bluuebunny/crossref_metadata_2025 huggingface dataset:
The Role of Incentive Design, Incentive Value, Communications Strategy, and Worksite Culture on Health Risk Assessment Participation
Authors: Seaverson Erin L. D. , Grossmeier Jessica , Miller Toni M. , Anderson David R.
Published: June 2010

Purpose.

To examine the impact of financial incentives, communications strategy, and worksite culture on health risk assessment (HRA) participation rates.

Design.

A cross-sectional study design was used to examine factors that influence employee participation, including incentive value, incentive design, communications strategy, and worksite culture.

Setting.

Large private-sector and public-sector employers.

Participants.

Thirty-six employers (n = 559,988 employees) that provided financial incentives to promote employee HRA participation.

Intervention.

Organizations implemented the HRA as part of a more comprehensive worksite health promotion strategy that included follow-up interventions and a variety of other components. The primary outcome of interest was employee HRA participation.

Measures.

Information on program design and structure, as well as on HRA eligibility and participation, was collected for each organization via standard client report and semi-structured interviews with account managers. General linear regression models were used to examine the extent to which factors influence HRA participation independently and when controlled for other factors.

Results.

Incentive value (r2 = .433; p < .000), benefits-integrated incentive design (r2 = .184; p = .009), culture (r2 = .113; p = .045), and communications strategy (r2 = .300; p = .001) had positive bivariate associations with HRA participation rates. When all factors were included in the model, incentive value (p = .001) and communications strategy (p = .023) were significantly associated with HRA participation. Variance accounted for by all factors combined was R2 = .584.

Conclusion.

This study suggests that incentive value, incentive type, supportive worksite culture, and comprehensive communications strategy may all play a role in increasing HRA participation.
Family Environmental Factors Do Not Explain Differences in the Behavioral Effect of a Healthy Diet Promotion Program in Lower Vocational Schools among 12- to 14-Year-Old Adolescents
Authors: Martens Marloes , van Assema Patricia , Knibbe Ronald , Engels Rutger C. M. E. , Brug Johannes
Published: June 2010

Purpose.

Assess whether family environmental factors affected changes in fruit and snack consumption among 12- to 14-year-old adolescents participating in a Dutch healthy diet promotion program.

Design.

Data were derived from pretest and posttest questionnaires completed by adolescents in 10 schools in the intervention arm of the program trial and questionnaires completed by their parents during program implementation.

Setting.

Lower vocational schools in the southern and central parts of The Netherlands.

Subjects.

Questionnaire answers of 502 parents were matched with those of their children.

Intervention.

Eight school lessons using various theory-based materials and strategies.

Measures.

Dietary intake, ethnicity, education level, employment status, parenting style, food purchase considerations, family food rules, and food availability and accessibility at home.

Analysis.

Regression analyses.

Results.

No significant family environmental predictors of program-induced changes in either fruit or snack intake were found.

Conclusion.

A limitation of the study was that all data were self-reported. No evidence was found that there were subgroups of adolescents who profited less from the program because of family environmental factors.
Behavioral Predictors of Low Fat Intake among Economically Disadvantaged African-American Adolescents
Authors: Di Noia Jennifer , Contento Isobel R.
Published: June 2010

Purpose.

To determine whether five behaviors shown to predict low fat intake in adults predicted low fat intake among economically disadvantaged African-American adolescents.

Design.

Cross-sectional.

Subjects and Measures.

Recruited through youth services agencies serving low-income communities in New York and New Jersey, participants were 265 African-American adolescents aged 10 to 14 years. Participants completed the Block Fat Screener and scales for measuring the following behaviors: avoiding fat as a seasoning, modifying meat to make it lower in fat, substituting high-fat foods with manufactured low-fat equivalents, replacing high-fat foods with fruits and vegetables, and replacing high-fat foods with low-fat foods other than fruits and vegetables.

Analysis.

The reliability and construct validity of the scales were assessed using internal consistency reliability and correlation analyses. Multiple regression analysis was used to determine behavioral predictors of low fat intake.

Results.

Scale coefficient alphas ranged from .60 to .80. Fat avoidance, substitution, and replacement with fruits and vegetables were significantly associated with fat intake. The regression equation containing these behaviors accounted for 12% of the variance in intake. All three behaviors were significant predictors of low fat intake.

Conclusions.

Fewer behaviors have salience for predicting low fat intake among economically disadvantaged African-American adolescents than among adults. Interventions to lower youths' intake should emphasize fat avoidance, substitution, and replacement with fruits and vegetables.
Modifiable Health Behaviors and Short-Term Medical Costs among Health Plan Members
Authors: Bland Patricia C. , An Lawrence , Foldes Steven S. , Garrett Nancy , Alesci Nina L.
Published: June 2010

Purpose.

Describe the relationship among modifiable health behaviors and short-term medical costs.

Design.

Prospective study linking cross-sectional survey data that assessed modifiable risk behaviors with insurance claims.

Setting.

A large health plan in Minnesota.

Subjects.

