Bachelor of Science, University of Houston (2004)
Master of Science, University of Houston (2007)
Doctor of Philosophy, University of South Carolina (2012)
Dr. Banda?s research aims to design, test, and disseminate creative solutions to prevent and treat childhood obesity. His research focuses on two areas: 1) using current generation triaxial accelerometers and innovative data analysis strategies to improve measures of sleep, sedentary behavior, and physical activity in youth, and 2) developing direct observation instruments and protocols to rigorously evaluate physical activity interventions.
To examine the effects of accelerometer epoch lengths, wear time (WT) algorithms, and activity cut-points on estimates of WT, sedentary behavior (SB), and physical activity (PA).268 7-11 year-olds with BMI ? 85th percentile for age and sex wore accelerometers on their right hips for 4-7 days. Data were processed and analyzed at epoch lengths of 1-, 5-, 10-, 15-, 30-, and 60-seconds. For each epoch length, WT minutes/day was determined using three common WT algorithms, and minutes/day and percent time spent in SB, light (LPA), moderate (MPA), and vigorous (VPA) PA were determined using five common activity cut-points. ANOVA tested differences in WT, SB, LPA, MPA, VPA, and MVPA when using the different epoch lengths, WT algorithms, and activity cut-points.WT minutes/day varied significantly by epoch length when using the NHANES WT algorithm (p < .0001), but did not vary significantly by epoch length when using the ? 20 minute consecutive zero or Choi WT algorithms. Minutes/day and percent time spent in SB, LPA, MPA, VPA, and MVPA varied significantly by epoch length for all sets of activity cut-points tested with all three WT algorithms (all p < .0001). Across all epoch lengths, minutes/day and percent time spent in SB, LPA, MPA, VPA, and MVPA also varied significantly across all sets of activity cut-points with all three WT algorithms (all p < .0001).The common practice of converting WT algorithms and activity cut-point definitions to match different epoch lengths may introduce significant errors. Estimates of SB and PA from studies that process and analyze data using different epoch lengths, WT algorithms, and/or activity cut-points are not comparable, potentially leading to very different results, interpretations, and conclusions, misleading research and public policy.
View details for DOI 10.1371/journal.pone.0150534
View details for PubMedID 26938240
Obesity is an increasingly prevalent condition among older adults, yet relatively little is known about how built environment variables may be associated with obesity in older age groups. This is particularly the case for more vulnerable older adults already showing functional limitations associated with subsequent disability.The Lifestyle Interventions and Independence for Elders (LIFE) trial dataset (n?=?1600) was used to explore the associations between perceived built environment variables and baseline obesity levels. Age-stratified recursive partitioning methods were applied to identify distinct subgroups with varying obesity prevalence.Among participants aged 70-78 years, four distinct subgroups, defined by combinations of perceived environment and race-ethnicity variables, were identified. The subgroups with the lowest obesity prevalence (45.5-59.4 %) consisted of participants who reported living in neighborhoods with higher residential density. Among participants aged 79-89 years, the subgroup (of three distinct subgroups identified) with the lowest obesity prevalence (19.4 %) consisted of non-African American/Black participants who reported living in neighborhoods with friends or acquaintances similar in demographic characteristics to themselves. Overall support for the partitioned subgroupings was obtained using mixed model regression analysis.The results suggest that, in combination with race/ethnicity, features of the perceived neighborhood built and social environments differentiated distinct groups of vulnerable older adults from different age strata that differed in obesity prevalence. Pending further verification, the results may help to inform subsequent targeting of such subgroups for further investigation.Clinicaltrials.gov Identifier?=? NCT01072500.
