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Lee AY, Lehmann C, Zhou P, Xie B, Reynolds KD, Stacy AW. A quantitative survey measure of moral evaluations of patient substance misuse among health professionals in California, urban France, and urban China. Philos Ethics Humanit Med 2023; 18:18. [PMID: 38049902 PMCID: PMC10696895 DOI: 10.1186/s13010-023-00148-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 11/11/2023] [Indexed: 12/06/2023] Open
Abstract
BACKGROUND The merits and drawbacks of moral relevance models of addiction have predominantly been discussed theoretically, without empirical evidence of these potential effects. This study develops and evaluates a novel survey measure for assessing moral evaluations of patient substance misuse (ME-PSM). METHODS This measure was tested on 524 health professionals (i.e., physicians, nurses, and other health professionals) in California (n = 173), urban France (n = 102), and urban China (n = 249). Demographic factors associated with ME-PSM were investigated using analyses of variance (ANOVAs) and t-tests, with results suggesting that ME-PSM is higher among younger health professionals, nurses (when compared with physicians and other health professionals), and Chinese health professionals (when compared with French and American health professionals). RESULTS Results provide preliminary support for the psychometric quality of the survey measure introduced in this study, including the existence of a single latent structure and partial invariance of collected data across countries. CONCLUSION The survey measure for ME-PSM which was developed and tested in the current study appears to hold potential utility for use as a measure of moral views of patient substance misuse. With development, this measure may be used to examine moral evaluations, both as factors of stigma and of other clinical factors associated with the treatment of patients with substance use disorders.
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Affiliation(s)
- Anna Yu Lee
- School of Community & Global Health, Claremont Graduate University, 150 E. 10th St, Claremont, CA, 91711, USA.
| | - Curtis Lehmann
- Department of Psychology, Azusa Pacific University, 901 E. Alosta Ave., Azusa, CA, 91702, USA
| | - Pengchong Zhou
- Department of Public Health, California State University Los Angeles, 5151 State University Drive, Los Angeles, CA, 90032, USA
| | - Bin Xie
- School of Community & Global Health, Claremont Graduate University, 150 E. 10th St, Claremont, CA, 91711, USA
| | - Kim D Reynolds
- School of Community & Global Health, Claremont Graduate University, 150 E. 10th St, Claremont, CA, 91711, USA
| | - Alan W Stacy
- School of Community & Global Health, Claremont Graduate University, 150 E. 10th St, Claremont, CA, 91711, USA
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Heshmati S, DavyRomano E, Chow C, Doan SN, Reynolds KD. Negative emodiversity is associated with emotional eating in adolescents: An examination of emotion dynamics in daily life. J Adolesc 2023; 95:115-130. [PMID: 36217272 PMCID: PMC9855302 DOI: 10.1002/jad.12103] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 08/11/2022] [Accepted: 09/21/2022] [Indexed: 01/24/2023]
Abstract
INTRODUCTION Emotional eating is a mental health concern, common in adolescents, that develops as a result of their tendency to use high-energy food to regulate their fluctuating emotions. Due to their highly fluctuating emotional life, adolescents tend to have unique within-person profiles of emotional experiences that change across moments and days, often lost in global assessments of emotions. Hence, it is imperative to examine individual differences in dynamics of emotions, as experienced in daily life, in relation to emotional eating in adolescents. METHODS In an Ecological Momentary Assessment study, we examined individual differences in three within-person dynamic characteristics (baseline levels, intraindividual variability, and emodiversity) of emotions in 158 dominantly Hispanic adolescents in the United States, aged 14-17 years old, predicting trait-level emotional eating. RESULTS Results indicated that higher negative emodiversity, baselines, and variability in stress were predictive of emotional eating in adolescents. When all considered together, negative emodiversity (i.e., variety of the types of negative emotions experienced in one's daily life) remained the only significant predictor of emotional eating. CONCLUSIONS This study affirms the importance of diversity in emotional experiences in relation to emotional eating, particularly in daily contexts of adolescents' lives. Additionally, the study emphasizes the importance of distinguishing between diversity (i.e., variety in types) in positive versus negative emotional experiences with regard to emotional eating. By taking into account the ecological validity of adolescents' daily lives and individual differences in dynamical changes in emotions, we are taking a step forward by shedding light on how the dynamics of negative emotions-in terms of within-person baselines, variability, and diversity-might be related to general levels of emotional eating in adolescents.
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Affiliation(s)
| | | | | | - Stacey N. Doan
- Department of Psychological Science, Claremont McKenna College
| | - Kim D. Reynolds
- School of Community and Global Health, Claremont Graduate University
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Johansen C, Reynolds KD, Xie B, Palmer P. Exploring mediation pathways on the relationship between acculturation and binge eating among Latino adolescents. Appetite 2022; 168:105775. [PMID: 34710486 PMCID: PMC8671351 DOI: 10.1016/j.appet.2021.105775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 10/07/2021] [Accepted: 10/22/2021] [Indexed: 01/03/2023]
Abstract
The objective of this study was to explore the mediating effects of emotional eating, restrained eating, and external eating on the relationship between acculturation and binge eating among Latino adolescents. Adolescents who self-identified as Latino (N = 285) at public high schools in Southern California were recruited and completed a self-report survey. Acculturation was assessed using the 8-item Acculturation, Habits, Interests for Multicultural Adolescents (AHIMSA) scale for adolescents, mediators were assessed using Dutch Eating Behavior Questionnaire (DEBQ), and binge eating was assessed using a 13-item Eating Disorder Diagnostic Scale. A bootstrapped multiple mediation model was used to test mediation pathways. Findings suggest that individually each eating style-emotional, restrained and external eating pathway did not reach significance singly, but that jointly, their combined effect was significant with a total indirect effect (B = 0.15, CI 0.01-0.30) indicating an additive effect of the three eating styles. Future research should examine additional mediators of the relationship between acculturation and binge eating.
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Affiliation(s)
- Christopher Johansen
- School of Community and Global Health, Claremont Graduate University, 150 E. Tenth Street, Claremont, CA,Department of Environmental and Occupational Health, University of Nevada Las Vegas, School of Public Health 4700 S Maryland Pkwy, Las Vegas, NV,Corresponding Author: Christopher Johansen, , Address: 4700 S Maryland Pkwy, Ste 335, Las Vegas, NV
| | - Kim D. Reynolds
- School of Community and Global Health, Claremont Graduate University, 150 E. Tenth Street, Claremont, CA
| | - Bin Xie
- School of Community and Global Health, Claremont Graduate University, 150 E. Tenth Street, Claremont, CA
| | - Paula Palmer
- School of Community and Global Health, Claremont Graduate University, 150 E. Tenth Street, Claremont, CA
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Doan SN, Xie B, Zhou Y, Lei X, Reynolds KD. Loneliness and cravings for sugar-sweetened beverages among adolescents. Pediatr Obes 2022; 17:e12834. [PMID: 34227251 DOI: 10.1111/ijpo.12834] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 05/14/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE The consumption of sugar-sweetened beverages (SSBs) is associated with weight gain in both children and adults. In addition to environmental factors, such as food availability, psychological variables, including mood states, also impact intake. In the current study, we focus on momentary associations between feelings of loneliness and craving for SSBs among adolescents and explore the moderating role of family functioning. Loneliness has been associated with a wide range of health outcomes, but to date, few studies have examined its association with cravings for SSBs. METHODS Using an ecological-momentary assessment design, data were collected on 158 (males = 68, mean age = 15.13 ± 2.27 years) participants. Multilevel mixed-effects models were used to examine the relations between the main and interactive effects of loneliness and family functioning on cravings for SSBs, independent of other negative emotions. RESULTS Results suggest that loneliness in adolescents was associated with a small increase in craving for SSBs. Importantly, the relationship held after controlling for negative emotions, suggesting the unique role of loneliness. However, positive family functioning did not mitigate the relations between loneliness and craving for SSBs. CONCLUSIONS Loneliness uniquely contributes to cravings for SSBs. At the same time, family functioning did not buffer the influence of loneliness on cravings for SSBs among adolescents.
