American Journal of Health Promotion

To examine relationships between physical activity (PA) and awareness and treatment status of low bone mineral density (BMD) among adults.

Cross-sectional.

Stratified sample of adults living independently in the community.

A total of 1928 adults aged 50 years and older who participated in the National Health and Nutrition Examination Survey 2005–2006 were included in the analysis. Among those, about 54% were women, 84% were non-Hispanic whites, 65% were married, and 44% were between 50 and 59 years of age.

Objective measures: femoral neck BMD and duration of PA and step counts measured by accelerometers. Self-report: strength exercise, and awareness and treatment of low bone density.

Multivariate regression analyses using SUDAAN.

Despite a high prevalence of low BMD, self-reported awareness, treatment, and PA were very low. After controlling socio-demographic and health-related factors, those who were aware of their low bone density status and who received treatment for it were less physically active than those who were unaware of their bone condition or who did not have any treatment.

PA levels are below the recommended level for bone health benefits. Health care providers should consider screening individuals at risk of low bone density and encourage them to implement prevention and treatment regimen including increasing daily levels of PA.

Examine the effectiveness of the “Eat Healthy, Stay Active!” pilot program, a multisite, 6-month educational intervention to promote healthy nutrition and physical activity among Head Start staff, parents, and children.

Comparison of within-group preintervention and postintervention knowledge and behavior, along with anthropomorphic measurements.

The study was conducted in a convenience sample of six large Head Start agencies in five states.

Participants included 496 staff, 438 parents, and 112 preschool children.

The 6-month intervention consisted of core trainings and reinforcing activities for staff and parents that aligned with children's curricula.

Pre-post questionnaires and anthropometric measurements examined changes in body mass index (BMI), knowledge, and behaviors related to nutrition and physical activity.

Paired t-tests to compare preintervention and postintervention weights and BMI; multiple regression analyses to examine associations between weight changes and other covariates, including knowledge and behavior changes, controlling for sociodemographic variables.

Each group of participants demonstrated significant reductions in BMI (mean = 30.1 to 29.2; p < .001 in adults and 17.0 to 16.6; p < 0.001 in children) and in the proportion of obese children (30% to 21%; p < .001) and adults (45% to 40%; p < .001). Child weight changes correlated with parent weight changes.

This intervention showed promising initial results, with potential effectiveness as an intervention to promote healthier behaviors among adults and children in Head Start settings.

The purpose of this study was to identify the association of environmental, managerial, and sociodemographic variables with hiker volume on the Florida National Scenic Trail.

Monthly hiker count data from 43 count stations along the Florida National Scenic Trail were used. For each station the characteristics of the built and natural environment as well as sociodemographic variables were computed within a Geographic Information System based on census, land use, and land cover data, together with managerial data.

Counts were performed on access points of the Florida National Scenic Trail located between the panhandle area in the northwest and the Everglades in the south.

A total of 34,734 hikers were counted across the 43 stations over 12-month periods for years 2003–2004 and 2008–2009.

Hiker volume was measured through infrared counters and registration cards at trail access points.

A negative binomial regression with monthly hiker counts as response variable.

Positive associations with hiker volume were observed for (population density per hectare)² (β = .207, p < .02), residential areas (β = .041, p < .0003), household income between $25,000 and $49,999 (β = .266, p < .0001), household income between $50,000 and $99,999 (β = .135, p < .0001), open water (β = .135, p < .0001), and station kilometers north (β = .003, p < .0001). Negative associations with hiker volume were observed for age <18 (β = –.305, p < .0001) and presence of trail fees (β = –.583, p < .0001). Positive and negative associations were observed for different categories in categorical variables including prominent vegetation type (p < .0001), trail management agency (p < .0001), and month (p < .0001).

The correlates should be considered for the design, planning, and promotion of hiking trails in publicly managed areas to increase hiker volume.

To assess changes in children's health behaviors and weight status after participation in community-originated interventions.

Prospective cohort study following body mass index (BMI) z-score trajectory over time.

Schools and community settings in 19 locations in North Carolina.

A total of 1144 children, with an average age of 9.5 years, participating in community-originated physical activity and nutrition interventions, such as active recess and healthy cafeteria offerings, and environment and policy changes designed to prevent and reduce the prevalence of childhood obesity. Retention from baseline to final collection was 54%.

Self-reported physical activity and eating behaviors; measured height and weight were collected at baseline and after interventions (average of 20 months). Z-score was compared with expected growth without intervention.

Descriptive statistics, χ² tests and t-tests, and ANOVA analyses of variance to assess changes in health behaviors and weight status.

