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ItemResearch at UHWO, 2018-01 (issue 01)(University of Hawai'i - West O'ahu, 2018-01)
ItemPeer Influence on Obesity-Related Behaviors: Design and Rationale of the Waipahu HART Project(John Hopkins University Press, 2014)
In the State of Hawaii in the first decade of the twenty-first century, 25.5% of Filipino students in grades 9-12 were ranked as obese.1 The Waipahu Health Action Research Training (HART) project addresses the issue of adolescent obesity among high school students in the community of Waipahu, Hawaii, a predominantly Filipino population* Waipahu is a former sugar plantation town where various cultures and races have taken root in the course of history. It is a semi-urban low-income community located on the leeward side of Oahu and has an estimated population of 38,216, predominantly Asian nationals, who make up 66% of the population. U.S. Census results show that the Waipahu population is primarily composed of young people aged 18 and under and adults aged 25-44 years. Females make up about 50% of the population, with a female-to-male ratio of 100:97.6.2 The community of Waipahu was chosen for this program due to an already established working relationship and the community’s need and support. The Waipahu Community Coalition and Waipahu High School have played large roles in supporting the HART project and in supporting community health. Focusing on this community for obesity prevention for Pacific Islanders, as well as for similar communities in the mainland United States, highlights the idea that culturally sensitive and sustainable programs are needed to promote positive behavioral change among often-forgotten communities.
This project uses existing classroom activities and assignments to address the feasibility of delivering a curriculum on obesity prevention behaviors (namely, physical activity and nutrition) to high school students. The obesity curriculum was specifically designed to address community need and based on previous data collected by the students. The intervention is tailored to the individual suggestions, needs, and culture of the students in this community.
ItemA systematic review of single health behavior change interventions vs. multiple health behavior change interventions among older adults(Springer Verlag, 2012)Multiple behavior change is widely used to reduce targeted health behaviors; however, its effect on behaviors such as physical activity, nutrition, and alcohol and tobacco use among older adults remains inconclusive. The primary purpose of this systematic review was to evaluate the effects of single health behavior change (SHBC) interventions vs. multiple health behavior change (MHBC) interventions among older age individuals. PubMed was searched for publications on health behavior interventions from 2006 to 2011. Twenty-one randomized clinical trials assessed the effects of health behavior change in older individuals. Results were reviewed by a number of health behaviors and effectiveness. Results revealed that within SHBC interventions, physical activity or exercise behavior revealed that interventions were the most common and showed the most promise in influencing positive outcomes in physical activity behavior among community-dwelling older adults. There were too few MHBC studies identified to allow confident comparison to SHBC interventions. The MHBC field is still at an early stage within the older adult literature, and more attention is recommended to investigate if the benefits of MHBC apply to this age group.
ItemDietary isoflavone intake is not statistically significantly associated with breast cancer risk in the Multiethnic Cohort(Cambridge University Press, 2014)Given high soy intake and low incidence rates in Asian countries, isoflavones, substances with an estrogen-like structure occurring principally in soybeans, are postulated to be cancer-protective. We examined the association of dietary isoflavone intake with breast cancer risk in 84,450 women (896 in situ and 3,873 invasive cases) who were part of the Multiethnic Cohort (Japanese Americans, whites, Latinos, African Americans, and Native Hawaiians) with wide ranges of soy intake. The absolute amount of dietary isoflavone consumption estimated from a baseline food frequency questionnaire was categorized into quartiles, with the top quartile further subdivided to examine high dietary intake. The respective intakes for the quartiles (Q1, Q2, Q3, lower and upper Q4s) were 0-<3.2, 3.2-<6.7, 6.7-<12.9, 12.9-<20.3, and 20.3-178.7 mg/day. After a mean follow-up of 13 years, hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Cox regression stratified by age and adjusted for known confounders. Linear trends were tested by modeling continuous variables of interest assigned the median value within the corresponding quartile. We observed no statistically significant association between dietary isoflavone intake and overall breast cancer risk (HR [and 95% CI] for upper Q4 vs. Q1: 0.96 [0.85-1.08]; P-trend=0.40). While the test for interaction was not significant (P=0.14), stratified analyses suggested possible ethnic/racial differences in risk estimates, with a suggestion that higher isoflavone intake may be protective in Latina, African American, and Japanese American women. These results agree with previous meta-analyses showing no protection at low intake levels but suggesting inverse associations in high-soy consuming populations.
ItemWhat Matters When Children Play(Elsevier, 2014)Objectives Social Cognitive Theory (SCT) has often been used as a guide to predict and modify physical activity (PA) behavior. We assessed the ability of commonly investigated SCT variables and perceived school environment variables to predict PA among elementary students. We also examined differences in influences between Hispanic and non-Hispanic students. Design This analysis used baseline data collected from eight schools who participated in a four-year study of a combined school-day curriculum and environmental intervention. Methods Data were collected from 393 students. A 3-step linear regression was used to measure associations between PA level, SCT variables (self-efficacy, social support, enjoyment), and perceived environment variables (schoolyard structures, condition, equipment/supervision). Logistic regression assessed associations between variables and whether students met PA recommendations. Results School and sex explained 6% of the moderate-to-vigorous PA models' variation. SCT variables explained an additional 15% of the models' variation, with much of the model's predictive ability coming from self-efficacy and social support. Sex was more strongly associated with PA level among Hispanic students, while self-efficacy was more strongly associated among non-Hispanic students. Perceived environment variables contributed little to the models. Conclusions Our findings add to the literature on the influences of PA among elementary-aged students. The differences seen in the influence of sex and self-efficacy among non-Hispanic and Hispanic students suggests these are areas where PA interventions could be tailored to improve efficacy. Additional research is needed to understand if different measures of perceived environment or perceptions at different ages may better predict PA.