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Affiliation(s)
- Stacey N Doan
- Department of Psychological Science, Claremont McKenna College, Claremont, California, USA
| | - Bin Xie
- School of Community and Global Health, Claremont Graduate University, Claremont, California, USA
| | - Yutong Zhou
- Department of Psychological Science, Claremont McKenna College, Claremont, California, USA
| | - Xiaomeng Lei
- Keck School of Medicine, Department of Radiology, University of Southern California, Los Angeles, California, USA
| | - Kim D Reynolds
- School of Community and Global Health, Claremont Graduate University, Claremont, California, USA
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Johansen C, Reynolds KD, Xie B, Palmer P. Exploring Potential Mediation Pathways on the Relationship Between Acculturation and Body Mass Index (BMI) Among Latino Adolescents. Hisp Health Care Int 2021; 20:89-97. [PMID: 34291690 DOI: 10.1177/15404153211029893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Positive associations have been observed between acculturation and body mass index (BMI), but the mediators of this relationship are not well established. Acculturation researchers have called for investigating the influence of socio-contextual variables as mediators. The objective of this study was to test the mediating effects of salty snacks, sweet snacks, physical activity, and sedentary behavior on the relationship between acculturation and BMI among Latino adolescents. METHODS Adolescents who self-identified as Latino (n = 431) at public high schools in Southern California were recruited and completed a self-report survey. A bootstrapped multiple mediation model was used to test mediation pathways. RESULTS Acculturation was positively associated with physical activity (B = 0.09, p < .05). The indirect effects of salty snacks, sweet snacks, physical activity, and sedentary behavior were not associated with BMI, suggesting no mediation. CONCLUSIONS Future research should examine additional mediating variables on the relationship between acculturation and BMI.
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Affiliation(s)
- Christopher Johansen
- School of Community and Global Health, Claremont Graduate University, CA, USA.,Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, NV, USA
| | - Kim D Reynolds
- School of Community and Global Health, Claremont Graduate University, CA, USA
| | - Bin Xie
- School of Community and Global Health, Claremont Graduate University, CA, USA
| | - Paula Palmer
- School of Community and Global Health, Claremont Graduate University, CA, USA
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Meenan RT, Reynolds KD, Buller DB, Massie K, Berteletti J, Buller MK, Ashley J, Liu X. Economic Evaluation of a Sun Protection Promotion Program in California Elementary Schools. Am J Health Promot 2020; 34:848-856. [PMID: 32054287 DOI: 10.1177/0890117120905217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND An economic evaluation of Sun Safe Schools intervention designed to aid California elementary schools with implementing sun safety practices consistent with local board-approved policy. DESIGN Program cost analysis: intervention delivery and practice implementation. SETTING California elementary schools (58 interventions and 60 controls). Principals at 52 intervention and 53 control schools provided complete implementation data. PARTICIPANTS Principals completing pre-/postintervention surveys assessing practice implementation. INTERVENTION Phone-based 45-minute session with a project coach on practice implementation, follow-up e-mails/phone contacts, $500 mini-grant. Schools chose from a list of 10 practices for implementation: ultraviolet monitoring, clothing, hats, and/or sunscreen recommendations, outdoor shade, class education, staff training and/or modeling, parent outreach, and resource allocation. The duration of intervention was 20 months. Rolling recruitment/intervention: February 2014 to December 2017. MEASURES Intervention delivery and practice implementation costs. Correlations of school demographics and administrator beliefs with costs. ANALYSIS Intervention delivery activities micro-costed. Implemented practices assessed using costing template. RESULTS Intervention schools: 234 implemented practices, control schools: 157. Twenty-month delivery costs: $29 310; $16 653 (per school: $320) for project staff, mostly mini-grants and coaching time. Administrator costs: $12 657 (per school: $243). Per-student delivery costs: $1.01. Costs of implemented practices: $641 843 for intervention schools (per-school mean: $12 343, median: $6 969); $496 365 for controls (per-school mean: $9365, median: $3123). Delivery costs correlated with implemented practices (0.37, P < .01) and total practice costs (0.37, P < .05). Implemented practices correlated with principal beliefs about the importance of skin cancer prevention to student health (0.46, P < .001) and parents (0.45, P < .001). CONCLUSION Coaching of elementary school personnel can stimulate sun safety practice implementation at a reasonable cost. Findings can assist schools in implementing appropriate sun safety practices.
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Affiliation(s)
- Richard T Meenan
- Center for Health Research, Kaiser Permanente Northwest, Portland, OR, USA
| | - Kim D Reynolds
- School of Community & Global Health, Claremont Graduate University, Claremont, CA, USA
| | | | - Kim Massie
- School of Community & Global Health, Claremont Graduate University, Claremont, CA, USA
| | | | | | | | - Xia Liu
- Klein Buendel, Inc, Golden, CO, USA
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Reynolds KD, Buller DB, Buller MK, Massie K, Berteletti J, Ashley J, Meenan R. Randomized controlled trial evaluating an intervention supporting implementation of sun safety policies in California public elementary schools. Prev Med 2020; 137:106125. [PMID: 32389679 PMCID: PMC7495886 DOI: 10.1016/j.ypmed.2020.106125] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 05/01/2020] [Accepted: 05/03/2020] [Indexed: 10/24/2022]
Abstract
Solar ultraviolet radiation (UV) exposure is the primary risk factor for skin cancer and children receive about one-quarter of lifetime UV exposure before age 18. Thus, skin cancer prevention is essential for children. The objective of this study was to test an intervention to facilitate implementation of district sun safety policies. Elementary schools (N = 118) from 40 California public school districts with a school board-approved policy for sun safety were recruited along with one principal and teacher from each school. Elementary schools were randomly assigned to receive the 20-month Sun Safe Schools intervention (N = 58) or to a minimal informational control condition (N = 60). Principals were 47.8 and teachers 44.3 years of age and were predominately female (principals 72.7%; teachers 86.7%) and White (principals 72.0%; teachers 68.2%). The 20-month Sun Safe Schools intervention was delivered to principals and included a coaching session, telephone and email contacts, provision of resources for practice implementation, and a small grant program. The principal (N = 118) and a teacher (N = 113) at each school reported on school sun protection practices 20-months post-baseline. The schools were diverse in student characteristics (M = 64.1% free/reduced price meals; M = 54.5% Hispanic). Intervention principals reported implementing more sun safety practices overall (control M = 2.7, intervention M = 4.2, p < .005) and more practices not present in the district's policy (control M = 0.4, intervention M = 0.9, p = .005). Principals and teachers combined replicated these findings and also reported implementing more practices present in the district policy (control M = 0.9, intervention M = 1.3, p = .005). In sum, the intervention increased sun safety practices in public elementary schools. Trial Registration. This study is registered in ClinicalTrials.gov, www.clinicaltrials.gov, with the identification number of NCT03243929.
