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Preventing Chronic Disease (PCD) welcomes your comments on selected published articles and posts from experts from CDC’s National Center for Chronic Disease Prevention and Health Promotion. PCD encourages an open dialogue among chronic disease prevention researchers, practitioners, and advocates. Check in weekly for new content.

Overreporting of Deaths From Coronary Heart Disease in New York City Hospitals, 2003

ORIGINAL RESEARCH
Overreporting of Deaths From Coronary Heart Disease in New York City Hospitals, 2003

Reena Agarwal, MD, MPH; Jennifer M. Norton, PhD; Kevin Konty, MS, MA; Regina Zimmerman, PhD, MPH; Maleeka Glover, ScD; Akaki Lekiachvili, PhD; Henraya McGruder, PhD; Ann Malarcher, PhD; Michele Casper, PhD; George A.  Mensah, MD; Lorna Thorpe, PhD

Suggested citation for this article: Agarwal R, Norton JM, Konty K, Zimmerman R, Glover M, Lekiachvili A, et al. Overreporting of deaths from coronary heart disease in New York City hospitals, 2003. Prev Chronic Dis 2010;7(3). http://www.cdc.gov/pcd/issues/2010/
may/09_0086.htm
. Accessed [date].

PEER REVIEWED

Abstract

Introduction
New York City has one of the highest reported death rates from coronary heart disease in the United States. We sought to measure the accuracy of this rate by examining death certificates.

Methods
We conducted a cross-sectional validation study by using a random sample of death certificates that recorded in-hospital deaths in New York City from January through June 2003, stratified by neighborhoods with low, medium, and high coronary heart disease death rates. We abstracted data from hospital records, and an independent, blinded medical team reviewed these data to validate cause of death. We computed a comparability ratio (coronary heart disease deaths recorded on death certificates divided by validated coronary heart disease deaths) to quantify agreement between death certificate determination and clinical judgment.

Results
Of 491 sampled death certificates for in-hospital deaths, medical charts were abstracted and reviewed by the expert panel for 444 (90%). The comparability ratio for coronary heart disease deaths among decedents aged 35 to 74 years was 1.51, indicating that death certificates overestimated coronary heart disease deaths in this age group by 51%. The comparability ratio increased with age to 1.94 for decedents aged 75 to 84 years and to 2.37 for decedents aged 85 years or older.

Conclusion
Coronary heart disease appears to be substantially overreported as a cause of death in New York City among in-hospital deaths.

Racial/Ethnic Differences in Perceived Access, Environmental Barriers to Use, and Use of Community Parks

ORIGINAL RESEARCH
Racial/Ethnic Differences in Perceived Access, Environmental Barriers to Use, and Use of Community Parks

Susan A. Carlson, MPH; Joseph D. Brooks, MS; David R. Brown, PhD; David M. Buchner, MD, MPH

Suggested citation for this article: Carlson SA, Brooks JD, Brown DR, Buchner DM. Racial/ethnic differences in perceived access, environmental barriers to use, and use of community parks. Prev Chronic Dis 2010;7(3). http://www.cdc.gov/pcd/issues/2010/
may/09_0150.htm
. Accessed [date].

PEER REVIEWED

Abstract

Introduction
Community parks provide places for people to be physically active. Our objective was to determine how access to, barriers to use of, and use of community parks differ by race/ethnicity.

Methods
Analyses are based on a cross-sectional national sample of adults (N = 5,157) participating in the 2006 HealthStyles mail survey. Community parks were defined as outdoor public areas within 10 miles or a 20-minute drive from where a person lives that include walking/bike paths, nature preserves, playgrounds, beaches, lakes, rivers, or similar places.

Results
Overall, 12% of respondents reported not having a community park. Among those with a community park, 14% reported personal safety concerns and 14% reported inadequate or poorly maintained facilities as barriers to park use. Race/ethnicity was not associated with park access; however, Hispanics and non-Hispanic blacks were more likely than non-Hispanic whites to report barriers. Among those with access to a community park, 83% reported any park use in the previous year and, of these, 67% reported an active visit. Odds of any park use did not differ significantly by race/ethnicity. Odds of an active visit were significantly lower in non-Hispanic blacks than whites (odds ratio, 0.67) but did not significantly differ between Hispanics and non-Hispanic whites.

Conclusions
Parks are valuable community resources to all racial/ethnic groups. To promote and increase community park use, it is important to be aware that parks are used differently by different racial/ethnic groups and that barriers may differentially influence park use.

Strategies for and Barriers to Managing Weight When Eating at Restaurants

ORIGINAL RESEARCH
Strategies for and Barriers to Managing Weight When Eating at Restaurants

Gayle M. Timmerman, PhD, RN, CNS; Marie Earvolino-Ramirez, PhD, RN

Suggested citation for this article: Timmerman GM, Earvolino-Ramirez M. Strategies for and barriers to managing weight when eating at restaurants. Prev Chronic Dis 2010;7(3). http://www.cdc.gov/pcd/issues/2010/
may/09_0130.htm
. Accessed [date].

