Tracking and characterizing longitudinal change in physical activity behaviors among study participants from different sociodemographic backgrounds
Encouraging physical activity is a well-established public health strategy that effectively supports disease prevention and health promotion across all age groups. In the US, Hispanic/Latino communities are part of a large minority population that experiences the burden of increased risk factors for cardiometabolic disease at disproportionate rates, and thus may benefit from strategies that support increased physical activity. In a recent publication supported by NHLBI, NIDDK, NCI, and others, researchers conducted a longitudinal study to assess correlates of physical activity patterns among adult participants of the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) as well as among adult participants of the Framingham Heart Study (FHS), who are primarily white and non-Hispanic.
In order to assess changes physical activity patterns, the researchers used accelerometry data and assessed moderate-to-vigorous physical activity (MVPA) at two time points, approximately eight years apart (2008 and 2019), with a prospective framework of physical activity integrated at both time points. The average age of HCHS/SOL participants was 49.2 years [N=3646, 65.4% female], and FHS participants was 46.9 years [N=1965, 53.1% female]. Researchers conducted multinomial logistic regression to note changes in compliance with the moderate-to-vigorous physical activity (MVPA) guidelines described within the 2018 Physical Activity Guidelines Advisory, in an attempt to isolate which sociodemographic and medical history covariates in these two study cohorts related to changes in physical activity. They found that the MVPA mean score dropped from 22.6 minutes at time 1 to 16.7 minutes at time 2 among HCHS/SOL participants. Among FHS participants, the mean MVPA was 21.7 minutes at time 1 and dropped to 21.3 minutes at time 2. Lower quality diet, advanced age, being married, and having a higher body mass index (BMI) were correlated with having lower odds of meeting the MVPA guidance, across both study groups. Retirement status for women and higher income for all participants were correlated with lower physical activity among HCHS/SOL participants at time 2. Additionally, an increase in physical activity was associated with high levels of self-reported depression symptoms among HCHS/SOL female participants only, at time 2. FHS participants with lower levels of education and income were more likely to demonstrate a decrease in physical activity by time 2. Among FHS adults, a higher perception of good health status and lower perception of pain were associated with sustained physical activity.
There were some limitations to this study, given that it focused on intrapersonal measures, and did not include cultural and environmental measures. Additionally, while the cohorts included in this study are large, well-characterized, and of similar age, with physical activity assessment data collected at similar timepoints using the same type of accelerometer, the cohorts themselves are limited in generalizability due to the specific inclusion criteria for both studies. Despite these limitations, this study uncovered similar patterns of associations between age, sex, BMI, and diet quality for both cohorts. However, the researchers noted differences for factors such as income, education, marital status, depression, and general perception of health and pain. For example, pain was associated with a greater chance of remaining inactive in FHS, but not in HCHS/SOL participants. The researchers suggest further attention to ethnicity differences in the life circumstances associated with higher physical activity.
Citation:
Mossavar-Rahmani Y, Lin J, Pan S, Song RJ, Xue X, Spartano NL, Xanthakis V, Sotres-Alvarez D, Marquez DX, Daviglus M, Carlson JA, Parada H Jr, Evenson KR, Talavera AC, Gellman M, Perreira KM, Gallo LC, Vasan RS, Kaplan RC. Characterizing longitudinal change in accelerometry-based moderate-to-vigorous physical activity in the Hispanic Community Health Study/Study of Latinos and the Framingham Heart Study. BMC Public Health. 2023 Aug 24;23(1):1614. doi: 10.1186/s12889-023-16442-9. PMID: 37620824; PMCID: PMC10464120.
Insights and strategies for improving equity in graduate school admissions: a program review
The path to becoming a scientist involves many milestones, beginning with admission into to graduate school. This application process is often a difficult hurdle for students from historically minoritized backgrounds, thus reinforcing the current lack of diversity in the areas of science, technology, engineering, and math (STEM). To help address this disparity, a group of STEM professionals who received support from NIAID, NIDA, NEI, NIA, and others, sought to determine areas in graduate school admissions that could be improved to promote equity and inclusion, by designing and running a graduate student application assistance program (AAP) called the Científico Latino Graduate Student Mentorship Initiative (CL-GSMI).