A stratified, random sample of 10,000 yielded an analytic data set for 7983 members.

Measures.

The dependent variable was per-member-per-month insurance payment plus subscriber liability. Eighteen months of medical costs were analyzed. Control variables included subscriber age, sex, type of insurance plan, days of enrollment, chronic disease status, education, and marital status. Independent variables included self-reported health behaviors of smoking, heavy drinking, nutrition, and physical activity.

Analysis.

Linear regression was performed on the natural log of the cost variable, followed by a retransformation to dollars.

Results.

Physical inactivity and smoking were significant predictors of higher medical costs. Each day a member did not exercise there was a 2.9% difference in cost. Compared with never smokers, current smokers had 16% higher costs. Former smokers who had quit more than 1 year before taking the survey had 15% higher costs than never smokers. Recent former smokers cost 32% more than never smokers and more frequently experienced smoking-related medical conditions before they quit. Alcohol consumption was nonsignificant. Nutrition also was not significant but was narrowly measured by only fruit and vegetable consumption.

Conclusion.

Physical inactivity and smoking were associated with higher short-term medical costs among health plan members.
The Effects of a 4-Week After-School Program on Motor Skills and Fitness of Kindergarten and First-Grade Students
Authors: Matvienko Oksana , Ahrabi-Fard Iradge
Published: June 2010

Purpose.

To examine the effects of an after-school NutriActive program on anthropometric measurements, motor skills, and fitness levels of young children.

Design.

In this quasi-experimental study, anthropometric, motor skill, and fitness measurements were compared between intervention and control students at baseline, following a 4-week intervention, and after a summer break (4 months).

Setting.

Two intervention and two control microurban elementary schools.

Subjects.

Forty-two intervention and 28 control kindergarten and first-grade students (50% boys, 82% Caucasian).

Intervention.

A 4-week program consisted daily of a morning walk and an after-school physical activity lesson with an emphasis on motor skill development, nutrition/health lesson, snack, and nonstructured active play.

Measures.

Body mass index, waist circumference, and fitness and motor skill levels.

Analysis.

Repeated-measures analysis of variance, t-test, and stepwise regression.

Results.

The intervention group scored significantly better on some fitness and all motor skill tests at 4 weeks. The improvements in fitness and skill levels ranged from 30% to 270%. At 4 months, differences between the groups diminished but remained significant, with better scores for the intervention group on some tests. Skill levels emerged as predictors of cardiovascular fitness at 4 months. Anthropometric measurements did not differ between the groups at any time point.

Conclusion.

A short, intense after-school program can produce significant, sustainable improvements in motor skill and fitness levels of young children.
Associations between Patterns of Objectively Measured Physical Activity and Risk Factors for the Metabolic Syndrome
Authors: Metzger Jesse S. , Catellier Diane J. , Evenson Kelly R. , Treuth Margarita S. , Rosamond Wayne D. , Siega-Riz Anna Maria
Published: June 2010

Purpose.

To determine whether certain patterns of objectively measured physical activity (PA) are associated with the risk factors for or the diagnosis of the metabolic syndrome (MS).

Design.

Latent class analysis, including assessment of the associations between latent PA classes and risk factors for the MS.

Setting.

Random sample from throughout the United States using data from the 2003–2004 National Health and Nutrition Examination Survey.

Subjects.

A total of 3458 civilian adult noninstitutionalized U.S. citizens.

Measures.

Daily minutes of moderate-to-vigorous PA across a 7-day week based on accelerometer measurements, as well as high blood pressure, blood glucose levels, triglyceride levels, and body mass index, along with low levels of high density lipoproteins, using clinical cut points.

Results.

Membership in the more active PA classes was consistently associated with lower odds of all risk factors for the MS. However, when participants were categorized into quartiles of the coefficients of variation of PA across 7 days, few differences were seen in any of the risk factors.

Conclusions.

Accumulating the total weekly recommended amount of PA is consistently associated with positive health profiles, and more PA than the recommended amounts may be even better. However, the manner in which this activity is accumulated, either spread over most days of the week or compressed into just a couple of days, may have similar associations with the risk factors for the MS.
Health Behaviors of Employed and Insured Adults in the United States, 2004-2005
Authors: Hughes M. Courtney , Hannon Peggy A. , Harris Jeffrey R. , Patrick Donald L.
Published: June 2010

Purpose.

To examine the prevalence of health behaviors, including clinical preventive services and lifestyle risk behaviors, among insured workers and to determine whether disparities in health behaviors based on demographic factors exist among this group.

Design.

Cross-sectional analysis of 2004–2005 Behavioral Risk Factor Surveillance System data.

Setting.

United States.

Subjects.

A representative sample of noninstitutionalized employed and insured adults aged 18 to 64 years (139,738 in 2004 and 159,755 in 2005).

Measures.

Self-reported clinical preventive services utilization and lifestyle-related behaviors, as well as multiple logistic regression analyses assessing the independent effects of demographic and access variables on health behaviors.

Results.

