bluuebunny/crossref_metadata_2025 huggingface dataset:
Encouraging Young Western Australians to Be Smarter than Smoking
Authors: Wood Lisa J. , Dip Postgrad , Rosenberg Michael , Clarkson Johanna , Phillips Fiona , Donovan Robert J. , Shilton Trevor , Dip Postgrad
Published: June 2010

Purpose.

Smarter than Smoking is a multistrategy statewide youth smoking intervention. This article describes key strategies and results from its inception in 1995 to 2005.

Design.

Comprehensive evaluation included formative research and baseline and follow-up surveys. Triennial national surveys provided independent monitoring of adolescent smoking prevalence.

Setting.

Western Australia.

Subjects.

10- to 15-year-olds.

Intervention.

A multipronged strategy mix, including mass media, the Internet, sponsorship, school initiatives, publications, and advocacy.

Measures.

Smoking prevalence, media awareness, and attitudes toward smoking and campaign messages.

Analysis.

Trend comparisons across the first decade of the project, along with descriptive statistics.

Results.

Significant attitudinal and behavioral shifts were observed following media waves and over time. There was a steady increase in the proportion who had never smoked (from 40% in 1996 to 61 % in 2005). Results also showed a significant decrease in smoking prevalence from 1996 to 2005, down from 28% to 7% among 14-year-olds and from 43% to 14% among 15-year-olds.

Conclusions.

Smarter than Smoking was effective in achieving positive shifts in awareness, attitudes, intentions, and behavior. Effectiveness appeared to have been enhanced by sustained long-term funding youth involvement in strategy development, and a strong research and evaluation base.
Validated Scales to Assess Adult Self-Efficacy to Eat Fruits and Vegetables
Authors: Mainvil Louise A. , Lawson Rob , Horwath Caroline C. , McKenzie Joanne E. , Reeder Anthony I.
Published: June 2010

Purpose.

An audience-centered approach was used to develop valid and reliable scales to measure adult self-efficacy to eat fruit and vegetables.

Design.

Cross-sectional survey of a national population.

Setting.

New Zealand.

Subjects.

A sample of 350 adults ages 25 to 60 years was randomly selected from a nationally representative sampling frame. Overall, 231 questionnaires were returned, producing a 72% response rate. The mean age of subjects was 42.7 years; 58% were female; 80% were of European descent; 11% were indigenous Maori.

Measures.

The 76–item, self-administered questionnaire collected data on demographics, fruit and vegetable intakes, stages of change, decisional balance, and self-efficacy (24 items).

Analysis.

Principal components analysis with oblimin rotation was performed.

Results.

Principal components analysis yielded three distinct and reliable scales for self-efficacy to eat “vegetables, ” “fruit, ”and “fruit and vegetables” (Cronbach α = .80, .85, and .73, respectively). These scales were correlated, but only the “vegetable” scale was positively correlated with the “fruit and vegetable” scale (Kendall tau r = 0.30, −0.26 [fruit, “fruit and vegetables”], −0.38 [fruit, vegetable]). As predicted, self-efficacy was associated with intake (r = 0.30 [fruit], 0.34 [vegetables]).

Conclusion.

Assuming the factor structure is confirmed in independent samples, these brief, psychometrically sound scales may be used to assess adult self-efficacy to eat fruit and to eat vegetables but not self-efficacy to eat “fruit and vegetables. ”
Effects of a Multilevel Dietary Intervention in Religious Organizations
Authors: Bowen Deborah J. , Beresford Shirley A. A. , Christensen Catherine L. , Kuniyuki Alan A. , McLerran Dale , Feng Ziding , Hart Alton , Tinker Lesley , Campbell Marci , Satia Jessie
Published: June 2010

Purpose.

This study examined how to improve dietary habits of individuals from the general public.

Design.

The Eating for a Healthy Life project was a randomized trial.

Setting.

The study was conducted among members of religious organizations (ROs).

Subjects.

Participants were a sample of RO members.

Intervention.

The intervention was a multilevel package, based on our previous experience, designed to lower fat and increase fruit and vegetable consumption.

Measures.

The Eating Behaviors Questionnaire was administered preintervention and postintervention, together with 24-hour food recalls in a randomly selected subset.

Analysis.

Linear mixed models were used to evaluate the study's intervention, incorporating the design effects of blocking, intraclass correlation within RO, and correlation between the preintervention and postintervention points.

Results.

Participants (n = 2175) reported significantly healthier dietary behaviors in intervention ROs at the 12-month follow-up period, compared to participants in the comparison ROs, for a fat scale change of .08 summary scale points and an adjusted intervention effect of .06 overall.

Conclusion.

Dietary intervention through ROs is a positive and successful method of changing dietary habits.
Worksite Policies and Environments Supporting Physical Activity in Midwestern Communities
Authors: Dodson Elizabeth A. , Lovegreen Sarah L. , Elliott Michael B. , Haire-Joshu Debra , Brownson Ross C.
Published: June 2010

Purpose.

To examine the association of worksite policies and environments to physical activity.

Methods.

Between 2001 and 2003, 977 adults from Missouri, Tennessee, and Arkansas participated in two random-digit-dialed telephone surveys regarding physical activity behaviors and worksite policies supporting physical activity. Logistic regression was used to investigate relationships between meeting national physical activity recommendations and supportive policies or environmental conditions (e.g., facilities, equipment, financial rewards) at worksites.

