Social and Health Research Center

San Antonio, TX, United States

Social and Health Research Center

San Antonio, TX, United States
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Garcia-Dominic O.,Pennsylvania State University | Wray L.A.,Pennsylvania State University | Ledikwe J.H.,University of Washington | Mitchell D.C.,Pennsylvania State University | And 5 more authors.
Obesity | Year: 2010

We examined the accuracy of self-reported energy intake (rEI) in low-income, urban minority school-aged children at risk for obesity and associated diabetes utilizing a relatively new, simple previously published prediction equation for identifying inaccurate reports of dietary energy intake. Participants included 614 nine-year-old boys (51%) and girls (49%). Three 24-h dietary recalls were collected. Children's height, weight (used to calculate BMI), and percent body fat (%BF) were measured. Physical fitness, reported family history of diabetes, and ethnicity were also collected. A previously published prediction equation was used to determine the validity of rEIs in these children to identify under-, plausible-, and over-reporters. Additionally, we examined the question of whether there is a difference in reporting by sex, ethnicity, BMI, and %BF. On average, 18% of the children were at risk of being overweight, 43% were already overweight at baseline, yet these children reported consuming fewer calories on average than recommended guidelines. Additionally, reported caloric intake in this cohort was negatively associated with BMI and %BF. Using the previously described methods, 49% of participants were identified as under-reporters, whereas 39 and 12% were identified as plausible- and over-reporters, respectively. On average, children reported caloric intakes that were almost 100% of predicted energy requirement (pER) when the sedentary category was assigned. Inactivity and excessive energy intake are important contributors to obesity. With the rising rates of obesity and diabetes in children, accurate measures of energy intake are needed for better understanding of the relationship between energy intake and health outcomes. © 2010 The Obesity Society.


Newman A.B.,University of Pittsburgh | Aviles-Santa M.L.,U.S. National Institutes of Health | Anderson G.,Fred Hutchinson Cancer Research Center | Heiss G.,University of North Carolina at Chapel Hill | And 7 more authors.
Contemporary Clinical Trials | Year: 2016

Novel approaches to observational studies and clinical trials could improve the cost-effectiveness and speed of translation of research. Hybrid designs that combine elements of clinical trials with observational registries or cohort studies should be considered as part of a long-term strategy to transform clinical trials and epidemiology, adapting to the opportunities of big data and the challenges of constrained budgets. Important considerations include study aims, timing, breadth and depth of the existing infrastructure that can be leveraged, participant burden, likely participation rate and available sample size in the cohort, required sample size for the trial, and investigator expertise. Community engagement and stakeholder (including study participants) support are essential for these efforts to succeed. © 2015.


PubMed | Fred Hutchinson Cancer Research Center, University of Mississippi Medical Center, U.S. National Institutes of Health, Social and Health Research Center and 6 more.
Type: | Journal: Contemporary clinical trials | Year: 2015

Novel approaches to observational studies and clinical trials could improve the cost-effectiveness and speed of translation of research. Hybrid designs that combine elements of clinical trials with observational registries or cohort studies should be considered as part of a long-term strategy to transform clinical trials and epidemiology, adapting to the opportunities of big data and the challenges of constrained budgets. Important considerations include study aims, timing, breadth and depth of the existing infrastructure that can be leveraged, participant burden, likely participation rate and available sample size in the cohort, required sample size for the trial, and investigator expertise. Community engagement and stakeholder (including study participants) support are essential for these efforts to succeed.


Kahn H.S.,Centers for Disease Control and Prevention | El Ghormli L.,George Washington University | Jago R.,University of Bristol | Foster G.D.,Temple University | And 5 more authors.
Journal of Obesity | Year: 2014

Convention defines pediatric adiposity by the body mass index z-score (BMIz) referenced to normative growth charts. Waist-to-height ratio (WHtR) does not depend on sex-and-age references. In the HEALTHY Study enrollment sample, we compared BMIz with WHtR for ability to identify adverse cardiometabolic risk. Among 5,482 sixth-grade students from 42 middle schools, we estimated explanatory variations (R2) and standardized beta coefficients of BMIz or WHtR for cardiometabolic risk factors: insulin resistance (HOMA-IR), lipids, blood pressures, and glucose. For each risk outcome variable, we prepared adjusted regression models for four subpopulations stratified by sex and high versus lower fatness. For HOMA-IR, R2 attributed to BMIz or WHtR was 19%-28% among high-fatness and 8%-13% among lower-fatness students. R2 for lipid variables was 4%-9% among high-fatness and 2%-7% among lower-fatness students. In the lower-fatness subpopulations, the standardized coefficients for total cholesterol/HDL cholesterol and triglycerides tended to be weaker for BMIz (0.13-0.20) than for WHtR (0.17-0.28). Among high-fatness students, BMIz and WHtR correlated with blood pressures for Hispanics and whites, but not black boys (systolic) or girls (systolic and diastolic). In 11-12 year olds, assessments by WHtR can provide cardiometabolic risk estimates similar to conventional BMIz without requiring reference to a normative growth chart. © 2014 Henry S. Kahn et al.