More than 11% of children improved their weight status, and 86% of children who began at a healthy weight remained there. The average BMI for children who were overweight at enrollment was significantly lower after intervention (1.1 kg/m² lower for boys and 0.88 kg/m² lower for girls). Overweight and obese children who made improvements in key health behaviors showed greater decreases in BMI z-score than those who did not improve those behaviors (increased fruit [−.2207 vs. −.0793] and vegetable [−.2215 vs. −.0855] intake, and drinking less soda [−.1985 vs. −.0912]). There were no significant increases in physical activity, and changes in physical activity were not related to decreases in BMI z-score in this study.

Community-originated interventions to raise awareness about food choices and to change policies and environments may improve BMI z-scores.

To assess whether state-sponsored agricultural marketing programs had a positive influence on adult consumers' fruit and vegetable consumption.

Differences in fruit and vegetable consumption between 2000 and 2005 in states that initiated marketing campaigns during this period and those that did not were examined.

A representative sample (n = 237,320) of adults aged 18 and older from states with and without marketing programs was used. The study used data from the 2000 and 2005 Behavioral Risk Factor Surveillance System.

The number of fruit and vegetable servings per week and the percentage of respondents consuming five or more servings of fruits and vegetables per day were examined.

Between-subjects analysis of variance and logistic regression.

In the absence of a marketing campaign, there was a significant decrease in fruit and vegetable consumption between 2000 and 2005. In states with campaigns, consumption remained stable or increased. Marketing effects were stronger for women than for men.

State-sponsored agricultural marketing programs had favorable effects on consumers' consumption of fruits and vegetables.

We examined the relationships among fruit and vegetable intake, alcohol consumption, and socioeconomic status (SES). We hypothesized that fruit and vegetable consumption would be inversely associated with alcohol consumption and the relationship would differ by SES.

A cross-sectional analysis.

Large, urban Midwestern county.

A unique, racially/ethnically diverse sample of 9959 adults (response rate: 66.3%).

Fruit and vegetable intake was measured using two items that assessed servings per day. Alcohol consumption was measured in terms of volume of alcohol consumed and binge drinking. Individual measures of SES included education and household income.

Weighted multivariate linear and Poisson regression were used to estimate effects.

The relationship between fruit and vegetable intake and alcohol consumption varied by SES. Those with lower household incomes who consumed five or more servings of fruits and vegetables per day were less likely to engage in binge drinking relative to those consuming zero to one servings of fruits and vegetables per day (risk ratio = .66; 95% confidence interval: .46, .95). No association was observed for higher–household-income individuals.

We observed an inverse relationship between fruit and vegetable consumption and alcohol intake in those with lower household incomes but not in those with higher household incomes. Results suggest that the relationship between diet and alcohol consumption may be more relevant in populations with more restricted economic choices. Results are, however, based on cross-sectional data.

To review published state tobacco control plans (STCPs) to determine the extent to which the needs of the states' populations are being addressed.

A qualitative cross-sectional comparison of states' strategic plans for tobacco control as of March 2010.

Online searches.

The 50 states and the District of Columbia.

Internet-based searches were completed using tobacco and other keywords (control, prevention, strategies, comprehensive/strategic plan) to obtain all publicly available STCPs; telephone follow-up was conducted to ensure that all publicly available plans were captured. Each plan was coded by two researchers using a standardized protocol to assess provisions made for addressing disparate populations as defined by the states.

A total of 43 states addressed disparate populations. Thirty-six states addressed these populations within published STCPs, six states had separate stand-alone tobacco disparities plans, and one addressed it within their cancer plan. Specific populations addressed included racial and ethnic minorities, blue-collar employees, pregnant women, children under the age of 18, and college students. There were also several STCPs that cited the general goal of eliminating tobacco use disparities.

More work is needed to address tobacco disparities, including additional planning efforts in some states and effective implementation and evaluation among states with plans. States can look to the experiences of other states to help guide tobacco control planning for their own populations.

Metabolic syndrome (MetS) is characterized by a constellation of metabolic risk factors that consist of the following: atherogenic dyslipidemia, elevated blood pressure, elevated glucose associated with insulin resistance, prothrombotic state, and proinflammatory state. The objective of the study was to quantify the prevalence of MetS among college students and to determine whether fatness (body mass index [BMI] and waist circumference) or physical activity was more strongly associated with individual components of the MetS.

A cross-sectional study.

Eau Claire, Wisconsin, United States.

Authors collected health history information and performed assessments of individual MetS components for 207 college students aged 18 to 24 years.