Results.

Having multiple policies at worksites was associated with meeting physical activity recommendations, specifically the provision of accessible stairways and personal services (e.g., fitness testing counseling). Meeting recommendations through walking was associated with having exercise facilities (e.g., gym, shower) and equipment (e.g., treadmill, weights).

Discussion.

This study highlights the importance of supplementing health promotion information in workplaces with policies and environmental interventions. Particular consideration should be given to accessible stairways for onsite exercise and provision of exercise facilities and equipment. Future interventions should combine policy change with program delivery.
Brief Multiple Behavior Health Interventions for Older Adolescents
Authors: Werch Chudley E. , Bian Hui , Moore Michele J. , Ames Steven C. , DiClemente Carlo C. , Thombs Dennis , Pokorny Steven B.
Published: June 2010

Purpose.

This study examined whether brief intervention strategies founded on the Behavior-Image Model and addressing positive images of college and career success could be potentially efficacious in impacting multiple health habits of high-risk adolescents transitioning into adulthood.

Design.

Participants were stratified by grade level and drug use and individually randomized to one of the three Plan for Success interventions, with baseline and 1 month postintervention data collections.

Setting.

A large, relatively diverse suburban school in northeast Florida.

Subjects.

A total of 375 11th and 12th grade students participated during the spring semester 2006.

Intervention.

Three interventions studied included: (1) Goal Survey, (2) Goal Survey plus Contract, or (3) Goal Survey plus Consult.

Measures.

Outcome measures included multiple health risk, health promotion, and personal development behaviors, as well as image and belief measures.

Analysis.

Repeated-measures MANOVAs and ANOVAs were used to examine intervention effects.

Results.

MANOVAs were significant for alcohol use, F(4,328) = 6.33, p = .001; marijuana use, F(4,317) = 3.72, p = .01; exercise, F(3,299) = 4.28, p = .01; college preparation, F(2,327) = 6.26, p = .001; and career preparation, F(2,329) = 6.17, p = .001, with most behaviors improving over time, whereas group-by-time interaction effects were found for nutrition habits, F(6,652) = 2.60, p = .02; and career preparation, F(4,658) = 3.26, p = .01, favoring the consultation.

Conclusion.

Brief interventions founded on the Behavior-Image Model may have potential to improve selected health and personal development habits among older adolescents.
The Impact of Socioeconomic Status on Perceived Barriers to Colorectal Cancer Testing
Authors: James Aimee S. , Hall Sandra , Greiner K. Allen , Buckles Dan , Born Wendi K. , Ahluwalia Jasjit S.
Published: June 2010

Purpose.

Colorectal cancer (CRC) screening is effective, but only one-half of age-eligible adults adhere to national guidelines. Lower socioeconomic status (SES) groups are less likely to be screened.

Methods.

Baseline data from a prospective study were used to examine the associations among CRC screening screening barriers, and SES. A convenience sample of adults (N = 291) aged 40 years and older was recruited from a federally qualified health center. Questionnaires were administered orally and included demographics, health, health behavior, and screening barriers.

Results.

In logistic regression, having health insurance was associated with greater odds of screening. Bivariate analyses detected few differences in fecal occult blood test (FOBT) barriers, but several endoscopy barriers were more common among the lowest SES groups. For example, fear of injury from endoscopy was more likely among low-income and uninsured participants.

Discussion.

The impact of SES on cancer screening is complex, but low-SES participants more often reported certain barriers than their higher-SES counterparts. This was more evident for endoscopy than for FOBT. Programs targeted at low-SES patients may need to focus on barriers that are not fully addressed in traditional promotion efforts.
Helping Chinese Fathers Quit Smoking through Educating Their Nonsmoking Spouses: A Randomized Controlled Trial
Authors: Chan Sophia S. C. , Leung Gabriel M. , Wong David C. N. , Lam Tai-Hing
Published: June 2010

Purpose.

Assess the effectiveness of a two-step health education program by nurses delivered through nonsmoking mothers to help fathers of sick children quit smoking.

Design.

Randomized, controlled trial.

Setting.

General pediatric wards of four major hospitals in Hong Kong.

Subjects.

Nonsmoking mothers who had a live-in smoking spouse were recruited when they brought sick children to the hospital. A total of 752 mothers were randomized into the intervention arm and 731 into the control arm.

Intervention.

The intervention group received standardized health advice, behavior modification booklets, and a 1–week telephone reminder. The control group received usual care.

Measurements.

The main outcome measure was the quit rate (7–day point prevalence) of smoking fathers as determined by telephone follow-up with mothers at 3 and 12 months. Quit attempts and smoking reduction were secondary outcome measures.

Results.

At 3 months, more fathers in the intervention group had quit smoking (7.4% vs. 4.8%; p = .03), reduced daily cigarette consumption by 50% or more (30.6% vs. 22.6%; p < .001), and reported quit attempts (6.5% vs. 3.6%; p = .01). The differences were not statistically significant by 12 months.

Conclusion.

A simple health education intervention provided by nurses to mothers of sick children has a short-term effect in helping smoking fathers quit, reduce consumption, and trigger quit attempts. Future studies should confirm the longer-term sustainability of the effect.
Telephone-Based Diet and Exercise Coaching and a Weight-Loss Supplement Result in Weight and Fat Loss in 120 Men and Women
Authors: Tucker Larry A. , Cook Amy J. , Nokes Neil R. , Adams Troy B.
Published: June 2010

Purpose.