Garcia-Dominic O.,Pennsylvania State University | Trevino R.P.,Social and Health Research Center | Echon R.M.,Social and Health Research Center | Mobley C.,University of Nevada, Las Vegas | And 3 more authors.
Health Promotion Practice | Year: 2012

The authors evaluated the validity and reliability of the Block Kids Food Frequency Questionnaire (BKFFQ) and the Block Kid Screener (BKScreener) in Mexican American children living along the Texas-Mexico border who participated in the National Institutes of Health-funded Proyecto Bienestar Laredo. The Bienestar/NEEMA health program is a school-based diabetes and obesity control program, and the Proyecto Bienestar Laredo is the translation of the Bienestar/NEEMA health program to 38 elementary schools in Laredo, Texas. Par ticipants included 2,376 eight-year-old boys (48%) and girls (52%) from two school districts in Laredo. Two Food Frequency Questionnaire (BKFFQ and BKScreener) dietary intakes were collected, and an expert panel of nutritionist assigned a classification response quality of "Good," "Questionable," and "Poor," based on playfulness (systematic or nonrandom) patterns and completion rates. In addition, both instruments were assessed for reliability (test-retest) in 138 students from a San Antonio School District. Children's height, weight, percentage body fat, reported family history of diabetes, and Texas Assessments of Knowledge and Skills in reading and mathematics scores were collected. This study showed that for Mexican American children living along the Texas-Mexico border, within the time constraints of the classroom, BKScreener yielded better data than the BKFFQ. © 2012 Society for Public Health Education.


Trevino R.P.,Social and Health Research Center | Pham T.,George Washington University | Mobley C.,University of Nevada, Las Vegas | Hartstein J.,Irvine Unified School District | And 2 more authors.
Journal of School Health | Year: 2012

Background: Food service directors have a concern that federal reimbursement is not meeting the demands of increasing costs of healthier meals. The purpose of this article is to report the food option changes and the annual revenues and expenses of the school food service environment. Methods: The HEALTHY study was a 3-year (2006 to 2009) randomized, cluster-designed trial conducted in 42 middle schools at 7 field centers. The schools selected had at least 50% of students who were eligible for free or reduced-price lunch or who belonged to a minority group. A randomly assigned half of the HEALTHY schools received a school health intervention program consisting of 4 integrated components: nutrition, physical activity, behavioral knowledge and skills, and social marketing. The nutrition component consisted of changing the meal plans to meet 5 nutrition goals. Revenue and expense data were collected from income statements, federal meal records, à la carte sale sheets, school store sale sheets, donated money/food records, and vending machines. Results: Although more intervention schools reached the nutritional goals than control schools, revenues and expenses were not significantly different between groups. Conclusion: The HEALTHY study showed no adverse effect of school food policies on food service finances. © 2012, American School Health Association.


Torrijos-Nino C.,Social and Health Research Center | Martinez-Vizcaino V.,Social and Health Research Center | Pardo-Guijarro M.J.,Social and Health Research Center | Pardo-Guijarro M.J.,University of Castilla - La Mancha | And 4 more authors.
Journal of Pediatrics | Year: 2014

Objective To examine the association of physical fitness and obesity with academic achievement and the independent association between fitness and academic achievement after controlling for relevant confounders such as age, parental education, and body mass index in school aged children. Study design Cross-sectional study including 893 schoolchildren, aged 9-11 years, from Cuenca, Spain. Data were collected from September to November 2010. We measured academic achievement (mean of the grades obtained in several core subjects), physical fitness (cardio-respiratory fitness, muscular fitness, and speed/agility), weight, height, and parental education. Multivariate logistic regression models were used to estimate the probability of being in high quartiles for academic achievement after controlling for potential confounders. Results Overall, academic achievement scores were positively related to fitness levels. Obese boys had lower scores for academic achievement than overweight or normal weight boys. Good cardio-respiratory and speed/agility levels were associated with high academic achievement after controlling for confounders (OR 3.06; 95% CI, 1.35-6.91; P =.007 and OR 4.25; 95% CI, 1.91-9.44; P <.001, respectively). Conclusions Academic success is associated with higher fitness levels. Schools should consider strategies to improve fitness as part of their overall strategy for improving academic achievement. © 2014 Elsevier Inc. All rights reserved.


