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Biomedical subjects

R M Chamberlain

Publications and source records attributed to R M Chamberlain.

44 records · Page 3Linked to original sources
PubMedDate not supplied

Cigarette smoking in a multiethnic population of youth: methods and baseline findings.

BACKGROUND: To expand upon recent research studies that have identified dramatic ethnic differences in adolescent cigarette smoking, this study was designed to characterize smoking among a multiethnic population of adolescents and to identify significant factors that may protect against smoking initiation. METHODS: During the first 2 years, this mixed cross-sectional, longitudinal study recruited and collected baseline data from a volunteer sample of 1,441 Houston-area public school students in the 5th, 8th, or 12th grade. A wide range of new and established predictors of smoking behavior was assessed, and their associations with ever smoking and susceptibility to smoking were assessed within ethnicity (white, N = 537; African-American, N = 454; and Hispanic, N = 297). RESULTS: Consistent with previous studies, white students smoked in substantially higher proportions than African-American students, with Hispanic adolescents in-between. Simultaneously adjusting for other variables, the odds of ever smoking (OR = 0.47, P < 0.01) and susceptibility to smoking (OR = 0.64, P < 0.01) were significantly lower among African-American adolescents when compared with whites; odds ratios for Hispanics and whites did not differ. Across all three ethnicities, the most important predictor of both ever smoking and susceptibility to smoking was the smoking status of the three best friends. Several ethnicity-specific variables also were identified. CONCLUSIONS: In concordance with previous investigations, cigarette smoking prevalence differs by ethnicity, and the factors associated with ever smoking and susceptibility to smoking differ among white, African-American, and Hispanic adolescents. The results of this study may be used to develop theory-based, culturally appropriate smoking intervention programs for adolescents.

Adolescent↗
PubMedDate not supplied

Durability and diffusion of the nutrition intervention in the Working Well Trial.

BACKGROUND: The Working Well Trial (WWT) emphasized employee participation in the planning and implementation of the health promotion intervention. These participatory strategies were intended to promote institutionalization of the health promotion program and thereby encourage maintenance of the intervention activities. We used data from 107 worksites in the WWT to test whether the nutrition intervention activities were maintained after the research program (i.e., durability) or were adopted by control sites (i.e., diffusion). METHODS: At baseline, upon the completion of the 2-year intervention, and 2 years later, we conducted organization surveys regarding worksite health promotion activities. A nutrition activity score from 0 to 3 was calculated based on availability of nutrition-related programs, self-help manuals or guides, and videos, tapes, brochures, or posters. RESULTS: From baseline to the end of the intervention, there was a significant increase in the nutrition activity score in intervention worksites compared with the controls (P < 0.001). However, 2 years later, there was no difference between intervention and control worksites. In addition, there was no significant increase in the nutrition activity score in control site 2 years after they received the intervention protocols and materials. CONCLUSIONS: Research is needed to develop and test worksite-based interventions to promote institutionalization, durability, and diffusion.

Adult↗
PubMedDate not supplied

Racial disparity in survival of patients with squamous cell carcinoma of the oral cavity and pharynx.