Among insured workers, rates of not using recommended clinical preventive services ranged from 8.5% (cervical cancer screening) to 73.9% (influenza vaccination). Rates for engaging in lifestyle-related risks ranged from 5.5% (heavy drinking) to 77.1% (inadequate fruit-vegetable consumption). In multivariate analyses, lower income, lower education, cost as a barrier to health care, and no health care provider were associated with significantly decreased clinical preventive services utilization (p < .01). Lower education and no health care provider were associated with lifestyle-related risks (p < .01).

Conclusions.

Working insured adults are not meeting recommendations for health behaviors. Significant disparities in health behaviors related to socioeconomic status exist among this group. Employers and insurers should consider these poor health behaviors and disparities when designing insurance benefits addressing clinical preventive services utilization and workplace health promotion programs addressing lifestyle-related behaviors.
Looking at Research Consent Forms through a Participant-Centered Lens: The PRISM Readability Toolkit
Authors: Ridpath Jessica R. , Wiese Cheryl J. , Greene Sarah M.
Published: June 2010

Synopsis

Communicating in lay language is an underdeveloped skill among many researchers—a limitation that contributes to low readability among research consent forms and may hinder participant understanding of study procedures and risks. We present the Project to Review and Improve Study Materials (PRISM) and its centerpiece, the PRISM Readability Toolkit. The toolkit provides strategies for creating study materials that are readable and participant centered, focusing on consent forms but also addressing other participant materials. Based on plain language principles, this free resource includes a flexible menu of tools, such as an editing checklist, before and after examples, easy-to-read template language, and a list of alternative words. Among PRISM's ongoing goals is to test the toolkit with populations groups.
Health Care Behaviors and Decision-Making Processes among Enrollees in a State High-Risk Insurance Pool: Focus Group Findings
Authors: Hall Jean P. , Carroll Shawna L. , Moore Janice M.
Published: June 2010

Purpose.

To better understand the relationship between health insurance coverage and health care behaviors of persons with potentially disabling conditions enrolled in a state high-risk insurance pool.

Design.

Six focus groups with risk pool enrollees at two sites.

Setting.

Suburban areas in the state of Kansas.

Participants.

Forty-two individuals 29 to 62 years, all with potentially disabling physical or mental health conditions.

Method.

Qualitative analysis of focus group transcripts using pile sorting and theme identification.

Results.

High premiums and deductibles limit participants' ability to afford basic health services and access to prescription medications despite their middle-class socioeconomic status. Participants report delaying or forgoing needed medical care because of lack of coverage and/or out-of-pocket costs. They employ numerous and potentially dangerous strategies to minimize costs, especially for prescription medications. Some report “saving up” needed procedures until their total costs will exceed that year's deductible.

Conclusion.

Individuals in the risk pool were making medical decisions on the basis of cost rather than need. Many shared stories of medical complications as a result of delayed care, and most expressed stress related to the difficulty of making decisions about their care and use of prescribed medications. The individual, nongroup insurance market, with its higher out-of-pocket costs, may not meet the needs of people with chronic health conditions.
Satisfaction with a Weight Loss Program: What Matters?
Authors: VanWormer Jeffrey J. , Martinez Anna M. , Cosentino Dan , Pronk Nicolaas P.
Published: June 2010

Purpose.

Satisfaction is understudied in weight loss programs. The purpose of this study was to examine the association between participant/program experiences and satisfaction with a weight loss intervention.

Design.

A prospective cohort design was utilized.

Setting.

The study was conducted in the Minneapolis metro area.

Sample.

Participants were obese employees of a managed care organization. One hundred were enrolled, and 78 had complete data available.

Intervention.

Treatment included telephone counseling along with a home telemonitoring scale and instructions to self-weigh daily.

Measures.

Outcomes included overall program satisfaction and willingness to refer the program to others. Predictors included demographics, treatment group, participation in other programs, expected weight, general health, body mass index, diet quality, physical activity, body image, mental health, counseling, and self-weighing.

Analysis.

Quantitative predictor-outcome associations were examined using multiple logistic regressions. Qualitative satisfaction responses were analyzed using a general inductive approach.

Results.

Weight loss (odds ratio [OR] = 1.83, p = .008), improved diet (OR = 1.27, p = .092), increased physical activity (OR = 1.05, p = .034), and improved body image (OR = 1.38, p = .051) were independent predictors of overall satisfaction. Treatment group (OR = 14.83, p = .015) and number of counseling calls (OR = 1.49, p = .009) were predictors of willingness to refer the program. Qualitative themes indicated desire to integrate counseling on emotional issues.

Conclusion.

Health progress explained overall satisfaction, whereas treatment characteristics explained willingness to endorse the intervention. Concentrating on these factors may improve retention. Limitations included self-reported measures.
Engaging Community Businesses in Human Immunodeficiency Virus Prevention: A Feasibility Study
Authors: Rovniak Liza S. , Hovell Melbourne F. , Hofstetter C. Richard , Blumberg Elaine J. , Sipan Carol L. , Batista Marcia F. , Martinez-Donate Ana P. , Mulvihill Mary M. , Ayala Guadalupe X.
Published: June 2010

Purpose.

