk Behavior Survey) and objectively measured physical activity (MTI accelerometer in sample 3, N = 100). RESULTS: Confirmatory factor analysis supported the four-factor structure, and there was also support for a higher-order model. LISREL correlations between the AIQ factors and self-reported physical activity ranged from 0.32 to 0.61, TV watching from -0.20 to -0.50, and sport-team participation from 0.20 to 0.54. Pearson correlations between the AIQ factors and MTI vigorous physical activity ranged from 0.09 to 0.26 and MTI moderate from -0.06 to 0.22. CONCLUSIONS: Findings support the factorial and construct validity of the AIQ for adolescents.

Adolescent↗

Constructing indices representing supportiveness of the physical environment for walking using the Rasch measurement model.

BACKGROUND: The objectives of this study were to use the Rasch model to 1) assess the psychometric properties of a physical environmental audit instrument and 2) to develop indices of interrelated environmental attributes that summarize environmental supportiveness for walking. METHODS: A set of items were derived representing two conceptual physical environmental constructs: 1) functional/safety, and; 2) aesthetics. Ad hoc criteria based on point-biserial and Rasch-based fit statistics were used to examine the construct validity and internal reliability of the two constructs. RESULTS: The Rasch-based fit statistics assisted in identifying 12 items that belonged to the functional/safety construct and 4 items that belonged to the aesthetic construct. The reliability of the two constructs were low to moderate (functional/safety r(beta) = 0.19 and aesthetics r(beta) = 0.35). CONCLUSION: Given the vast number of built environmental attributes, a means of developing summary indices is essential. Future studies should assess the reliability and validity of indices that summarize physical environmental characteristics conducive to walking before testing them in predictive models of physical activity. More research examining procedures for measuring the built environment and techniques for analyzing environmental data are needed to guide future research in this area.

Journal Article↗

Does participation in an intervention affect responses on self-report questionnaires?

There has been some concern that participation in an intervention and exposure to a measurement instrument can change participants' interpretation of the items on a self-report questionnaire thereby distorting subsequent responses and biasing results. Differential item functioning (DIF) analysis using item response modeling can ascertain possible differences in item interpretation by testing for differences in item location between groups. The DIF for treatment versus control group differences at post-intervention assessment and the Time 1 and Time 2 differences in a control group were analyzed using data from a dietary change intervention trial for Boy Scouts. The measures included fruit and vegetable (FV) frequency of consumption, preferences and self-efficacy. Treatment-control group DIF at post-intervention assessment was detected in a higher percentage of items for FV frequency than for preference or self-efficacy. Time 1 to Time 2 differences in items for the control group were detected in one item for each of the three scales. Further research will need to clarify whether the obtained DIFs reflected true changes in frequency, preference or self-efficacy or some reinterpretation of items by participants following an intervention or merely after previous exposure to the measure.

Bias↗

Evaluating the properties of a stage-specific self-efficacy scale for physical activity using classical test theory, confirmatory factor analysis and item response modeling.

The purpose of this paper was to evaluate the psychometric properties of a stage-specific self-efficacy scale for physical activity with classical test theory (CTT), confirmatory factor analysis (CFA) and item response modeling (IRM). Women who enrolled in the Women On The Move study completed a 20-item stage-specific self-efficacy scale developed for this study [n=226, 51.1% African-American and 48.9% Hispanic women, mean age = 49.2 (+/-7.0) years, mean body mass index = 29.7 (+/-6.4)]. Three analyses were conducted: (i) a CTT item analysis, (ii) a CFA to validate the factor structure and (iii) an IRM analysis. The CTT item analysis and the CFA results showed that the scale had high internal consistency (ranging from 0.76 to 0.93) and a strong factor structure. Results also showed that the scale could be improved by modifying or eliminating some of the existing items without significantly altering the content of the scale. The IRM results also showed that the scale had few items that targeted high self-efficacy and the stage-specific assumption underlying the scale was rejected. In addition, the IRM analyses found that the five-point response format functioned more like a four-point response format. Overall, employing multiple methods to assess the psychometric properties of the stage-specific self-efficacy scale demonstrated the complimentary nature of these methods and it highlighted the strengths and weaknesses of this scale.

