Center for Health Outcomes and Prevention Research

Sioux Falls, SD, United States

Center for Health Outcomes and Prevention Research

Sioux Falls, SD, United States
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Himes S.K.,U.S. National Institute on Drug Abuse | Dukes K.A.,DM Statistics Inc. | Tripp T.,DM Statistics Inc. | Petersen J.M.,DM Statistics Inc. | And 8 more authors.
Clinical Chemistry | Year: 2015

BACKGROUND: We investigated agreement between selfreported prenatal alcohol exposure (PAE) and objective meconium alcohol markers to determine the optimal meconium marker and threshold for identifying PAE. METHODS: Meconium fatty acid ethyl esters (FAEE), ethyl glucuronide (EtG), and ethyl sulfate (EtS) were quantified by LC-MS/MS in 0.1 g meconium from infants of Safe Passage Study participants. Detailed PAE information was collected from women with a validated timeline follow-back interview. Because meconium formation begins during weeks 12-20, maternal selfreported drinking at or beyond 19 weeks was our exposure variable. RESULTS: Of 107 women, 33 reported no alcohol consumption in pregnancy, 16 stopped drinking by week 19, and 58 drank beyond 19 weeks (including 45 thirdtrimester drinkers). There was moderate to substantial agreement between self-reported PAE at ≥19 weeks and meconium EtG ≥30 ng/g (κ = 0.57, 95% CI 0.41-0.73). This biomarker and associated cutoff was superior to a 7 FAEE sum ≥2 nmol/g and all other individual and combination marker cutoffs. With meconium EtG ≥30 ng/g as the gold standard condition and maternal selfreport at ≥19 weeks' gestation as the test condition, 82% clinical sensitivity (95% CI 71.6-92.0) and 75% specificity (95% CI 63.2- 86.8) were observed. A significant dose- concentration relationship between self-reported drinks per drinking day and meconium EtG ≥30 ng/g also was observed (all P < 0.01). CONCLUSIONS: Maternal alcohol consumption at ≥19 weeks was better represented by meconium EtG ≥30 ng/g than currently used FAEE cutoffs. © 2014 American Association for Clinical Chemistry.


Puumala S.E.,Center for Health Outcomes and Prevention Research | Puumala S.E.,University of South Dakota | Ross J.A.,University of Minnesota | Aplenc R.,Children's Hospital of Philadelphia | Spector L.G.,University of Minnesota
Pediatric Blood and Cancer | Year: 2013

Although leukemia is the most common childhood cancer diagnosis, the subtype, acute myeloid leukemia (AML), is less common and fewer etiologic studies exist. This review summarizes the major risk factors for AML. We searched the literature using PubMed for articles on childhood AML and reviewed 180 articles. While few risk factors are definitive, we identified several with consistent evidence of a possible effect. Thorough analysis of genetic and epigenetic factors is missing from this literature and methodological issues are unresolved. Future studies should more closely examine causal mechanisms, improve exposure measurement, and include analysis using genetic and epigenetic factors. © 2013 Wiley Periodicals, Inc.


Puumala S.E.,Center for Health Outcomes and Prevention Research | Puumala S.E.,University of South Dakota | Nelson H.H.,University of Minnesota | Ross J.A.,University of Minnesota | And 3 more authors.
BMC Pediatrics | Year: 2012

Background: While a possible link between assisted reproductive technology (ART) and rare imprinting disorders has been found, it is not clear if this is indicative of subtler disruptions of epigenetic mechanisms. Results from previous studies have been mixed, but some methylation differences have been observed.Methods: Children conceived through ART and children conceived spontaneously were recruited for this cross-sectional study. Information about reproductive history, demographic factors, birth characteristics, and infertility treatment was obtained from maternal interview and medical records. Peripheral blood lymphocytes and buccal cell samples were collected from participating children. Methylation analysis was performed on five loci using pyrosequencing. Statistical analysis of methylation differences was performed using linear regression with generalized estimating equations. Results are reported as differences with 95% confidence intervals (CI).Results: A total of 67 ART children and 31 spontaneously conceived (SC) children participated. No significant difference in methylation in lymphocyte samples was observed between groups for any loci. Possible differences were found in buccal cell samples for IGF2 DMR0 (Difference: 2.07; 95% confidence interval (CI): -0.28, 4.42; p = 0.08) and IGF2R (Difference: -2.79; 95% CI: -5.74, 0.16; p = 0.06). Subgroup analysis indicated potential lower methylation in those whose parents used ART for unexplained infertility.Conclusions: Observed differences in methylation between the ART and SC groups were small for all loci in the two sample types examined and no statistical differences were observed. It is still unclear whether or not small differences observed in several studies represent a real difference between groups and if this difference is biologically meaningful. Larger studies with long term follow-up are needed to fully answer these questions. © 2012 Puumala et al; licensee BioMed Central Ltd.