To explore the feasibility of engaging community businesses in human immunodeficiency virus (HIV) prevention.

Design.

Randomly selected business owners/managers were asked to display discreetly wrapped condoms and brochures, both of which were provided free-of-charge for 3 months. Assessments were conducted at baseline, mid-program, and post-program. Customer feedback was obtained through an online survey.

Setting.

Participants were selected from a San Diego, California neighborhood with a high rate of acquired immune deficiency syndrome.

Participants.

Fifty-one business owners/managers who represented 10 retail categories, and 52 customers.

Measures.

Participation rates, descriptive characteristics, number of condoms and brochures distributed, customer feedback, business owners'/managers' program satisfaction, and business owners'/managers' willingness to provide future support for HIV prevention were measured.

Analysis.

Kruskal-Wallis, Mann-Whitney U, Fisher's exact, and McNemar's tests were used to analyze data.

Results.

The 20 business owners/managers (39%) who agreed to distribute condoms and brochures reported fewer years in business and more employees than those who agreed only to distribute brochures (20%) or who refused to participate (41%; p < .05). Bars were the easiest of ten retail categories to recruit. Businesses with more employees and customers distributed more condoms and brochures (p < .05). More than 90% of customers supported distributing condoms and brochures in businesses, and 96% of business owners/managers described their program experience as positive.

Conclusion.

Businesses are willing to distribute condoms and brochures to prevent HIV. Policies to increase business participation in HIV prevention should be developed and tested.
Potential Societal Savings from Reduced Sodium Consumption in the U.S. Adult Population
Authors: Polar Kartika , Sturm Roland
Published: June 2010

Purpose.

Policies that address the food environment at the population level may help prevent chronic disease, but their value to society is still uncertain. Dietary sodium is linked to increased prevalence of hypertension, a primary risk factor for cardiovascular and renal diseases. This study calculates the potential societal savings of reducing hypertension and related cardiovascular disease via a reduction in population-level sodium intake. On average, U. S. adults consume almost twice the recommended maximum of dietary sodium, most of it from processed foods.

Design.

This study modeled sodium-reduction scenarios by using a cross-sectional simulation approach. The model used population-level data on blood pressure, antihypertensive medication use, and sodium intake from the National Health and Nutrition Examination Survey (1999–2004). This data was then combined with parameters from the literature on sodium effects, disease outcomes, costs, and quality of life to yield model outcomes.

Measures.

This study calculated the following outcome measures: hypertension prevalence, direct health care costs, and quality-adjusted life years for noninstitutionalized U.S. adults.

Analysis.

The simulation was conducted with STATA 9.2 and Microsoft Excel. Survey weights were used to calculate population averages.

Results.

Reducing average population sodium intake to 2300 mg per day, the recommended maximum for adults, may reduce cases of hypertension by 11 million, save $18 billion health care dollars, and gain 312,000 QALYs that are worth $32 billion annually. Greater reductions in population sodium consumption bring even greater savings to society.

Conclusions.

Large benefits to society may result from efforts to lower sodium consumption on a population level by modest amounts over time. Although savings in direct health care costs are likely to be quite high, they could easily be matched or exceeded by the value of quality-of-life improvements.
Reported Barriers to Cancer Screening: Montana Behavioral Risk Factor Surveillance System 2007
Authors: Ballew Carol , Cummings Susan J. , Oreskovich Joanne
Published: June 2010

Purpose.

To determine self-identified barriers to cancer screening participation in Montana among respondents to the Behavioral Risk Factor Surveillance System (BRFSS).

Design.

The 2007 BRFSS survey.

Setting.

State of Montana.

Subjects.

A total of 3433 respondents (2029 women) 50 years and older.

Measures.

Respondents who had never had an endoscopy and women who had not had a recent mammogram were asked why they had not been screened.

Analysis.

Associations between health care access variables and screening participation were assessed using X2 tests. Joint effects of multiple independent predictors of screening participation were assessed using odds ratios (ORs) and 95% confidence intervals (CIs) from multiple logistic regression analysis.

Results.

The strongest predictor of having an endoscopy (OR, 23.62; 95% CI, 18.42-30.28) or recent mammogram (OR, 10.87; 95%, CI, 6.42-18.40) was provider recommendation. The most common reasons for not being screened were respondent's belief that it was not necessary (44% for endoscopy and 39% for mammography), no provider recommendation (22% for endoscopy), and cost (12% for endoscopy and 19% for mammography). Among unscreened respondents whose providers recommended endoscopy and mammography, 30% and 36%, respectively, believed that it was not necessary.

Conclusions.

Many Montanans remain unaware of the importance of cancer screening. Health care providers and public health officials must increase patient education, and providers must continue to refer patients for screening.
Factors Associated with Incidental Sickness Absence among Employees in One Health Care System
Authors: Pai Chih-Wen , Mullin John , Payne Gina M. , Love Jeaneeta , O'Connell Gayle , Edington Dee W.
Published: June 2010

Purpose.