Physical activity levels were self-reported, while direct measurements were obtained for MetS components (waist circumference, blood pressure, high-density lipoprotein (HDL)–cholesterol, triglycerides, blood glucose).

Descriptive statistics and multiple regression analysis.

The prevalence of MetS was found to be 6.8% according to the National Cholesterol Education Program Adult Treatment Panel III guidelines. The authors also found that 42.5% and 13.0% of our sample had one and two MetS components, respectively. Waist circumference was independently associated (p < .05) with HDL-cholesterol, triglycerides, and systolic blood pressure.

Our findings provide evidence for the presence of MetS on college campuses. It also appears, in part, that central adiposity contributes to the high incidence of individual MetS components. Given the elevated lifetime risk for cardiovascular disease and lower survival for those with risk factors in young adulthood, there appears to be a need for primary prevention programs within university and college settings.

To examine changes in parent-child communication related to sexual behavior after exposure to public health messages.

Randomized, controlled trial that was part of precampaign message testing.

Exposure occurred online or through DVDs mailed to participants and viewed on their personal computers. Data collection occurred via a secure Web site.

Participants included parents (n = 1969) living with a child age 10 to 14 years drawn from a nationally representative sample of U.S. households.

Treatment participants were exposed to video, audio, and print advertisements that promoted the benefits of speaking to their children early and often about delaying initiation of sexual activity; messages also directed parents to an informational Web site.

The dependent variable assessed frequency of parent-child communication related to sexual behavior. The primary independent variable was treatment assignment.

Longitudinal growth modeling that included five waves of data.

The trajectory of growth over time differed between fathers in the treatment group and fathers in the control group (F [1, 2357] = 4.15; p < .042), indicating more frequent communication among treatment fathers than among control fathers. Trajectories did not differ between mothers in treatment and control groups.

This study demonstrates that father-child and mother-child communication patterns differ over time in response to public health messages. Findings have implication for researchers developing health marketing campaigns.

Access and quality of physical activity resources (PARs) influence physical activity (PA) participation. This study examined the type, size, accessibility, features, amenities, and incivilities of PARs in two cities.

Researchers identified all PARs within an 800-meter radius of the homes of participants from a larger study. Each PAR was evaluated by a trained assessor.

PARs were evaluated in Houston and Austin, Texas.

The final sample included 1326 PARs in Houston and 297 in Austin, Texas.

The 2010 Physical Activity Resource Assessment (PARA), a direct-observation audit tool, was used to assess the type, size, accessibility, features, amenities, and incivilities of a PAR.

Both t-tests and analyses of variance were used to determine differences in features, amenities, and incivilities by city, type, and accessibility.

Houston PARs had greater amenities (t[421] = 4.445; p < .001) and fewer incivilities (t[371] = −6.89; p < .001) than Austin PARs. Combination resources had the highest score for features (M = 9.94; standard deviation [SD] = 5.62); fitness clubs had the highest score for amenities (M = 17.06; SD = 5.27); and trails had the most incivilities (M = 4.23; SD = 4.88). Free PARs had greater features (F[3, 1509] = 16.87; p < .001), amenities (F[3, 1500] = 3.13; p = .025), and incivilities (F[3, 1540] = 21.97; p < .001) than pay for use PARs.

Improvements to quality and maintenance of existing free PARs may be an economical strategy to increase PA.

To provide initial tests of internal consistency reliability and both structural and concurrent validity of a smoker identity (SI) scale for college student populations.

Cross-sectional design.

Midsouth university.

Undergraduates in a random sample of university classes completed surveys (92.3% response rate).

SI items derived from a literature review and clinical expertise, lifetime and current tobacco use, cigarette purchasing patterns, and quitting variables.

Current (some days or every day) cigarette users (n = 362) were divided into daily, intermittent, and experimental smoker groups. After principal components analysis was conducted on the SI items, analysis of variance (ANOVA) was used to assess SI differentiation of smoker groups, and correlational analysis or ANOVA was used to assess SI relationships with smoking and quitting variables.

Eight SI items produced a high–internal-consistency, single-factor structure (α = .93) and clearly differentiated the three smoker groups. Higher SI scores indicated greater smoking rate, smoking within 30 minutes of awakening, larger purchased quantities, and both greater interest and lower confidence in quitting.

The scale demonstrated good reliability and validity. Other SI measures exist, but this is the first scale to establish utility with experimental and intermittent smokers—substantial groups among college students. The extent to which cigarette users identify as smokers may provide useful information beyond behavioral measures, especially among college students.