Nothwehr F.,University of Iowa | Hanson J.D.,Center for Health Outcomes and Prevention Research
Topics in Clinical Nutrition | Year: 2013

Food and nutrition interventions are often designed to enhance outcome expectations in hopes of influencing dietary intake. However, outcome expectations in the context of dietary behavior have not been studied extensively. This study examined this association in a sample of 384 adults, of whom 59% were women (mean age, 56 years). Analyses examined the cross-sectional and longitudinal association between outcome expectations and use of specific diet-related behavioral strategies and dietary intake. Results suggest that outcome expectations are associated with strategy use. When measurement of dietary intake is impractical, measures of strategy use could be beneficial and sensitive indicators of program impact. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins.


Hauge C.H.,Center for Health Outcomes and Prevention Research | Jacobs-Knight J.,Oglala Sioux Tribe CHOICES Program | Jensen J.L.,Center for Health Outcomes and Prevention Research | Burgess K.M.,Center for Health Outcomes and Prevention Research | And 3 more authors.
Qualitative Health Research | Year: 2015

The purpose of this study was to use a mixed-methods approach to determine the validity and reliability of measurements used within an alcohol-exposed pregnancy prevention program for American Indian women. To develop validity, content experts provided input into the survey measures, and a "think aloud" methodology was conducted with 23 American Indian women. After revising the measurements based on this input, a test-retest was conducted with 79 American Indian women who were randomized to complete either the original measurements or the new, modified measurements. The test-retest revealed that some of the questions performed better for the modified version, whereas others appeared to be more reliable for the original version. The mixed-methods approach was a useful methodology for gathering feedback on survey measurements from American Indian participants and in indicating specific survey questions that needed to be modified for this population. © The Author(s) 2015.


Noble K.G.,Columbia University | Engelhardt L.E.,University of Texas at Austin | Brito N.H.,Columbia University | Mack L.J.,University of Iowa | And 5 more authors.
Developmental Psychobiology | Year: 2015

Socioeconomic status (SES) is strongly associated with cognition and achievement. Socioeconomic disparities in language and memory skills have been reported from elementary school through adolescence. Less is known about the extent to which such disparities emerge in infancy. Here, 179 infants from socioeconomically diverse families were recruited. Using a cohort-sequential design, 90 infants were followed at 9 and 15 months, and 89 were followed at 15 and 21 months. SES disparities in developmental trajectories of language and memory were present such that, at 21 months of age, children of highly educated parents scored approximately.8 standard deviations higher in both language and memory than children of less educated parents. The home language and literacy environment and parental warmth partially accounted for disparities in language, but not memory development. © 2015 Wiley Periodicals, Inc.


Payne N.R.,Childrens Hospitals and Clinics of Minnesota | Puumala S.E.,Center for Health Outcomes and Prevention Research
Pediatric Emergency Care | Year: 2013

OBJECTIVE: The objective of this study was to examine the association of race and language on laboratory and radiological testing in the pediatric emergency department (ED). METHODS: This retrospective, case-cohort study examined laboratory and radiological testing among patients discharged home from 2 urban, pediatric EDs between March 2, 2009, and March 31, 2010. RESULTS: There were 75,254 visits among 49,164 unique patients, of whom 31.0% had laboratory and 30.5% had radiological testing. African American (adjusted odds ratio [aOR], 0.93; confidence interval [CI], 0.89-0.98; P = 0.004) and biracial racial categories (aOR, 0.91; CI, 0.86-0.98; P = 0.007) were associated with decreased odds of laboratory testing compared with non-Hispanic whites. Similarly, Native American (aOR, 0.82; CI, 0.73-0.94), African American (aOR0.81; CI, 0.72-0.81), biracial (aOR, 0.82; CI, 0.77-0.88), Hispanic (aOR.76; CI, 0.72-0.81), and "other" (aOR, 0.84; CI, 0.73-0.97) racial categories were each associated with lower odds of radiological testing compared with non-Hispanic whites. Subgroup analysis of visits with a final diagnosis of fever and upper respiratory tract infection, conditions for which there were few treatment protocols, confirmed the racial differences. Subgroup analysis in visits for head injury, for which there is an established evaluation protocol, did not find a lower odds of laboratory or radiological testing by race compared with non-Hispanic whites. CONCLUSIONS: Racial disparities in laboratory and radiological testing were present in pediatric ED visits. No racial differences were seen in the radiological and laboratory charges in the head injury subgroup, suggesting that evaluation algorithms can ameliorate racial disparities in pediatric ED care. Copyright © 2013 by Lippincott Williams & Wilkins.