Assess the association of taking incidental sickness absence with health risks and health status.

Design.

Observational.

Setting.

One Midwest health care system.

Subjects.

Individuals who were employed for 2 years (2006–2007) and had completed at least one health risk appraisal (HRA) in 2007 (N = 3790).

Measures.

Outcomes were any incidental sickness absence and absence duration in 2007 measured by an absence tracking system. Health risks and health status were estimated by HRAs. Program participation was captured using 7-year HRA data and 5-year wellness data.

Analysis.

Multivariate, binary logistic regression for the probability of taking any absence day among the overall population as well as four demographic subgroups; proportional odds model for the probability of taking more absence days.

Results.

Different patterns were observed in association with taking incidental sickness absence among age and gender subgroups. Among the overall population, three health risks (smoking overweight, and use of medication for relaxation) were positively associated with taking absence (at least p <. 05 for all three health risks). Participation in a wellness program for more years was also associated with a less likelihood of taking absence (odds ratio, .72; p = .002). Results from the proportional odds model were consistent with results from the binary logistic regression.

Conclusion.

Sickness absence is an important productivity concern of employers. Employers may implement early interventions to focus on preventable causes. Special interventions may target absence-causing risks such as smoking behavior and excess body weight. Study limitation includes a lack of measures for psychosocial work environment.
Impact of Body Mass Index on the Effectiveness of a Disease Management—Health Promotion Intervention on Disability Status
Authors: Meng gdao , Wamsley Brenda R. , Friedman Bruce , Liebel Dianne , Dixon Denise A. , Gao Song , Oakes David , Eggert Gerald M.
Published: June 2010

Purpose.

To examine the impact of body mass index (BMI) on the effectiveness of a disease management—health promotion intervention among community-dwelling Medicare beneficiaries with disabilities.

Design.

Secondary data analyses of a randomized controlled trial.

Settings.

Nineteen counties in upstate New York and on the West Virginia—Ohio border.

Subjects.

Four hundred fifty-two Medicare beneficiaries who participated in the Medicare Primary and Consumer-Directed Care Demonstration between August 1998 and June 2002 and completed the 22-month follow-up.

Intervention.

Multicomponent disease management—health promotion intervention involving patient education, individualized health promotion coaching, medication management, and physician care management.

Measures.

Body mass index and dependence in Activies of Daily Living (ADLs).

Analysis.

Multivariate linear regression.

Results.

The intervention resulted in significantly less worsening in ADLs dependence among normal-weight participants (coefficient, − .42; p = .04). However, the intervention did not have a significant effect for underweight participants (F test p = .33 vs. underweight participants in the control group) or overweight or obese participants (F test p = .78 vs. overweight or obese participants in the control group).

Conclusions.

A positive effect of the intervention on disability was found among normal-weight participants but not among underweight or overweight or obese participants. Future health promotion interventions should take into consideration the influence of BMI categories on treatment effects.
Work Performance of Employees with Depression: The Impact of Work Stressors
Authors: Lerner Debra , Adler David A. , Rogers William H. , Chang g , Lapitsky Leueen , McLaughlin Thomas , Reed John
Published: June 2010

Purpose.

Depressed employees are vulnerable to adverse work outcomes. We hypothesized that work performance is impaired by depression and is worsened by exposure to psychosocial work stressors.

Design.

Longitudinal cohort study with surveys administered at baseline, 6, 12, and 18 months.

Setting.

Recruitment in primary care offices.

Subjects.

A total of 14,268 were screened; 286 depressed, employed adults (18–62 years) and 193 controls were enrolled.

Measures.

At-work limitations (presenteeism) and absenteeism were measured with the Work Limitations Questionnaire (WLQ) and WLQ Work Absence Module, respectively. Work stressors were assessed using a modified version of the Job Content Questionnaire.

Analysis.

Univariate and multivariate tests assessed the degree to which at-work limitations were related to depression and/or stressful work.

Results.

Presenteeism and absenteeism were significantly worse for the depression group at each time point (p ≤ .001). In cross-sectional models, presenteeism was associated with more severe depression symptoms, poorer general physical health, psychologically demanding work, the interaction of psychologically demanding work with depression, and less job control (r2 range = .33–.54). Absences were explained by depression symptom severity and poorer general physical health but not work stressors (r2 = .19). Because of minimal change in the work stressors, their longitudinal effects on outcomes were mostly nonsignificant.

Conclusion.

This study found that depression symptoms are related to work absences and impaired work performance, and results partly confirmed that work stressors add to this impact. Results suggest that workers with depression may benefit from care involving medical and vocational interventions.
How Does the Built Environment Relate to Body Mass Index and Obesity Prevalence among Public Housing Residents?
Authors: Heinrich Katie M. , Lee Rebecca E. , Regan Gail R. , Reese-Smith Jacqueline Y. , Howard Hugh H. , Haddock C Keith , Poston Walker S. Carlos , Ahluwalia Jasjit S.
Published: June 2010

Purpose.