Determine the effects of telephone-based coaching and a weight-loss supplement on the weight and body fat (BF) of overweight adults.

Design.

Randomized, placebo-controlled experiment with assessments at baseline, 2 months, and 4 months.

Setting.

Community.

Subjects.

Sixty overweight or obese men and 60 overweight or obese women, 25 to 60 years old.

Intervention.

Eleven 30-minute telephone coaching sessions were spaced throughout the study; the initial conversation lasted 60 to 90 minutes. Supplement or placebo capsules were taken daily over the 17 weeks.

Measures.

Weight was measured using an electronic scale, and BF was assessed using dual energy x-ray absorptiometry.

Results.

Subjects taking the placebo lost 1.8 + 3.3 kg of weight and 0.7 + 2.2 kg of BF, whereas supplement users lost more: 3.1 + 3.7 kg of weight (F = 4.1, P = .045) and 1.7 + 2.6 kg of BF (F = 4.4, p = .039). Participants receiving no coaching lost 1.8 + 3.3 kg of weight and 0.7 + 2.2 kg of BF, whereas adults receiving coaching lost more: 3.2 + 3.6 kg of weight (F = 4.8, p = .032) and 1.6 + 2.5 kg of BF (F = 4.2, p = .044). Adults receiving both the supplement and coaching had the greatest losses of weight and BF, suggesting an additive effect (F = 3.2, p = .026; F = 2.9, p = .039, respectively).

Conclusions.

Both treatments, coaching and the supplement, viewed separately and in combination, worked to help subjects lose weight and BF. Adults can be educated and motivated via telephone to change behaviors leading to weight loss, and a weight-loss supplement can be included to increase success.
Restrained Eating and Risk of Gaining Weight and Body Fat in Middle-Aged Women: A 3-Year Prospective Study
Authors: Tucker Larry A. , Bates Laura
Published: June 2010

Purpose.

Examine the extent to which restrained eating (RE) and changes in RE influence the risk of weight and fat gain over 36 months in women.

Design.

Prospective cohort.

Setting.

Several communities.

Subjects.

Baseline and follow-up assessments were completed by 192 middle-aged women (ages 40.0 ± 3 years).

Measures.

Body weight was measured with an electronic scale, body fat (BF) was assessed using the Bod Pod, energy intake was evaluated using 7–day weighed food records, physical activity was measured objectively using accelerometers, and RE was indexed using the Dutch Eating Behavior Questionnaire.

Analysis.

Relative risk (RR) was calculated using incidence data.

Results.

The risk of weight gain (> 1 kg) over the 36 months was 69% greater in women who did not increase in RE compared with their counterparts (RR = 1.69, 95% confidence interval [CI] = 1.12–2.52). The risk of substantial weight gain (≥3 kg) was 138% greater in women who did not increase in RE compared with women who did (RR = 2.38, 95% CI = 1.16–4.89), and the risk of gains in BF (≥ 1% point) was 49%) greater (RR = 1.49, 95% CI = 1.02–2.17). Control of potential confounding factors, except changes in energy intake, had little influence on risk.

Conclusion.

Women who do not become more restrained in their eating over time are at much greater risk of gaining weight and BF compared with those who become more restrained.
Risk Perception and its Association with Cardiac Risk and Health Behaviors among Urban Minority Adults: The Bronx Coronary Risk Perception Study
Authors: Barnhart Janice M. , Wright Natania D. , Freeman Katherine , Silagy Frank , Correa Nereida , Walker Elizabeth A.
Published: June 2010

Purpose.

Examine the relationship among risk perceptions, health behaviors, and a measure for actual risk of coronary heart disease (CHD).

Design.

Cross-sectional survey.

Setting/Subjects.

Adults from three outpatient medical clinics with at least one CHD risk factor.

Measures.

Perceived risk using the new Coronary Risk, Individual Perception (CRIP) scale, an index of CHD risk, and summary scores for self-reported diet and exercise.

Analysis.

Bivariate associations using Spearman rank and Kruskal-Wallis; multiple regression models for outcomes (health behaviors).

Results.

The 16-item CRIP scale had acceptable internal consistency (α = 0.76; interitem total correlation = 0.34 ± 0.17). The response rate was 80.3%, and the mean age of 256 respondents was 56.6 (± 9.9) years; 70 % were women, 63% Hispanic, and 27% black. CRIP scores were inversely associated with low fat/high fiber intake (r = −0.17; p = .007) and exercise (r = −0.19; p = .003). Among respondents with three or more CHD risk factors (n = 132), 44 % perceived themselves to be at low risk for CHD. In multivariable models, men with high CRIP scores had higher fat intake than women (p = .02), but men exercised more (p = .04).

Conclusions.

In this study, gender moderated the relationship between risk perception and health behaviors, and many respondents underestimated their risk of CHD. Behavioral intervention research aimed at reducing cardiometabolic risk in minority populations should resolve differences between perceived and actual risk of CHD to foster lifestyle changes and examine temporal relationships between risk perception and health behaviors.
The Role of Labor Organizations in Tobacco Control: What Do Unionized Workers Think?
Authors: Mitchell Rebecca J. , Weisman Susan R. , Jones Resa M. , Erickson Darin
Published: June 2010

Purpose.