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Affiliation(s)
- Kim D Reynolds
- School of Community & Global Health, Claremont Graduate University, 675 W, Foothill Blvd., Ste. 200, Claremont, CA 91711, USA.
| | - David B Buller
- Klein Buendel, Inc., 1667 Cole Boulevard, Suite 225, Golden, CO 80401, USA
| | - Mary K Buller
- Klein Buendel, Inc., 1667 Cole Boulevard, Suite 225, Golden, CO 80401, USA
| | - Kim Massie
- School of Community & Global Health, Claremont Graduate University, 675 W, Foothill Blvd., Ste. 200, Claremont, CA 91711, USA
| | - Julia Berteletti
- Klein Buendel, Inc., 1667 Cole Boulevard, Suite 225, Golden, CO 80401, USA
| | - Jeff Ashley
- Sun Safety for Kids, 2625 W. Alameda Ave., Suite 517, Burbank, CA 91505, USA
| | - Richard Meenan
- Kaiser Permanente Center for Health Research, 3800 N. Interstate Ave, Portland, OR 97227, USA
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Buller DB, Reynolds KD, Buller MK, Massie K, Berteletti J, Ashley J, Meenan R. Parent reports of sun safety communication and behaviour for students in a randomised trial on a school policy implementation intervention. Aust N Z J Public Health 2020; 44:208-214. [PMID: 32459394 DOI: 10.1111/1753-6405.12987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 02/01/2020] [Accepted: 03/01/2020] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE Schools are an important setting for skin cancer prevention. An intervention for implementation of school sun safety policy, Sun Safety Schools (SSS), was evaluated. METHODS Primary schools (n=118) in California school districts that had already adopted a sun safety policy were enrolled in a study with a randomised controlled design. Half of the schools were randomised to SSS intervention (N=58). Parents completed an online post-test. RESULTS More parents in intervention schools received information about sun safety (mean=26.3%, sd=3.1%, p=0.017) and children more frequently wore sun-protective clothing when not at school (mean=2.93, sd=0.03, p=0.033) than in control schools (mean=18.0%, sd=2.5%; mean=2.83, sd=0.03, respectively). In schools where principals reported implementing sun safety practices, parents reported that children spent less time outdoors at midday (mean=14.78 hours, sd=0.25, p=0.033) and fewer were sunburned (mean=12.7%, sd=1.1%, p=0.009) than in non-implementing schools (M=16.3 hours, sd=0.67; mean=21.2%, sd=3.8%, respectively). Parents who received sun safety information (mean=3.08, sd=0.04, p=0.008) reported more child sun protection than parents not receiving information (mean=2.96, sd=0.02). CONCLUSIONS A school district sun protection policy and support for implementation increased dissemination of sun safety information to parents and student sun safety. Implications for public health: Technical assistance for sun safety policies may increase sun protection of children.
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Affiliation(s)
| | - Kim D Reynolds
- School of Community and Global Health, Claremont Graduate University, California, US
| | | | - Kim Massie
- School of Community and Global Health, Claremont Graduate University, California, US
| | | | | | - Richard Meenan
- Kaiser Permanente Center for Health Research, Oregon, US
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Johansen C, Reynolds KD, Wolch J, Byrne J, Chou CP, Boyle S, Spruijt-Metz D, Lienemann BA, Weaver S, Jerrett M. The Association of Trail Features With Self-Report Trail Use by Neighborhood Residents. J Phys Act Health 2020; 17:715-722. [PMID: 32464596 PMCID: PMC8274481 DOI: 10.1123/jpah.2019-0347] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 02/11/2020] [Accepted: 04/21/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND Urban trails are a useful resource to promote physical activity. This study identified features of urban trails that correlated with trail use. METHODS Multiuse urban trails were selected in Chicago, Dallas, and Los Angeles. An audit of each trail was completed using the Systematic Pedestrian and Cyclist Environmental Scan for Trails instrument, identifying built environmental features. A self-report of trail use was obtained from trailside residents (N = 331) living within 1 mile of each trail. Univariate and multivariate Poisson regressions controlled for trail time from home and motivation for physical activity. RESULTS Positive associations with the past month's hours on the trail were observed for the presence of distance signs, vegetation height, vegetation maintenance, and trail crowding, and a negative association was observed for the presence of crossings on the trail. Positive associations with dichotomous trail use were observed for the presence of distance signs, vegetation height, and vegetation maintenance, and a negative association was observed for the presence of crossings on the trail. CONCLUSIONS These correlates should be confirmed in other studies and, if supported, should be considered in the promotion and design of urban trails.
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Affiliation(s)
| | - Kim D. Reynolds
- School of Community and Global Health, Claremont Graduate University
| | - Jennifer Wolch
- College of Environmental Design, University of California Berkeley
| | - Jason Byrne
- School of Technology, Environments and Design, University of Tasmania
| | | | - Sarah Boyle
- School of Community and Global Health, Claremont Graduate University
| | - Donna Spruijt-Metz
- Dornsife College of Letters, Arts and Sciences, University of Southern California
| | | | | | - Michael Jerrett
- Fielding School of Public Health, University of California Los Angeles
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Reynolds KD, Buller DB, Berteletti J, Massie K, Ashley J, Buller MK, Meenan RT, Liu X. School-Level Factors Associated with Sun Protection Practices in California Elementary Schools. J Sch Health 2020; 90:386-394. [PMID: 32141621 PMCID: PMC7127930 DOI: 10.1111/josh.12884] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 03/15/2019] [Accepted: 05/04/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND This study examined implementation of district sun safety policy in schools and tested correlates of implementation in California public school districts. METHODS Principals (N = 118) and teachers (N = 113) in California public elementary schools (N = 118) were recruited and completed a survey on sun protection policies and practices. The sample contained schools whose districts subscribed to the California School Boards Association and adopted Board Policy 5141.7 for sun safety. Principals and teachers reported on implementation of 10 school practices related to BP 5141.7 indicating which practices were implemented in the school. RESULTS Years in public education (Exponentiated Score (ES) = 0.51, p < .001), years worked in the current district (ES = 0.49, p < .001), perception that parents should take action to protect children from the sun (ES = 0.43, p < .01), and personal skin phenotype (Low Risk ES = 0.55; High Risk ES = 0.09, p < .05) were associated with number of practices implemented in the school using multiple Poisson regression. CONCLUSIONS Policy implementation is more likely among schools with experienced faculty, when parents are seen as important partners in student skin cancer prevention, and when school principals and teachers have a lower personal risk phenotype.
