Background Sedentary behavior is recognized as a distinct construct from lack of moderate-vigorous physical activity and is associated with deleterious health outcomes. Previous studies have primarily relied on self-reported data, while data on the relationship between objectively-measured sedentary time and cardiometabolic biomarkers are sparse, especially among U.S. Hispanics/Latinos. Methods and Results We examined associations of objectively-measured sedentary time (via Actical accelerometers for 7 days) and multiple cardiometabolic biomarkers among 12,083 participants, aged 18–74 years, from the Hispanic Community Health Study/Study of Latinos. Hispanics/Latinos of diverse backgrounds (Central American, Cuban, Dominican, Mexican, Puerto Rican, and South American) were recruited from 4 U.S. cities between 2008 and 2011. Sedentary time (<100 counts/minute) was standardized to 16-hour/day of wear time. The mean sedentary time was 11.9 hours/day (74% of accelerometer wear time). After adjustment for moderate-vigorous physical activity and confounding variables, prolonged sedentary time was associated with decreased high-density lipoprotein (HDL)-cholesterol (P=0.04), and increased triglycerides, 2-hour glucose, fasting insulin and HOMA-IR (all P<0.0001). These associations were generally consistent across age, sex, Hispanic/Latino backgrounds, and physical activity levels. Even among individuals meeting physical activity guidelines, sedentary time was detrimentally associated with several cardiometabolic biomarkers (diastolic blood pressure, HDL-cholesterol, fasting and 2-hour glucose, fasting insulin and HOMA-IR; all P<0.05). Conclusions Our large population-based, objectively-derived data showed deleterious associations between sedentary time and cardiometabolic biomarkers, independent of physical activity, in U.S. Hispanics/Latinos. Our findings emphasize the importance of reducing sedentary behavior for the prevention of cardiometabolic diseases, even in those who meet physical activity recommendations.

The Center for Epidemiologic Studies Depression Scale (CES-D) is a widely used self-report measure of depression symptomatology. This study evaluated the reliability, validity, and measurement invariance of the CES-D 10 in a diverse cohort of Hispanics/Latinos from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). The sample consisted of 16,415 Hispanic/Latino adults recruited from four field centers (Miami, FL; San Diego, CA; Bronx, NY; Chicago, IL). Participants completed interview administered measures in English or Spanish. The CES-D 10 was examined for internal consistency, test-retest reliability, convergent validity, and measurement invariance. The total score for the CES-D 10 displayed acceptable internal consistencies (Cronbach α’s = .80 – .86) and test-retest reliability (r’s = .41 – .70) across the total sample, language group and ethnic background group. The total CES-D 10 scores correlated in a theoretically consistent manner with the Spielberger State-Trait Anxiety Inventory (r = .72, p < .001), the Patient Health Questionnaire-9 depression measure (r = .80, p < .001) the Short Form-12’s Mental Component Summary (r = −.65, p < .001) and Physical Component Summary score (r = −.25, p < .001). A confirmatory factor analysis showed that a one-factor model fit the CES-D 10 data well (CFI = .986, RMSEA = .047) after correlating one pair of item residual variances. Multiple group analyses showed the one-factor structure to be invariant across English and Spanish speaking responders and partially invariant across Hispanic/Latino background groups. The total score of the CES-D 10 can be recommended for use with Hispanics/Latinos in English and Spanish.

Background Excessive sedentary time is ubiquitous in developed nations and is associated with deleterious health outcomes. Few studies have examined whether the manner in which sedentary time is accrued (in short or long bouts) carries any clinical relevance. The purpose of this study was to examine the association of prolonged-uninterrupted sedentary behavior with glycemic biomarkers in a cohort of U.S. Hispanic/Latino adults. Methods We studied 12,083 participants from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), a population-based study of Hispanic/Latino adults 18–74 years. Homeostatic model assessment of insulin resistance (HOMA-IR) and glycosylated hemoglobin (Hb1Ac) were measured from a fasting blood sample and 2-hour glucose was measured following an oral glucose tolerance test. Sedentary time was objectively measured using a hip-mounted accelerometer. Prolonged, uninterrupted sedentariness was expressed as mean sedentary bout length. Results Adjusted for potential confounders and moderate-vigorous physical activity, longer sedentary bout duration was dose-dependently associated with increased HOMA-IR (p-trend <0.001) and 2-hour glucose levels (p-trend=0.015). These associations were not independent of total sedentary time, however a significant interaction between sedentary bout duration and total sedentary time was observed. Evaluation of the joint association of total sedentary time and sedentary bout duration showed that participants in the upper quartile for both sedentary characteristics (i.e. high total sedentary time and high sedentary bout duration) had the highest levels of HOMA-IR (p<0.001 vs. low group for both sedentary characteristics) and 2-hour glucose (p=0.002 vs. low group for both sedentary characteristics). High total sedentary time or high sedentary bout duration alone were not associated with differences in any glycemic biomarkers Conclusions Accruing sedentary time in prolonged, uninterrupted bouts may be deleteriously associated with biomarkers of glucose regulation.

Purpose Depression is common among patients diagnosed with cancer and may be inversely associated with spiritual well-being. While numerous strategies are employed to manage and cope with illness, spiritual well-being has become increasingly important in cancer survivorship research. This study examined the association between spiritual well-being and depressive symptoms. Methods This cross-sectional study utilized self-report data from 102 diverse cancer survivors recruited from peer-based cancer support groups in San Diego County. Depression was measured with the Patient Health Questionnaire-8 (PHQ-8) and spiritual well-being was measured with the Functional Assessment of Chronic Illness Therapy--Spiritual Well-being (FACIT-Sp) comprised of two subscales (Meaning/Peace and Faith). Results Hierarchal regression analysis indicated that Meaning/Peace significantly predicted depressive symptoms after adjusting for socio-demographics, cancer stage, time since diagnosis, and Faith (p < .001). Conclusions Findings suggest that spiritual well-being is a valuable coping mechanism and that Meaning/Peace has a unique advantage over Faith in protecting cancer survivors from the effects of depression symptoms; therefore, turning to Meaning/Peace as source of strength may improve psychological well-being during survivorship. Implications Future programs and healthcare providers should be cognizant of the influential role of spiritual well-being in depression symptoms in an effort to improve psychological well-being among cancer survivors.