Examine unionized workers' knowledge and attitudes about workplace tobacco use, their exposure to secondhand smoke, and the role of labor unions in addressing smoking and cessation coverage policies.

Design.

Random-digit dial telephone survey.

Subjects.

Unionized workers in Minnesota (N = 508).

Measures.

Knowledge and attitudes about workplace tobacco use and tobacco control policy making.

Analysis.

Multiple logistic regression.

Results.

The majority of respondents viewed secondhand smoke exposure as an important workplace health and safety issue, a health risk to nonsmokers, and a driver of increased health care costs, but smokers were less likely than nonsmokers to agree. Only 7% of respondents supported their unions taking the lead in tobacco control policy making. A large majority of those surveyed rated smoking cessation programs as an important benefit for which their labor unions could bargain; however, smokers and those whose workplaces allowed smoking were less likely than their counterparts to agree.

Conclusions.

Most unionized workers were aware of the health effects of exposure to secondhand smoke and supported union bargaining for restrictions on workplace smoking and cessation programs, although few workers supported their unions taking the lead in initiating worksite smoking policies. Results suggest that campaigns to promote smoke-free worksites should be tailored to unionized workers, and further collaborations with labor unions to promote policy change are needed.
Systematic Review of Interventions to Increase Physical Activity and Physical Fitness in African-Americans
Authors: Whitt-Glover Melicia C. , Kumanyika Shiriki K.
Published: June 2010

Objective.

To identify characteristics of effective interventions designed to increase physical activity (PA) or fitness among African-Americans.

Data Sources.

Articles published between 1985 and 2006.

Study Inclusion Criteria.

Studies reporting PA or fitness change data in African-American participants were included.

Data Extraction.

Information on study design, intervention, data collection methods, and outcomes was extracted using a standardized form.

Data Synthesis.

Studies were ranked on quality and were summarized separately for adults and children.

Results.

We identified 29 studies in adults and 14 studies in children. Most were randomized controlled trials. All but six specifically targeted African-Americans; comparisons of effectiveness in African-Americans vs. others were not possible. Methodological heterogeneity limited comparisons of findings across studies. In adults, most studies showed significant within-group pre-post improvements in PA, but only 10 studies found differences between intervention and comparison groups. Most studies in children were null.

Conclusions.

Effective programs in adults were from randomized controlled trials and involved structured exercise programs. Studies with explicit cultural adaptations did not necessarily result in better PA outcomes. Additional studies are needed with larger sample sizes, longer follow-up, attention controls, strategies informed by proven behavior change theories, and objective PA assessment.
The Benefits of Physical Activity for Youth with Developmental Disabilities: A Systematic Review
Authors: Johnson Connie C.
Published: June 2010

Objective.

Analyze evidence of the benefits of physical activity for youth with developmental disabilities.

Data Sources.

Key word searches for “disability,” “physical activity,” “exercise,” “fitness,” and “sport” in major databases. A total of 3263 citations was found.

Study Inclusion/Exclusion Criteria.

Systematic reviews and articles about studies quantitatively examining the effects of physical activity in youth with developmental disabilities ages 0 to 20 years were included. Only articles published in English in peer-reviewed journals were included.

Data Extraction.

A Measurement Tool to Assess Reviews criteria were used for systematic reviews; Grading of Recommendations, Assessment, Development, Evaluation criteria were used for observational studies; and Population, Intervention, Comparison, Outcome criteria were used for all studies.

Data Synthesis.

Data, shown in table format, were synthesized in relation to five research questions.

Results.

Three systematic reviews and 14 studies were reviewed. Strong evidence indicated that children and adolescents with developmental disabilities derive health benefits from participation in group exercise programs, treadmill training, or therapeutic riding/hippotherapy. Lesser levels of evidence indicated that health benefits might be present for adapted skiing or aquatic programs. Documented benefits of physical activity include improvements in aerobic capacity, improved gross motor function, and high levels of participant/parent satisfaction.

Conclusions.

Evidence exists that physical activity is beneficial for youth with developmental disabilities. Further research studies are needed that are of greater scientific rigor including larger sample sizes, control groups, and stringent, replicable methodology.
Prevalence of Metabolic Syndrome and Associated Risk Factors in Illinois
Authors: Reppert Adam , Steiner Bruce F. , Chapman-Novakofski K.
Published: June 2010

Purpose.

To examine the prevalence of metabolic syndrome (MS) in Illinois and associated risk factors to document emerging problems as a basis for preventive and/or therapeutic interventions.

Design.

The 2005 Illinois Behavioral Risk Factor Surveillance System data were analyzed for prevalence rates and relative risk (RR) of risk factors for MS.

Setting.

Illinois.

Subjects.

Representative sample of 5077 noninstitutionalized Illinoisans aged ≥ 18.

Measures.

Presence of diabetes, hypertension, hypercholesterolemia, angina, and obesity; adequate fruit/vegetable intake; adequate daily physical activity; routine consumption of calcium-rich foods; smoking; and demographic variables.

Analysis.

Prevalence, chi-square, RR, and analyses of variance.

Results.

