bluuebunny/crossref_metadata_2025_split huggingface dataset:
Using the RE-AIM Framework to Evaluate the Statewide Dissemination of a School-Based Physical Activity and Nutrition Curriculum: “Exercise Your Options”
Authors: Dunton Genevieve F. , Lagloire Renee , Robertson Trina 
Published: June 2010

Purpose. Examine the reach, efficacy, adoption, implementation, and maintenance of a physical activity and nutrition curriculum for middle-school students. Design. Nonexperimental pilot evaluation of a statewide dissemination trial. Setting. California middle schools during the 2006 to 2007 school year. Subjects. Sixteen classes (N = 668 students and 16 teachers) sampled from the statewide pool who used the program. Intervention. An eight-lesson nutrition and physical activity curriculum, “Exercise Your Options” (EYO), including a teacher guide, video clips, a student activity booklet, and ancillary materials was made available to teachers. Measures. Program records, classroom observations, teacher surveys, and student presurveys and postsurveys (assessing physical activity, sedentary behaviors, and dietary intake). Analysis. Descriptive statistics and multilevel random-coefficient modeling. Results. The EYO program reached 234, 442 middle-school students in California. During the program, total physical activity increased (p ≤ .001), whereas watching TV/DVDs and playing electronic games/computer use decreased (p ≤ .05). Intake of dairy products increased (p < .05), whereas consumption of sugars/sweets decreased (p < .001). Forty-two percent of eligible middle-school classrooms ordered the program materials. Eighty-six percent of sampled teachers implemented all of the lessons. Over the past 5 years, 51% of all middle-school students in California were exposed to the program. Conclusions. The EYO program showed its potential for moderate to high public health impact among California middle-school students.
Physical Activity Patterns of American Indian and Alaskan Native People Living in Alaska and the Southwestern United States
Authors: Redwood Diana , Schumacher Mary C. , Lanier Anne P. , Ferucci Elizabeth D. , Asay Elvin , Heizer Laurie J. , Tom-Orme Lillian , Edwards Sandra L. , Murtaugh Maureen A. , Slattery Martha L. 
Published: June 2010

Purpose. Assessment of self-reported physical activity (PA) and effects on health measures. Design. Cross-sectional analysis of baseline data from a cohort study. Setting. Education and Research Towards Health study participants from Alaska and the Southwestern United States enrolled from 2004 to 2007. Subjects. Total of 10,372 American Indian and Alaskan Native people (AI/AN) of at least 18 years. Measures. Participants completed computer-assisted, self-administered questionnaires, and anthropometric and health measurements were taken of each participant. Analysis. Analysis of variance, χ2 tests, and multiple linear regressions were used. Results. Almost 23% of participants reported less than 30 minutes per week of moderate or vigorous activities. Half (49%) reported no vigorous activities. Characteristics associated with more time spent performing vigorous activity were male gender, age less than 40 years, higher income and education levels, and living in a rural area. Almost 70 % of Alaskan participants and 36% of Southwest participants engaged in wild food—harvesting activities. Participants with higher levels of activity had significantly better clinical characteristics (high-density lipoprotein cholesterol, triglycerides, body mass index, and waist circumference). Conclusion. AI/AN people engage in many different physical activities, including traditional harvesting activities. Women had lower levels of PA than men, and participation in vigorous PA was associated with better clinical characteristics. These data can be used to guide health promotion efforts in AI/AN populations.
Do Alcohol Consumers Exercise More? Findings from a National Survey
Authors: French Michael T. , Popovici Ioana , Maclean Johanna Catherine 
Published: June 2010

Purpose. Investigate the relationship between alcohol consumption and physical activity because understanding whether there are common determinants of health behaviors is critical in designing programs to change risky activities. Design. Cross-sectional analysis. Setting. United States. Subjects. A sample of adults representative of the U.S. population (N = 230,856) from the 2005 Behavioral Risk Factor Surveillance System. Measures. Several measures of drinking and exercise were analyzed. Specifications included numerous health, health behavior, socioeconomic, and demographic control variables. Results. For women, current drinkers exercise 7.2 more minutes per week than abstainers. Ten extra drinks per month are associated with 2.2 extra minutes per week of physical activity. When compared with current abstainers, light, moderate, and heavy drinkers exercise 5.7, 10.1, and 19.9 more minutes per week. Drinking is associated with a 10.1 percentage point increase in the probability of exercising vigorously. Ten extra drinks per month are associated with a 2.0 percentage point increase in the probability of engaging in vigorous physical activity. Light, moderate, and heavy drinking are associated with 9.0, 14.3, and 13.7 percentage point increases in the probability of exercising vigorously. The estimation results for men are similar to those for women. Conclusions. Our results strongly suggest that alcohol consumption and physical activity are positively correlated. The association persists at heavy drinking levels.
The Animadora Project: Identifying Factors Related to the Promotion of Physical Activity among Mexican Americans with Diabetes
Authors: Ingram Maia , Ruiz Maricruz , Mayorga Maria Theresa , Rosales Cecilia 
Published: June 2010

