Biomedical subjects

Patricia M Dubbert

Publications and source records attributed to Patricia M Dubbert.

14 recordsLinked to original sources

PubMed2006

Physical activity intervention studies: what we know and what we need to know: a scientific statement from the American Heart Association Council on Nutrition, Physical Activity, and Metabolism (Subcommittee on Physical Activity); Council on Cardiovascular Disease in the Young; and the Interdisciplinary Working Group on Quality of Care and Outcomes Research.

In this review, our first purpose is to provide an overview of existing physical activity intervention research, focusing on subpopulations and intervention modalities. Our reviews within each area are not exhaustive or quantitative, as each area has been reviewed in more depth in numerous other reports. Instead, our goal is to provide a single document that provides a qualitative overview of intervention research that emphasizes selected topics of particular importance for improving the population-wide impact of interventions. Therefore, in synthesizing this vast literature, we begin with existing reviews of physical activity research in each area and incorporate in our discussions recent reports of well-designed individual physical activity intervention studies that expand the existing research base and/or target new areas of research. Our second purpose is to offer new ideas and recommendations to improve the state of the science within each area and, where possible, to propose ideas to help bridge the gaps between these existing categories of research.

Adolescent↗

PubMed2006

Physical activity in patients who are severely mentally ill: feasibility of assessment for clinical and research applications.

Few studies have examined physical activity in patients who are severely mentally ill. We assessed feasibility and validity of using standardized self-report and objective measures of physical activity in 20 community-dwelling veteran patients, most with psychotic disorders and substance abuse in remission. Test-retest reliability of a past week physical activity survey and the Community Healthy Activities Model Program for Seniors interview were evaluated with repeated interviews. RT3 accelerometer data provided objective physical activity data. Test-retest reliability and validity correlations for the self-report instruments were similar in magnitude to those reported for nonclinical adult samples. Some activity measures were correlated with cognitive status and quality of life. Results indicate that self-reported physical activity can provide valid information for clinical and research applications in mental health settings. Correlations between physical activity measures and psychiatric symptoms suggested interesting patterns for future study.

Acceleration↗

PubMed2006

Overweight and obesity: prevalence, consequences, and causes of a growing public health problem.

This paper provides an overview of the evidence on the current epidemic of obesity in the United States. The prevalence of overweight and obesity now exceeds 60% among US adults, and the rate is rapidly increasing among children and adolescents. Dismal medical, social, and economic consequences are already apparent and likely to worsen without multipronged intervention. Increased rates of hypertension, diabetes, and dyslipidemia, among other medical conditions, threaten to shorten the longevity of the American populace by as much as 5 years. The incidence of depression is increasing and experts suggest this is linked with the increased prevalence of obesity. The cost of obesity-related medical care has increased astronomically since 1987, in addition to lost productivity and income. Novel multidisciplinary, preventive, and therapeutic approaches, and social changes are needed that address the complex interplay of biologic, genetic, and social factors that have created the current obesity epidemic.

Cardiovascular Diseases↗

PubMed2006

Psychological assessment and management of the weight loss surgery patient.

Psychological evaluation of the weight loss surgery patient is recommended because of the prevalence of psychiatric comorbidities in persons with severe obesity and the behavioral adaptations required for successful surgical outcomes. Although there is currently no national standard for the specific components of these evaluations, there is general agreement in the literature about the objectives and the kinds of assessment methods that are most useful. This paper summarizes the current literature on psychological evaluation of weight loss surgery patients. Methods of assessment relevant to the major behavioral health characteristics of surgical candidates are reviewed, and results from several studies examining weight loss and quality of life outcomes in relation to pre-surgery psychological characteristics are discussed.

Bariatric Surgery↗

PubMed2005

Pregnant women's beliefs and influences regarding exercise during pregnancy.