Adult↗

Introducing equating methodologies to compare test scores from two different self-regulation scales.

Standardizing the measurement tools that researchers use to assess the effectiveness of interventions would strengthen our ability to compare results across studies. In practice, however, standardization is difficult to implement, in part, because researchers prefer to use measurement tools that focus specifically on the components of their interventions. This paper demonstrates the usefulness of item response modeling linking methodology in comparing groups of participants who were administered different scales intended to measure the same underlying constructs. The Treatment Self-Regulation Questionnaire (TSRQ) as it relates to diet improvement provided the empirical application to demonstrate how two different scales that measure the same construct can be compared. The results showed that two eight-item TSRQ scales can be linked if they have at least four items in common. As expected, varying the number of linking items did not affect the reliability of the results; however, it significantly affected the relative rating with respect to the 15-item scale. In health behavior and health education research, linking methodologies can be used to compare results across studies that use slightly different versions of a scale to measure the same construct.

Adult↗

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↗

Controlled physical activity trials in cancer survivors: a systematic review and meta-analysis.

BACKGROUND: Approximately 9.8 million cancer survivors are alive in the United States today. Enthusiasm for prescribing physical activity for cancer survivors depends on evidence regarding whether physical activity during or after completion of treatment results in improved outcomes such as cardiorespiratory fitness, fatigue, symptoms, quality of life, mental health, or change in body size. METHODS: A systematic qualitative and quantitative review of the English language scientific literature identified controlled trials of physical activity interventions in cancer survivors during and after treatment. Data from 32 studies were abstracted, weighted mean effect sizes (WMES) were calculated from the 22 high-quality studies, and a systematic level of evidence criteria was applied to evaluate 25 outcomes. RESULTS: There was qualitative and quantitative evidence of a small to moderate effect of physical activity interventions on cardiorespiratory fitness (WMES = 0.51 and 0.65 during and after treatment respectively, P < 0.01), physiologic outcomes and symptoms during treatment (WMES = 0.28, P < 0.01 and 0.39, P < 0.01, respectively), and vigor posttreatment (WMES = 0.83, P = 0.04). Physical activity was well tolerated in cancer survivors during and after treatment, but the available literature does not allow conclusions to be drawn regarding adverse events from participation. CONCLUSIONS: Physical activity improves cardiorespiratory fitness during and after cancer treatment, symptoms and physiologic effects during treatment, and vigor posttreatment. Additional physical activity intervention studies are needed to more firmly establish the range and magnitude of positive effects of physical activity among cancer survivors.

Clinical Trials as Topic↗

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↗

Discrepant views of oncologists and cancer patients on complementary/alternative medicine.

GOALS: Complementary/ alternative medicine (CAM) is widely used by patients but rarely discussed with oncologists. To understand reasons for the communication gap, this study compares physicians and patients on perceived reasons for CAM use and nondisclosure of use, reactions of physicians to disclosure, and expectations for CAM. PATIENTS AND METHODS: Cross-sectional studies assessed 82 physicians (response 68.3%) and 244 of 374 outpatients (response 65.2%) identified as CAM users at the MD Anderson Cancer Center. Data were summarized by frequency and compared using chi-square tests. MAIN RESULTS: Physicians were more likely (p<0.001) than patients to attribute CAM use to hope (chi2=17.7), control (chi2=17.5), incurable disease (chi2=42.8), or a nontoxic approach (chi2=50.9). Both physicians and patients agreed CAM could relieve symptoms/side effects, but physicians were less likely (p<0.001) than patients to expect that CAM improved immunity (chi2=72.2) or quality of life (chi2=17.1), cured disease (chi2=42.5), or prolonged life (chi2=58.4). Physicians and patients responded differently (p<0.005) on reasons for nondisclosure. Physicians believed patients felt CAM discussions were unimportant (chi2=7.9) and physicians would not understand (chi2 =48.1), discontinue treatment (chi2=26.4), discourage or disapprove of the use (chi2=131.7); patients attributed nondisclosure to their uncertainty of its benefit (chi2=10.4) and never being asked about CAM (chi2=9.9) by physicians. Physicians were more likely (chi2=9.5, p<0.002) to warn of risks and less likely (chi2=23.5, p<0.001) to encourage use than patients perceived. CONCLUSION: Oncologists and cancer patients hold discrepant views on CAM that may contribute to a communication gap. Nevertheless, physicians should ask patients about CAM use, discuss possible benefits, and advise of potential risks.

