This study is registered at ClinicalTrials.gov with clinical trial registration number NCT02188875. AbstractBackground: Studies have shown self-monitoring can modify health behaviors, including physical activity (PA). This study tested the utility of a wearable sensor/device (Fitbit Ò OneÔ;

Background. The study examined the association of obesity with acculturation in a large and diverse sample of US Hispanic/Latino adults. Methods. The Hispanic Community Health Study (HCHS)/Study of Latinos (SOL) is a community-based cohort study of Hispanic/Latino adults aged 18–74 years (N = 16,415) from four urban areas. Height and weight were directly measured using a standardized protocol. Acculturation was assessed by the Short Acculturation Scale for Hispanics (SASH). Other immigration related variables included place of birth, length of residency in the US, and age at immigration. Odds ratios were calculated to assess the association of overweight, moderate obesity, and extreme obesity (≥40 kg/m2) with acculturation and sociodemographic variables. Results. The prevalence of obesity was 42.4% for women and 36.5% for men and varied by field center and Hispanic/Latino background. The strongest predictor of moderate and extreme obesity was length of residency in mainland US. This association was consistent across Hispanic/Latino backgrounds. Acculturation was not significantly associated with obesity. Discussion. The burden of obesity is high among Hispanic/Latino adults. The study findings suggest that prolonged exposure to the environments in these communities, rather than acculturation, is an important risk factor for obesity in this population.

Background Internet use for health information is important, given the rise of electronic health (eHealth) that integrates technology into health care. Despite the perceived widespread use of the internet, a persistent “digital divide” exists in which many individuals have ready access to the internet and others do not. To date, most published reports have compared characteristics of internet users seeking health information vs nonusers. However, there is little understanding of the differences between internet users seeking health information online and users who do not seek such information online. Understanding these differences could enable targeted outreach for health interventions and promotion of eHealth technologies. Objective This study aims to assess population-level characteristics associated with different types of internet use, particularly for seeking online health information. Methods The 2015-2016 California Health Interview Survey datasets were used for this study. Internet use was classified as never used the internet ( Never use ), ever used the internet but not to search for health information in the last 12 months ( Use not for health ), and ever used the internet and have used it to search for health information in the last 12 months ( Use for health ). Weighted multinomial logistic regression was used to assess sociodemographic and health characteristics associated with types of internet use. Findings are reported as odds ratios (ORs) with 95% CIs. Results Among 42,087 participants (weighted sample of 29,236,426), 19% reported Never Use of the internet, 27.9% reported Use not for health , and 53.1% reported Use for health . Compared to Never Use individuals, Use for health individuals were more likely to be younger (OR: 0.1, 95% CI 0.1-0.2 for ≥60 years vs <60 years), female (OR: 1.6, 95% CI 1.3-1.9 compared to males), and non-Hispanic white (OR: 0.54, 95% CI 0.4-0.7 for Latinos and OR: 0.2, 95% CI 0.2-0.4 for African Americans) and have a higher socioeconomic status (>400% of Federal Poverty Guidelines; OR: 1.3, 95% CI 1.4-2.4). Overall, characteristics for the Use not for health and Use for health groups were similar, except for those with lower levels of education and respondents not having visited a physician in the last year. For these two characteristics, the Use not for health group was more similar to the Never Use group. Conclusions Our findings indicate that a digital divide characterized by sociodemographic and health information exists across three types of users. Our results are in line with those of previous studies on the divid...

Background As wearable sensors/devices become increasingly popular to promote physical activity (PA), research is needed to examine how and which components of these devices people use to increase their PA levels. Aims (1) To assess usability and level of engagement with the Fitbit One and daily SMS-based prompts in a 6-week PA intervention, and (2) to examine whether use/ level of engagement with specific intervention components were associated with PA change. Methods Data were analyzed from a randomized controlled trial that compared (1) a wearable sensor/ device (Fitbit One) plus SMS-based PA prompts, and (2) Fitbit One only, among overweight/ obese adults (N = 67). We calculated average scores from Likert-type response items that assessed usability and level of engagement with device features (e.g., tracker, website, mobile app, and SMS-based prompts), and assessed whether such factors were associated with change in steps/day (using Actigraph GT3X+). Results Participants reported the Fitbit One was easy to use and the tracker helped to be more active. Those who used the Fitbit mobile app (36%) vs. those who did not (64%) had an increase in steps at 6-week follow-up, even after adjusting for previous web/app use: +545 steps/ day (SE = 265) vs. −28 steps/ day (SE = 242) (p = .04). Conclusions Level of engagement with the Fitbit One, particularly the mobile app, was associated with increased steps. Mobile apps can instantly display summaries of PA performance and could optimize self-regulation to activate change. More research is needed to determine whether such modalities might be cost-effective in future intervention research and practice.

Breast cancer awareness studies of women in Jordan do not exist. This study used data from 163 nurses and 178 teachers surveyed in Amman to determine 2 dimensions of breast cancer awareness: general breast cancer awareness, defined as knowledge of risk factors associated with the disease and breast cancer screening awareness, defined as knowledge of breast self-examination and mammography. The survey instrument was based on 2 previously validated knowledge-based questionnaires in the literature (Breast Cancer Knowledge Test and the Comprehensive Breast Cancer Questionnaire). Analysis of covariance indicated that family history was associated with general breast cancer awareness. Profession, age, and family history significantly influenced breast cancer screening awareness. The average percentage of correct responses to general breast cancer awareness was adjusted for select covariates (adjusted means). The adjusted mean general awareness score for nurses was not significantly different from that of teachers (P =.8470). Nurses were more aware than teachers of the importance of breast cancer screening and its techniques. The adjusted mean screening awareness score for nurses was 88.3%, compared with 73.1% for teachers (P <.0001). These results provide important information about the level of breast cancer awareness among women nurses and teachers in Jordan and may be useful for developing future prevention and screening education programs.