OBJECTIVE: To sample women's exercise habits and beliefs regarding exercise during pregnancy and to determine patient awareness and physician communication of ACOG's 2002 guidelines for exercise during pregnancy. METHODS: A 28-item questionnaire was completed by 211 patients at a private obstetric and gynecology (Ob/Gyn) group practice during a 4-week study period. RESULTS: Ninety-five percent of the women believed that participating in prenatal exercise was helpful. There was a significant correlation (P<0.000) between a woman's beliefs regarding the benefits of prenatal exercise and whether or not she chose to exercise during pregnancy. Forty-one percent of women surveyed and 41.6% of women who exercised indicated that their doctor had the most influence on their beliefs regarding exercise. Approximately 92% of the women who discussed exercise with their physicians were encouraged by them to exercise. In addition, women who were encouraged to exercise by their physician were more likely (P=0.005) to exercise than those who were not. Only 9.8% of the 133 women who talked to their physician reported that their physician helped them develop an exercise program. Over 69% of women were advised by their physician to place limitations on their exercise habits according to ACOG's 1985 guidelines rather than the current guidelines. A significant relationship was found between BMI and whether or not women exercised (P=0.001). Despite the previously known correlation between BMI and gestational diabetes, we failed to find a significant relationship between BMI and whether or not their physician encouraged them to exercise (P=0.531). CONCLUSION: A majority of women studied believed that exercise will have a positive impact on their pregnancy, are deciding to exercise during their pregnancy, and indicated that their doctor had the most influence on their beliefs about exercise during pregnancy. Because women's behaviors are influenced by their physician's instructions, physicians should be prepared to counsel their healthy ante-partum patients on the benefits of prenatal exercise and be informed of ACOG's current guidelines.

Adult↗

PubMed2005

Sociocultural methods in the Jackson Heart Study: conceptual and descriptive overview.

The Jackson Heart Study (JHS) is a prospective, population-based cohort study designed to investigate risk factors for cardiovascular disease (CVD) in African-American men and women. An aim of the JHS is the elucidation of the role that sociocultural factors play in the excess CVD risk and mortality in African Americans. Considerable evidence is available to document the influence of social, cultural, psychological, and other lifestyle risk factors on cardiovascular outcomes. Far less is known about how these factors affect health outcomes for African Americans. The JHS provides a unique opportunity to evaluate the presence and impact of these factors in this ethnoracial group. This paper describes the rationale and overall approach for sociocultural assessment in the JHS, both generally and for each content area.

Adult↗

PubMed2005

Dietary assessment in African Americans: methods used in the Jackson Heart Study.

OBJECTIVES: The dietary assessment methods used in the Jackson Heart Study (JHS) with the entire cohort and a subset of the cohort who participated in a diet and physical activity substudy (DPASS) are reported. These methods were employed to validate culturally explicit data collection instruments developed by Delta Nutrition Intervention Research Initiative (NIRI) for assessing dietary intake in an all African-American cohort. DESIGN: A validation/calibration design was employed. A short food frequency questionnaire (FFQ) was used with all JHS participants (N=5302). A long FFQ and four 24-hour diet recalls were used for the subset of DPASS participants (n=449). OUTCOME MEASURES: Completion rates and preliminary macronutrient intakes are reported for the cohort and DPASS methods. RESULTS: Participants (5302) in the JHS full cohort completed the short FFQ. Of these, 572 were enrolled in the DPASS. A total of 506 participants completed four 24-hour dietary recalls, and 499 completed all six measures, including the long FFQ. Validation of dietary instruments in African Americans will help assure that valid conclusions can be drawn regarding the effects of diet on cardiovascular disease in this population.

Adult↗

PubMed2005

Physical activity assessment methods in the Jackson Heart Study.

