Publications by authors named "Deborah R. Young"

Importance: Sugar-sweetened beverage (SSB) excise taxes are popular policy interventions aimed at decreasing SSB purchasing and consumption to improve cardiometabolic health and generate revenue for public health initiatives. There is limited evidence that these taxes in the US are associated with weight-related outcomes in adults, a primary contributor to cardiometabolic health.

Objective: To determine the association between SSB excise taxes and adult body mass index (BMI) and proportion of adults with overweight or obesity among California cities and assess whether associations vary by demographic characteristics.

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Background: Health behavior change theories provide a conceptual basis to promote physical activity, one of which is the Self-Determination Theory (SDT). This cross-sectional study compared SDT constructs, specifically exercise goal setting, exercise planning, and outcome expectations, with objectively assessed Moderate-To-Vigorous Physical Activity (MVPA) among a demographically diverse cohort of adults.

Methods: Participants were 18 to 74 years with prediabetes or type 2 diabetes not prescribed insulin and were physically inactive by self-report.

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Background: Insomnia is a modifiable risk factor for type 2 diabetes.

Objective: Describe the methodology for the Sleep for Health study, a randomized clinical trial examining the effectiveness of digital cognitive behavioral therapy for insomnia (dCBT-I) in reducing hyperglycemia in 300 people with both insomnia and prediabetes.

Outcomes: Primary outcome is glucose level 2 h after a 75-g glucose load.

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Given the finite space available for parks in most urban areas, understanding the impact of design and park amenities on park visitation and physical activity should be considered when remodeling or creating new parks. This study analyzed park use and engagement in moderate-to-vigorous physical activity (MVPA) in specific park amenities across 198 parks in 27 US cities from the 2016 National Study of Neighborhood Parks based on each feature's square footage. The study also specifically measured use of park space by age group and gender.

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Importance: Levying excise taxes on sugar-sweetened beverage (SSB) distributors, which are subsequently passed on to consumers, is a policy implemented to reduce the high prevalence of cardiometabolic disease and generate public health funding. Taxes are associated with lower SSB purchases and consumption, but it is unknown whether they are associated with weight-related outcomes in youth.

Objective: To determine the association of SSB excise taxes with youth body mass index (BMI) trajectories.

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Objective: Prediabetes, which is a condition characterized by higher-than-normal blood glucose levels that are under the threshold for diabetes, impacts over one-third of U.S. adults.

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Background: Analyzing trajectories of weight loss may address how particular groups of patients respond to metabolic and bariatric surgery.

Objectives: The Bariatric Experience Long Term (BELONG) study was designed to use a theoretical model to examine determinants of weight loss and recurrence.

Setting: Large integrated health system in Southern California with 11 surgical practices and 23 surgeons.

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Purpose: Weight loss surgery is an effective, long-term treatment for severe obesity but individual response to surgery varies widely. The purpose of this study was to test a comprehensive theoretical model of factors that may be correlated with the greatest surgical weight loss at 1-3 years following surgery. Such a model would help determine what predictive factors to measure when patients are preparing for surgery that may ensure the best weight outcomes.

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Importance: Recent evidence links air pollution to the severity COVID-19 symptoms and to death from the disease. To date, however, few studies have assessed whether air pollution affects the sequelae to more severe states or recovery from COVID-19 in a cohort with individual data.

Objective: To assess how air pollution affects the transition to more severe COVID-19 states or to recovery from COVID-19 infection in a cohort with detailed patient information.

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Importance: Tobacco smoking drives markedly elevated cardiovascular disease risk and preventable death in persons with serious mental illness, and these risks are compounded by the high prevalence of overweight/obesity that smoking cessation can exacerbate. Guideline-concordant combined pharmacotherapy and behavioral smoking cessation treatment improves abstinence but is not routinely offered in community settings, particularly to those not seeking to quit smoking immediately.

Objective: To determine the effectiveness of an 18-month pharmacotherapy and behavioral smoking cessation intervention incorporating weight management and support for physical activity in adults with serious mental illness interested in quitting smoking within 1 or 6 months.

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Playgrounds have features that benefit visitors, including opportunities to engage in outdoor physical activity. We surveyed 1350 adults visiting 60 playgrounds across the USA in Summer 2021 to determine if distance to the playground from their residence was associated with weekly visit frequency, length of stay, and transportation mode to the site. About 2/3 of respondents living within ½ mile from the playground reported visiting it at least once per week compared with 14.

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Background: The study goal was to identify playground features associated with visitor length of stay and physical activity.

Methods: We observed playground visitors over 4 days during summer 2021 in 60 playgrounds in 10 US cities, selected based on design, population density, and poverty levels. We observed 4278 visitors and documented their length of stay.

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Objective: This study examined the association between individual- and neighborhood-level sociodemographic factors and surgical weight loss at 1 year (short term) and 3 years (long term).