Purpose. There is a dearth of information about factors related to physical activity among Mexican-Americans with diabetes. Self-efficacy and social support are associated with physical activity; however, little is known about their roles within different cultural groups. Design. Focus groups were used to identify factors that motivated walking. Setting. Two Mexican-American communities located in Tucson, Arizona. Subjects. Individuals who attended diabetes education. Intervention. A community-based provider organized walking groups with people who previously attended diabetes classes. Walkers participated in focus groups exploring themes related to their experiences. Measures. Self-efficacy, social support, and collective efficacy. Grounded theory was used to analyze focus group results using two rounds of analysis; the first identified references to self-efficacy and social support, and the second added collective efficacy as a theoretic basis for walking. Results. Among 43 eligible participants, 20 participated in focus groups. Social support was expressed as commitment and companionship. Walkers demonstrated a high level of self-efficacy for walking. Development of group identity/social cohesion was also a motivator to walk. Collective efficacy emerged as an applicable theoretic model encompassing these themes and their interrelationship. Conclusion. Collective efficacy, or the belief that the group can improve their lives through collective effort, is a viable theoretic construct in the development of physical activity interventions targeting Mexican-Americans with diabetes.
Disseminating Health Promotion Practices in After-School Programs through YMCA Learning Collaboratives
Authors: Wiecha Jean L. , Nelson Toben F. , Roth Barbara A. , Glashagel Jerry , Vaughan Lynne 
Published: June 2010

Purpose. We describe the perceived usefulness of a learning collaborative for translating obesity prevention science into practice at YMCA after-school programs. Approach. We conducted mixed-methods research to identify beneficial aspects of the collaborative and to assess perceived effect of the collaborative on ability to meet goals. Setting. Sixty-one YMCA after-school programs serving roughly 2500 children in 21 states. Participants. After-school program staff attending learning sessions for the collaborative. Intervention. YMCA learning collaboratives comprise a structured organizational change process delivered during 9 to 12 months that aim to empower staff to find local methods for achieving specific program outcomes related to diet and physical activity. Research Method. Eight focus groups conducted during the collaboratives assessed their usefulness. A post hoc Web-based follow-up survey (39 respondents; response rate, 40.6%) assessed final perceived effect. Results. Qualitative and quantitative data were highly positive about the usefulness of the collaborative. The collaboratives' duration, peer learning, multilevel staff involvement, focus on creating a supportive organization, and regular coaching support enabled many respondents to make program and policy changes consistent with project goals. There was consensus that executive-level commitment to the work was critical. Conclusion. Learning collaboratives are a promising tool for embedding health promotion practices in existing after-school programs through a structured organizational change process.
An Environmental Intervention to Prevent Excess Weight Gain in African-American Students: A Pilot Study
Authors: Newton Robert L. , Hon Hangmei , Anton Stephen D. , Martin Corby K. , Stewart Tiffany M. , Lewis Leslie , Champagne Catherine M. , Sothern Melinda , Ryan Donna , Williamson Donald A. 
Published: June 2010

Purpose. To examine the influence of an environmental intervention to prevent excess weight gain in African-American children. Design. Single-group repeated measures. Setting. The intervention was delivered to a school composed of African-American children. Participants. Approximately 45% (N = 77) of enrolled second through sixth grade students. Intervention. The 18-month intervention was designed to alter the school environment to prevent excess weight gain by making healthier eating choices and physical activity opportunities more available. Measures. Body mass index percentile was the primary outcome variable. Body mass index z score was also calculated, and percent body fat, using bioelectrical impedance, was also measured. Total caloric intake (kilocalories) and percent kilocalories from fat, carbohydrate, and protein were measured by digital photography. Minutes of physical activity and sedentary behavior were self-reported. Analysis. Mixed-models analysis was used with covarying baseline values. Results. Boys maintained, whereas girls increased, percent body fat over 18 months (p = .027). All children decreased percent of kilocalories consumed from total and saturated fat and increased carbohydrate intake and self-reported physical activity during the intervention (p < .025). Body mass index z score, sedentary behavior, and total caloric intake were unchanged. Conclusion. The program may have resulted in maintenance of percent body fat in boys. The percent body fat in girls steadily increased, despite similar behavioral changes as boys. School-based interventions targeting African-American children should investigate strategies that can be effective across gender.
Effects of the Built Environment on Physical Activity of Adults Living in Rural Settings
Authors: Frost Stephanie S. , Goins R. Turner , Hunter Rebecca H. , Hooker Steven P. , Bryant Lucinda L. , Kruger Judy , Pluto Delores 
Published: June 2010

Objective. To conduct a systematic review of the literature to examine the influence of the built environment (BE) on the physical activity (PA) of adults in rural settings. Data Source. Key word searches of Academic Search Premier, PubMed, CINAHL, Web of Science, and Sport Discus were conducted. Study Inclusion and Exclusion Criteria. Studies published prior to June 2008 were included if they assessed one or more elements of the BE, examined relationships between the BE and PA, and focused on rural locales. Studies only reporting descriptive statistics or assessing the reliability of measures were excluded. Data Extraction. Objective(s), sample size, sampling technique, geographic location, and definition of rural were extracted from each study. Methods of assessment and outcomes were extracted from the quantitative literature, and overarching themes were identified from the qualitative literature. Data Synthesis. Key characteristics and findings from the data are summarized in Tables 1 through 3. Results. Twenty studies met inclusion and exclusion criteria. Positive associations were found among pleasant aesthetics, trails, safety/crime, parks, and walkable destinations. Conclusions. Research in this area is limited. Associations among elements of the BE and PA among adults appear to differ between rural and urban areas. Considerations for future studies include identifying parameters used to define rural, longitudinal research, and more diverse geographic sampling. Development and refinement of BE assessment tools specific to rural locations are also warranted.
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.