OBJECTIVES: Physical activity measures used in exam 1 of the Jackson Heart Study (JHS), including the diet and physical activity substudy (DPASS), are described. DESIGN: The JHS physical activity (PAC) survey instrument was administered by interview. Accelerometer data, pedometer step counts, and additional questionnaire data were collected from volunteer subsamples of the cohort, including the DPASS. OUTCOME MEASURES: The PAC assessed four different domains of physical activity (active living, work, home and garden, and sport and exercise indexes). The 24-hour accelerometer and pedometer monitoring provided objective measures for validation of cohort survey responses. The DPASS past week activity (PWA) questionnaire assessed time spent in moderate and vigorous activity during the previous seven days. Pedometer step counts for three days before three DPASS visits provided additional data for the DPASS. RESULTS: 5296 respondents completed the PAC, 423 completed 24-hour accelerometer monitoring, and 499 completed the DPASS measures; 85 completed both 24-hour monitoring and DPASS measures. Initial analyses of leisure and sports activity items showed similar distributions for men and women and for the cohort and DPASS participants, in a bimodal distribution, with similar proportions reporting infrequent and frequent activity. The physical activity measures from the JHS can provide unique information about the association between physical activity, other risk factors, and cardiovascular disease in African Americans.

Activities of Daily Living↗

PubMed2004

Evaluation of the 7-day physical activity recall in urban and rural men.

PURPOSE: To assess reliability and validity of the 7-d physical activity recall (PAR) in 60- to 80-yr-old men from urban and rural homes in the southeastern United States. METHODS: Two hundred twenty 60- to 80-yr-old men (29% minority ethnicity) from Veterans Affairs primary care clinics completed two PAR interviews at 2- to 4-wk intervals. The PAR included modifications to elicit and score light-moderate (2-3 METs) as well as moderate (3-6 METs) and hard (>/=7 METs) physical activity. Reliability was assessed using intraclass correlations from the two interviews. Validity was assessed using Spearman correlations of PAR variables with 6-min walk performance, and with treadmill performance and accelerometer activity counts from subsamples, as well as measures of gait, balance, activities of daily living, and perceived quality of life. Results were examined separately for urban and rural participants. RESULTS: Reliability coefficients were acceptable and PAR measures of estimated energy expenditure, and time spent in hard, moderate, and light-moderate activity correlated as hypothesized with the fitness and health measures. CONCLUSION: Reliability and validity coefficients were generally similar to those found in studies of the PAR with younger samples and with instruments designed specifically for use with elders. The PAR is a useful and flexible instrument for assessing physical activity of varying intensity in older men living in both urban and rural home settings.

Humans↗

PubMed2002

Effects of nurse counseling on walking for exercise in elderly primary care patients.

Background. Counseling sedentary primary care patients can increase physical activity, but whether this approach will increase exercise and fitness in elderly adults with chronic diseases remains to be determined. Methods. After receiving individualized nurse counseling to begin a program of walking for health, 60- to 80-year-old primary care patients were randomized to one of three levels of telephone contacts over 10 months: (i) 20 nurse-initiated calls, (ii) 10 nurse-initiated calls plus 10 motivational calls programmed through an automated phone calling system, or (iii) no program-initiated phone contacts. Self-reported (diary) walking adherence was the primary outcome; other activity, social support, health quality of life, and measured walking performance, mobility, and body mass index and girths were also assessed during the initiation (months 1-6) and maintenance (months 7-10) phases of the trial. Results. Average adherence for the 181 participants to the goal of walking at least 20 minutes on 3 or more days per week was 44% for initiation and 42% for maintenance. Participants receiving the combination of nurse-initiated personal and automated phone calls walked significantly more frequently than those with no phone contacts. Fitness improved in all three groups; changes were generally correlated with self-reported walking. Having a companion was associated with more frequent walking. Perceived quality of physical and mental health did not change. Conclusions. Simple and relatively inexpensive nurse contacts can motivate elderly primary care patients to walk for exercise, and this activity is associated with measurable health benefits.

Aged↗

PubMed2002

Obesity, physical inactivity, and risk for cardiovascular disease.

