scholarly journals Accelerometer-Measured Patterns of Sedentary Behavior in Older Women: The OPACH Study

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 340-340
Author(s):  
Eric Hyde ◽  
John Bellettiere ◽  
Blake Anuskiewicz ◽  
Andrea LaCroix ◽  
Benjamin Schumacher

Abstract Excessive sedentary behavior (SB) is related to deleterious health outcomes. Understanding the patterns and contexts in which SB accumulates can promote healthy aging. Daily sitting time and mean sitting bout duration (MBD) were measured by triaxial accelerometers. Participants self-reported how much time they spent sitting while: watching TV, reading, using the computer, driving, working, or taking phone calls. Data were compared across aging-related characteristics. Age-adjusted sitting time (minutes/day) for 5,838 diverse (33.2% Black, 16.9% Hispanic), older women (mean age 78.7±6.7) were 577.2 for Hispanic women, 630.3 for Black women, and 632.0 for White women. Those in the lowest vs. highest physical function category had the longest MBD (16.1 vs. 11.7 minutes/bout). Watching television was the most common self-reported sedentary activity. The highest vs. lowest quartile of MBD spent, on average, 30.6 and 22.3 minutes/day watching television, respectively. This presentation will illuminate critical factors associated with sitting patterns in older adults.

2016 ◽  
Vol 24 (4) ◽  
pp. 649-658 ◽  
Author(s):  
Anamica Batra ◽  
Stefany Coxe ◽  
Timothy F. Page ◽  
Michael Melchior ◽  
Richard C. Palmer

Despite the well-known benefits of exercise, only 50% of U.S. women met recommended physical activity levels in 2014. To combat this issue, the Healthy Aging Regional Collaborative of South Florida has been offering the EnhanceFitness (EF) program in community-based settings since 2008. In the current study, we examined the factors associated with the program completion among older women (≥ 60 years). During the first 4 years, 3,829 older women attended EF sessions. Of these, 924 (24.2%) attended the recommended 32 sessions within first 4 months. Results revealed that women who lived in Miami-Dade County, were ≥ 80 years, and did not report depression and/or risk factors for chronic conditions were more likely to complete EF. Black women were less likely to complete the program. Recognition of these factors might help identify at-risk individuals. More efforts are needed to improve completion rates. Theory-based interventions would allow comprehensive understanding of all factors and, therefore, should be explored in the future.


2021 ◽  
pp. 003335492098414
Author(s):  
Erika L. Thompson ◽  
Tracey E. Barnett ◽  
Dana M. Litt ◽  
Erica C. Spears ◽  
Melissa A. Lewis

Objective In the United States, guidelines indicate all pregnant women should be screened for and counseled on alcohol use to prevent adverse perinatal outcomes due to alcohol consumption. The objective of this study was to describe sociodemographic factors associated with receipt of prenatal alcohol counseling and perinatal alcohol use among US women. Methods State health departments collected data for the Pregnancy Risk Assessment Monitoring System Phase 7 during 2012-2015, and we restricted the sample to a complete case analysis (N = 135 111). The 3 dichotomous outcomes were preconception alcohol use (3 months before pregnancy), prenatal alcohol use (during last 3 months of pregnancy), and prenatal alcohol counseling. Predictor variables were age, race, Hispanic ethnicity, education, marital status, health insurance status, and previous live births. We estimated survey-weighted logistic regression models for each outcome. Results Half (56.0%) of pregnant women reported preconception alcohol use, 70.5% received prenatal alcohol counseling, and 7.7% reported prenatal alcohol use during the last 3 months of pregnancy. Black women were significantly less likely than White women (odds ratio [OR] = 0.49; 95% CI, 0.46-0.52) and Hispanic women were significantly less likely than non-Hispanic women (OR = 0.62; 95% CI, 0.58-0.66) to report preconception alcohol use. We found similar patterns for prenatal alcohol use among Black women. Black women were significantly more likely than White women (OR = 1.66; 95% CI, 1.55-1.77) and Hispanic women were significantly more likely than non-Hispanic women (OR = 1.51; 95% CI, 1.40-1.61) to receive prenatal alcohol counseling. We found similar patterns for age, education, and health insurance status. Conclusion Disparities in alcohol counseling occurred despite the national recommendation for universal screening and counseling prenatally. Continued integration of universal screening for alcohol use during pregnancy is needed.


Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Xi Zhang ◽  
Wanzhu Tu ◽  
Lesley Tinker ◽  
JoAnn E Manson ◽  
Simin Liu ◽  
...  