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Affiliation(s)
- Kim D. Reynolds
- Professor, School of Community & Global Health, Claremont Graduate University. 675 W. Foothill Blvd., Ste. 310, Claremont, CA 91711, USA
| | - David B. Buller
- Director of Research and Senior Scientist, Klein Buendel, Inc. 1667 Cole Boulevard, Suite 225, Golden, CO 80401, USA
| | - Julia Berteletti
- Research Program Manager, Klein Buendel, Inc. 1667 Cole Boulevard, Suite 225, Golden, CO 80401, USA
| | - Kim Massie
- Project Manager, School of Community & Global Health, Claremont Graduate University. 675 W. Foothill Blvd., Ste. 310, Claremont, CA 91711, USA
| | - Jeff Ashley
- President, Sun Safety for Kids. 2625 W. Alameda Ave., Suite 517, Burbank, CA 91505, USA
| | - Mary Klein Buller
- President, Klein Buendel, Inc. 1667 Cole Boulevard, Suite 225, Golden, CO 80401, USA
| | - Richard T. Meenan
- Senior Investigator, Kaiser Permanente Center for Health Research. 3800 N. Interstate Ave, Portland, OR 97227, USA
| | - Xia Liu
- Biostatistical Manager, Klein Buendel, Inc. 1667 Cole Boulevard, Suite 225, Golden, CO 80401, USA
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Johansen C, Reynolds KD, Xie B, Palmer P. An Examination of Family Variables as Mediators of the Association of Acculturation With Sugar-Sweetened Beverage Consumption Among Latinx Adolescents. Fam Community Health 2020; 43:287-295. [PMID: 32658030 PMCID: PMC7483803 DOI: 10.1097/fch.0000000000000278] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The objective of this study was to examine the mediating effects of family support for dietary habits and family meal frequency on the relationship between acculturation and sugar-sweetened beverage (SSB) consumption among Latinx adolescents (N = 131). Acculturation was positively associated with SSB consumption (B = 0.07, P < .01). Results suggest that family support for dietary habits and family meal frequency did not mediate the relationship between acculturation and SSB consumption. However, acculturation was negatively associated with family support for dietary habits (B = -0.10, P < .01) and family meal frequency (B = -0.11, P < .05). Future research should examine other family influences as mediators of the relationship between acculturation and SSB consumption.
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Affiliation(s)
- Christopher Johansen
- Corresponding Author: Christopher Johansen, , Address 675 W. Foothill Blvd, Suite 200, Claremont, CA 91711
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Abstract
This study builds upon prior research on associations between moods, family functioning, and binge eating, using ecological momentary assessment to examine moderating effects of family functioning on associations between moods and binge eating. This study was conducted among a nonclinical sample of urban adolescents. Family functioning was assessed using five constructs adopted from the FACES-IV measure: 'family cohesion,' 'family flexibility' 'family communication,' 'family satisfaction,' and 'family balance.' Mood data was gathered using 13 items from a daily affect scale. Binge eating was assessed using two subscales from the Eating Disorder Diagnostic Scale-binge eating associated with 'embarrassment' (BE1), and binge eating associated with a sense of 'loss of control' (BE2). A multilevel modeling approach was employed to examine how associations between momentary moods and binge eating behaviors were moderated by family functioning. Results indicated that measures of negative affect, stress/frustration, and tiredness/boredom were significantly and positively associated with two measures of binge eating (BE1 and BE2; p values ≤ 0.05), and that multiple factors of family functioning buffered the positive predictive effects of moods on binge eating. Findings indicate the importance of inclusion of family functioning in the development of eating behavior interventions for adolescents.
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Affiliation(s)
- Anna Yu Lee
- School of Community and Global Health, Claremont Graduate University, 675 W. Foothill Blvd., Ste. 310, Claremont, CA, 91711, USA.
| | - Kim D Reynolds
- School of Community and Global Health, Claremont Graduate University, 675 W. Foothill Blvd., Ste. 310, Claremont, CA, 91711, USA
| | - Alan Stacy
- School of Community and Global Health, Claremont Graduate University, 675 W. Foothill Blvd., Ste. 310, Claremont, CA, 91711, USA
| | - Zhongzheng Niu
- University at Buffalo, The State University of New York, New York, USA
| | - Bin Xie
- School of Community and Global Health, Claremont Graduate University, 675 W. Foothill Blvd., Ste. 310, Claremont, CA, 91711, USA
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Berteletti J, Buller DB, Massie K, Ashley J, Liu X, Reynolds KD. Sun Protection Policies in Public School Districts With Elementary Schools in California. JAMA Dermatol 2019; 154:103-105. [PMID: 29071347 DOI: 10.1001/jamadermatol.2017.3725] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
| | | | - Kim Massie
- School of Community & Global Health, Claremont Graduate University, Claremont, California
| | | | - Xia Liu
- Klein Buendel Inc, Golden, Colorado
| | - Kim D Reynolds
- School of Community & Global Health, Claremont Graduate University, Claremont, California
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Johansen CM, Reynolds KD, Xie B, Unger JB, Ames SL. Acculturation and sugar-sweetened beverage consumption among Hispanic adolescents: The moderating effect of impulsivity. Appetite 2019; 134:142-147. [PMID: 30578800 DOI: 10.1016/j.appet.2018.12.026] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 10/09/2018] [Accepted: 12/19/2018] [Indexed: 12/25/2022]
Abstract
Consumption of sugar-sweetened beverages is a risk factor for obesity. Acculturation to the United States (US) might increase sugar-sweetened beverage consumption among Hispanic adolescents, but few moderators of this relationship have been examined. This study examined the moderating influence of impulsivity on the association between acculturation and sugar-sweetened beverages. Hispanic adolescents (n = 154), 14-17 years, were identified and screened for eligibility through low-SES high schools and parents provided consent. Adolescents completed measures of acculturation using Unger's 8-item acculturation scale, impulsivity, and diet. Multiple linear regression was used to examine the main effect of acculturation and the interaction of acculturation with impulsivity on the diet outcomes: sugar-sweetened beverage consumption and percent of calories from sugar. Acculturation was positively associated with sugar-sweetened beverages (β = 0.43; p < .05). The interaction of acculturation x impulsivity was significant (β = 0.42, p < .05). Among youth who were more acculturated, those who were more impulsive consumed more sugar-sweetened beverages. Youth who were more acculturated, but less impulsive consumed less sugar-sweetened beverages. Neurocognitive variables such as impulsivity may be important moderators of the influence of acculturation on dietary behavior. Targeted messaging strategies based on levels of acculturation and impulsivity might enhance the effectiveness of interventions designed to reduce the intake of sugar-sweetened beverages among Hispanic adolescents.