Griese E.R.,Center for Health Outcomes and Prevention Research | Buhs E.S.,University of Nebraska - Lincoln
Journal of Youth and Adolescence | Year: 2014

A majority of peer victimization research focuses on its associations with negative outcomes, yet efforts to understand possible protective factors that may mitigate these negative outcomes also require attention. The present study was an investigation of the potential moderating effect of prosocial behaviors on loneliness for youth who are peer victimized. Participants were fourth and fifth grade students (511 total; 49 % boys) who were primarily European American (43.4 %) and Hispanic (48.2 %). Structural Equation Modeling was used to test the interaction of prosocial behavior and peer victimization (relational and overt forms) on loneliness 1 year later. The results indicated that prosocial behavior significantly moderated the relationship between peer victimization (for the relational form only) and loneliness while controlling for levels of perceived peer support. A multi-group comparison by gender further indicated the moderation was significant for boys only. Potential implications for intervention/prevention efforts focused on developing children's prosocial skills as a possible protective factor for relationally victimized youth are discussed. © 2013 Springer Science+Business Media New York.


Hanson J.D.,Center for Health Outcomes and Prevention Research | Miller A.L.,Center for Health Outcomes and Prevention Research | Winberg A.,University of South Dakota | Elliott A.J.,Center for Health Outcomes and Prevention Research
American Journal of Health Promotion | Year: 2013

Purpose: The goal of this project was to evaluate an intervention on reducing alcoholexposed pregnancies with nonpregnant American Indian women, with a focus on risky drinking and ineffective contraception use. Design. This study had a descriptive longitudinal study design, with follow-up every 3 months for 1 year. Setting: Three American Indian tribes in the Northern Plains. Subjects. Participants were 231 nonpregnant American Indian women. Intervention. Participants responded to drinking and contraception questions through the telephone and then received intervention materials via mail. Follow-up telephone surveys occurred at 3, 6, 9, and 12 months after the baseline call, and participants were again mailed intervention materials. Measures. Alcohol consumption and birth control measurements were modified from the Project CHOICES program. The intervention was based on motivational interviewing constructs. Analysis. Analysis techniques included covariate-adjusted generalized estimating equation methods and Bonferroni correction. Results: All of the alcohol consumption amount responses had significant decreases with each follow-up intervention session; the average change for the range of questions was 26% to 17%. The proportion of those stating they did not use birth control decreased from 29% to 10% during the first 3 months. Conclusions. The intervention was successful in modifying self-reported drinking and contraception behaviors. This project is the only one to date that has focused on preventing alcohol-exposed pregnancies in nonpregnant American Indian women. Copyright © 2013 by American Journal of Health Promotion, Inc.


Hanson J.D.,Center for Health Outcomes and Prevention Research | Jensen J.,Center for Health Outcomes and Prevention Research
Journal of Community Health | Year: 2014

Recent research concludes that prevention of alcohol-exposed pregnancies (AEP) must occur with preconceptional women, either by reducing alcohol consumption in women at-risk or planning pregnancy or preventing pregnancy in women drinking at risky levels. One AEP prevention program currently underway with non-pregnant American Indian women is the Oglala Sioux Tribe (OST) Changing High-risk alcohOl use and Increasing Contraception Effectiveness Study (CHOICES) Program. The OST CHOICES Program shows promise in lowering the AEP risk in American Indian women, and it is a natural next step to evaluate the potential impact that social support can have on further encouraging behavioral changes. Focus groups with community members and key informant interviews with health and social service professionals were completed. To uncover and interpret interrelated themes, a conventional content analysis methodology was used. Eight focus groups were held with 58 American Indian participants, including adult women of child-bearing age, elder women, and adult men. Key informant interviews were completed with 25 health and social service professionals. Based on input from the focus groups and key informant interviews, several subthemes regarding social support in the prevention of AEP stood out, including the role of family (especially elders), the impact community can have, and the important function of culture. In this study, we highlighted the important influence that social support can have on AEP prevention, especially among the American Indian population, where social support has cultural and historical significance. © 2014, Springer Science+Business Media New York.

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