Background: Recent evidence suggests that racial differences in circulating levels of free or bioavailable 25(OH)D rather than total 25(OH)D may explain the apparent racial disparities in cardiovascular disease(CVD).However, few prospective studies have directly tested this hypothesis. Objective: Our study prospectively examined black white differences in the associations of total, free, and bioavailable 25(OH)D, vitamin D binding protein (VDBP), and parathyroid hormone (PTH) levels at baseline with incident CVD in a large, multi-ethnic, geographically diverse cohort of postmenopausal women. Method: We conducted a case-cohort study among 79,705 black and non-Hispanic white postmenopausal women aged 50 to 79 years and free of CVD at baseline in the Women’s Health Initiative Observational Study (WHI-OS). We included a randomly chosen subcohort of 1,300 black and 1,500 white noncases at baseline and a total of 550 black and 1,500 white women who developed incident CVD during the follow up. We directly measured circulating levels of total 25(OH)D, VDBP (monoclonal antibody assay), albumin, and PTH and calculated free and bioavailable vitamin D levels. Weighted Cox proportional hazards models were used while adjusting for known CVD risk factors. Results: At baseline, white women had higher mean levels of total 25(OH)D and VDBP and lower mean levels of free and bioavailable 25(OH)D and PTH than black women (all P values < 0.0001). White cases had lower levels of total 25(OH)D and VDBP and higher levels of PTH than white noncases, while black cases had higher levels of PTH than black noncases (all P values < 0.05). There was a trend toward an increased CVD risk associated with low total 25(OH)D and VDBP levels or elevated PTH levels in both US black and white women. In the multivariable analyses, the total, free, and bioavailable 25(OH)D, and VDBP were not significantly associated with CVD risk in black or white women. A statistically significant association between higher PTH levels and increased CVD risk persisted in white women, however. The multivariate-adjusted hazard ratios [HRs] comparing the extreme quartiles of PTH were 1.37 (95% CI: 1.06-1.77; P-trend=0.02) for white women and 1.12 (95% CI: 0.79-1.58; P-trend=0.37) for black women. This positive association among white women was also independent of total, free, and bioavailable 25(OH)D or VDBP. There were no significant interactions with other pre-specified factors, including BMI, season of blood draw, sunlight exposure, recreational physical activity, sitting time, or renal function. Interpretation: Findings from a large multiethnic case-cohort study of US black and white postmenopausal women do not support the notion that circulating levels of vitamin D biomarkers may explain black-white disparities in CVD but indicate that PTH excess may be an independent risk factor for CVD in white women.


Author(s):  
Margaret H. Bogardus ◽  
Timothy Wen ◽  
Cynthia Gyamfi-Bannerman ◽  
Jason D. Wright ◽  
Dena Goffman ◽  
...  

Objective This study aimed to determine whether race and ethnicity contribute to risks associated with peripartum hysterectomy. Study Design This retrospective cross-sectional study utilized the 2000–2014 Nationwide Inpatient Sample to analyze risk of peripartum hysterectomy and associated severe maternal morbidity, mortality, surgical injury, reoperation, surgical-site complications, and mortality by maternal race and ethnicity. Race and ethnicity were categorized as non-Hispanic white, non-Hispanic black, Hispanic, other, and unknown. Multivariable log-linear regression models including patient, clinical, and hospital risk factors were performed with adjusted risk ratios (aRRs) and 95% confidence intervals (CIs). Results Of 59,854,731 delivery hospitalizations, there were 45,369 peripartum hysterectomies (7.6 per thousand). Of these, 37.8% occurred among non-Hispanic white, 13.9% among non-Hispanic black, and 22.8% among Hispanic women. In adjusted analyses, non-Hispanic black (aRR: 1.21, 95% CI: 1.17–1.29) and Hispanic women (aRR: 1.25, 95% CI: 1.22–1.29) were at increased risk of hysterectomy compared with non-Hispanic white women. Risk for severe morbidity was increased for non-Hispanic black (aRR: 1.25, 95% CI: 1.19–1.33), but not for Hispanic (aRR: 1.02, 95% CI: 0.97–1.07) women. Between these three groups, risk for intraoperative complications was highest among non-Hispanic white women, risk for reoperation was highest among Hispanic women, and risk for surgical-site complications was highest among non-Hispanic black women. Evaluating maternal mortality, non-Hispanic black women (RR: 3.83, 95% CI: 2.65–5.53) and Hispanic women (RR: 2.49, 95% CI: 1.74–3.59) were at higher risk than non-Hispanic white women. Conclusion Peripartum hysterectomy and related complications other than death differed modestly by race. In comparison, mortality differentials were large supporting that differential risk for death in the setting of this high-risk scenario may be an important cause of disparities. Key Points