This study examined associations of environmental variables with obesity prevalence and individual body mass index (BMI) among impoverished residents of public housing developments.

Design.

Cross-sectional data were drawn from two studies in the same Midwestern metropolitan area of participants within neighborhoods.

Setting.

Pathways to Health interviewed housing development residents and Understanding Neighborhood Determinants of Obesity assessed built environment factors in the surrounding neighborhoods (i.e., 800–m radius from center of housing development).

Subjects.

Four hundred twenty-one residents participated (mean age = 43.8 years; 72.0% women, 59.6% high school degree, 79.6% African-American). Fifty-five physical activity resources were identified and assessed.

Measures.

Demographics and measured weights and heights were obtained for participants. The Physical Activity Resource Assessment measured the type, accessibility, features, amenities, qualities, and incivilities of neighborhood physical activity resources. Neighborhood street connectivity was also measured.

Results.

Average age-adjusted BMI was 31.4 (SD = 1.3), with 45% of residents obese. High negative correlations were found between BMI and street connectivity (p = .05) and between obesity prevalence and resource accessibility (p = .09), number of amenities (p = .04), and amenity quality (p = .04). Higher resource accessibility, feature quality, number of amenities, and fewer incivilities per resource accounted for 71% of obesity variance (p < .05). Male gender and higher feature quality, F(11, 407)37.19 and 12.66, p < .001, predicted lower BMI among residents.

Conclusion.

Supportive neighborhood environments were related to lower obesity prevalence and lower BMI among residents.
Changing the Hearts and Minds of Policy Makers: An Exploratory Study Associated with the West Virginia Walks Campaign
Authors: Leyden Kevin M. , Reger-Nash Bill , Bauman Adrian , Bias Tom
Published: June 2010

Purpose.

To pilot test whether West Virginia Walks changed local policy makers' awareness of walking-related issues.

Design.

A quasi-experimental design with preintervention and postintervention mail surveys.

Setting.

Morgantown, WV (intervention community), and Huntington, WV (comparison community).

Subjects.

One hundred thirty-three and 134 public officials in Morgantown and 120 and 116 public officials in Huntington at baseline and at follow-up, respectively.

Intervention.

An 8–week mass media social ecological campaign designed to encourage moderate-intensity walking among insufficiently active persons aged 40 to 65 years.

Measures.

Policy makers listed three problems they believed needed to be addressed in their community. They then rated the severity of several problems that many communities face using a Likert scale, with 1 representing “not a problem” and 5 representing “an extremely important problem.”

Analysis.

Independent sample t-tests were used to examine differences in mean responses at baseline and at follow-up.

Results.

Statistically significant increases in the perceived importance of walking-related issues were observed among policy makers in Morgantown but not in the comparison community.

Conclusions.

Integrated communitywide health promotion campaigns designed to influence the public can also affect the perceptions of policy makers. Future research should examine this linkage and determine whether resource allocation and policy changes follow such interventions.
The Effectiveness of a Physical Activity Intervention for Seniors
Authors: Jancey Jonine M. , Lee Andy H. , Howat Peter A. , Clarke Ann , Wang Kui , Shilton Trevor
Published: June 2010

Purpose.

To determine whether a tailored, 6-month, neighborhood-based, physical activity intervention for people aged 65 to 74 years could increase their total physical activity levels and to identify factors associated with physical activity times.

Design.

A longitudinal, prospective, intervention study.

Setting.

Perth, Western Australia.

Subjects.

A total of 573 older adults, recruited from 30 intervention (n = 260) and 30 control (n = 313) neighborhoods. Initial response rates were 74% (260/352) in the intervention group and 82% (313/382) in the control group, which provided the 573 adults for participation in the study. A total of 413 participants (177 and 236 in the intervention and control groups, respectively) completed the program.

Intervention.

A neighborhood-based physical activity intervention.

Measures.

A self-reported questionnaire administered at three time points. Physical activity levels were measured using the International Physical Activity Questionnaire. Personal and demographic information, including perceived financial struggle and proximity to friends, were collected.

Analysis.

Descriptive statistics, repeated measures analysis of variance, and generalized estimating equations (GEE).

Results.

The intervention resulted in a significant increase in total average physical activity times of 2.25 hours per week (p < .001). The GEE analysis confirmed significant increases in physical activity from baseline to midpoint (p = .002) and to postintervention (p = .031). Perception of financial struggle (p = .020) was positively associated with physical activity time spent by participants, whereas having no friends or acquaintances living nearby (p = .037) had a significant negative correlation. The main limitation of this study was the restricted duration of the intervention.

Conclusion.

The program was successful in increasing weekly mean time for physical activity in seniors and in identifying factors that affect their commitment to physical activities.
The Association of Television Viewing with Snacking Behavior and Body Weight of Young Adults
Authors: Thomson Maria , Spence John C. , Raine Kim , Laing Lory
Published: June 2010

Purpose.

