American journal of preventive medicine
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African-American women are at higher risk than white women of cardiovascular disease and stroke. In addition, fewer African-American women reap the cardiovascular benefits of exercise, because of low physical activity. The study goals were to identify personal, social environmental, and physical environmental correlates of physical activity of urban-dwelling, Midwestern, African-American women and to obtain their recommendations for increasing exercise in their communities. ⋯ Interventions that target urban African-American women must address the safety of the physical environment and personal and social environmental correlates of physical activity, and they should focus especially on inactive women who have less than a high school education or perceive themselves to be in poor health.
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Evidence suggests that unplanned/unwanted pregnancy may be an important antecedent of negative birth outcomes, such as low birth weight. This study identified correlates of perceiving a current pregnancy as both unplanned and unwanted among unmarried African-American adolescents aged 14-20 years. ⋯ Findings provide initial evidence for specifically targeting intensified prenatal care programs to teens perceiving their pregnancy as unplanned and unwanted.
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Alcohol abuse and alcoholism are leading causes of death among Native Americans. Little is known about the impact of negative childhood exposures, including parental alcoholism, childhood maltreatment, and out-of-home placement, on risk of lifetime DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, 4th edition) diagnosis of alcohol dependence in this population. ⋯ Effects of childhood exposures on high-risk behaviors emphasize screening for violence in medical settings and development of social and educational programs for parents and children living on and near tribal reservations.
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Balance is important for the safe performance of many activities that allow older people to remain independent in their community. Housework, cooking, shopping, and travel generally require the ability to stand, reach, turn, and bend down and pick up objects from the floor. Multiple interacting factors are implicated in the deterioration of balance. ⋯ Home-based exercise programs that included low-intensity strength and balance training have improved balance and reduced fall rates by about 40% compared to controls. Class-based exercise programs in senior centers or exercise centers have improved balance and physical performance, and some have reduced falls. Programs such as tai chi and social dance look promising and should be further investigated.
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Despite the increased focus on disability as an important research outcome, there remains a need to improve disability instrumentation. This article discusses the need for improved operational differentiation in instruments used to assess disability outcomes. ⋯ Computer adaptive testing is discussed as a promising avenue for resolving the methodologic limitations inherent in existing outcome instruments. Priorities for future research that move the field forward in both of these areas are discussed.