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1.  Effect of an intervention to improve the cardiovascular health of family members of patients with coronary artery disease: a randomized trial 
Background:
Family members of patients with coronary artery disease (CAD) have higher risk of vascular events. We conducted a trial to determine if a family heart-health intervention could reduce their risk of CAD.
Methods:
We assessed coronary risk factors and randomized 426 family members of patients with CAD to a family heart-health intervention (n = 211) or control (n = 215). The intervention included feedback about risk factors, assistance with goal setting and counselling from health educators for 12 months. Reports were sent to the primary care physicians of patients whose lipid levels and blood pressure exceeded threshold values. All participants received printed materials about smoking cessation, healthy eating, weight management and physical activity; the control group received only these materials. The main outcomes (ratio of total cholesterol to high-density lipoprotein [HDL] cholesterol; physical activity; fruit and vegetable consumption) were assessed at 3 and 12 months. We examined group and time effects using mixed models analyses with the baseline values as covariates. The secondary outcomes were plasma lipid levels (total cholesterol, low-density lipoprotein cholesterol, HDL cholesterol and triglycerides); glucose level; blood pressure; smoking status; waist circumference; body mass index; and the use of blood pressure, lipid-lowering and smoking cessation medications.
Results:
We found no effect of the intervention on the ratio of total cholesterol to HDL cholesterol. However, participants in the intervention group reported consuming more fruit and vegetables (1.2 servings per day more after 3 mo and 0.8 servings at 12 mo; p < 0.001). There was a significant group by time interaction for physical activity (p = 0.03). At 3 months, those in the intervention group reported 65.8 more minutes of physical activity per week (95% confidence interval [CI] 47.0–84.7 min). At 12 months, participants in the intervention group reported 23.9 more minutes each week (95% CI 3.9–44.0 min).
Interpretation:
A health educator–led heart-health intervention did not improve the ratio of total cholesterol to HDL cholesterol but did increase reported physical activity and fruit and vegetable consumption among family members of patients with CAD. Hospitalization of a spouse, sibling or parent is an opportunity to improve cardiovascular health among other family members. Trial registration: clinicaltrials.gov, no NCT00552591.
doi:10.1503/cmaj.130550
PMCID: PMC3883820  PMID: 24246588
2.  A longitudinal and cross-sectional examination of the relationship between reasons for choosing a neighbourhood, physical activity and body mass index 
Background
The purpose of this study was to examine the relationship between body mass index and neighborhood walkability, socioeconomic status (SES), reasons for choosing neighborhoods, physical activity, fruit and vegetable intake, and demographic variables.
Methods
Two studies, one longitudinal and one cross-sectional, were conducted. Participants included adults (n = 572) who provided complete data in 2002 and 2008 and a concurrent sample from 2008 (n = 1164). Data were collected with longitudinal and cross-sectional telephone surveys. Objective measures of neighborhood characteristics (walkability and SES) were calculated using census data and geographic information.
Results
In the longitudinal study, neighborhood choice for ease of walking and proximity to outdoor recreation interacted with whether participants had moved during the course of study to predict change in BMI over 6 years. Age, change in activity status, and neighborhood SES were also significant predictors of BMI change. Cross-sectionally, neighborhood SES and neighborhood choice for ease of walking were significantly related to BMI as were gender, age, activity level and fruit and vegetable intake.
Conclusions
Results demonstrate that placing importance on choosing neighborhoods that are considered to be easily walkable is an important contributor to body weight. Findings that objectively measured neighbourhood SES and neighborhood choice variables contributed to BMI suggest that future research consider the role of neighborhood choice in examining the relationships between the built environment and body weight.