View details for DOI 10.1186/s12966-015-0322-1
View details for PubMedID 26684894
To test the effects of a three-year, community-based, multi-component, multi-level, multi-setting (MMM) approach for treating overweight and obese children.Two-arm, parallel group, randomized controlled trial with measures at baseline, 12, 24, and 36months after randomization.Seven through eleven year old, overweight and obese children (BMI?85th percentile) and their parents/caregivers recruited from community locations in low-income, primarily Latino neighborhoods in Northern California.Families are randomized to the MMM intervention versus a community health education active-placebo comparison intervention. Interventions last for three years for each participant. The MMM intervention includes a community-based after school team sports program designed specifically for overweight and obese children, a home-based family intervention to reduce screen time, alter the home food/eating environment, and promote self-regulatory skills for eating and activity behavior change, and a primary care behavioral counseling intervention linked to the community and home interventions. The active-placebo comparison intervention includes semi-annual health education home visits, monthly health education newsletters for children and for parents/guardians, and a series of community-based health education events for families.Body mass index trajectory over the three-year study. Secondary outcome measures include waist circumference, triceps skinfold thickness, accelerometer-measured physical activity, 24-hour dietary recalls, screen time and other sedentary behaviors, blood pressure, fasting lipids, glucose, insulin, hemoglobin A1c, C-reactive protein, alanine aminotransferase, and psychosocial measures.The Stanford GOALS trial is testing the efficacy of a novel community-based multi-component, multi-level, multi-setting treatment for childhood overweight and obesity in low-income, Latino families.
View details for DOI 10.1016/j.cct.2013.09.001
View details for Web of Science ID 000329265300012
To determine the effects and mediating factors of a physical activity (PA) or vegetable and fruit (VF) group cohesion intervention.Longitudinal design.Harris County and Travis County, Texas.Community-dwelling African-American and Hispanic or Latina women.Three hundred ten women were randomized to a PA (n ?=? 204) or VF (n ?=? 106) intervention group. Women met in groups six times over the course of 6 months and were exposed to a group cohesion intervention to promote walking or to increase VF consumption.Women completed the International PA Questionnaire, National Cancer Institute VF and fat screeners, PA Group Environment Questionnaire, and 7-day accelerometer protocol at baseline and post-intervention.The direct and mediated effects of the intervention on outcomes were evaluated using a mediational chain model, controlling for baseline values and covariates using path analysis.Women were middle aged (mean ?=? 44.4 years) and overweight or obese (mean body mass index ?=? 34.0 kg/m(2)). PA increased and fat consumption decreased for both groups, whereas VF consumption increased for women in VF group only (all p < .05). Increased task cohesion led to hypothesized increases in psychosocial factors in the PA group but not to behavioral changes.Group cohesion interventions may have psychological and physical health benefits for African-American and Hispanic or Latina women, but refinement of measures and intervention delivery is needed to determine whether hypothesized mediational pathways are valid.
View details for DOI 10.4278/ajhp.101215-QUAN-400
View details for Web of Science ID 000301473000013
View details for PubMedID 22375580
Childhood obesity prevention has fallen short of anticipated impact. Therefore, intervention programs need to be redirected to other potential settings to increase youth physical activity. This qualitative study, using autodriven interview techniques, was conducted to identify out-of-school settings that youth perceive as important for physical activity. Sixty-six children took photographs involving their physical activity involvement. A subsample completed follow-up focus groups. Salient themes included types of physical activities related to free play, fitness, organized sports, and chores. Most photographs included multiple children of similar age and were taken outdoors. Data suggest children associate chores with physical activity and engage in fitness-related activities. In addition, friends and family, the outdoors, and importantly, the home emerged as natural intervention components that may prove useful towards decreasing the physical inactivity and obesity of youth.
View details for Web of Science ID 000297881000019
View details for PubMedID 22276418
Increasing children's active travel to school may be 1 strategy for addressing the growing prevalence of obesity among school age children. Using the School Travel Survey, we examined South Carolina school district leaders' perceptions of factors that influence elementary and middle school students walking to school.Frequency distributions and chi-square tests were used to analyze the survey responses; open-ended questions were reviewed qualitatively for recurring topics and themes.School and district leaders (N = 314) most often reported street crossing safety (54.0%) and number of sidewalks (54.0%) as priority factors that should be addressed to increase students' active travel to school, followed by distance to school (46.0%), traffic volume (42.4%), parental attitudes (27.0%), traffic speed (26.7%), neighborhood condition (24.4%), and student attitudes (10.0%). Several respondents expressed concerns about liability issues related to students' active travel to school while others reported that schools are not responsible for students' safety once students leave school grounds. Independent of their comments about liability, respondents were concerned about the safety of students while walking to school.Those promoting active travel to school may benefit from addressing those factors perceived as most important by school and district leaders, including street crossing safety, number of sidewalks, and by educating school and district leaders about liability and safety issues related to students walking to school.