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Affiliation(s)
- Christopher M Johansen
- School of Community and Global Health, Claremont Graduate University, 675 W. Foothill Blvd, Suite 310, Claremont, CA, 91711, USA.
| | - Kim D Reynolds
- School of Community and Global Health, Claremont Graduate University, 675 W. Foothill Blvd, Suite 310, Claremont, CA, 91711, USA.
| | - Bin Xie
- School of Community and Global Health, Claremont Graduate University, 675 W. Foothill Blvd, Suite 310, Claremont, CA, 91711, USA.
| | - Jennifer B Unger
- University of Southern California, Department of Preventive Medicine, 2001 N. Soto St., SSB 302, Los Angeles, CA, 90089, USA.
| | - Susan L Ames
- School of Community and Global Health, Claremont Graduate University, 675 W. Foothill Blvd, Suite 310, Claremont, CA, 91711, USA.
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Buller DB, Reynolds KD, Berteletti J, Massie K, Ashley J, Buller MK, Meenan RT. Accuracy of Principal and Teacher Knowledge of School District Policies on Sun Protection in California Elementary Schools. Prev Chronic Dis 2018; 15:E07. [PMID: 29346065 PMCID: PMC5774306 DOI: 10.5888/pcd15.170342] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Introduction Policy is a key aspect of school-based efforts to prevent skin cancer. We explored the extent and accuracy of knowledge among principals and teachers in California public school districts about the elements specified in their district’s written sun safety policy. Methods The sample consisted of California public school districts that subscribed to the California School Boards Association, had an elementary school, adopted Board Policy 5141.7 for sun safety, and posted it online. The content of each policy was coded. Principals (n = 118) and teachers (n = 113) in elementary schools were recruited from September 2013 through December 2015 and completed a survey on sun protection policies and practices from January 2014 through April 2016. Results Only 38 of 117 principals (32.5%) were aware that their school district had a sun protection policy. A smaller percentage of teachers (13 of 109; 11.9%) than principals were aware of the policy (F108 = 12.76, P < .001). We found greater awareness of the policy among principals and teachers who had more years of experience working in public education (odds ratio [OR] = 1.05, F106 = 4.71, P = .03) and worked in schools with more non-Hispanic white students (OR = 7.65, F109 = 8.61, P = .004) and fewer Hispanic students (OR = 0.28, F109 = 4.27, P = .04). Conclusion Policy adoption is an important step in implementing sun safety practices in schools, but districts may need more effective means of informing school principals and teachers of sun safety policies. Implementation will lag without clear understanding of the policy’s content by school personnel.
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Affiliation(s)
- David B Buller
- Klein Buendel, Inc, 1667 Cole Blvd, Suite 225, Golden, CO 80401.
| | - Kim D Reynolds
- School of Community & Global Health, Claremont Graduate University, Claremont, California
| | | | - Kim Massie
- School of Community & Global Health, Claremont Graduate University, Claremont, California
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Abstract
Purpose. The purpose of this study was to identify the environmental correlates of urban trail use. Design. Three multiuse urban trails at least 15 miles in length were selected. Trails were divided into one-half-mile segments (N = 102 total segments) and marked in the field. An audit of each trail was completed identifying built environmental features. A cross-sectional count of trail users was completed at each segment estimating the type of use, age, gender. Setting. Data collection occurred on urban trails in Chicago, Dallas, and Los Angeles. Subjects. Trained observers counted 17,338 users across the three trails. Measures. The SPACES for Trails instrument was used, and a trail count data collection sheet was developed. Analysis. Univariate and multivariate Poisson regressions controlling for location of trail and density of the population within 1 mile of the trail. Results. Positive associations with trail use were observed for mixed views (β = .33, p < .0001), streetlights (β = .30, p < .0001), good trail condition (β = .28, p < .0001), and the presence of cafés (β = .38, p < .0001) and other trailside facilities (β = .08, p < .0001). Negative associations were observed for litter (β = −.22, p < .0001), noise (β = −.41, p < .0001), higher vegetation density (β = −.10, p > .001), drainage features (β = −.67, p < .0003), natural areas adjacent to the trail (β = −.39, p < .0001), and tunnel present (β = −.20, p < .04). Conclusions. These correlates should be confirmed in other studies and if supported should be considered in the promotion and design of urban trails.
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Affiliation(s)
- Kim D Reynolds
- Department of Preventive Medicine, University of Southern California, Los Angeles, California, USA.
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Abstract
Prior research has demonstrated that imagining hypothetical future events may render those events subjectively more likely. The suggestion has been made that this effect is due to the increased availability in memory of the events imagined. To test directly this explanation in a health context, the present study examined the effects of both ease and difficulty of imagining contracting a disease on subjects' beliefs that the event would occur. Subjects were asked to imagine contracting a disease described either as having certain easy-to-imagine symptoms or difficult-to-imagine symptoms. Following this, subjects rated their ease of imagination and estimated the likelihood of contracting the disease. The results revealed that judgments of ease or difficulty of imagination paralleled judgments of the likelihood of contracting the disease. Those subjects who rated the disease as easy-to-imagine judged the disease as more likely to occur, whereas those who experienced difficulty in imagining the disease rated it as less likely to occur. The results are interpreted in terms of the availability heuristic and give direct support for and extend this principle by showing that trying to imagine difficult-to-construct or cognitively inaccessible events reduces likelihood estimates. Implications for preventive health programs are discussed.
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Abstract
This article describes a validity study conducted among middle school students comparing self-reported sun safetybehaviorsfroma diarywith readingsfromultraviolet(UV)monitorswornondifferentbodysites. The UV monitors are stickers with panels that turn increasingly darker shades of blue in the presence of increasing amounts of UV light. Three schools participated ( N = 527). Statistically significant associations were found between self-reported behaviors and the UV monitor measurements, with Kendall's tau b's ranging from 0.400 to 0.823. Multiple regression was performed and indicator variables created separately for arm ( R = .12) and leg ( R = .49) coverage by protective clothing. The effect of time spent outdoors on the UV monitor measure was attenuated when the students reported having the corresponding body site covered with clothing. Self-reported shade was not a significant predictor of UV monitor change. Overall, the results provide evidence of validity of students' self-reports of time outdoors and protective clothing use.
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Affiliation(s)
- Amy L Yaroch
- Division of Cancer Control and Population Sciences, Health Promotion Research Branch, National Cancer Institute, 6130 Executive Blvd., Rm. 4074/MSC 7335, Bethesda, MD 20892, USA.