Hypertension ◽  
2021 ◽  
Vol 78 (Suppl_1) ◽  
Author(s):  
Lara C Kovell ◽  
Claire Meyerovitz ◽  
Didem Ayturk ◽  
Stephen P Juraschek ◽  
Tiffany A Moore Simas ◽  
...  

Introduction: Hypertension (HTN) is the most important modifiable risk factor of serious maternal mortality and morbidity. Social determinants, including economic stability and access to healthcare, influence HTN outcomes and are critical to understanding and addressing racial and ethnic differences in HTN control. Objective: To assess social determinants and co-morbidities in US women of child-bearing age with HTN by race/ethnicity Methods: We studied women (age 20-50) with HTN in the National Health and Nutrition Examination Surveys 2001-2018. Social determinants and co-morbid conditions were examined in groups categorized by race/ethnicity - Non-Hispanic White (White), Non-Hispanic Black (Black), and Hispanic. Demographics, anthropometric measures, and co-morbid conditions were compared with White women as reference. Results: In all women with HTN, the mean (SE) age was 36.0 (0.3) years and 63% were on BP medication. Compared to white women, Black and Hispanic women had lower food security, poverty income ratio, smoking use, and private insurance (all p<0.0001, Table ). Black women had higher BP medication use, BMI, and BP compared to White women (all p<0.0001). Hispanic women had higher rates of diabetes (p=0.009) and no place to go for healthcare (p=0.005) compared to White women. Food insecurity was present in 34% of Hispanic women. Conclusions: Despite effective diagnostics and therapy, health inequity is common in women of child-bearing age with HTN, with differences by race/ethnicity in social determinants and co-morbid conditions. Each racial/ethnic group with HTN brings social determinants and comorbid conditions important for providers to recognize.


2021 ◽  
pp. 2100606
Author(s):  
Yue Liu ◽  
Lin Yang ◽  
Meir J. Stampfer ◽  
Susan Redline ◽  
Shelley S. Tworoger ◽  
...  

Reduced physical activity and increased sedentary behavior may independently contribute to development of obstructive sleep apnea (OSA) through increased adiposity, inflammation, insulin resistance and body fluid retention. However, epidemiologic evidence remains sparse, and is primarily limited to cross-sectional studies.We prospectively followed 50 332 women from the Nurses’ Health Study (2002–2012), 68 265 women from the Nurses’ Health Study II (1995–2013), and 19 320 men from the Health Professionals Follow-up Study (1996–2012). Recreational physical activity (quantified by metabolic equivalent of task [MET]-hours/week) and sitting time spent watching TV and at work/away from home were assessed by questionnaires every 2–4 years. Physician-diagnosed OSA was identified by validated self-report. Cox models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for OSA incidence associated with physical activity and sedentary behavior.During 2 004 663 person-years of follow-up, we documented 8733 incident OSA cases. After adjusting for potential confounders, the pooled HR for OSA comparing participants with ≥36.0 versus <6.0 MET-hours/week of physical activity was 0.46 (95% CI: 0.43, 0.50; ptrend<0.001). Compared with participants spending <4.0 h/week sitting watching TV, the multivariable-adjusted HR (95% CI) was 1.78 (1.60, 1.98) for participants spending ≥28.0 h/week (ptrend<0.001). The comparable HR (95% CI) was 1.49 (1.38, 1.62) for sitting hours at work/away from home (ptrend<0.001). With additional adjustment for several metabolic factors including BMI and waist circumference, the associations with physical activity and sitting hours at work/away from home were attenuated but remained significant (ptrend<0.001), whereas the association with sitting hours watching TV was no longer statistically significant (ptrend=0.18).Higher levels of physical activity and fewer sedentary hours were associated with lower OSA incidence. The potential mediating role of metabolic factors in the association between sedentary behavior and OSA incidence may depend on type of sedentary behavior. Our results suggest that promoting an active lifestyle may reduce OSA incidence.