PEER REVIEWED

Abstract

Introduction
Eating in restaurants contributes to excess caloric intake, which leads to weight gain, but little is known about strategies used to manage weight or barriers to weight management in restaurant settings. We describe and compare the strategies men and women use and the barriers they encounter when eating at restaurants.

Methods
We recruited a convenience sample of 146 adults at a university open house. Participants completed questionnaires on demographics and eating patterns, strategies used to manage weight in restaurants, and barriers to managing weight in restaurants.

Results
The most common strategies used by participants were avoiding sugar-filled drinks, choosing steamed vegetables and whole-grain foods, and stopping eating when full. We found few differences by sex: women were more likely to share appetizers or meals, substitute appetizers for meals, have salads as entrées, order salad dressing on the side, and bring half of the meal home.

Conclusion
Women and men had more similarities than differences in strategies for and barriers to managing weight in restaurants. We need to understand what influences food choices at restaurants in order to develop comprehensive plans for weight management.

Cognitive Health Messages in Popular Women’s and Men’s Magazines, 2006-2007

ORIGINAL RESEARCH
Cognitive Health Messages in Popular Women’s and Men’s Magazines, 2006-2007

Daniela B. Friedman, PhD; James N. Laditka, DA, PhD; Sarah B. Laditka, PhD; Anna E. Mathews, PhD

Suggested citation for this article: Friedman DB, Laditka JN, Laditka SB, Mathews AE. Cognitive health messages in popular women’s and men’s magazines, 2006-2007. Prev Chronic Dis 2010;7(2). http://www.cdc.gov/pcd/issues/2010/
mar/09_0021.htm
. Accessed [date].

PEER REVIEWED

Abstract

Introduction
Growing evidence suggests that physical activity, healthy diets, and social engagement may promote cognitive health. Popular media helps establish the public health agenda. In this study, we describe articles about cognitive health in top-circulating women’s and men’s magazines.

Methods
To identify articles on cognitive health, we manually searched all pages of 4 top-circulating women’s magazines and 4 top-circulating men’s magazines published in 2006 and 2007 to identify articles on cognitive health. We examined article volume, narrative and illustrative content, information sources, and contact resources.

Results
Women’s magazines had 27 cognitive health articles (5.32/1,000 pages), and men’s magazines had 26 (5.26/1,000 pages). Diet was the primary focus (>75% of content) in 30% of articles in women’s magazines and 27% of men’s magazines. Vitamins/supplements were the focus of 15% of articles in men’s magazines and 11% in women’s magazines. Articles mentioned physical activity, cognitive activity, and social interaction, although these subjects were rarely the focus. Articles focused more on prevention than treatment. Topics were primarily “staying sharp,” memory, and Alzheimer’s disease. Colleges/universities were most often cited as sources; contacts for further information were rare. Most articles were illustrated.

Discussion
Although the volume of cognitive health articles was similar in the magazines, content differed. More articles in men’s magazines discussed multiple chronic conditions (eg, Alzheimer’s disease), whereas more in women’s magazines discussed memory. Including more articles that focus on physical activity and direct readers to credible resources could enhance the quality of cognitive health communication in the popular media.

The GirlStars Program: Challenges to Recruitment and Retention in a Physical Activity and Health Education Program for Adolescent Girls Living in Public Housing

COMMUNITY CASE STUDY
The GirlStars Program: Challenges to Recruitment and Retention in a Physical Activity and Health Education Program for Adolescent Girls Living in Public Housing

Maisha Douyon, MPH; Maria Chavez; Doris Bunte; C. Robert Horsburgh, MD; Lee Strunin, PhD

Suggested citation for this article: Douyon M, Chavez M, Bunte D, Horsburgh CR, Strunin L. The GirlStars program: challenges to recruitment and retention in a physical activity and health education program for adolescent girls living in public housing. Prev Chronic Dis 2010;7(2). http://www.cdc.gov/pcd/issues/2010/
mar/08_0248.htm
. Accessed [date].

PEER REVIEWED

Abstract

Background
Although physical inactivity is a concern for all adolescents, physical activity levels are especially low among minority adolescents and minimal among girls from low-income families. After-school programs can reduce high-risk behaviors and strengthen schools, families, and communities.

Context
We conducted an operational research project that provided free access to a program of regular, organized physical activity combined with health education sessions for adolescent girls in 2 public housing developments in Boston, Massachusetts.

Methods
From July 2002 through October 2005, at each of 2 public housing sites, the GirlStars program participants met each week for two 2-hour sessions, 1 dedicated to physical activity and 1 dedicated to health education. Sessions were led by the project coordinator and a resident assistant at each development.

Outcome
Participants in the GirlStars program increased their health knowledge, self-confidence, and decision-making skills, but rates of participation were low. Factors that affected participation included safety concerns, lack of community support for the program, interpersonal conflicts, attrition in staff, and conflicts with other activities.

Interpretation
Programs in public housing developments that address these barriers to recruitment and retention may be more successful and reach more girls. 

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