Peer-reviewed articles by Joan Vaccaro
Journal of Environmental and Public Health, 2019
Environmental factors, preventive medical care, and behaviors play a role in childhood obesity. T... more Environmental factors, preventive medical care, and behaviors play a role in childhood obesity. This study used the National
Survey of Children’s Health, 2011-2012, for 42,828 children, ages 10–17 years. Greater percent of children in the overweight/
obese category performed no moderate-to-vigorous physical activity: 11.9 (10.6, 13.3) as compared to children in the
underweight/normal weight category: 9.7 (8.9 10.6). No moderate-to-vigorous physical activity was associated with no
preventive medical care, inadequate or no health care, parents reporting higher percent of no parks or playgrounds, and unsafe
and unsupportive neighborhoods. Odds ratios of overweight/obesity were higher for males [OR 2.06 (1.64, 2.60)], Hispanics
[OR 1.49 (1.17, 1.90)], non-Hispanic Black females [OR 1.59 (1.20, 2.08)], younger females [OR10–12 yrs. 1.35 (1.03, 1.79)
OR 0.84 (0.72, 0.99) vs. OR 1.00 ,] and lower categories of physical activity [OR 1.38 (1.13, >1 to <4 hrs./day ≥ 4 hrs./day 0 days/wk.
and OR13–15 yrs. 1.4. (1.06, 1.89) vs. OR 1.0016-17 yrs.], children with high television viewing [OR0-1 hr./day 0.72 (0.61, 0.86);
1.62); OR1–3 days/wk. 1.14 (1.22, 1.62) vs. OR7 days/wk. 1.00], higher poverty, smoke exposure, and parental perception of their neighborhood as unsupportive. Promoting preventive medical care and neighborhood cooperation may have potential to lower childhood obesity.
The purpose of this study was to determine health-related characteristics of a representative sam... more The purpose of this study was to determine health-related characteristics of a representative sample of older adults who attend congregate meal sites in the United States, and compare races/ethnicities and sexes. Participants were adults, aged 60 years and older, (N = 901) of the 2015 Tenth Annual National Survey of Older American Act Participants (NSOAAP). Difficulties with mobility and Activities of Daily Living were common among older adults who attended congregate meals. Health-related characteristics differed by race/ethnicity and sex. Higher percentages of men reported eating more than half their calories from the site: 61.0% (53, 68), compared to women: 41.2% (33,50); while twice the number of women reported exercising at the site: 42.7% (36, 50), compared to 21.8% (16, 29) for men. Hispanics reported poor/fair health, food insecurity, diabetes, and poverty more often than White non-Hispanics. The odds of reporting that meals helped maintain independence were higher for persons with food insecurity: OR = 2.67 (1.05, 6.80) and those who reported eating half or more of their calories from the site: OR = 5.78 (2.36, 14.30). Strategies that consider preferences by sex and race/ethnicity are required at congregate meal sites to encourage mobility and healthy eating.
Abstract
This study examined sex by race/ethnicity differences in medical advice received for die... more Abstract
This study examined sex by race/ethnicity differences in medical advice received for diet and exercise with corresponding health behaviors of a U.S. representative sample of adults with type 2 diabetes (N = 1,269). Data from the National Health and Nutrition Examination Surveys for 2011-2014 for 185 Mexican Americans, 123 Other Hispanics, 392 non-Hispanic Blacks, 140 non-Hispanic Asians, and 429 non-Hispanic Whites were analyzed using logistic regression analyses. Reporting being given dietary and exercise advice was positively associated with reporting
following the behavior. There were differences in sex and sex by race/ethnicity for reporting receiving medical advice and performing the advised health behavior. These results suggest the importance of physicians having patient-centered communication skills and cultural competency when discussing diabetes management.
This study examined sex by race/ethnicity differences in medical advice received for diet and exe... more This study examined sex by race/ethnicity differences in medical advice received for diet and exercise with corresponding health behaviors of a U.S. representative sample of adults with type 2 diabetes (N = 1,269). Data from the National Health and Nutrition Examination Surveys for 2011-2014 for 185 Mexican Americans, 123 Other Hispanics, 392 non-Hispanic Blacks, 140 non-Hispanic Asians, and 429 non-Hispanic Whites were analyzed using logistic regression analyses. Reporting being given dietary and exercise advice was positively associated with reporting following the behavior. There were differences in sex and sex by race/ethnicity for reporting receiving medical advice and performing the advised health behavior. These results suggest the importance of physicians having patient-centered communication skills and cultural competency when discussing diabetes management.