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Czajkowski SM, Powell LH, Adler N, Naar-King S, Reynolds KD, Hunter CM, Laraia B, Olster DH, Perna FM, Peterson JC, Epel E, Boyington JE, Charlson ME. From ideas to efficacy: The ORBIT model for developing behavioral treatments for chronic diseases. Health Psychol 2015; 34:971-82. [PMID: 25642841 PMCID: PMC4522392 DOI: 10.1037/hea0000161] [Citation(s) in RCA: 537] [Impact Index Per Article: 59.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Given the critical role of behavior in preventing and treating chronic diseases, it is important to accelerate the development of behavioral treatments that can improve chronic disease prevention and outcomes. Findings from basic behavioral and social sciences research hold great promise for addressing behaviorally based clinical health problems, yet there is currently no established pathway for translating fundamental behavioral science discoveries into health-related treatments ready for Phase III efficacy testing. This article provides a systematic framework for developing behavioral treatments for preventing and treating chronic diseases. METHOD The Obesity-Related Behavioral Intervention Trials (ORBIT) model for behavioral treatment development features a flexible and progressive process, prespecified clinically significant milestones for forward movement, and return to earlier stages for refinement and optimization. RESULTS This article presents the background and rationale for the ORBIT model, a summary of key questions for each phase, a selection of study designs and methodologies well-suited to answering these questions, and prespecified milestones for forward or backward movement across phases. CONCLUSIONS The ORBIT model provides a progressive, clinically relevant approach to increasing the number of evidence-based behavioral treatments available to prevent and treat chronic diseases. (PsycINFO Database Record
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Affiliation(s)
- Susan M Czajkowski
- Clinical Applications and Prevention Branch, Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, National Institutes of Health
| | - Lynda H Powell
- Department of Preventive Medicine, Rush University Medical Center
| | - Nancy Adler
- Department of Psychiatry, Center for Health and Community, University of California, San Francisco
| | | | - Kim D Reynolds
- School of Community and Global Health, Claremont Graduate University
| | - Christine M Hunter
- Division of Diabetes, Endocrinology, and Metabolic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health
| | - Barbara Laraia
- Division of Community Health and Human Development, School of Public Health, University of California, Berkeley
| | - Deborah H Olster
- Office of Behavioral and Social Sciences Research, Office of the Director, National Institutes of Health
| | - Frank M Perna
- Behavioral Research Program, National Cancer Institute, National Institutes of Health
| | | | - Elissa Epel
- Department of Psychiatry, Center for Health and Community, University of California, San Francisco
| | - Josephine E Boyington
- Clinical Applications and Prevention Branch, Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, National Institutes of Health
| | - Mary E Charlson
- Center for Integrative Medicine, Weill Cornell Medical College
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Tanenbaum HC, Felicitas JQ, Li Y, Tobias M, Chou CP, Palmer PH, Spruijt-Metz D, Reynolds KD, Anderson Johnson C, Xie B. Overweight Perception: Associations with Weight Control Goals, Attempts, and Practices among Chinese Female College Students. J Acad Nutr Diet 2015; 116:458-466. [PMID: 26260670 DOI: 10.1016/j.jand.2015.06.383] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2014] [Accepted: 06/26/2015] [Indexed: 01/02/2023]
Abstract
BACKGROUND Concurrent with the dramatic cultural and economic shifts occurring as mainland China becomes increasingly "Westernized," the weight perceptions, ideal body weight, and weight management goals and practices of Chinese females have also undergone significant changes. OBJECTIVE To investigate relationships between overweight status, weight perception patterns, and weight management goals and practices in Chinese female college students. DESIGN/PARTICIPANTS/SETTING A cross-sectional analysis was conducted with data from 902 female subjects aged 18 to 25 years participating in the China Seven Cities Study, a health promotion and smoking prevention study conducted in mainland China in 2003. MAIN OUTCOME MEASURES/STATISTICAL ANALYSES Logistic regression models were used to explore associations between overweight status, weight perception, specific weight management goals and practices, and current levels of vigorous-intensity physical activity and food consumption. RESULTS Based on World Health Organization standards for Asian adults, 16.7% of college females were overweight or obese, although 50.8% considered themselves to be "too heavy." Among participants perceiving themselves as overweight (n=458), 69.2% (n=371) were inaccurate and did not meet criteria for overweight or obese. The percentage of participants attempting weight loss was 48.2%, and 33.1% wanted to maintain their current weight. Attempts to lose or maintain weight were related to actual and perceived weight status, but not to increased vigorous-intensity physical activity or fruit and vegetable intake, nor to decreased consumption of sweets, soda, Western fast foods, and fried foods. Only 21.5% of participants desiring weight loss or maintenance reported using a combination of vigorous-intensity physical activity and a reduced-fat and -calorie diet, whereas 20.2% tried extreme methods such as fasting, using diet pills, vomiting, or smoking. CONCLUSIONS Our findings underscore the need to promote healthy weight management practices among Chinese female college students, with an emphasis on diet and physical activity strategies that encourage balance rather than extremes.
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21
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Felicitas JQ, Tanenbaum HC, Li Y, Chou CP, Palmer PH, Spruijt-Metz D, Reynolds KD, Johnson CA, Xie B. A longitudinal analysis of the effects of socioeconomic factors, foreign media, and attitude toward appearance on general and central adiposity in Chinese adolescents. Prev Med Rep 2015; 2:608-214. [PMID: 26279973 PMCID: PMC4535427 DOI: 10.1016/j.pmedr.2015.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
This paper explores the longitudinal effects of socioeconomic factors (i.e., parent education and family income level), foreign media, and attitude toward appearance on general and central adiposity among Chinese adolescents. A longitudinal analysis was performed using data from the China Seven Cities Study, a health promotion and smoking prevention study conducted in seven cities across Mainland China between 2002 and 2005. Participants included 5,020 middle and high school students and their parents. Explanatory variables included foreign media exposure, attitude toward appearance, parent education, and family income. Three-level, random-effect models were used to predict general adiposity (i.e., body mass index) and central adiposity (i.e., waist circumference). The Generalized Estimating Equation approach was utilized to determine the effect of explanatory variables on overweight status. Among girls, foreign media exposure was significantly negatively associated with general adiposity over time (β = − 0.06, p = 0.01 for middle school girls; β = − 0.06, p = 0.03 for high school girls). Attitude toward appearance was associated with lesser odds of being overweight, particularly among high school girls (OR = 0.86, p < 0.01). Among boys, parental education was significantly positively associated with general adiposity (β = 0.62, p < 0.01 for middle school boys; β = 0.37, p = 0.02 for high school boys) and associated with greater odds of being overweight (OR = 1.55, p < 0.01 for middle school boys; OR = 1.26, p = 0.04 for high school boys). Across all gender and grade levels, family income was significantly negatively associated with central adiposity over time. Interventions addressing Chinese adolescent overweight/obesity should consider these factors as potential focus areas. Foreign media exposure decreases BMI over time among girls. Girls placing importance on appearance have lesser odds of being overweight. Boys have greater odds of being overweight with high parent education. High family income was negatively associated with central adiposity.