Investigate whether TV viewing and recognition of snack food advertisements were associated with snack food consumption and the odds of being overweight or obese.

Design.

Cross-sectional internet-based survey.

Setting.

University of Alberta, Edmonton, Canada.

Subjects.

Undergraduate university students aged 18 to 25 years (N = 613).

Measures.

Self-reported TV viewing, energy-dense snack consumption, snacking while viewing TV, and body weight.

Analysis.

Hypothesis testing was completed using multiple analysis of variance, analysis of covariance, and logistic regression.

Results.

Students reporting medium or high TV viewership snacked more frequently while watching TV and recognized more advertising than students who were considered low viewers. High viewers also reported more consumption of energy-dense snacks than low viewers. Snacking frequency appeared to be related to TV viewing and place of residence, but the association between snacking frequency and TV viewing was not accounted for by advertising. Conversely, the association between TV viewing and consumption of energy-dense snacks was accounted for by advertising recognition. Finally, male students (odds ratio [OR], 2.78; 99% confidence interval [CI], 1.68–4.59) and medium (OR, 3.11;99% CI, 1.37–7.08) and high (OR, 5.47; 99% CI, 1.97–15.16) TV viewers had higher odds of being overweight or obese.

Conclusions.

Associations were found among TV viewing, energy-dense snack consumption, and snacking behavior, and between TV viewing and body weight status.
Computer-Mediated Intervention Tailored on Transtheoretical Model Stages and Processes of Change Increases Fruit and Vegetable Consumption among Urban African-American Adolescents
Authors: Di Noia Jennifer , Contento Isobel R. , Prochaska James O.
Published: June 2010

Purpose.

To examine the efficacy of an intervention based on the transtheoretical model (TTM) for increasing fruit and vegetable consumption among economically disadvantaged African-American adolescents.

Design.

Pretest-posttest quasi-experimental study.

Setting.

Youth services agencies located in New York, New Jersey, and Pennsylvania. Agencies were assigned to computer intervention (CIN) and nonintervention control study arms.

Subjects.

A total of 507 African-American adolescents ages 11 to 14 years.

Intervention.

Youths in the CIN arm completed four 30-minute intervention sessions tailored on TTM stages and processes of change.

Measures.

Self-reported fruit and vegetable consumption and stages, pros, cons, and self-efficacy for consumption.

Analysis.

Intervention effects were examined with analysis of covariance models that were controlled for demographic variables and baseline measures of each outcome. Chi-square analyses were used to examine between-arm differences in youths' stage progressions.

Results.

After adjustment by covariates, pros (p < .025) and fruit and vegetable consumption (p < .001) varied significantly with study arm. Youths in the CIN arm had higher pro scores and fruit and vegetable consumption than controls. More youths in the CIN arm than in the control arm progressed to later stages and maintained recommended intake levels (p < .05).

Conclusions.

A TTM-based intervention can increase fruit and vegetable intake and effect positive changes in TTM variables related to intake among economically disadvantaged African-American adolescents.
Assessing Management Support for Worksite Health Promotion: Psychometric Analysis of the Leading by Example (LBE) Instrument
Authors: Della Lindsay J. , DeJoy David M. , Goetzel Ron Z. , Ozminkowski Ronald J. , Wilson Mark G.
Published: June 2010

Purpose.

Describe the development of the leading by example (LBE) instrument.

Methods.

A total of 135 responses from employees of a private corporation working at 11 different worksites were factor analyzed in 2005. Exploratory factor analysis was used to obtain an initial factor structure. Factor validity was evaluated using confirmatory factor analysis methods. A second sample was collected in 2006 from the same population (N = 178) and was used to confirm the factor structure via confirmatory factor analysis. Cronbach's α and item-total correlations provided information on the reliability of the factor subscales.

Results.

Four subscales were identified: business alignment with health promotion objectives, awareness of the health-productivity link, worksite support for health promotion, and leadership support for health promotion. Factor by group comparisons revealed that the initial factor structure was effective in detecting differences in organizational support for health promotion across different employee groups.

Conclusions.

Management support for health promotion can be assessed using the LBE, a brief self-report questionnaire. Researchers can use the LBE to diagnose, track, and evaluate worksite health promotion programs.
Multi-Ethnic Adolescents' Attitudes toward Smoking: A Focus Group Analysis
Authors: Mitschke Diane B. , Matsunaga Doris Segal , Loebl Karen , Tatafu Elitei , Robinett Hali
Published: June 2010

Purpose.

To explore young, multi-ethnic adolescents' attitudes and influences related to cigarette smoking for the purpose of developing and producing a youth-led, tobacco-prevention drama.

Design.

Focus groups and demographic surveys.

Setting.

Island of Oahu, Hawaii.

Participants.

Fifty-four multi-ethnic youth, ranging in age from 10 to 14 years, participated. The study was promoted in schools with a large representation of Hawaiian, Filipino, and Pacific Islander students.

Methods.