Background. Approximately 17% of children aged 6–11 years were classified as obese in the United ... more Background. Approximately 17% of children aged 6–11 years were classified as obese in the United States. Obesity adversely affects physical functioning and leads to reduced quality of life. Heart function for overweight and obese children has not been reported. Methods. Data for this study were from NHANES National Youth Fitness Survey (NNYFS) conducted in conjunction with the National Health and Nutrition Examination Survey (NHANES) in 2012. This study used data from children aged 6–12 (í µí± = 732) that had the cardiorespiratory endurance measure, body mass index for age and sex, and dietary data (í µí± = 682). Cardiovascular endurance was estimated by heart rate reserve. Results. Compared to the highest percentile of heart rate reserve, those in the first percentile had 3.52 (2.36, 5.24) odds and those in the second percentile had 3.61 (1.84, 7.06) odds of being in the overweight/obese as compared to the under/normal weight category. Considering the highest percentile, boys had a heart rate reserve of 35%, whereas girls had a heart rate reserve of 13% (less than half that of boys). Conclusion. Having an overweight or obese classification for children in this study demonstrated a compromise in cardiovascular endurance. Parental awareness should be raised as to the detrimental consequence of overweight and heart health.
Background. The State of Kuwait has a growing obesity epidemic in both genders and all age groups... more Background. The State of Kuwait has a growing obesity epidemic in both genders and all age groups; however, obesity rates in the young seem to be rising. Methods. We conducted a cross-sectional survey in 169 Kuwaiti female adolescents attending both private and public schools spanning the six governorates in the State of Kuwait in order to explore female adolescents' self-image, body dissatisfaction, type of school (private versus public), TV viewing, and computer games and their relationship to body mass index. Results. Approximately half the students classified as obese perceived their body image to lie in the normal range. Females in the obese category were the most dissatisfied with their body image, followed by those in the overweight category. Eating behavior, level of physical activity, school type, television viewing, computer/video usage, and desired BMI were not significantly associated with level of obesity. Conclusion. This study was one of the few studies to assess adolescent females' body image dissatisfaction in relation to obesity in the State of Kuwait. The results suggest that including body image dissatisfaction awareness into obesity prevention programs would be of value.
The Faseb Journal, Apr 1, 2014
The Faseb Journal, Apr 1, 2014
The Faseb Journal, Apr 1, 2014
Journal of health and human services administration
Objective: to examine the relationships among reported medical advice, diabetes education, health... more Objective: to examine the relationships among reported medical advice, diabetes education, health insurance and health behavior of individuals with diabetes by race and gender. Method: Secondary analysis of data (N = 654) for adults ages ≥ 21 years with diabetes acquired through the National Health and Nutrition Examination Survey (NHANES) for the years 2007-2008 comparing Black, non-Hispanics (BNH) and Mexican-Americans (MA) with White, non-Hispanics (WNH). The NHANES survey design is a stratified, multistage probability sample of the civilian noninstitutionalized U.S. population. Sample weights were applied in accordance with NHANES specifications using the complex sample module of IBM SPSS version 18. Results: The findings revealed statistical significant differences in reported medical advice given. BNH [OR = 1.83 (1.16, 2.88), p = 0.013] were more likely than WNH to report being told to reduce fat or calories. Similarly, BNH [OR = 2.84 (1.45, 5.59), p = 0.005] were more likely than WNH to report that they were told to increase their physical activity. Mexican-Americans were less likely to self-monitor their blood glucose than WNH [OR = 2.70 (1.66, 4.38), p<0.001]. There were differences among ethnicities for reporting receiving recent diabetes education. Black, non-Hispanics were twice as likely to report receiving diabetes education than WNH [OR = 2.29 (1.36, 3.85), p= 0.004]. Having recent diabetes education increased the likelihood of performing several diabetes self-management behaviors independent of race. Conclusions: There were significant differences in reported medical advice received for diabetes care by race/ethnicities. The results suggest ethnic variations in patient-provider communication and may be a consequence of their health beliefs, patient-provider communication as well as length of visit and access to healthcare. These findings clearly demonstrate the need for government sponsored programs, with a patient-centered approach, augmenting usual medical care for diabetes. Moreover, the results suggest that public policy is needed to require the provision of diabetes education at least every two years by public health insurance programs and recommend this provision for all private insurance companies.
Journal of health care finance
Cuban Americans have a high prevalence of type 2 diabetes, placing them at risk for cardiovascula... more Cuban Americans have a high prevalence of type 2 diabetes, placing them at risk for cardiovascular disease (CVD) and increased medical costs. Little is known regarding the lifestyle risk factors of CVD among Cuban Americans. This study investigated modifiable CVD risk factors of Cuban Americans with and without type 2 diabetes. Sociodemographics, anthropometrics, blood pressure, physical activity, dietary intake, and biochemical parameters were collected and assessed for n=79 and n=80 Cuban Americans with and without type 2 diabetes. Fourteen percent with diabetes and 24 percent without diabetes engaged in the recommended level of physical activity. Over 90 percent had over the recommended intake of saturated fats. Thirty-five percent were former or current smokers. Cuban Americans had several lifestyle factors that are likely to increase the risk of CVD. Their dietary factors were associated with blood cholesterol and body weight, which has been shown to impact on medical expenses....