Neurology ◽  
2020 ◽  
Vol 95 (24) ◽  
pp. e3438-e3447
Author(s):  
Muzi Na ◽  
Jing Wu ◽  
Mengying Li ◽  
Stefanie N. Hinkle ◽  
Cuilin Zhang ◽  
...  

ObjectiveTo determine whether the incidence and risk factors of restless legs syndrome (RLS) in pregnancy differ by race/ethnicity, we estimated relative risks of demographic, socioeconomic, and nutritional factors in association with risk of any incident RLS in pregnancy in a cohort of 2,704 healthy pregnant women without prior RLS.MethodsUsing data from the multicenter, multiracial National Institute of Child Health and Human Development (NICHD) Fetal Growth Studies–Singletons, we examined the incidence of RLS from early pregnancy to near delivery through up to 6 assessments. Multivariable Poisson models with robust variance were applied to estimate relative risks (RRs).ResultsThe cumulative incidence of RLS in pregnancy was 18.1% for all women, 20.3% for White women, 15.4% for Black women, 17.1% for Hispanic women, and 21.1% for Asian women. Among Hispanic women, older age (RR [reference ≤25 years]: 25–35 years, 1.51; 95% confidence interval [CI] 1.05–2.16; ≥35 years, 1.58; 95% CI 0.93–2.68), anemia (RR [reference no]: yes, 2.47; 95% CI 1.31–4.64), and greater total skinfolds of the subscapular and triceps sites, independent of body mass index (RR [reference quartile 1]: quartile 5, 2.54; 95% CI 1.30–4.97; p trend = 0.01) were associated with higher risk of RLS, while multiparity was associated with a lower risk (RR [reference nulliparity]: 0.69; 95% CI 0.50–0.96). In Black women, greater skinfolds and waist circumference were associated with higher risk of pregnancy RLS, although the trends were less clear.ConclusionsThe incidence of RLS in pregnancy was high and differed by race/ethnicity, which is likely accounted for by differences in other risk factors, such as age, parity, and nutritional factors.


2016 ◽  
Vol 34 (36) ◽  
pp. 4398-4404 ◽  
Author(s):  
Alana Biggers ◽  
Yushu Shi ◽  
John Charlson ◽  
Elizabeth C. Smith ◽  
Alicia J. Smallwood ◽  
...  

Purpose To investigate the role of out-of-pocket cost supports through the Medicare Part D Low-Income Subsidy on disparities in breast cancer hormonal therapy persistence and adherence by race or ethnicity. Methods A nationwide cohort of women age ≥ 65 years with a breast cancer operation between 2006 and 2007 and at least one prescription filled for oral breast cancer hormonal therapy was identified from all Medicare D enrollees. The association of race or ethnicity with nonpersistence (90 consecutive days with no claims for a hormonal therapy prescription) and nonadherence (medication possession rate < 80%) was examined. Survival analyses were used to account for potential differences in age, comorbidity, or intensity of other treatments. Results Among the 25,111 women in the study sample, 77% of the Hispanic and 70% of the black women received a subsidy compared with 21% of the white women. By 2 years, 69% of black and 70% of Hispanic patients were persistent compared with 61% of white patients. In adjusted analyses, patients in all three unsubsidized race or ethnicity groups had greater discontinuation than subsidized groups (white patients: hazard ratio [HR], 1.83; 95% CI, 1.70 to 1.95; black patients: HR, 2.09; 95% CI, 1.73 to 2.51; Hispanic patients: HR, 3.00; 95% CI, 2.37 to 3.89). Racial or ethnic persistence disparities that were present for unsubsidized patients were not present or reversed among subsidized patients. All three subsidized race or ethnicity groups also had higher adherence than all three unsubsidized groups, although with the smallest difference occurring in black women. Conclusion Receipt of a prescription subsidy was associated with substantially improved persistence to breast cancer hormonal therapy among white, black, and Hispanic women and lack of racial or ethnic disparities in persistence. Given high subsidy enrollment among black and Hispanic women, policies targeted at low-income patients have the potential to also substantially reduce racial and ethnic disparities.


2020 ◽  
pp. OP.20.00381
Author(s):  
Cosette D. Champion ◽  
Samantha M. Thomas ◽  
Jennifer K. Plichta ◽  
Edgardo Parrilla Castellar ◽  
Laura H. Rosenberger ◽  
...  