Adult↗

Skin cancer prevention and detection by nurses: attitudes, perceptions, and barriers.

BACKGROUND: To examine attitudes and perceptions of nurses with respect to skin cancer prevention and detection; to identify barriers to skin cancer prevention and detection by nurses. METHODS: Descriptive survey of 457 nurses from the Texas State Board of Nurse Examiners in 1997. RESULTS: Eighty-nine percent of the nurses reported that skin cancer was a serious problem, and 97% believed that many people were at risk. More than 89% stated that skin cancer prevention/detection would benefit patients, and 94% believed that such skills would benefit nurses. Eighty-four percent reported that it was in their scope of practice to teach skin cancer prevention to patients, and 61% stated that it was in their scope of practice to detect skin cancer in patients. Barriers to skin cancer prevention and detection included lack of national guidelines (69%), low priority among doctors (63%), and the belief that patients should take full responsibility for prevention (50%). Barriers to continuing education for skin cancer screening included lack of money (43%), not knowing how to obtain education (41%), time away from work (36%), and time away from home (26%). CONCLUSIONS: These findings may suggest that nurses can play a role in skin cancer prevention and detection.

Adult↗

Lack of time for physical activity: perception or reality for African American and Hispanic women?

Lack of time is a well-known barrier to physical activity. It is not known, however, whether this barrier reflects actual time commitments. This study examined time commitments of women and assessed the relationship between time commitments and perceived lack of time for physical activity. Participants were 249 African American and Hispanic women, aged 45 to 70 years. These women devoted much of their time to their responsibilities as workers, housekeepers, mothers and wives. They also spent 28 hours per week in sedentary leisure-time activity. Actual time commitments did not predict perceived lack of time for physical activity. These findings can be used to address the misperceptions of women about time available to them for physical activity.

Black or African American↗

Influence of body composition on physical activity validation studies using doubly labeled water.

This study investigated the influence of two approaches (mathematical transformation and statistical procedures), used to account for body composition [body mass or fat-free mass (FFM)], on associations between two measures of physical activity and energy expenditure determined by doubly labeled water (DLW). Complete data for these analyses were available for 136 African American (44.1%) and Hispanic (55.9%) women (mean age 50 +/- 7.3 yr). Total energy expenditure (TEE) by DLW was measured over 14 days. Physical activity energy expenditure (PAEE) was computed as 0.90 x TEE - resting metabolic rate. During week 2, participants wore an accelerometer for 7 consecutive days and completed a 7-day diary. Pearson's product-moment correlations and three statistical procedures (multiple regressions, partial correlations, and allometric scaling) were used to assess the effect of body composition on associations. The methods-comparison analysis was used to study the effect of body composition on agreement. The statistical procedures demonstrated that associations improved when body composition was included in the model. The accelerometer explained a small but meaningful portion of the variance in TEE and PAEE after body mass was accounted for. The methods-comparison analysis confirmed that agreement with DLW was affected by the transformation. Agreement between the diary (transformed with body mass) and TEE reflected the association that exists between body mass and TEE. These results suggest that the accelerometer and diary accounted for a small portion of TEE and PAEE. Most of the variance in DLW-measured energy expenditure was explained by body mass or FFM.

Adult↗

Emerging measurement and statistical methods in physical activity research.

Although many studies have attempted to identify mediators and moderators of changes in physical activity involvement, the literature is inconclusive regarding which variable(s) relate to physical activity behavior change. The Cooper 2001 Conference series dedicated a session to discussing measurement and statistical methods that could contribute to advancing this research agenda. This article focuses on four such methodologic approaches: qualitative; psychometric; latent-variable, structural equation modeling; and multilevel modeling. The article presents a brief overview of these methods and discusses potential advantages and limitations of using them.