BACKGROUND: This study was designed to determine if race and age are independent prognostic factors for survival in patients treated for squamous cell carcinoma of the oral cavity and pharynx. METHODS: Retrospective study. RESULTS: Out of 909 patients registered, 815 (90%) were white and 94 (10%) were African-American. The median age was 60 years (range 19-93). The African-American patients had a significantly lower 5 year survival rate of 27.6% (95% CI 19.9-38.3) compared with white patients with a survival rate of 52.0% (95% CI 48.7-55.6) (P < 0.001). The greatest racial disparities in survival were observed in patients under 60 years of age [29.2% (95% CI 19.5-43.6) vs 60.9% (95% CI 56.3-66.0) for African-American and white patients, respectively, P < 0.001], and in African-American men compared with white men [20.2% (95% CI 12.6-30.2) vs 51.0% (95% CI 46.7-53.0), P < 0.001]. A multivariate Cox model, stratified according to stage of disease, indicated that race, age, and type of treatment were statistically significant predictors of survival. After adjusting for race and treatment received, African-American patients had a relative risk of dying of 1.61 (95% CI 1.23-2.10) compared with white patients. All patients 60 years of age and older had a higher risk of dying 1.59 (95% CI 1.31-1.92). Compared with surgical treatment alone, radiotherapy and other treatments were both associated with increased risk of dying with respective relative risks of 1.34 (95% CI 1.01-1.76) and 1.94 (95% CI 1.52-1.48). CONCLUSIONS: African-American patients had poorer survival outcomes, with race and age emerging as significant independent predictors of survival after treatment for oral and pharyngeal cancer, compared with their white counterparts. Primary and secondary prevention programs that target younger patients at high risk might reduce environmental risk factors such as smoking and alcohol consumption, which may play a greater role in the acquired susceptibility for oral and pharyngeal cancer in African-American males.

Adult↗
PubMedDate not supplied

A voice that wraps around the body--communication problems in the advanced stages of non-small cell lung cancer.

INTRODUCTION: Significant problems in clinician-patient communication have been described in the oncology literatures. Advanced stage non-small lung cancer a devastating disease, can cause the communication between survivors, significant others, and clinicians to falter. To date, however, no studies have used qualitative methods to examine experiential aspects of living with non-small cell lung cancer. Nor have any studies evaluated the tools survivors might use to repair some of the damage caused by living with this disease. METHODS: Exploratory, two-part qualitative design. RESULTS: Survivors of non-small cell lung cancer live with multiple fears and losses. These include a diminished sense of self, the loss of health, fears of pain in a future tainted by the threat of death, and increased feelings of alienation due to the loss of previous sources of meaning in life. These experiences significantly affect cancer survivors abilities to communicate with clinicians and significant others. CONCLUSIONS: Survivors of non-small cell lung cancer often have difficulty sharing their experiences with others not suffering a similar affliction. Through their narratives with other survivors, however, patients are better able to initiate a biopsychosocial mechanism which enables them to create a cognitive map. This cognitive map helps survivors share their experiences with others, thereby repairing some of the damage caused by this disease, including the harm done to their communication with other people.

Adult↗
PubMedDate not supplied

Components of the working well trial intervention associated with adoption of healthful diets.

INTRODUCTION: This report examines whether variability in the type and amount of the nutrition intervention in a worksite-based intervention could explain dietary outcomes. METHODS: Data are from 55 intervention worksites in the Working Well Trial, a randomized controlled trial of worksite-based health promotion. The components of the nutrition intervention were kickoff event, direct education, interactive activities (e.g., food sampling), contests, printed information picked up by employees, and materials distributed to employees. We measured delivery of the nutrition intervention (i.e., dose) by determining the amount of workforce participation in each intervention component. Diet outcomes were changes in intakes of fat, fiber, and servings of fruits and vegetables (reported on food frequency questionnaires). All variables were aggregated to the worksite level. We correlated the dose variables with indices of receipt of the intervention and with the dietary outcomes. RESULTS: Contests were associated with employee awareness of and participation in the nutrition intervention (r = 0.49 and 0.28, respectively), and interactive activities were associated with intervention participation (r = 0.43). Contests were associated with increased fiber intake and fruit and vegetable consumption (r = 0.36 and 0.31, respectively), and direct education was associated with fruit and vegetable consumption (r = 0.38). All the above correlation coefficients were statistically significant (P < .05). Intervention dose was not associated with changes in fat intake. CONCLUSIONS: It appears that longer, interactive intervention efforts (contests and classes) resulted in more positive outcomes than did one-time activities (such as the kickoffs) or more passive efforts (use of printed materials). There is a need for studies designed to test worksite- and community-based nutrition intervention methods.

Diet↗