MS prevalence was 16.2%. The RR for MS was 8 for those having diabetes; 20 for those with hypertension; 14 for those with hypercholesterolemia; 6 for those with angina; and 7 for those with obesity. Fruit/vegetable intake did not significantly influence the RR (RR = 1.01), but RR was greater when calcium-rich foods were not routinely consumed (RR = 1.61) and with inadequate physical activity (RR = 1.85). MS prevalence was highest in those over 65 years; with incomes <$15,000; and among Blacks. Differences among those with one through five indicators of MS were not significant for fruit/vegetable intake, but were for physical activity, age group, income, and education level (p < .001).

Conclusion.

These findings reveal that MS prevention should be emphasized for lower-income, older Blacks. Increasing physical activity and calcium-rich foods are areas for community-based education.
A Brief Intervention Designed to Increase Breast Cancer Self-Screening
Authors: Lindberg Nangel M. , Stevens Victor J. , Smith K. Sabina , Glasgow Russell E. , Toobert Deborah J.
Published: June 2010

Purpose.

To assess the efficacy of an intervention designed to increase appropriate use of breast self-examination (BSE).

Methods.

Two-armed randomized clinical trial of cancer-control interventions in women that compared a BSE intervention program to a dietary intervention, which served as the control group. The study was conducted at a large health maintenance organization in Portland, Oregon. Participants were 616 female members of the health maintenance organization who were aged 40 to 70 years. The intervention consisted of a 30- to 45-minute individual counseling session that featured BSE instruction, training and practice with silicone models, identification of barriers to BSE, and problem-solving. This intervention was followed by two brief follow-up telephone calls. The study outcome measure was self-reported BSE practice, which included duration, frequency, and specific elements of exam.

Results.

The study had a 90% response rate. At the 1-year follow-up, χ2 analyses showed that significantly more individuals in the BSE intervention (59%) reported adequate BSE performance compared with those in the control group (12.2%; p < .001).

Conclusions.

This brief intervention was successful in encouraging women to perform adequate BSEs. Although the role of the BSE in patient care remains controversial, these results show that even brief intervention programs can be effective at encouraging self-screening for cancer. This intervention could easily be modified to target other screening practices (e.g., skin or testicular cancer screening) that are associated with reduced cancer morbidity and mortality.
School Performance, Lack of Facilities, and Safety Concerns: Barriers to Parents' Support of Their Children's Physical Activity
Authors: Davison Kirsten Krahnstoever
Published: June 2010

Purpose.

To identify barriers to parents' support of their children's physical activity (PA) and to develop a survey to assess such barriers.

Methods.

Eighty-two parents (40 white; 36 African-American; 6 other) of elementary school-aged children participated in small-group interviews. Parents reported barriers to supporting their children's PA and suggested possible solutions. This information was used to develop the Barriers to Activity Support Scale (BASS), which was completed by 75 of the 82 parents along with a survey that assessed the parents' support for their children's PA.

Results.

Parents reported community-based, interpersonal, and intrapersonal barriers to supporting their children's PA. Top barriers included the importance of children's school performance, a lack of facilities, and concerns about safety. Parents who reported greater barriers reported lower support for their children's PA.

Discussion.

Results provide preliminary evidence for the reliability and validity of the BASS and highlight the need to address barriers during the development of family-based PA programs.
Obesity and the Built Environment: Does the Density of Neighborhood Fast-Food Outlets Matter?
Authors: Li Fuzhong , Harmer Peter , Cardinal Bradley J. , Bosworth Mark , Johnson-Shelton Deb
Published: June 2010

Purpose.

Examine variation in obesity among older adults relative to the joint influences of density of neighborhood fast food outlets and residents' behavioral, psychosocial, and sociodemographic characteristics.

Design.

Cross-sectional and multilevel design.

Setting.

Census block groups, used as a proxy for neighborhoods, within the metropolitan region's Urban Growth Boundary in Portland, Oregon.

Subjects.

A total of 1221 residents (mean age, 65 years) recruited randomly from 120 neighborhoods (48% response rate).

Measures.

A geographic information system-based measure of fast food restaurant density across 120 neighborhoods was created. Residents within the sampled neighborhoods were assessed with respect to their body mass indices (BMI), frequency of visits to local fast food restaurants, fried food consumption, levels of physical activity, self-efficacy of eating fruits and vegetables, household income, and race/ethnicity.

Analyses.

Multilevel logistic regression analyses.

Results.

Significant associations were found between resident-level individual characteristics and the likelihood of being obese (BMI ≥ 30) for neighborhoods with a high-density of fast food restaurants in comparison with those with a low density: odds ratios for obesity, 95% confidence intervals (CI), were 1.878 (CI, 1.006–3.496) for weekly visits to local fast food restaurants; 1.792 (CI, 1.006–3.190) for not meeting physical activity recommendations; 1.212 (CI, 1.057–1.391) for low confidence in eating healthy food; and 8.057 (CI, 1.705–38.086) for non-Hispanic black residents.

Conclusion.

Increased density of neighborhood fast food outlets was associated with unhealthy lifestyles, poorer psychosocial profiles, and increased risk of obesity among older adults.
State Legislation to Improve Employee Wellness
Authors: Lankford Tina , Kruger Judy , Bauer Deborah
Published: June 2010

Objective.

Categorize and describe the content and status of state legislation of worksite wellness.

Methods.

