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American Journal of Health Behavior 34(4): 387-401 Objectives: To produce evidence for factor validity and longitudinal invariance of scales used to examine the theory of planned behavior applied to physical activity. Methods: Self-report questionnaires were administered at 3- (n = 267) and 12-months (n = 333) postpartum. Results: A single-factor model fit data from the normative beliefs, perceived behavioral control, and behavioral beliefs scales. Attitude and control beliefs were found to be multidimensional. Longitudinal invariance of all scales was supported. Conclusions: Each scale had strong validity evidence. Future research using these measures will help identify areas for intervention and reveal how changes in these constructs influence physical activity.

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American Journal of Health Behavior 34(4): 402-411 Objectives: To examine the prevalence and content of pharmaceutical ads in demographically different women’s magazines. Methods: A content analysis was conducted using one year’s worth of 5 different women’s magazines of varying age demographics. Results: Magazines differed in the proportion of drug ads for different health conditions (eg, cardiovascular) and target audience by age demographic. Use of persuasive elements (types of appeals, evidence) varied by condition promoted (eg, mental-health drug ads more frequently used emotional appeals). Ads placed greater emphasis on direction to industry information resources than on physician discussions. Conclusions: Prevalence of pharmaceutical advertising in women’s magazines is high; continued surveillance is recommended.

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American Journal of Health Behavior 34(4): 412-419 Objective: To investigate the association between theoretically grounded psychosocial motivators and the sun safety practice intentions of rural youth. Methods: A survey was given to 219 members of FFA (Future Farmers of America) at high schools in the rural Midwest (average age = 16). Results: Perceived self-efficacy, peer norms, response efficacy, and susceptibility predicted protective clothing and sunscreen use intentions. Among boys, perceived norms among same-sex peers; but among girls, norms among both same- and opposite-sex peers, were significant. Conclusions: Self-efficacy should be an important component of sun safety education for rural youth. Gender-specific peer norms should also be addressed.

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American Journal of Health Behavior 34(4): 420-431 Objectives: To examine the construct validity and reliability of existing self-report items measuring perceptions of the built environment for physical activity. Methods: Exploratory factor analysis, internal consistency, and nonparametric scaling were assessed using data from a cross-sectional sample of adults (n = 479). Results: A new 5-factor model was identified. Internal consistency and scaling reliabilities were moderate to strong, providing support for the new structure. Conclusions: Further studies are needed to confirm these results. Subscales should be treated as indices and use sum scores in analysis to detect subtle variations and provide more precise power calculations.

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American Journal of Health Behavior 34(4): 432-441 Objectives: To describe recruitment of Latinas in a randomized clinical trial conducted within 2 health care organizations. Methods: The study relied on project-initiated telephone calls as part of a multifaceted recruitment approach. Chi-square and t tests were conducted to compare participants and nonparticipants on a number of variables. Results: From 4045 telephone contacts, 280 Latinas agreed to participate. Most were ineligible due to non-Latino ethnicity (89%). Of eligible candidates, 61% took part. Few significant differences were found on participant vs nonparticipant characteristics. Conclusions: Using appropriate recruitment procedures, a representative sample of Latinas can be obtained.

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American Journal of Health Behavior 34(4): 442-452 Objective: To examine the relationship between the total volume of leisure-time physical activity (LTPA) and obesity among African American adults in Indianapolis. Methods: Logistic regression analysis with 649 African American adults. Results: The data show an inverse graded relationship between the total volume of LTPA and obesity for African American women, but not for men. Conclusions: African American women who accumulate a high volume of LTPA (ie, 300 minutes or more per week) are less likely to be obese. Further research is needed to investigate the gender difference in the effect of LTPA on obesity.