Methods: Data were obtained from the baseline survey of the BELONG (Bariatric Experience Long Term) prospective longitudinal cohort study. Individual-level self-reported data on sex, race and ethnicity, education, and household income were obtained by survey.

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Background: Recent evidence links ambient air pollution to COVID-19 incidence, severity, and death, but few studies have analyzed individual-level mortality data with high quality exposure models.

Methods: We sought to assess whether higher air pollution exposures led to greater risk of death during or after hospitalization in confirmed COVID-19 cases among patients who were members of the Kaiser Permanente Southern California (KPSC) healthcare system (N=21,415 between 06-01-2020 and 01-31-2022 of whom 99.85 % were unvaccinated during the study period).

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Introduction: Physical activity before COVID-19 infection is associated with less severe outcomes. The study determined whether a dose‒response association was observed and whether the associations were consistent across demographic subgroups and chronic conditions.

Methods: A retrospective cohort study of Kaiser Permanente Southern California adult patients who had a positive COVID-19 diagnosis between January 1, 2020 and May 31, 2021 was created.

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Introduction: This study compares traditional post-and-platform playgrounds with innovatively designed playgrounds to assess the degree to which design influences use and physical activity. Innovative playgrounds are defined as having (1) a variety of surface types; (2) naturalized and planted areas designed for play; (3) open-ended structures that do not dictate play sequences; (4) loose, movable equipment; and (5) not comprised solely of traditional post-and-platform structures. This study also examines how neighborhood contextual factors contribute to playground use and physical activity.

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Objective: This study evaluates whether changes in weight among school-aged youth in California due to the COVID-19 lockdown vary by social constructs of race/ethnicity and associated social factors.

Methods: Including 160,472 youth aged 5 to 17 years enrolled at Kaiser Permanente Southern California, mixed effects models stratified by age group were fitted to estimate changes in distance from the median BMI-for-age from March 2020 to January 2021 (lockdown) compared with the same period before the pandemic.

Results: Excess pandemic weight gain was higher among Black and Hispanic youth aged 5 to 17 years than among White and Asian youth; this difference was most pronounced in those aged 5 to 11 years.

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Objective: This study examined the association of weight loss following bariatric surgery with self-reported sleep quality after accounting for other sleep-related factors.

Methods: Participants were from the Bariatric Experience Long Term (BELONG) study. Participants completed a survey up to 6 months before surgery and approximately 1 year after surgery.

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Reducing cardiovascular disease disparities will require a concerted, focused effort to better adopt evidence-based interventions, in particular, those that address social determinants of health, in historically marginalized populations (ie, communities excluded on the basis of social identifiers like race, ethnicity, and social class and subject to inequitable distribution of social, economic, physical, and psychological resources). Implementation science is centered around stakeholder engagement and, by virtue of its reliance on theoretical frameworks, is custom built for addressing research-to-practice gaps. However, little guidance exists for how best to leverage implementation science to promote cardiovascular health equity.

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Purpose: The Bariatric Experience Long Term (BELONG) prospective study cohort was created to address limitations in the literature regarding the relationship between surgical weight loss and psychosocial, health, behaviour and environmental factors. The BELONG cohort is unique because it contains 70% gastric sleeve and 64% patients with non-white race/ethnicity and was developed with strong stakeholder engagement including patients and providers.

Participants: The BELONG cohort study included 1975 patients preparing to have bariatric surgery who completed a baseline survey in a large integrated health system in Southern California.

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We examined multi-level factors related to the longitudinal physical activity trajectories of adolescent girls to determine the important predictors for physical activity. The Trial of Activity in Adolescent Girls (TAAG) Maryland site recruited participants at age 14 (n = 566) and followed up with these girls at age 17 (n = 553) and age 23 (n = 442). Individual, social factors and perceived environmental factors were assessed by questionnaire; body mass index was measured at age 14 and age 17, and self-reported at age 23.

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Background: Quantification of the impact of local masking policies may help guide future policy interventions to reduce SARS-COV-2 disease transmission. This study's objective was to identify factors associated with adherence to masking and social distancing guidelines.

Methods: Faculty from 16 U.

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Background: The Kaiser Permanente Research Bank (KPRB) is collecting biospecimens and surveys linked to electronic health records (EHR) from approximately 400,000 adult KP members. Within the KPRB, we developed a Cancer Cohort to address issues related to cancer survival, and to understand how genetic, lifestyle and environmental factors impact cancer treatment, treatment sequelae, and prognosis. We describe the Cancer Cohort design and implementation, describe cohort characteristics after 5 years of enrollment, and discuss future directions.

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Youth with mental illness have higher levels of obesity than children in the general population. Both regular physical activity and limited screen time have been recommended to reduce and prevent childhood obesity. This study examines accelerometer-based moderate-vigorous physical activity (MVPA) and screen time among youth with overweight/obesity issues who are receiving mental health care.

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