View details for DOI 10.1111/j.1746-1561.2011.00653.x
View details for Web of Science ID 000297242500003
View details for PubMedID 22070505
Compared measures of physical activity and dietary habits used in the Health Is Power (HIP) study, and described the associations of physical activity and dietary habits among African American and Hispanic or Latino women, adjusted for weight status. Cross-sectional baseline data were compared for community dwelling, healthy African American (N = 262) and Hispanic or Latina women (N = 148) who participated in HIP. Physical activity was measured using the International Physical Activity Questionnaire (IPAQ) long form, the Check And Line Questionnaire (CALQ) log and accelerometry. Dietary habits were measured using NCI 24-h recall screeners, vegetable and fruit (VF) logs and the NCI Diet History Questionnaire (DHQ). Differences in physical activity and dietary habits were assessed using simultaneous 2 (ethnicity) × 3 (weight status) ANCOVAs adjusted for age and socioeconomic status. Women (M age = 44.4 ± 10.9 years) were obese (M = 34.0 ± 9.7 kg/m(2)), did not meet physical activity guidelines as measured by accelerometry (M = 19.4 ± 19.1 min MVPA/day) and ate few VF (M = 2.8 ± 2.7 servings/day). DHQ variables differed by weight status. IPAQ was associated with CALQ, and CALQ with accelerometry (P < .05). IPAQ was not associated with accelerometry. Regardless of ethnicity, normal weight women did more physical activity, reported more VF consumption, and consumed more fat calories than overweight and obese women (Ps < .05). African American women did more MVPA than Hispanic or Latino women (P < .001). Relationships between behaviors and weight status suggest accelerometry and DHQ are preferable, regardless of ethnicity; and studies may capture different domains of physical activity and dietary habits depending on measure used.
View details for DOI 10.1007/s10900-011-9403-5
View details for Web of Science ID 000296300400016
View details for PubMedID 21519867
Pedometer step-frequency thresholds (120 steps·min-1, SPM) corresponding to moderate-to vigorous intensity physical activity (MVPA) have been proposed for youth. Pedometers now have internal mechanisms to record time spent at or above a user-specified SPM. If pedometers provide comparable MVPA (P-MVPA) estimates to those from accelerometry, this would have broad application for research and the general public. The purpose of this study was to examine the convergent validity of P-MVPA to accelerometer-MVPA for youth.Youth (N = 149, average 8.6 years, range 5 to 14 years, 60 girls) wore an accelerometer (5-sec epochs) and a pedometer for an average of 5.7 ± 0.8 hours·day-1. The following accelerometer cutpoints were used to compare P-MVPA: Treuth (TR), Mattocks (MT), Evenson (EV), Puyau (PU), and Freedson (FR) child equation. Comparisons between MVPA estimates were performed using Bland-Altman plots and paired t tests.Overall, P-MVPA was 24.6 min ± 16.7 vs. TR 25.2 min ± 16.2, MT 18.8 min ± 13.3, EV 36.9 min ± 21.0, PU 22.7 min ± 15.1, and FR 50.4 min ± 25.5. Age-specific comparisons indicated for 10 to 14 year-olds MT, PU, and TR were not significantly different from P-MVPA; for the younger children (5-8 year- olds) P-MVPA consistently underestimated MVPA.Pedometer-determined MVPA provided comparable estimates of MVPA for older children (10-14 year-olds). Additional work is required to establish age appropriate SPM thresholds for younger children.