State worksite wellness legislation was compiled from the Centers for Disease Control's Division of Nutrition, Physical Activity and Obesity State Legislative Database ( http://apps.nccd.cdc.gov/DNPALeg/index.asp ) and from LexisNexis ( http://www.lexisnexis.com ). Key word searches were used to gather worksite wellness legislation (2001–2006), with the exception of resolutions and those bills not pertaining to general employee wellness. Legislation was individually examined, categorized, and analyzed for content and status.

Results.

The four categories of state legislation that appeared to be most common were tax credits (n = 34; 0 passed), wellness policies and programs (n = 21; 4 passed), alternative transportation (n = 18; 4 passed), and health insurance (n = 14; 3 passed).

Conclusion.

During 2001 to 2006, seven of 27 states enacted worksite wellness bills. In the three categories in which bills passed, 19% to 22% were enacted. This proportion, similar to other health promotions bills, indicates that worksite health promotion legislation passed as favorably as other health promotion topics. Further, the language in the bills did not recommend a specific standard for employee health, such as that in the national Healthy People 2010 objectives.
Investigating Fruit and Vegetable Consumption Using the Transtheoretical Model
Authors: Horwath Caroline C. , Nigg Claudio R. , Motl Rob W. , Wong Kristen T. , Dishman Rod K.
Published: June 2010

Purpose.

Test the applicability of the transtheoretical model (TTM) to adult fruit/vegetable consumption.

Design.

Cross-sectional random-digit dial survey.

Setting.

Hawaii.

Subjects.

700 (62.6% female; age [mean ± SD], 47 ± 17.1 years; education [mean ± SD], 14.6 ± 2.8 years; 35.0% white, 31.1% Asian, 22.1% native Hawaiian/Pacific Islander, 11.8% other).

Measures.

Stages, processes, self-efficacy, decisional balance, and self-reported fruit/vegetable consumption.

Analysis.

Confirmatory factor analysis tested the factor structure. Analyses of variance were used to explore stage differences in constructs.

Results.

Stage distribution was precontemplation (33%), contemplation (4%), preparation (37%), action (3%), and maintenance (23%). A 10-factor process model with two higher-order correlated factors (experiential and behavioral) provided the best data fit (X2 = 1446.12; df = 366; p < .0001; comparative fit index [CFI] = .89; standardized root mean square residual [SRMR] = .05). The self-efficacy structure fit the data well (X2 = 81.86; df = 9; p < .0001; CFI = .94; SRMR = .04), as did the decisional balance structure (X2 = 37.42; df = 19;p = .007; CFI = .99; SRMR = .02). Processes, self-efficacy, decisional balance, and fruit/vegetable consumption behavior differed significantly by stage, with medium effect sizes for most variables.

Conclusion.

The variables revealed adequate fit to the theorized measurement models. TTM predictions regarding stage differences in self-efficacy, pros and cons, and fruit/vegetable consumption were confirmed; however, most experiential and behavioral processes increased in the early stages and then leveled off.
Clinical Utility of a Fingerstick Technology to Identify Individuals with Abnormal Blood Lipids and High-Sensitivity C-Reactive Protein Levels
Authors: Parikh Parin , Mochari Heidi , Mosca Lori
Published: June 2010

Purpose.

The purpose of this study was to determine the ability of a commonly used fingerstick technology to identify individuals with abnormal blood levels of total cholesterol (TC), calculated low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), and high-sensitivity C-reactive protein (hsCRP) compared with a standardized laboratory.

Methods.

Participants (n = 250; mean age, 48.0 + 13.5 years; 66% female; 36% nonwhite) were eligible for primary prevention of cardiovascular disease (CVD). Blood lipids and hsCKP were measured simultaneously by (1) fingerstick analyzed by Cholestech LDX analyzers and (2) fresh venous blood that was analyzed by Columbia University General Clinical Research Center (GCRC) Core Laboratory. Pearson correlation coefficients, kappa, sensitivity, and specificity were calculated for fingerstick versus GCRC laboratory values for lipids and hsCRP.

Results.

The correlations between fingerstick and core laboratory for TC, LDL-C, HDL-C, TG, and hsCRP were .91, .88, .77, .93, and .81, respectively (all p < .01). Sensitivity and specificity of the fingerstick to identify those with abnormal lipids and hsCRP ≥ 1 mg/L were all ≥ 75%.

Conclusion.

Fingerstick screening is accurate and has good clinical utility to identify persons with abnormal blood lipids and hsCRP at the point of care in a diverse population that is eligible for primary prevention of CVD. These results may not be generalizable to patients at high risk for CVD or who have known hyperlipidemia.
Impact of a Worksite Wellness Program on the Nutrition and Physical Activity Environment of Child Care Centers
Authors: Gosliner Wendi A. , James Paula , Yancey Antronette K. , Ritchie Lorrene , Studer Natalie , Crawford Patricia B.
Published: June 2010

Purpose.

To test whether implementing a staff wellness program affects the nutrition and physical activity environment at child care centers.

Design.

Quasi-experimental controlled trial.

Setting.

Child care centers in low income neighborhoods in California.

Subjects.

Eighty-two staff members at 13 centers completed the study.

Intervention.

Intervention and control groups received training and education about nutrition and physical activity. The intervention group also participated in a worksite wellness program.

Measures.

Staff members' personal health habits, self-efficacy in working with families on nutrition and physical activity, and changes in children's food and physical activity environments were assessed.