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Peer-reviewed articles by Joan Vaccaro
Survey of Children’s Health, 2011-2012, for 42,828 children, ages 10–17 years. Greater percent of children in the overweight/
obese category performed no moderate-to-vigorous physical activity: 11.9 (10.6, 13.3) as compared to children in the
underweight/normal weight category: 9.7 (8.9 10.6). No moderate-to-vigorous physical activity was associated with no
preventive medical care, inadequate or no health care, parents reporting higher percent of no parks or playgrounds, and unsafe
and unsupportive neighborhoods. Odds ratios of overweight/obesity were higher for males [OR 2.06 (1.64, 2.60)], Hispanics
[OR 1.49 (1.17, 1.90)], non-Hispanic Black females [OR 1.59 (1.20, 2.08)], younger females [OR10–12 yrs. 1.35 (1.03, 1.79)
OR 0.84 (0.72, 0.99) vs. OR 1.00 ,] and lower categories of physical activity [OR 1.38 (1.13, >1 to <4 hrs./day ≥ 4 hrs./day 0 days/wk.
and OR13–15 yrs. 1.4. (1.06, 1.89) vs. OR 1.0016-17 yrs.], children with high television viewing [OR0-1 hr./day 0.72 (0.61, 0.86);
1.62); OR1–3 days/wk. 1.14 (1.22, 1.62) vs. OR7 days/wk. 1.00], higher poverty, smoke exposure, and parental perception of their neighborhood as unsupportive. Promoting preventive medical care and neighborhood cooperation may have potential to lower childhood obesity.
This study examined sex by race/ethnicity differences in medical advice received for diet and exercise with corresponding health behaviors of a U.S. representative sample of adults with type 2 diabetes (N = 1,269). Data from the National Health and Nutrition Examination Surveys for 2011-2014 for 185 Mexican Americans, 123 Other Hispanics, 392 non-Hispanic Blacks, 140 non-Hispanic Asians, and 429 non-Hispanic Whites were analyzed using logistic regression analyses. Reporting being given dietary and exercise advice was positively associated with reporting
following the behavior. There were differences in sex and sex by race/ethnicity for reporting receiving medical advice and performing the advised health behavior. These results suggest the importance of physicians having patient-centered communication skills and cultural competency when discussing diabetes management.
Survey of Children’s Health, 2011-2012, for 42,828 children, ages 10–17 years. Greater percent of children in the overweight/
obese category performed no moderate-to-vigorous physical activity: 11.9 (10.6, 13.3) as compared to children in the
underweight/normal weight category: 9.7 (8.9 10.6). No moderate-to-vigorous physical activity was associated with no
preventive medical care, inadequate or no health care, parents reporting higher percent of no parks or playgrounds, and unsafe
and unsupportive neighborhoods. Odds ratios of overweight/obesity were higher for males [OR 2.06 (1.64, 2.60)], Hispanics
[OR 1.49 (1.17, 1.90)], non-Hispanic Black females [OR 1.59 (1.20, 2.08)], younger females [OR10–12 yrs. 1.35 (1.03, 1.79)
OR 0.84 (0.72, 0.99) vs. OR 1.00 ,] and lower categories of physical activity [OR 1.38 (1.13, >1 to <4 hrs./day ≥ 4 hrs./day 0 days/wk.
and OR13–15 yrs. 1.4. (1.06, 1.89) vs. OR 1.0016-17 yrs.], children with high television viewing [OR0-1 hr./day 0.72 (0.61, 0.86);
1.62); OR1–3 days/wk. 1.14 (1.22, 1.62) vs. OR7 days/wk. 1.00], higher poverty, smoke exposure, and parental perception of their neighborhood as unsupportive. Promoting preventive medical care and neighborhood cooperation may have potential to lower childhood obesity.
This study examined sex by race/ethnicity differences in medical advice received for diet and exercise with corresponding health behaviors of a U.S. representative sample of adults with type 2 diabetes (N = 1,269). Data from the National Health and Nutrition Examination Surveys for 2011-2014 for 185 Mexican Americans, 123 Other Hispanics, 392 non-Hispanic Blacks, 140 non-Hispanic Asians, and 429 non-Hispanic Whites were analyzed using logistic regression analyses. Reporting being given dietary and exercise advice was positively associated with reporting
following the behavior. There were differences in sex and sex by race/ethnicity for reporting receiving medical advice and performing the advised health behavior. These results suggest the importance of physicians having patient-centered communication skills and cultural competency when discussing diabetes management.