Trevino R.P.,Social and Health Research Center | Pham T.H.,George Washington University | Edelstein S.L.,George Washington University
Journal of Obesity | Year: 2013

To date, studies examining the relation between body mass index percentile (BMI%) categories and health-related quality of life (QOL) measurements have not reported preference-weighted scores among ethnically diverse children. We report the associations between BMI% categories and preference-weighted scores among a large cohort of ethnically diverse sixth grade children who participated in the HEALTHY school-based type 2 diabetes risk factor prevention study. Health Utility Index 2 (HUI2) and Health Utility Index 3 (HUI3) and the feeling thermometer (FT) were the preference-weighted QOL instruments used to measure student's preference scores. Of 6358 consented students, 4979 (78.3%) had complete QOL, height, weight, and covariate data. Mean (SD) preference scores were 0.846 (0.160), 0.796 (0.237), and 0.806 (0.161) for the HUI2, HUI3, and FT, respectively. After adjusting for age, sex, blood glucose and insulin, Tanner stage, race/ethnicity, family history of diabetes, and educational attainment, children with severe obesity (>99%) had significantly lower preference scores compared to normal weight on all three instruments (HUI2 P=0.013; HUI3 P=0.025; and FT P<0.001). Obese and severe obese categories were significantly associated with lower HUI2 functional ratings in the mobility domain and with lower HUI3 functional ratings in the speech domain. © 2013 R. P. Treviño et al.


Balvin Frantzen L.,Dairy MAX | Trevino R.P.,Social and Health Research Center | Echon R.M.,Social and Health Research Center | Garcia-Dominic O.,Penn State College of Medicine | DiMarco N.,Texas Womans University
Journal of the Academy of Nutrition and Dietetics | Year: 2013

Background The consumption of non-ready-to-eat cereal and ready-to-eat cereal (RTEC) breakfasts have been associated with increased nutrient intakes and lower body mass index (BMI). These relationships have not been examined in low-income minority children. Objectives To evaluate, in low-income minority children, whether there is a relationship among the frequency of RTEC consumption and nutrient intakes measured at baseline, and whether there is a relationship between the frequency of RTEC and BMI controlling for age, sex, ethnicity, and energy intake. Design A longitudinal study design where a cohort was followed for 3 years. Subjects/setting Participants were 625 fourth- through sixth-grade, low-income children living in San Antonio, Texas, and enrolled in the control arm of the Bienestar Diabetes Prevention Program's cluster randomized trial. Three multiple-pass 24-hour dietary recalls were collected at the beginning of their fourth-grade year and at the end of their fifth- and sixth-grade years. Children's age, sex, ethnicity, and height and weight (used to calculate BMI) were collected between August 2001 and May 2004. Statistical analyses performed Descriptive and inferential statistical analyses were performed. The frequency of breakfast consumption was examined using a 6×4 crosstabulation table with x2 test to establish categorical differences. The degree of association between BMI percentile and frequency of RTEC consumption adjusted for age, sex, ethnicity, and nutrition-related parameters were calculated using a partial correlation multivariate linear model analysis. Results There was a significant positive relationship between the frequency of RTEC consumption and nutrient intakes measured at baseline. There was also a significant inverse relationship between frequency of RTEC consumption and BMI percentile over the cumulative 3-year period controlling for age, sex, ethnicity, and energy intake. Conclusions Children who frequently consumed RTEC had greater intakes of essential nutrients at baseline and significantly lower BMI over a 3-year period. © 2013 Academy of Nutrition and Dietetics.


PubMed | Social and Health Research Center
Type: Journal Article | Journal: The Journal of school health | Year: 2012

Food service directors have a concern that federal reimbursement is not meeting the demands of increasing costs of healthier meals. The purpose of this article is to report the food option changes and the annual revenues and expenses of the school food service environment.The HEALTHY study was a 3-year (2006 to 2009) randomized, cluster-designed trial conducted in 42 middle schools at 7 field centers. The schools selected had at least 50% of students who were eligible for free or reduced-price lunch or who belonged to a minority group. A randomly assigned half of the HEALTHY schools received a school health intervention program consisting of 4 integrated components: nutrition, physical activity, behavioral knowledge and skills, and social marketing. The nutrition component consisted of changing the meal plans to meet 5 nutrition goals. Revenue and expense data were collected from income statements, federal meal records, la carte sale sheets, school store sale sheets, donated money/food records, and vending machines.Although more intervention schools reached the nutritional goals than control schools, revenues and expenses were not significantly different between groups.The HEALTHY study showed no adverse effect of school food policies on food service finances.

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