Analysis.

Statistical software was used to analyze change scores for pre-post measures and to test differences for end point—only measures.

Results.

Although significant differences in staff members' personal health behaviors were not observed, staff from intervention sites exhibited more positive changes in their comfort level in talking to parents about nutrition and physical activity. Intervention sites reported providing more fresh fruits (p = .004) and vegetables (p = .03) to children as part of regular meals and snacks and serving more fresh fruits (p = .05) at children's celebrations. Control sites reported greater increases in sweetened foods (p = .02) and sweetened beverages (p = .05) at children's celebrations.

Conclusion.

The wellness intervention shows promise in improving the children's food environment in a child care setting.
Six-Month Follow-up and Participant Use and Satisfaction of an Electronic Mail Intervention Promoting Physical Activity and Nutrition
Authors: Plotnikoff Ronald C. , Pickering Michael A. , McCargar Linda J. , Loucaides Constantinos A. , Hugo Kylie
Published: June 2010

Purpose.

To evaluate the effects of a 12-week e-mail intervention promoting physical activity and nutrition, and to describe participant use and satisfaction feedback.

Design.

A longitudinal, randomized trial.

Setting.

Five large workplaces in Alberta, Canada.

Participants.

One thousand forty-three participants completed all three assessments, and 1263 participants in the experimental group provided use and satisfaction feedback after receiving the 12-week intervention.

Intervention.

Paired physical activity and nutrition messages were e-mailed weekly to the experimental group. The control group received all messages in bulk (i.e., within a single e-mail message) at the conclusion of the intervention.

Measures.

Self-report measures of knowledge, cognitions, and behaviors related to physical activity and nutrition were used. Satisfaction with e-mail messages was assessed at Time 2.

Analysis.

Planned contrasts compared the experimental group measures at Time 3 with those reported at Time 2 and with control group measures reported at Time 3. Control group measures at Time 3 were also compared with control group measures at Time 2.

Results.

The small intervention effects previously reported between Time 1 and Time 2 were maintained at Time 3. Providing the e-mail messages in bulk also had a significant positive effect on many of the physical activity and nutrition variables.

Conclusions.

E-mail offers a promising medium for promoting health-enhancing knowledge, attitudes, and behaviors. Additional research is needed to determine optimal message dose and content.
Associations among Body Mass Index, Waist Circumference, and Health Indicators in American Indian and Alaska Native Adults
Authors: Slattery Martha L. , Ferucci Elizabeth D. , Murtaugh Maureen A. , Edwards Sandra , Ma Khe-Ni , Etzel Ruth A. , Tom-Orme Lillian , Lanier Anne P.
Published: June 2010

Purpose.

Little is known about obesity-related health issues among American Indian and Alaska Native (AIAN) populations.

Approach.

A large cohort of AIAN people was assembled to evaluate factors associated with health.

Setting.

The study was conducted in Alaska and on the Navajo Nation.

Participants.

A total of 11,293 AIAN people were included.

Methods.

We present data for body mass index (BMI, kg/m2) and waist circumference (cm) to evaluate obesity-related health factors.

Results.

Overall, 32.4% of the population were overweight (BMI 25-29.9 kg/m2), 47.1% were obese (BMI ≥ 30 kg/m2), and 21.4% were very obese (BMI, ≥ 35 kg/m2). A waist circumference greater than 102 cm for men and greater than 88 cm for women was observed for 41.7% of men and 78.3% of women. Obese people were more likely to perceive their health as fair/poor than nonobese participants (prevalence ratio [PR], 1.91; 95% CI, 1.71-2.14). Participants younger than 30 years were three times more likely to perceive their health as being fair or poor when their BMI results were 35 or greater compared with those whose BMI results were less than 25 kg/m2. A larger BMI was associated with having multiple medical conditions, fewer hours of vigorous activity, and more hours of television watching.

Conclusions.

Given the high rates of obesity in AIAN populations and the association of obesity with other health conditions, it is important to reduce obesity among AIAN people.
Relationship between 100% Juice Consumption and Nutrient Intake and Weight of Adolescents
Authors: O'Neil Carol E. , Nicklas Theresa A. , Kleinman Ronald
Published: June 2010

Purpose.

This study investigated the associations among 100% juice consumption, nutrient intake, and measures of weight in adolescents.

Design.

A cross-sectional secondary analysis of data from adolescents aged 12 to 18 years (n = 3939) participating in the National Health and Nutrition Examination Survey 1999–2002 was conducted to assess nutrient and weight in categories of 100% juice consumption.

Methods.

Least square means and logistic regression analyses were generated, and were adjusted for gender, age, ethnicity, and energy intake. Analyses were Bonferroni corrected with an effective p value of .0125.

Results.

Twenty-eight percent of adolescents (51% male, 42% Hispanic, 25% non-Hispanic white, 29% non-Hispanic black) consumed 100% juice the day of the recall. The mean amount of 100% juice consumed was 3.7 ounces (2.2% of energy intake). Compared with non-juice consumers, carbohydrate, fiber, vitamins C and B6, folate, potassium, copper, magnesium, and iron intakes of juice consumers were higher, and intakes of fat and saturated fatty acids were lower. Those consuming greater than 6 ounces of juice consumed more servings of fruit and less discretionary fat and added sugar than nonconsumers. No differences were found in weight by juice consumption group.