Despite considerable progress in understanding disease mechanisms and risk factors, improved treatments, and public education efforts, cardiovascular disease (CVD) remains the leading cause of death in the United States. Obesity and physical inactivity, 2 important lifestyle-related risk factors for CVD, are prevalent in the southeastern United States and are becoming more prevalent in all racial groups and areas of the country. In reviewing these risk factors, we explored topics including prevalence and trends in population data; associated psychosocial and environmental factors; and some of the mechanisms through which these risk factors are thought to contribute to CVD. We identified significant, but as yet poorly understood, racial disparities in prevalence of obesity, low levels of physical activity, and correlates of these risk factors and examined important differences in the complex relationship between obesity, diabetes, and cardiovascular disease risk between African American and European American women. The Jackson Heart Study will provide important and unique information relevant to many unanswered questions about obesity, physical inactivity, and obesity in African Americans.

Behavior↗

PubMed2002

Mechanisms of obesity-associated cardiovascular and renal disease.

Obesity is the most common nutritional disorder in the United States. Growing evidence suggests that obesity initiates a cascade of disorders including hypertension, diabetes, atherosclerosis, and chronic renal disease, many of which are interdependent. Abnormal kidney function, caused by increased renal tubular reabsorption, initiates volume expansion and increased blood pressure during excess weight gain, and the hypertension and metabolic abnormalities associated with obesity, in turn, contribute to chronic renal disease. Obesity causes cardiac and vascular disease through well-known mediators such as hypertension, type II diabetes, and dyslipidemia, but there is evidence for less well-characterized mediators such as chronic inflammation and hypercoagulation. Although obesity is increasingly recognized as a serious health problem, there are still many unanswered questions about how the multiple disorders associated with excess weight gain interact to cause cardiovascular and renal disease. Also, there are few studies that have examined whether sustained weight loss in obese subjects can reverse these changes. In view of the "epidemic" of obesity in our country and the excess burden of cardiovascular and renal disease in minority populations, addressing these issues is of paramount importance for the Jackson Heart Study, as well as for other national health initiatives.

Animals↗

PubMed2002

Physical activity and exercise: recent advances and current challenges.

This article presents an overview of major developments in physical activity and exercise for health promotion and disease prevention during the past 10 years. The importance of physical activity to physical and mental health was increasingly recognized. Assessment methods appropriate for diverse population groups were developed, and understanding of correlates of regular physical activity improved. Many studies focused on moderate activity that can be integrated into people's everyday lives. Research in community, school, and health care settings demonstrated that interventions based on cognitive-behavioral theories can change physical activity. Nevertheless, physical activity remained at low levels in most population subgroups throughout the past decade. Psychologists can make important contributions to efforts to address this ongoing challenge to public health.

Exercise↗

PubMedDate not supplied

Affective modulation of pain in substance-dependent veterans.

OBJECTIVE: Prior work suggests that positive affect inhibits pain while negative affect facilitates it. The current study sought to determine whether: 1) affective modulation of pain extends to a patient population; 2) cocaine and alcohol dependence influences the pattern of modulation; and 3) affective modulation of pain is mediated by changes in arm temperature. DESIGN: Thirty-seven participants with and without substance dependence (14 alcohol, 13 cocaine, 10 none) attended three experimental sessions intended to induce emotions (negative, neutral, positive) by picture-viewing. Following emotion-induction, participants were asked to submerge their arm in 33 degrees F water and keep it there until they reached tolerance. During submersion, pain ratings were made on a mechanical visual analog scale (M-VAS). OUTCOME MEASURES: Latency from submersion to first movement of the M-VAS (pain threshold) and latency to arm removal (pain tolerance) were measured. Arm temperature and manipulation checks for emotion-induction (corrugator electromyogram, heart rate, skin conductance, self-report) were also recorded. RESULTS: Manipulation checks confirmed that targeted affective states were achieved. Pain threshold and tolerance were higher after viewing pleasant pictures than after unpleasant ones. Although arm temperature did vary based on the affect induced, analyses suggested that temperature did not influence pain outcomes. CONCLUSIONS: Affect modulates pain perception in patients and does not appear to be mediated by changes in arm temperature. Additionally, pain modulation was not significantly influenced by cocaine or alcohol dependence. These data are encouraging, because they suggest that nonpharmacological methods of pain modulation may be effective in substance-dependent individuals.

Adult↗