The CL-GSMI program was founded in 2019 and consists of 500 volunteer mentors of various scientific backgrounds, who are current graduate students, postdoctoral scientists, or active faculty members affiliated with over 100 US-accredited universities. In its first year of operation, this AAP assisted 443 students with successfully applying to and ultimately enrolling in STEM graduate programs. Using CL-GSMI program evaluation data collected between 2020 and 2021, the authors of this publication contribute to the evidence base for changes in graduate admissions best practices that can better support the equitable inclusion of students belonging to groups that have been economically, culturally, or socially marginalized.
The programmatic review indicated that first-generation and lower-income undergraduate students often lack the implicit cultural socialization and network of advisors and mentors to successfully apply to and gain enrollment within graduate STEM programs. By matching program participants with one-on-one mentoring provided by a STEM professional, CL-GSMI program officers and volunteer mentors were able to support participating undergraduates by empowering them to capitalize on the peer support provided by their families and communities. Program participants were also provided with input and guidance via online resources, educational webinars, access to a global network of STEM professions, and mock interviews. Whenever possible, participants were matched with volunteer mentors belonging to the same cultural, socioeconomic, or ethnic background. CL-GSMI also partnered with over 25 universities or graduate programs to secure waivers for application fees that would otherwise have posed a financial barrier.
CL-GSMI program participants and mentors reported a consistently high level of program satisfaction during 2020 and 2021. The admissions rates for participants were high, at 81% acceptance rate in 2020 (207 out of 253 participants) and 71% in 2021 (160 out of 225 participants). Universities and graduate programs can use these findings to develop best practices to ensure their STEM admissions processes are more accessible to students from diverse backgrounds.
Citation:
Cadena MA, Amaya C, Duan D, Rico CA, García-Bayona L, Blanco AT, Agreda YS, Villegas Rodríguez GJ, Ceja A, Martinez VG, Goldman OV, Fernandez RW. Insights and strategies for improving equity in graduate school admissions. Cell. 2023 Aug 17;186(17):3529-3547. doi: 10.1016/j.cell.2023.07.029. PMID: 37595563; PMCID: PMC10512701.
Using community-based geographical information system (GIS) to recruit older Asian Americans in an Alzheimer's disease study
It is well established that the literature on Alzheimer’s Disease (AD) carries a bias towards study populations with White ancestry, and that there are significant gaps in minority enrollment in AD studies. Supported by NIA, researchers sought to respond to the gaps in data regarding Asian American elder populations by addressing barriers to reaching these community members, which include low levels of contact with the healthcare system, language, health beliefs and attitudes. The objective of this pilot study was to utilize a novel community-based geographical information system (GIS) to recruit 60 participants aged 60 and older of Korean heritage to study genetic and lifestyle AD risk factors, and to establish blood biomarker levels for AD diagnosis, as part of Asian Cohort for Alzheimer’s Disease (ACAD).
The researchers used a mapping approach based on voluntary community participation to develop a group-specific GIS. Community leaders and members of local community organizations offered information about patterns of residence, care utilization, and social activities of older residents belonging to the Korean American (KA) community in one county within New Jersey. By including “grey literature,” a term used to describe evidence or findings self-published without formal peer-review, researchers overlayed locally volunteered community social data with statistical data made available by the US Census’ American Community Survey (ACS) data. Researchers also mapped locations of clinical and social centers that provided services in Korean.
A chain referral sampling method was used to reach older KA adults, such that the subject matter of this study was shared from community leaders and neighbors with their peers at various churches or within the same apartment complexes. The researchers developed GIS maps and conducted analyses by age, English proficiency, socioeconomic status (SES), and education levels, to understand the geospatial trends regarding where KA adults preferred to reside and how they accessed services.
This pilot was successful in meeting its goal of recruiting 60 KA older adults, and also was successful in demonstrating community interest in a GIS recruitment method that builds on social practices already in place. In addition to recruitment, researchers also sought community consensus to determine diagnostic criteria for AD within a KA cultural context. Despite data limitations including the lack of urban vs. rural data and the lack of longitudinal data, this study provides valuable insight into the relevance of a participatory approach used in tandem with GIS to recruit hard to reach ethnic or cultural minority groups within the US.
Citation:
Lee H, Ha H, Yim S, Yang HS, Lee V, Hong E, Chow TW, Park VT, Wang LS, Jun G, Choi YB. Using community-based geographical information system (GIS) to recruit older Asian Americans in an Alzheimer's disease study. BMJ Open. 2023 Aug 3;13(8):e072761. doi: 10.1136/bmjopen-2023-072761. PMID: 37536975; PMCID: PMC10401260.