Excessive sedentary behavior is associated with negative health outcomes independent of physical activity. Objective estimates of time spent in sedentary behaviors are lacking among adults from diverse Hispanic/Latino backgrounds. The objective of this study was to describe accelerometer-assessed sedentary time in a large, representative sample of Hispanic/Latino adults living in the United States, and compare sedentary estimates by Hispanic/Latino background, sociodemographic characteristics and weight categories. This study utilized baseline data from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) that included adults aged 18–74 years from four metropolitan areas (N = 16,415). Measured with the Actical accelerometer over 6 days, 76.9% (n = 12,631) of participants had > 10 h/day and > 3 days of data. Participants spent 11.9 h/day (SD 3.0), or 74% of their monitored time in sedentary behaviors. Adjusting for differences in wear time, adults of Mexican background were the least (11.6 h/day), whereas adults of Dominican background were the most (12.3 h/day), sedentary. Women were more sedentary than men, and older adults were more sedentary than younger adults. Household income was positively associated, whereas employment was negatively associated, with sedentary time. There were no differences in sedentary time by weight categories, marital status, or proxies of acculturation. To reduce sedentariness among these populations, future research should examine how the accumulation of various sedentary behaviors differs by background and region, and which sedentary behaviors are amenable to intervention.

Background Previous United States (U.S.) population-based studies have found that body weight may be underestimated when self-reported. However, this research may not apply to all U.S. Hispanics/Latinos, many of whom are immigrants with distinct cultural orientations to ideal body size. We assessed the data quality and accuracy of self-reported weight in a diverse community-based U.S. sample of primarily foreign-born Hispanics/Latino adults. Methods Using baseline data (2008–2011) from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), we described the difference between contemporaneous self-reported and measured current body weight (n=16,119) and used multivariate adjusted models to establish whether the observed trends in misreporting in potential predictors of inaccuracy persisted after adjustment for other predictors. Lastly, we described the weighted percentage agreement in body mass classification using either self-reported or measured weight (n=16,110). Results Self-reported weight was well correlated with (r2=0.95) and on average 0.23 kg greater than measured weight. The range of this misreporting was large and several factors were associated with misreporting: age group, gender, body mass categories, nativity, study site by background, unit of self-report (kg or lb), and end digit preference. The percentage agreement of body mass classification using self-reported versus measured weight was 86% and varied across prevalent health conditions. Conclusions The direction of misreporting in self-reported weight, and thus the anticipated bias in obesity prevalence estimates based on self-reported weights, may differ in U.S. Hispanic/Latinos from that found in prior studies. Future investigations using self-reported body weight in U.S. Hispanic/Latinos should consider this information for bias analyses.

Background Anxious-depression is a constellation of symptoms, frequently encountered among patients in primary care centers. There is a need to study how anxious-depression presents among Hispanic/Latinos of different backgrounds. Objective To study the construct of anxious-depression among 16,064 Hispanic/Latinos of different backgrounds participating in the Hispanic Community Health Study/ Study of Latinos (HCHS/SOL). We hypothesized that Hispanic/Latinos will cluster in 3 classes: low anxiety/high depression, high anxiety/low depression and a combined anxious-depression construct. Methods Using latent profile analysis, symptoms of depression and anxiety measured by the 10-item Center for Epidemiologic Studies Depression Scale (CES-D) and 10-item State-Trait Anxiety Inventory (STAI) were evaluated to determine if an anxious-depression typology would result. A multinomial logistic regression analysis explored the association of the 3-class solution with different Hispanic/Latino backgrounds controlling for age, gender, language, education and income. Results A 3-class mixed anxious-depression structure emerged with 10% of Hispanic/Latinos in the high, 30% in the moderate and 60% in the low anxious-depression category. After adjusting for age, gender, language preference, income and education, individuals of Puerto-Rican background were more likely to experience high (OR=1.79,p<0.05) and moderate (OR=1.36,p<0.05) (vs.low) anxious-depression symptomatology compared to those of Mexican background. Individuals of Central-American and South-American background were less likely to experience high (OR=0.68,p<0.05) and moderate (OR=0.8,p<0.05) (vs.low) anxious-depression compared to those of Mexican background. Conclusion Anxious-depression symptomatology varied among this sample of Hispanic/Latino groups. These classes should be investigated as to their relationship with different health outcomes relevant to the Hispanic/Latino of different backgrounds.

This study examined relationship power as a possible mediator of the relationship between dating violence and sexually transmitted infections (STIs). The proposed mediation model was based on the theory of gender and power as well as previous research on intimate partner violence and STI risk. Survey results from a sample of 290 single, undergraduate women indicated that 85% experienced at least one form of dating violence victimization in the past year, 5.9% tested positive for an STI, and 5.2% received treatment for an STI. Results revealed that women with lower levels of sexual relationship power had higher rates of dating violence victimization and STIs; also, sexual relationship power partially mediated the relationship between dating violence victimization and STIs. Future dating violence and STI-prevention interventions targeting young women may want to use an empowerment approach to decrease their likelihood of dating violence victimization and STI risk.