The authors surveyed 738 college students aged 18 to 27 years to assess overweight, obesity, dietary habits, and physical activity. They used BMI (body mass index) > or = 25 kg/m2 or BMI > or = 85th percentile and BMI > or = 30 kg/m2 or BMI > or = 95th percentile to estimate overweight and obesity in those aged < or = 19 years. To define overweight and obesity in those > or = 20 years, they used BMI > or = 25 kg/m2 and > or = 30 kg/m2. They found overweight rates of 21.6% using BMI directly and 16.2% using BMI percentile and obesity rates of 4.9% using BMI directly and 4.2% using BMI percentile. More than 69% of the participants reported < 5 servings of fruits and vegetables per day and more than 67% reported < 20 g of fiber per day; participants reported physical activity on fewer than 3 d/wk. Most college students are not meeting dietary and physical activity guidelines, suggesting the need for prevention interventions and increased understanding of overweight in college students.

African Americans and Latinos in this study were highly receptive to end-of-life care that would provide relief for patients and caregivers and emphasize spirituality and family consensus. Improving awareness of hospice services would likely increase utilization.

OBJECTIVE: To explore colorectal cancer (CRC) screening knowledge, attitudes, barriers, and preferences among urban African Americans as a prelude to the development of culturally appropriate interventions to improve screening for this group. DESIGN:Qualitative focus group study with assessment of CRC screening preferences.SETTING: Community health center serving low-income African Americans. PARTICIPANTS:Fifty-five self-identified African Americans over 40 years of age. MEASUREMENTS AND MAIN RESULTS:Transcripts were analyzed using an iterative coding process with consensus and triangulation on final thematic findings. Six major themes were identified: (1) Hope-a positive attitude toward screening, (2) Mistrust-distrust that the system or providers put patients first, (3) Fear-fear of cancer, the system, and of CRC screening procedures, (4) Fatalism-the belief that screening and treatment may be futile and surgery causes spread of cancer, (5) Accuracy-a preference for the most thorough and accurate test for CRC, and (6) Knowledge-lack of CRC knowledge and a desire for more information. The Fear and Knowledge themes were most frequently noted in transcript theme counts. The Hope and Accuracy themes were crucial moderators of the influence of all barriers. The largest number of participants preferred either colonoscopy (33%) or home fecal occult blood testing (26%).CONCLUSIONS: Low-income African Americans are optimistic and hopeful about early CRC detection and believe that thorough and accurate CRC screening is valuable. Lack of CRC knowledge and fear are major barriers to screening for this population along with mistrust, and fatalism. Studies show CRC screening disparities between whites and African Americans, 15-18 especially for sigmoidoscopy. [19][20][21][22] African Americans have exhibited higher rates of late-stage CRC diagnosis and less overall decline in colorectal deaths than whites over the past decade. [23][24][25] Barriers to CRC screening include the inconvenient or impractical nature of the tests, 26-29 the embarrassing or unpleasant nature of the tests, 28,29 fatalistic cancer beliefs, 30,31 and participants not wanting to know that something is wrong. 28,32,33 Studies of African Americans have shown that these barriers and others, such as lack of physician recommendation, limited CRC knowledge, and the uncomfortable nature of tests, may contribute to inadequate screening 16,[34][35][36] Although prior qualitative studies have explored how knowledge, socio-culturally mediated attitudes and perceptions, and testing preferences influence screening for breast and prostate cancer among African Americans, 37-40 few qualitative studies have been conducted with African Americans on CRC screening. 20,41,42 These qualitative studies had enrolled from multiethnic populations and had not specifically focused on the attitudes, opinions, and preferences of African Americans. The purpose of our focus group study was to explore CRC screening knowledge, attitudes, barriers, and preferences among urban African A...

Smoking prevalence among homeless persons is approximately 70%, yet little is known about tobacco use patterns or smoking cessation practices in this population. We assessed smoking attitudes and behaviors, psychosocial and environmental influences on smoking, barriers to and interest in quitting, and preferred methods for cessation among some homeless smokers. Six 90-min focus groups of current smokers (N = 62) were conducted at homeless service facilities. Participants had a mean age of 41.5 years (SD = 9.3), were predominantly male (69.4%) and African American (59%), and smoked an average of 18.3 cigarettes/day. Although most reported that they were motivated to quit, a number of barriers to quitting were identified. Participants reported that the pervasiveness and social acceptance of tobacco use in homeless settings contributed to smoking more cigarettes per day, adopting alternative smoking behaviors such as smoking cigarette butts and making their own cigarettes, and experiencing difficulty in quitting. High levels of boredom and stress also were cited as reasons for continued smoking. Smoking frequently occurred in combination with alcohol or illicit drug use or to achieve a substitute "high." Most participants (76%) reported that they planned to quit smoking in the next 6 months. Many were interested in using pharmacotherapy in combination with behavioral treatments. Results suggest that, although motivated to quit smoking, homeless smokers are faced with unique social and environmental barriers that make quitting more difficult. Interventions must be flexible and innovative to address the unique needs of homeless smokers. Smoking restrictions at homeless service facilities and funding for smoking cessation assistance in this underserved population may help to reduce prevalence.