Conclusion.

In conclusion, when compared with non-juice consumers, adolescents consuming 100% juice did not show mean increased weight measures. Juice provided valuable nutrients, and consumption was associated with lower intakes of total fat, saturated fatty acids, discretionary fat, and added sugars and with higher intakes of whole fruit; however, consumption was not associated with decreased intake of milk, meat, or grains.
Using Built Environmental Observation Tools: Comparing Two Methods of Creating a Measure of the Built Environment
Authors: Keast Erin M. , Carlson Nichole E. , Chapman Nancy J. , Michael Yvonne L.
Published: June 2010

Purpose.

Identify an efficient method of creating a comprehensive and concise measure of the built environment integrating data from geographic information systems (GIS) and the Senior Walking Environmental Assessment Tool (SWEAT).

Design.

Cross-sectional study using a population sample.

Setting.

Eight municipally defined neighborhoods in Portland, Oregon.

Subjects.

Adult residents (N = 120) of audited segments (N = 363).

Measures.

We described built environmental features using SWEAT audits and GIS data. We obtained information on walking behaviors and potential confounders through in-person interviews.

Analysis.

We created two sets of environmental measures, one based on the conceptual framework used to develop SWEAT and another using principal component analysis (PCA). Each measure's association with walking for transportation and exercise was then assessed and compared using logistic regression.

Results.

A priori measures (destinations, safety, aesthetics, and functionality) and PCA measures (accessibility, comfort/safety, maintenance, and pleasantness) were analogous in conceptual meaning and had similar associations with walking. Walking for transportation was associated with destination accessibility and functional elements, whereas walking for exercise was associated with maintenance of the walking area and protection from traffic. However, only PCA measures consistently reached statistical significance.

Conclusion.

The measures created with PCA were more parsimonious than those created a priori. Performing PCA is an efficient method of combining and scoring SWEAT and GIS data.
Elements of External Validity of Tools for Health: An Intervention for Construction Laborers
Authors: Hunt Mary K. , Harley Amy E. , Stoddard Anne M. , Lederman Ruth I. , MacArthur Mary Jane , Sorensen Glorian
Published: June 2010

Purpose.

To examine the external validity of an efficacious tailored smoking cessation and nutrition improvement telephone intervention.

Design.

Comparison of characteristics of participants and nonparticipants (representativeness); examination of the extent of intervention implementation.

Setting.

Cancer center collaboration with a labor union.

Subjects.

Unionized construction laborers.

Intervention.

Tailored feedback report, telephone counseling, and supplementary educational materials focused on smoking cessation and improved nutrition.

Measures.

Background survey identifying socio-demographic and behavioral characteristics; process evaluation data; and final efficacy survey to determine participant satisfaction.

Analysis.

Cross-classification and the X2 test of homogeneity were used with categorically measured variables comparing participants and nonparticipants. We compared the means in the two groups for continuously scaled measures using the Student t-test and investigated the multivariable association of the characteristics of participation with a multiple logistic regression. For process data we present frequencies, percentages, and means.

Results.

Characteristics associated with participation included self-efficacy to change fruit and vegetable consumption (p = .0009) and self-identification with union's problems (p = 0.05). Eighty-six percent of non-smokers and 61% of smokers completed between 1 and 4 counseling sessions. Over one-half of non-smokers (61%) and smokers (53%) completed 4 or more calls and more smokers (34%) than non-smokers (11%) completed the 5+ sessions.

Conclusions.

These results provide a snapshot of characteristics of construction laborers to whom this intervention can be generalized and indicators of feasibility necessary for translating research into practice.
Potential Health Benefits and Medical Cost Savings from Calorie, Sodium, and Saturated Fat Reductions in the American Diet
Authors: Doll Timothy M. , Fulgoni Victor L. , Zhang Yiduo , Reimers Kristin J. , Packard Patricia T. , Astwood James D.
Published: June 2010

Purpose.

Model the potential national health benefits and medical savings from reduced daily intake of calories, sodium, and saturated fat among the U.S. adult population.

Design.

Simulation based on secondary data analysis; quantitative research. Measures include the prevalence of overweight/obesity, uncontrolled hypertension, elevated cholesterol, and related chronic conditions under various hypothetical dietary changes.

Setting.

United States.

Subjects.

Two hundred twenty-four million adults.

Measures.

Findings come from a Nutrition Impact Model that combines information from national surveys, peer-reviewed studies, and government reports.

Analysis.

The simulation model predicts disease prevalence and medical expenditures under hypothetical dietary change scenarios.

Results.

We estimate that permanent 100-kcal reductions in daily intake would eliminate approximately 71.2 million cases of overweight/obesity and save $58 billion annually. Long-term sodium intake reductions of 400 mg/d in those with uncontrolled hypertension would eliminate about 1.5 million cases, saving $2.3 billion annually. Decreasing 5 g/d of saturated fat intake in those with elevated cholesterol would eliminate 3.9 million cases, saving $2.0 billion annually.

Conclusions.

Modest to aggressive changes in diet can improve health and reduce annual national medical expenditures by $60 billion to $120 billion. One use of the model is to estimate the impact of dietary change related to setting public health priorities for dietary guidance. The findings here argue that emphasis on reduction in caloric intake should be the highest priority.