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1.  Fidelity issues in secondhand smoking interventions for children 
This paper reviews methodological and theoretical fidelity of secondhand smoking (SHS) intervention studies (n=29) that target protection of children in their home. In 2005, interventions were evaluated in terms of treatment fidelity according to guidelines provided by Borrelli et al. of the National Institutes of Health Behavior Change Consortium. The degree of fidelity was evaluated based on the percentage of criteria met; the inter-rater reliability based on percent agreement across independent raters was 0.78. Analysis indicated that studies with higher treatment fidelity were more likely to obtain statistically significant results (p=.003) with the average fidelity rating of 0.74 for statistically significant studies vs. 0.50 for statistically non-significant studies. Higher treatment fidelity was also significantly associated with being a more recent investigation (year 2000 or later), an efficacy as compared to effectiveness trial, more intensive as compared to less intensive intervention, a trial in the U.S. as compared to foreign nations, and having a theoretical basis. After taking all other variables into account, only treatment fidelity was significantly related to study outcome (p=.052). Ratings of treatment fidelity were ranked and compared to previous rankings based on 342 behavioral change interventions; the rank-ordered correlation between previous and current ratings was 0.84, although median fidelity ratings were 0.10 points lower in the previous than in the present study (0.52 vs. 0.62; intraclass correlation=0.79). Improvements to the treatment fidelity evaluation guidelines were suggested, including the consideration of theoretical fidelity. Enhancing methodological and theoretical fidelity will speed identification of valid theoretical precepts that will, in turn, guide effective public health prevention programs.
PMCID: PMC3533496  PMID: 19023822
2.  Assessment of Dietary Intakes of Filipino-Americans: Implications for Food Frequency Questionnaire Design 
PMCID: PMC3204150  PMID: 21705276
acculturation; diet; Asian Americans; nutrition assessment
3.  Adolescents Validly Report Their Exposure to Secondhand Smoke 
Journal of clinical epidemiology  2010;63(8):914-919.
This study examined the validity of child-reported exposure to secondhand smoke (SHS) and investigated factors, such as child's age, that might affect accuracy of recall.
Study Design and Setting
Participants were drawn from a nonprobability sample of 380 families who completed baseline assessment as part of a randomized trial of a SHS reduction intervention conducted in an urban setting in Southern California. Parents and children (aged 8-13 years) retrospectively reported child's exposure to SHS using timeline follow-back methodology; reports were compared to child's urine cotinine.
Validity coefficients for parents and children were comparable (r = 0.58 vs. r = 0.53) but parents recalled three times more exposure than children (2.2 vs. 0.8 cigarettes per day; p < 0.001). Regression models predicting cotinine indicated that including child in addition to parent reports resulted in better prediction than either alone.
When there is a choice, parent reports are preferable over child reports due to decreased underreporting. However, child-reported SHS exposure had adequate validity (r > 0.50) and might be appropriate in some situations. Researchers might consider collecting both parent and child reports, since each made a unique contribution to the prediction of cotinine.
PMCID: PMC2895011  PMID: 20346628
Bias; Cotinine; Passive smoking; Psychometrics; Questionnaires; Validity of results
4.  Colorectal Cancer Test Use among Californians of Mexican Origin: Influence of Language Barriers 
Ethnicity & disease  2009;19(3):315-322.
Striking decreases in colorectal cancer (CRC) incidence have been seen recently in non-Latino Whites but not in Latinos. The purpose of our study was to examine the influence of limited English proficiency (LEP) on differences in CRC test use rates between Mexican American and non-Latino White adults in California and reported reasons for not getting a CRC exam.
Cross-sectional analysis of the 2005 California Health Interview Survey (CHIS).
Representative sample of non-institutionalized adults living in California.
Mexican American (n=1,529) and non-Latino White men and women aged 50 and older (n=16,775) who had not been diagnosed with CRC.
Logistic regression analyzed the effect of ethnicity and limited English proficiency (LEP) on CRC test use after adjusting for sociodemographics, healthcare access, health status, and other health behaviors.
Main Outcome Measures
Respondents' likelihood of not receiving the CRC exam was examined as a function of ethnicity and LEP status; differences in reasons for not receiving CRC testing between ethnic groups were also examined.
More than 40% of Californian Mexican American adults aged 50 and older have never had either fecal occult blood test or lower endoscopy CRC tests. Mexican Americans were more likely to have difficulty understanding their doctor due to language barriers (P<.01). Mexican Americans more often reported provider barriers in getting an endoscopy (ie, test was not recommended by their medical provider) than non-Latino Whites (P=.01). After adjustment for covariates, Mexican Americans were 1.32 times and those with LEP were 1.68 times more likely to have never had either CRC test.
Limited English proficiency significantly decreased the likelihood of getting tested for CRC (P<.01). Eliminating language barriers should result in improvements in CRC test use among limited English proficiency Mexican Americans.
PMCID: PMC2757758  PMID: 19769015
Mexican Americans; Colonoscopy; Colorectal Cancer; Screening
5.  Reducing the Gap Between the Economic Costs of Tobacco and Funds for Tobacco Training in Schools of Public Health 
Public Health Reports  2006;121(5):538-546.
Tobacco use costs approximately $167 billion annually in the U.S., but few tobacco education opportunities are available in schools of public health. Reasons for the discrepancy between the costs of tobacco use and the creation of tobacco training opportunities have not been well explored. Based on the Behavioral Ecological Model, we present 10 recommendations for increasing tobacco training in schools of public health. Six recommendations focus on policy changes within the educational, legislative, and health care systems that influence funds for tobacco training, and four recommendations focus on strategies to mobilize key social groups that can advocate for change in tobacco control education and related policies. In addition, we present a model tobacco control curriculum to equip public health students with the skills needed to advocate for these recommended policy changes. Through concurrent changes in the ecological systems affecting tobacco control training, and through the collaborative action of legislators, the public, the media, and health professionals, tobacco control training can be moved to a higher priority in educational settings.
PMCID: PMC1564463  PMID: 16972507
6.  Comparative validation of the IPAQ and the 7-Day PAR among women diagnosed with breast cancer 
The criterion-related validity and measurement bias of the long form of the International Physical Activity Questionnaire (IPAQ) was compared to the 7-Day Physical Activity Recall (PAR).
Participants were women who have been diagnosed with breast cancer and enrolled in the ongoing Women's Healthy Eating and Living Study. Women (N = 159, average age 57 years) wore an accelerometer for one week and then completed the IPAQ or the PAR.
The validity correlation of the PAR was significantly higher (p < 0.001) than the IPAQ (0.73 vs. 0.33, respectively). The PAR and IPAQ overestimated total physical activity by 13% vs. 247%, respectively. The PAR had better sensitivity (p = 0.14) and specificity (p < .01) than the IPAQ (100% vs. 71% and 84% vs. 59%, respectively) in predicting attainment of the ACSM physical activity guideline.
The PAR was superior to the IPAQ in terms of validity, measurement bias, and screening statistics.
PMCID: PMC1468425  PMID: 16579852

Results 1-6 (6)