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Affiliation(s)
- Jamie Q. Felicitas
- Claremont Graduate University, School of Community and Global Health, 675 West Foothill Boulevard, Suite 310, Claremont, CA 91711, USA
- Corresponding authors. Fax: + 1 909 621 5221.
| | - Hilary C. Tanenbaum
- Claremont Graduate University, School of Community and Global Health, 675 West Foothill Boulevard, Suite 310, Claremont, CA 91711, USA
| | - Yawen Li
- San Diego State University, School of Social Work, Hepner Hall #119, 5500 Campanile Drive, San Diego, CA 92182, USA
| | - Chih-Ping Chou
- Keck School of Medicine, Department of Preventive Medicine, 1441 Eastlake Avenue, USC Norris Comprehensive Cancer Center, NOR-4435, Los Angeles, CA 90089, USA
| | - Paula H. Palmer
- Claremont Graduate University, School of Community and Global Health, 675 West Foothill Boulevard, Suite 310, Claremont, CA 91711, USA
| | - Donna Spruijt-Metz
- Keck School of Medicine, Department of Preventive Medicine, 1441 Eastlake Avenue, USC Norris Comprehensive Cancer Center, NOR-4435, Los Angeles, CA 90089, USA
| | - Kim D. Reynolds
- Claremont Graduate University, School of Community and Global Health, 675 West Foothill Boulevard, Suite 310, Claremont, CA 91711, USA
| | - C. Anderson Johnson
- Claremont Graduate University, School of Community and Global Health, 675 West Foothill Boulevard, Suite 310, Claremont, CA 91711, USA
| | - Bin Xie
- Claremont Graduate University, School of Community and Global Health, 675 West Foothill Boulevard, Suite 310, Claremont, CA 91711, USA
- Corresponding authors. Fax: + 1 909 621 5221.
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Ghai NR, Reynolds KD, Xiang AH, Massie K, Rosetti S, Blanco L, Martinez MP, Quinn VP. Recruitment results among families contacted for an obesity prevention intervention: the Obesity Prevention Tailored for Health Study. Trials 2014; 15:463. [PMID: 25428433 PMCID: PMC4256806 DOI: 10.1186/1745-6215-15-463] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Accepted: 11/10/2014] [Indexed: 11/12/2022] Open
Abstract
Background Overweight and obesity are serious threats to health and increase healthcare utilization and costs. The Obesity Prevention Tailored for Health (OPT) study was designed to test the effectiveness of a family-based intervention targeting diet and physical activity. We describe the results of efforts to recruit parents and children enrolled in a large managed-care organization into the OPT study. Methods Parents with 10- to 12-year-old children were randomly selected from the membership of Kaiser Permanente Southern California, a large integrated health plan, and contacted between June 2010 and November 2011. We describe recruitment outcomes and compare characteristics of parents and children who did and did not participate. Information was collected from calls with parents and through the administrative and electronic medical records of the health plan. Results Of the 4,730 parents contacted, 16.1% expressed interest in participation (acceptors), 28.8% declined participation (refusers), 4.7% were ineligible, and, even after multiple attempts, we were unable to reach 50.4%. Slightly less than half of the acceptors (n = 361) were ultimately randomized to receive either the OPT program plus usual care or usual care alone (7.6% of all parents initially contacted). There were not any significant differences between acceptors who were or were not randomized. Overall, we found that acceptors were more likely to be female parents, have overweight/obese children, and higher utilization of outpatient visits by parents and children compared with refusers and those we were unable to reach. We found no differences in recruitment outcomes by body mass index or comorbidity score of the parents, level of physical activity of the parents and children, education of the parents, or household income. Conclusions Recruiting parents and children into an obesity prevention program in a healthcare setting proved to be challenging and resource-intensive. Barriers and incentives for participation in obesity prevention programs need to be identified and addressed. Concern for the weight of their children may motivate parents to participate in family-based lifestyle interventions; however, the healthcare setting may be more relevant to weight-related treatment than to primary prevention. Trial registration Trial Registration Number: ISRCTN06248443, 30 January 2014.
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Affiliation(s)
| | | | | | | | | | | | | | - Virginia P Quinn
- Department of Research & Evaluation, Kaiser Permanente Southern California, 100 S, Los Robles, 2nd Floor, Pasadena, CA 91101, USA.
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Ames SL, Kisbu-Sakarya Y, Reynolds KD, Boyle S, Cappelli C, Cox MG, Dust M, Grenard JL, Mackinnon DP, Stacy AW. Inhibitory control effects in adolescent binge eating and consumption of sugar-sweetened beverages and snacks. Appetite 2014; 81:180-92. [PMID: 24949566 DOI: 10.1016/j.appet.2014.06.013] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2013] [Revised: 05/22/2014] [Accepted: 06/09/2014] [Indexed: 11/16/2022]
Abstract
Inhibitory control and sensitivity to reward are relevant to the food choices individuals make frequently. An imbalance of these systems can lead to deficits in decision-making that are relevant to food ingestion. This study evaluated the relationship between dietary behaviors - binge eating and consumption of sweetened beverages and snacks - and behavioral control processes among 198 adolescents, ages 14 to 17. Neurocognitive control processes were assessed with the Iowa Gambling Task (IGT), a generic Go/No-Go task, and a food-specific Go/No-Go task. The food-specific version directly ties the task to food cues that trigger responses, addressing an integral link between cue-habit processes. Diet was assessed with self-administered food frequency and binge eating questionnaires. Latent variable models revealed marked gender differences. Inhibitory problems on the food-specific and generic Go/No-Go tasks were significantly correlated with binge eating only in females, whereas inhibitory problems measured with these tasks were the strongest correlates of sweet snack consumption in males. Higher BMI percentile and sedentary behavior also predicted binge eating in females and sweet snack consumption in males. Inhibitory problems on the generic Go/No-Go, poorer affective decision-making on the IGT, and sedentary behavior were associated with sweetened beverage consumption in males, but not females. The food-specific Go/No-Go was not predictive in models evaluating sweetened beverage consumption, providing some initial discriminant validity for the task, which consisted of sweet/fatty snacks as no-go signals and no sugar-sweetened beverage signals. This work extends research findings, revealing gender differences in inhibitory function relevant to behavioral control. Further, the findings contribute to research implicating the relevance of cues in habitual behaviors and their relationship to snack food consumption in an understudied population of diverse adolescents not receiving treatment for eating disorders.
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Affiliation(s)
- Susan L Ames
- School of Community and Global Health, Claremont Graduate University, 675 West foothill Blvd. Suite 310, Claremont, CA 91711-3475, USA.