doi:10.1186/1479-5868-7-57
PMCID: PMC2910030  PMID: 20602776
3.  Further Validation of the Multidimensional Fatigue Symptom Inventory-Short Form 
A growing body of evidence is documenting the multidimensional nature of cancer-related fatigue. Although several multidimensional measures of fatigue have been developed, further validation of these scales is needed. To this end, the current study sought to evaluate the factorial and construct validity of the 30-item Multidimensional Fatigue Symptom Inventory-Short Form (MFSI-SF). A heterogeneous sample of 304 cancer patients (mean age 55 years) completed the MFSI-SF, along with several other measures of psychosocial functioning including the MOS-SF-36 and Fatigue Symptom Inventory, following the fourth cycle of chemotherapy treatment. The results of a confirmatory factor analysis indicated the 5-factor model provided a good fit to the data as evidenced by commonly used goodness of fit indices (CFI 0.90 and IFI 0.90). Additional evidence for the validity of the MFSI-SF was provided via correlations with other relevant instruments (range −0.21 to 0.82). In sum, the current study provides support for the MFSI-SF as a valuable tool for the multidimensional assessment of cancer-related fatigue.
doi:10.1016/j.jpainsymman.2003.06.003
PMCID: PMC2547485  PMID: 14711465
Fatigue; assessment; cancer
4.  Prediction of leisure-time walking: an integration of social cognitive, perceived environmental, and personality factors 
Background
Walking is the primary focus of population-based physical activity initiatives but a theoretical understanding of this behaviour is still elusive. The purpose of this study was to integrate personality, the perceived environment, and planning into a theory of planned behaviour (TPB) framework to predict leisure-time walking.
Methods
Participants were a random sample (N = 358) of Canadian adults who completed measures of the TPB, planning, perceived neighbourhood environment, and personality at Time 1 and self-reported walking behaviour two months later.
Results
Analyses using structural equation modelling provided evidence that leisure-time walking is largely predicted by intention (standardized effect = .42) with an additional independent contribution from proximity to neighbourhood retail shops (standardized effect = .18). Intention, in turn, was predicted by attitudes toward walking and perceived behavioural control. Effects of perceived neighbourhood aesthetics and walking infrastructure on walking were mediated through attitudes and intention. Moderated regression analysis showed that the intention-walking relationship was moderated by conscientiousness and proximity to neighbourhood recreation facilities but not planning.
Conclusion
Overall, walking behaviour is theoretically complex but may best be addressed at a population level by facilitating strong intentions in a receptive environment even though individual differences may persist.
doi:10.1186/1479-5868-4-51
PMCID: PMC2174941  PMID: 17974022
5.  Oh baby! Motivation for healthy eating during parenthood transitions: a longitudinal examination with a theory of planned behavior perspective 
Background
Transitioning to parenthood is a major life event that may impact parents’ personal lifestyles, yet there is an absence of theory-based research examining the impact of parenthood on motives for dietary behaviour. As a result, we are unaware of the social cognitive variables that predict eating behaviour among those transitioning to parenthood. The purpose of the study was to examine eating behaviour motives across 12 months within the framework of the theory of planned behavior (TPB) and compare these across groups of new parents, non-parents, and established parents.
Methods
Non-parents (n = 92), new parents (n = 135), and established parents (n = 71) completed TPB questionnaires assessing attitudes, subjective norms, perceived behavioral control (PBC), and intentions and three day food records at baseline, and 6- and 12-months post-delivery (for parents) and 6- and 12-months post-baseline (for non-parents).
Results
Repeated measures ANOVAs revealed that among men, new- and established-parents had greater intentions to eat healthy compared to non-parents, F(2) = 3.59, p = .03. Among women, established parents had greater intentions than new- and non-parents, F(2) = 5.33, p = .01. Among both men and women during the first 6-months post-delivery, new-parents experienced decreased PBC, whereas established parents experienced increased PBC. Overall, affective attitudes were the strongest predictor of intentions for men (β = 0.55, p < .001) and women (β = 0.38, p < .01). PBC predicted changes in fruit and vegetable consumption for men (β = 0.45, p = .02), and changes in fat consumption for men (β = −0.25, p = .03) and women (β = −.24, p < .05), regardless of parent status.
Conclusion
The transition to parenthood for new and established parents may impact motivation for healthy eating, especially PBC within the framework of TPB. However, regardless of parental status, affective attitudes and PBC are critical antecedents of intentions and eating behaviour. Interventions should target affective attitudes and PBC to motivate healthy eating and may need to be intensified during parenthood.
doi:10.1186/1479-5868-10-88
PMCID: PMC3706269  PMID: 23829582
Theory of planned behaviour; Nutrition; Dietary behaviour; Parenthood

Results 1-5 (5)