View details for Web of Science ID 000295295600018
View details for PubMedID 21918244
Obesity in African American (AA) and Hispanic or Latina (HL) women has been partly attributed to low physical activity (PA) and cultural influences on body image. The purpose of this study was to determine the relationship among body mass index (BMl=kg/m2), body image perception (perceived and desired) and PA.The current study is a cross-sectional, secondary data analysis of the Health Is Power (HIP) project (1R01CA109403).Women residing in Harris County, Houston and Travis County, Austin, Texas were recruited to participate in the study.Over four hundred (N=410) AA (N=262) and HL (N=148) women participated in the HIP project and were included in the current study.BMI, Pulvers' body image, PA and demographic data were collected from each participant.Women (mean age=45.2 yrs) were educated (44% college graduates) and obese (mean BMI =34.6 kg/m2). Less than half perceived themselves correctly regardless of actual weight and ethnicity (P<.001). Nearly three-fourths of AA (73.9%) and less than half of HL (42.9%) women who were normal weight desired to be obese, and only 39.4% of AA and HL women desired to be normal weight. Women varied on measures of PA (P<.05). Regression analyses showed objectively measured PA was significantly associated with BMI and ethnicity (P<.01).Results reveal dichotomous distortion in body images. Women need strategies to perceive normal weight as desirable for health and beauty, leading to increased PA and reducing obesity.
View details for Web of Science ID 000294930500004
View details for PubMedID 21942159
Women of color report the lowest levels of physical activity and highest rates of overweight and obesity in the US. The purpose of this study was to develop an individualized, ecologically valid, field based method to assess physical activity over seven days for community dwelling women of color using accelerometers.Accelerometer-measured physical activity, Borg perceived exertion, demographics, blood pressure, heart rate, and anthropometric measures were collected from African American and Hispanic or Latina women (N = 209). A threshold for increased physical activity was determined for each participant by calculating the average count per minute (plus one standard deviation) for each participant collected during a self-selected pace that corresponded to a 'recreational' walk about their neighborhood. The threshold was then used to calculate the amount of time spent doing increased intensity physical activity during a typical week.Women were middle-aged and obese (M BMI = 34.3 ± 9.3). The average individual activity counts per day ranged from 482-1368 in African American women and 470-1302 in Hispanic or Latina women. On average, African American women spent significantly more time doing what was labeled 'increased' physical activity than Hispanic and Latino women. However neither group approached recommended physical activity levels, as African American women, averaged 1.73% and Hispanic and Latino women averaged 0.83% of their day engaged in increased physical activity (p < 0.05).This study presents a simple field-based method for developing accelerometer thresholds that identify personalized thresholds of moderate intensity physical activity that can be used by in community-based settings. Findings highlight a need for physical activity programs whose starting points are based upon the individual's typical baseline physical activity level, which is likely to be well below the minimum recommended published guidelines.
View details for DOI 10.1186/1479-5868-8-21
View details for Web of Science ID 000289248800001
View details for PubMedID 21439052
To compare self-report and objective measures of moderate- and vigorous-intensity physical activity (MVPA min·d(-1)) in midlife and older adults.Seventy-one participants (69% female, 74.6% Caucasian, 25.4% African American) completed the Behavioral Risk Factor Surveillance System physical activity (PA) questions, the Aerobic Center Longitudinal Study PA short survey (PASS), and the Aerobic Center Longitudinal Study PA long survey (PALS) and wore an accelerometer for seven consecutive days. Accelerometer MVPA minutes per day were determined using 1- and 10-min MVPA bout methods.Participants were older (mean ± SD; age = 57.4 ± 9.9 yr) and overweight (body mass index = 27.9 ± 4.9 kg·m(-2)) but otherwise healthy. Median (interquartile range) MVPA minutes per day were 42.9 (51.4) from the Behavioral Risk Factor Surveillance System PA questions, 51.4 (68.6) from the PASS, 25.7 (48.6) from the PALS, 32.4 (33.5) from the 1-min MVPA bout accelerometer data, and 4.6 (16.8) from the 10-min MVPA bout accelerometer data. Pearson correlations adjusted for participant demographics revealed low to moderate correlations between self-report and 1-min MVPA bout accelerometer-determined MVPA minutes per day (r = 0.11-0.31), with the PASS (P < 0.05) and PALS (P < 0.01) having significant correlations with accelerometry. Cohen ? coefficients showed poor agreement between all three questionnaires and 1-min MVPA bout accelerometry for having ?150 MVPA min·wk(-1) (? = 0.26-0.38, all P < 0.05).Our results indicate that there was poor agreement between self-report and accelerometer-based assessments of PA in midlife and older adults.