PURPOSE: We sought to examine tumor subtype, stage at diagnosis, time to surgery (TTS), and overall survival (OS) among Hispanic patients of different races and among Hispanic and non-Hispanic (NH) women of the same race. METHODS: Women 18 years of age or older who had been diagnosed with stage 0-IV breast cancer and who had undergone lumpectomy or mastectomy were identified in the National Cancer Database (2004-2014). Tumor subtype and stage at diagnosis were compared by race/ethnicity. Multivariable linear regression and Cox proportional hazards modeling were used to estimate associations between race/ethnicity and adjusted TTS and OS, respectively. RESULTS: A total of 44,374 Hispanic (American Indian [AI]: 79 [0.2%]; Black: 1,011 [2.3%]; White: 41,126 [92.7%]; Other: 2,158 [4.9%]) and 858,634 NH women (AI: 2,319 [0.3%]; Black: 97,206 [11.3%]; White: 727,270 [84.7%]; Other: 31,839 [3.7%]) were included. Hispanic Black women had lower rates of triple-negative disease (16.2%) than did NH Black women (23.5%) but higher rates than did Hispanic White women (13.9%; P < .001). Hispanic White women had higher rates of node-positive disease (23.2%) versus NH White women (14.4%) but slightly lower rates than Hispanic (24.6%) and NH Black women (24.5%; P < .001). Hispanic White women had longer TTS versus NH White women regardless of treatment sequence (adjusted means: adjuvant chemotherapy, 42.71 v 38.60 days; neoadjuvant chemotherapy, 208.55 v 201.14 days; both P < .001), but there were no significant racial differences in TTS among Hispanic patients. After adjustment, Hispanic White women (hazard ratio, 0.77 [95% CI, 0.74 to 0.81]) and Black women (hazard ratio, 0.75 [95% CI, 0.58 to 0.96]) had improved OS versus NH White women (reference) and Black women (hazard ratio, 1.15 [95% CI, 1.12 to 1.18]; all P < .05). CONCLUSION: Hispanic women had improved OS versus NH women, but racial differences in tumor subtype and nodal stage among Hispanic women highlight the importance of disaggregating racial/ethnic data in breast cancer research.


2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 765-765
Author(s):  
Wanhui Kang ◽  
Carrie Irvine ◽  
Eva Pressman ◽  
Kimberly O'Brien

Abstract Objectives This study aimed to characterize prevalence and determinants of anemia in a multiethnic cohort of pregnant women. Methods A retrospective medical chart review was undertaken of all deliveries occurring from 2011 to 2020 at Strong Memorial Hospital and Highland Hospital in Rochester, NY. Among a total of 53,642 deliveries, 42,289 occurred to women with no underlying health complications. Anemia was defined using the CDC criteria as &lt; 11g/dL in the first (T1) and third trimesters (T3) and &lt; 10.5 g/dL in the second trimester (T2). Mean Hb concentration was compared between trimesters and racial groups by ANOVA and post-hoc pairwise comparisons. Relationships between prevalence of anemia by trimesters, racial groups, and BMI were examined by chi-square or t-tests. Logistic regression models were conducted to estimate the risk factors associated with anemia. Results Pregnant women had a mean age of 29.8 ± 5.5 y (range: 13−52 y) at delivery. The majority of women (66.8%) self-identified as white, 20.0% as black, 3.8% as Asian, and 9.4% as Other. Mean Hb concentrations significantly differed by trimester [12.6 ± 1.0, 11.5 ± 1.1, and 11.8 ± 1.3 g/dL in T1, T2 and T3, respectively, p &lt; 0.001]. Mean Hb was significantly lower in black women in each trimester by -0.8 (T1), -0.7 (T2), and -1.0 g/dL (T3) compared to white women. White women had the highest Hb concentrations in T1 and T2 (12.8 ± 0.9, 11.8 ± 1.0 g/dL) while Asian women had the highest Hb concentrations in T3 (12.2 ± 1.2 g/dL, n = 1577, p &lt; 0.001). The overall prevalence of anemia was 17.1%, which significantly increased across pregnancy [4.5% (T1), 16.4% (T2) and 25.2% (T3), p &lt; 0.001]. Observed rates of anemia were higher than the estimated NHANES (1999–2006) prevalence in pregnant women. After stratifying by racial groups, higher BMI was significantly associated with a lower prevalence of anemia in T2 and T3 only in black women and in those whose race was categorized as Other. Conclusions The prevalence of anemia was highest in black pregnant women in all trimesters, while it was lowest in white pregnant women in T1 and T2, and in Asians in T3. Risk factors associated with anemia included late gestation or self-reported race as black or Other. Funding Sources None.


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