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American Journal of Health Behavior 34(4): 453-464 Objective: To develop a community-based chronic disease prevention program for Inuit in Nunavut, Canada. Methods: Stake-holders contributed to intervention development through formative research (in-depth interviews (n = 45), dietary recalls (n = 42)), community workshops, group feedback and implementation training. Results: Key cultural themes included the perceived healthiness of country foods, food sharing, and importance of family. During community workshops, key problem foods for intervention were identified as well as healthier culturally and economically acceptable alternatives for these foods. Behaviors for promotion were identified and prioritized. Conclusions: This approach resulted in project acceptance, stakeholder collaboration, and a culturally appropriate program in stores, worksites, and other community venues.

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Purpose: To discuss (i) optic disc appearance and (ii) the retinal course of the temporal vessel arcade in a longitudinal series of high myopia patients followed between the ages of 16 and 54.Methods: Thirty-nine individuals from a 1948 Copenhagen birth cohort (n = 9243) who had myopia of [minus]6 to [minus]15 D when aged 14 years were invited for current follow-up exams with 7[ndash]10-year intervals. Fundus photos were available from up to five occasions over 38 years, and single eye photo collages were studied with respect to posterior pole changes over time.Results: Fifty-two eyes with high myopia were available. (i) Contrary to the expected predominance of large flat optic discs in long eyes, more than half the eyes in the sample had neurodiscs that were perceived to be small; many were also oval/kinked/tilted and with minimum or absent physiological cups. Among the fellow eyes with unilateral high myopia only one out of the 10 discs appeared as small/tilted. (ii) By age, a more acute angle between upper and lower temporal retinal vessel trunks was found in 12/20 eyes with adult myopia progression (change over time 5[ndash]23°) and in 6/24 eyes with stable myopia. In the myopia-progression subgroup, peaking of the angle was correlated with myopia degree, myopia increase and axial elongation.Conclusion: Contrary to clinical expectation, we found neurodiscs that appeared to be small and dense in eyes with high myopia. We further discussed the eventual peaking of the angle between the temporal vessel arcades that is sometimes observed in high myopia. Occasionally, literature on myopia reports the presence of small and tilted discs whereas no mention was found of the issue of temporal vessel arcade peaking.

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Objectives: This study aimed to evaluate the evidence for the effects of steroid injection in addition to macular laser grid (MLG) photocoagulation versus those of MLG photocoagulation alone on visual acuity (VA) in patients with diabetic macular oedema (DMO).Methods: An extensive literature search in Medline (PubMed), Experta Medica (EMBASE) and the Cochrane Library (CENTRAL) using synonyms for MLG photocoagulation, steroid injection and DMO found 181 articles. Of the articles that met selection criteria, three studies in which patients receiving MLG photocoagulation were randomized to additional pretreatment with steroids provided the best available evidence. In addition to VA, central foveal thickness (CFT) was measured at baseline and at 6 months in all three studies.Results: Two studies, with total populations of 73 and 42 eyes, respectively, reported no additional effect of steroid injection on VA. One study, with a total of 41 eyes, reported a beneficial effect of pretreatment with steroids on VA of [minus] 0.21 ETDRS logMAR units. All three studies reported larger reductions in CFT in eyes pretreated with steroids, the smallest of which was 64 [mu]m.Conclusions: Although there is a greater reduction in CFT in eyes pretreated with steroids, this does not consistently result in higher VA. The literature search does not provide sufficiently strong evidence to recommend steroid injection before MLG photocoagulation in DMO.

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American Journal of Health Behavior 34(4): 465-475 Objective: To explain rural-urban differences in mammography screening by supply of health care services. Methods: Logistic regression models were used to assess whether variation in the supply of health care services related to mammography screening explained rural-urban differences in mammography screening rates. Results: Women living in small (thinly populated) rural areas not adjacent to a metro area were less likely to obtain a mammogram (OR = 0.682, CI: 0.62-0.75) compared to women in large metro counties. This difference was reduced after adjusting for predisposing and enabling factors (OR = 0.843, CI: 0.76-0.93). Conclusions: Contextual-level enabling factors mediated the rural-urban difference in mammography screening.

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