View details for DOI 10.1249/MSS.0b013e3181e32e9a
View details for Web of Science ID 000284353500014
View details for PubMedID 20421836
Few studies have examined the association between a combination of lifestyle factors and the incidence of hypertension, particularly among men. This is important as lifestyle factors are often interrelated, and may often occur in combination. Thus, we investigated the individual and combined effects of body mass index (BMI), smoking status, alcohol intake, physical activity (PA), and cardiorespiratory fitness (CRF) on the incidence of hypertension in men.A total of 14,568 men (mean age = 44.0 + or - 9.3 years) from the Aerobics Center Longitudinal Study (ACLS) initially free of hypertension completed an extensive baseline examination during 1974-2003, and were followed for the incidence of hypertension.A total of 1,959 men reported having hypertension during a mean of 10.7 + or - 7.6 years of follow-up. Our data indicated that a combination of five protective health factors significantly reduced the risk of hypertension by 47% (95% confidence interval (CI): 36-56%). We also found that whether all participants in our sample had five protective health factors, the incidence of hypertension would be expected to decrease by 29% (95% CI: 26-31%). Additionally, having a normal BMI and being a nonsmoker and physically fit were significantly and independently associated with a lower risk of developing hypertension.Our results show that among men aged 20-82 years, a healthy lifestyle can significantly reduce the risk of developing hypertension, and should be considered for the prevention of this chronic condition.
View details for DOI 10.1038/ajh.2010.26
View details for Web of Science ID 000278041700005
View details for PubMedID 20224555
When promoting active travel to school, it is important to consider school and district policies as well as attitudes of school and district administrators.School principals and district officials in South Carolina participated in the School Travel Survey. Frequency distributions and Chi-squared tests were used to analyze the data.Three hundred fourteen persons responded to the survey (53.2% response rate). Sixty-five percent of district officials reported having a clear position about students walking to school, 80.0% of which were supportive. Seventy-two percent of principals reported having a clear position about walking to school, 67% of which were supportive. These positions were most commonly communicated either orally or through memos or other written documentation rather than through official, written policies or directives. Respondents who personally supported walking to school were more likely to believe that walking to school benefited students' health (Chi-squared = 8.82, df = 1, P = .003) and academic performance (Chi-squared = 14.87, df = 1, P < .0001).Promotion of walking to school should encourage schools and districts to develop official, written directives or policies. Promotional efforts may benefit from linking active travel to academic performance and health.
View details for Web of Science ID 000280738300007
View details for PubMedID 20440006
More than two thirds of Americans are overweight or obese, and African Americans are particularly vulnerable to obesity when compared to Caucasians. Ecological models of health suggest that lower individual and environmental socioeconomic status and the built environment may be related to health attitudes and behaviors that contribute to obesity. This cross-sectional study measured the direct associations of neighborhood physical activity resource attributes with body mass index (BMI) and body fat among low-income 216 African Americans (Mean (M) age = 43.5 years, 63.9% female) residing in 12 public housing developments. The Physical Activity Resource Assessment instrument measured accessibility, incivilities, and the quality of features and amenities of each physical activity resource within an 800-m radius around each housing development. Sidewalk connectivity was measured using the Pedestrian Environment Data Scan instrument. Ecological multivariate regression models analyzed the associations between the built environment attributes and resident BMI and body fat at the neighborhood level. Sidewalk connectivity was associated with BMI (M = 31.3 kg/m(2); p < 0.05). Sidewalk connectivity and resource accessibility were associated with body fat percentage (M = 34.8%, p < 0.05). Physical activity resource attributes and neighborhood sidewalk connectivity were related to BMI and body fat among low-income African Americans living in housing developments.
View details for DOI 10.1007/s11524-009-9385-0
View details for Web of Science ID 000269195200005
View details for PubMedID 19585244