Each of five focus groups was audio-recorded, and an observer recorded extensive notes throughout the sessions. Content analysis consisted of coding focus group notes for recurrent themes and using the audio recording as confirmation.

Results.

Just more than one quarter (n = 15) of the youth had tried smoking, and two-thirds (n = 35) currently lived with someone who smoked. Participants expressed the feeling of being surrounded by smoking influences at home, in their communities, and at school. Youth were negatively affected by family members' tobacco use, and they desired skills that could enable them to help family members stop using tobacco.

Conclusion.

Family influences may play an important role in youth attitudes toward tobacco use, especially given the cultural significance of extended family and of filial piety that are reflected in many traditional, Asian and Pacific Islander families. Interventions targeting youth in Asian and Pacific Islander communities should incorporate key cultural references to the extended family and to a respect for elders to establish relevance in the life experiences of young people in these population groups.
Exploring Obesogenic Food Environments in Edmonton, Canada: The Association between Socioeconomic Factors and Fast-Food Outlet Access
Authors: Hemphill Eric , Raine Kim , Spence John C. , Smoyer-Tomic Karen E.
Published: June 2010

Purpose.

To explore the relationship between the placement of fast-food outlets and neighborhood-level socioeconomic variables by determining if indicators of lower socioeconomic status were predictive of exposure to fast food.

Design.

A descriptive analysis of the fast-food environment in a Canadian urban center, using secondary analysis of census data and Geographic Information Systems technology.

Setting.

Edmonton, Alberta, Canada.

Measures.

Neighborhoods were classified as High, Medium, or Low Access based on the number of fast-food opportunities available to them. Neighborhood-level socioeconomic data (income, education, employment, immigration status, and housing tenure) from the 2001 Statistics Canada federal census were obtained.

Analysis.

A discriminant function analysis was used to determine if any association existed between neighborhood demographic characteristics and accessibility of fast-food outlets.

Results.

Significant differences were found between the three levels of fast-food accessibility across the socioeconomic variables, with successively greater percentages of unemployment, low income, and renters in neighborhoods with increasingly greater access to fast-food restaurants. A high score on several of these variables was predictive of greater access to fast-food restaurants.

Conclusion.

Although a causal inference is not possible, these results suggest that the distribution of fast-food outlets relative to neighborhood-level socioeconomic status requires further attention in the process of explaining the increased rates of obesity observed in relatively deprived populations.
The Effect of Objectively Measured Crime on Walking in Minority Adults
Authors: McDonald Noreen C.
Published: June 2010

Purpose.

Evaluate the relationship between neighborhood crime and the amount of daily walking by minority adults.

Design.

This was a cross-sectional study of minority adult walking behavior and crime.

Setting.

Oakland, California was chosen as the study area because of the substantial spatial variation in levels of criminal activity combined with detailed information on walking trips.

Participants.

The study was restricted to minority adults who responded to the 2000 Bay Area Travel Survey and lived in Oakland, California (n = 359).

Method.

Data on leisure and utilitarian walking were collected through the 2000 Bay Area Travel Survey and combined with crime data from the Oakland Police Department. A negative binomial model was used to test if violent, property, or quality of life crimes had significant associations with daily minutes walked, controlling for individual and neighborhood covariates.

Results.

The model showed a significant negative association between violent crime and minutes walked per day (b = - .07; p = .016). Neither property nor quality of life crimes were correlated with amount of walking.

Conclusions.

Reductions in violent crime may increase opportunities for minority residents in urban areas to participate in physical activity such as walking thereby providing another reason to pursue anticrime measures. Urban designers' efforts to increase physical activity by improving neighborhood walkability may consider violent crime prevention in their designs.
Diet digestibility in growing rabbits: effect of origin and oxidation level of dietary fat and vitamin e supplementation.
Authors: Casado C. , Moya V.J. , Fernández C. , Pascual J.J. , Blas E. , Cervera C.
Published: June 2010

The effects of the dietary inclusion of fats with different origin (lard or vegetal oil), fatty acid profile (linseed or sunflower), oxidation level (fresh, peroxidised: 11 d at 55ºC or oxidised: 31 h at 140ºC) and vitamin E supplementation (0 or 100 ppm) on the rabbit diet apparent digestibility were studied. Digestibility coefficients of dry matter, organic matter, crude protein, ether extract and gross energy were determined in eight diets using 58 rabbits aged 49 d. Contrast analysis between groups of diets showed that lard, characterised by a greater saturated fatty acid content, compared with vegetal oils, rich in unsaturated fatty acid, reduced the apparent digestibility of ether extract (62.3 vs. 68.4%; P=0.0329). However, there were no significant differences in the nutrient digestibility when linseed or sunflower oils (rich in ω-3 or in ω-6 polyunsaturated fatty acids, respectively) were compared. The oxidation degree of the sunflower oil and the supplementation with 100 ppm of vitamin E to the diets did not modify the apparent digestibility values of any dietary fraction.
Key Words: rabbit, fat, ω-3/ω-6 fatty acids, oxidation level, tocopherol, digestibility.