Factor Analysis, Statistical↗

Type A behavior and daily living activity among older minority women.

INTRODUCTION: The association between type A behavior pattern (TABP) and physical activity is unclear, with studies reporting both positive and negative results and some reporting no association. Because previous studies have looked primarily at the relationship between TABP and exercise, the purpose of this study was to assess the association between TABP and (1) total activity, (2) activity at work, (3) exercise, (4) household chores, (5) leisure activity, and (6) inactivity. METHODS: Two hundred twenty-seven women (111 African American, 116 Hispanic) from a larger study (Women on the Move) were used in the analysis for this study. The mean age was 49.3 years (SD 7 years), mean weight 77 kg (SD 17.6 kg), and mean body mass index (BMI) 30 (SD 6.5). As part of the Women on the Move Study, participants completed a 7-day diary and a 10-item Activity Temperament Scale. Multiple regression analysis was conducted to test the relationship between TABP and daily activity. Significant findings were observed for total activity and leisure activity with the Activity Temperament Scale summary score. Both had positive associations, indicating that those who had a higher score on the Activity Temperament Scale also had higher total activity kilocalories (kcal) and leisure activity kilocalories. Significant positive findings were also observed for total activity, leisure activity, and exercise with individual items on the Activity Temperament Scale. Household chores, work, and inactivity had significant negative associations with one or more of the individual items on the Activity Temperament Scale. CONCLUSIONS: Although previous studies have reported on TABP and physical activity (primarily exercise), these findings provide new information specific to daily living activity by dimension in an older minority population. Results suggest a positive association between TABP and daily living activity with a general pattern of higher scores associated with higher activity and lower scores associated with higher inactivity. However, even though some significant findings were observed, the overall models did not reveal meaningful associations.

Activities of Daily Living↗

Recruiting and retaining minority women: findings from the Women on the Move study.

OBJECTIVES: To describe the recruitment, enrollment, and retention of women participating in the Women on the Move study, a physical activity validation study targeting urban minority women aged 40 to 70 years. DESIGN: The intensive 15-day validation protocol included ingestion of doubly labeled water (2H2 18O), collection of 9 urine samples, completion of multiple physical activity surveys, including selected questions from the BRFSS and NHANES III, wearing an accelerometer, and completing a detailed diary of physical activity for 7 days. The follow-up interview included completion of more questionnaires, followed by measurement of resting metabolic rate. In planning for recruitment, enrollment, and retention of participants, investigators consulted with a community advisory board and conducted focus groups with members of the target communities and with key community leaders. METHODS: Recruitment methods included print, television, and radio advertisements and presentations at community health fairs, churches, and health clinics. RESULTS: Of the 656 women who expressed interest in the study, 386 (59%) met eligibility criteria, and 260 were enrolled (130 Latina, 130 African-American). To retain participants in the study, investigators had intensive telephone contact with the participants, scheduled meetings at times and locations convenient for the participants, used bilingual and bicultural staff, and offered participants staged monetary payments. Of the women enrolled, the retention for the meetings that could happen at more convenient locations was 98.8% and for the required meeting at a central location it was 85.4%. CONCLUSION: Experience from the Women on the Move study suggests that by working with community members, Latina and African-American women can be successfully recruited and, through extensive contact, retained, even in research studies with demanding protocols.

Adult↗

Ethnic differences among correlates of physical activity in women.

PURPOSE: This study investigated differences between two ethnic minority groups on five hypothesized correlates of physical activity (beliefs about the value of physical activity, normative modeling, perceived barriers, outcome expectations, and self-efficacy). DESIGN: A cross-sectional sample consisting of 246 African American and Hispanic women 40 to 70 years of age was used. Multivariate analysis of covariance including interactions with education and income was used. RESULTS: A three-way interaction (ethnicity by education by income) was significant for perceived barriers. In addition, a two-way interaction (education by income) was significant for normative modeling. CONCLUSIONS: Ethnic differences by education and income were associated with some correlates of physical activity; therefore, it is important to consider this diversity when designing physical-activity interventions for minority women.

Adult↗