| | - Yasemin Kisbu-Sakarya
- Department of Psychology, Arizona State University, PO Box 871104, 950 S. McAllister, Room 237, Tempe, AZ 85287-1104, USA
| | - Kim D Reynolds
- School of Community and Global Health, Claremont Graduate University, 675 West foothill Blvd. Suite 310, Claremont, CA 91711-3475, USA
| | - Sarah Boyle
- School of Behavioral and Organizational Sciences, Claremont Graduate University, East 10th Street, Claremont, CA 91711-3475, USA
| | - Christopher Cappelli
- School of Community and Global Health, Claremont Graduate University, 675 West foothill Blvd. Suite 310, Claremont, CA 91711-3475, USA
| | - Matthew G Cox
- Department of Psychology, Arizona State University, PO Box 871104, 950 S. McAllister, Room 237, Tempe, AZ 85287-1104, USA
| | - Mark Dust
- School of Community and Global Health, Claremont Graduate University, 675 West foothill Blvd. Suite 310, Claremont, CA 91711-3475, USA
| | - Jerry L Grenard
- School of Community and Global Health, Claremont Graduate University, 675 West foothill Blvd. Suite 310, Claremont, CA 91711-3475, USA
| | - David P Mackinnon
- Department of Psychology, Arizona State University, PO Box 871104, 950 S. McAllister, Room 237, Tempe, AZ 85287-1104, USA
| | - Alan W Stacy
- School of Community and Global Health, Claremont Graduate University, 675 West foothill Blvd. Suite 310, Claremont, CA 91711-3475, USA
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Reynolds KD, Dahmann N, Wolch J, Joassart-Marcelli P, Dunton G, Rudulph D, Newell J, Thayer J, Jerrett M. Factors predicting the capacity of Los Angeles city-region recreation programs to promote energy expenditure. Health Place 2014; 28:67-72. [PMID: 24755531 DOI: 10.1016/j.healthplace.2014.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2012] [Revised: 03/25/2014] [Accepted: 03/27/2014] [Indexed: 11/24/2022]
Abstract
An audit of recreation programs with moderate or higher levels of physical activity (PA) in Los Angeles area cities (N=82) was conducted using internet, telephone, and survey methods. Metabolic Equivalents (METs) were used to code programs׳ physical activity intensity. MET-hours per recreation program was associated with required age for enrollment, percent of residents >64 years of age, and fiscal capacity of cities. Capacity to promote energy expenditure may depend on targeted age groups, age of population, and municipal fiscal capacity. Cities with lower fiscal capacity might offer those higher MET-hour activities which require less specialized equipment and seek outside funding to offer higher MET programs.
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Affiliation(s)
- Kim D Reynolds
- Claremont Graduate University, School of Community and Global Health, 675 W. Foothill Blvd, Suite 310, Claremont, CA 91711, USA.
| | - Nicholas Dahmann
- University of Southern California, Department of American Studies & Ethnicity, 3620 S. Vermont Avenue, Kaprielian Hall 462, Los Angeles, CA 90089-2534, USA.
| | - Jennifer Wolch
- University of California, Berkeley, College of Environmental Design, 230 Wurster Hall #1820, Berkeley, CA 94720-1820, USA.
| | - Pascale Joassart-Marcelli
- San Diego State University, Department of Geography, 5500 Campanile Drive, San Diego, CA 92182, USA.
| | - Genevieve Dunton
- University of Southern California, Institute for Prevention Research, Health Sciences Campus, SSB 302E, M/C 9239, Los Angeles, CA 90089-9239, USA.
| | - Diana Rudulph
- Claremont Graduate University, School of Community and Global Health, 675 W. Foothill Blvd, Suite 310, Claremont, CA 91711, USA.
| | - Joshua Newell
- University of Michigan, School of Natural Resources & Environment, 1064 Dana Building, 440 Church Street, Ann Arbor, MI 48109-1041, USA.
| | - Jennifer Thayer
- Claremont Graduate University, School of Community and Global Health, 675 W. Foothill Blvd, Suite 310, Claremont, CA 91711, USA.
| | - Michael Jerrett
- University of California, Berkeley, School of Public Health, 50 University Hall #7360, Berkeley, CA 9472, USA.
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Grenard JL, Stacy AW, Shiffman S, Baraldi AN, MacKinnon DP, Lockhart G, Kisbu-Sakarya Y, Boyle S, Beleva Y, Koprowski C, Ames SL, Reynolds KD. Sweetened drink and snacking cues in adolescents: a study using ecological momentary assessment. Appetite 2013; 67:61-73. [PMID: 23583312 DOI: 10.1016/j.appet.2013.03.016] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2012] [Revised: 03/14/2013] [Accepted: 03/16/2013] [Indexed: 11/19/2022]
Abstract
The objective of this study was to identify physical, social, and intrapersonal cues that were associated with the consumption of sweetened beverages and sweet and salty snacks among adolescents from lower SES neighborhoods. Students were recruited from high schools with a minimum level of 25% free or reduced cost lunches. Using ecological momentary assessment, participants (N=158) were trained to answer brief questionnaires on handheld PDA devices: (a) each time they ate or drank, (b) when prompted randomly, and (c) once each evening. Data were collected over 7days for each participant. Participants reported their location (e.g., school grounds, home), mood, social environment, activities (e.g., watching TV, texting), cravings, food cues (e.g., saw a snack), and food choices. Results showed that having unhealthy snacks or sweet drinks among adolescents was associated with being at school, being with friends, feeling lonely or bored, craving a drink or snack, and being exposed to food cues. Surprisingly, sweet drink consumption was associated with exercising. Watching TV was associated with consuming sweet snacks but not with salty snacks or sweet drinks. These findings identify important environmental and intrapersonal cues to poor snacking choices that may be applied to interventions designed to disrupt these food-related, cue-behavior linked habits.
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Affiliation(s)
- Jerry L Grenard
- School of Community and Global Health, Claremont Graduate University, 675 West Foothill Blvd. Suite 310, Claremont, CA 91711-3475, USA.
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Reynolds KD, Buller DB, French SA, Buller MK, Ashley JL. School sun-protection policies: measure development and assessments in 2 regions of the United States. J Sch Health 2012; 82:499-507. [PMID: 23061553 PMCID: PMC3475509 DOI: 10.1111/j.1746-1561.2012.00729.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND In 2002, the US Centers for Disease Control and Prevention recommended that schools adopt policies that reduce exposure of children to ultraviolet radiation to prevent skin cancer. We report here the development of a school sun-safety policy measure and baseline descriptive statistics from the assessment of written policies collected in 2005-2007 from public school districts that enrolled in a randomized trial evaluating a policy promotion program. METHODS Written policies were collected from 103 of 112 school districts in Colorado and Southern California prior to randomization. We developed methods for selecting policy headings/sections topics likely to contain sun-safety policies for students and for assessing the presence, strength, and intent of policies. Trained coders assessed the content of each policy document. RESULTS Overall, 31% of districts had a policy addressing sun safety, most commonly, protective clothing, hats, sunscreen, and education at baseline. More California districts (51.9%) had these policies than Colorado districts (7.8%, p < .001). Policy scores were highest in districts with fewer Caucasian students (b = -0.02, p = .022) in Colorado (b = -0.02, p = .007) but not California (b = 0.01, p = .299). CONCLUSION The protocol for assessing sun-safety policy in board-approved written policy documents had several advantages over surveys of school officials. Sun-protection policies were uncommon and limited in scope in 2005-2007. California has been more active at legislating school policy than Colorado. School district policies remain a largely untapped method for promoting the sun protection of children.
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Affiliation(s)
- Kim D. Reynolds
- Claremont Graduate University School of Community and Global Health 675 W. Foothill Blvd, Suite 310 Claremont, CA 91711 Phone: 909-607-7300 Fax: 909-621-5221
| | - David B. Buller
- Klein Buendel, Inc. 1667 Cole Boulevard, Suite 225 Golden, CO 80401 Phone: 303-565-4340 Fax: 303-565-4320
| | - Simone A. French
- Division of Epidemiology & Community Health University of Minnesota Suite 300 1300 South Second Street Minneapolis MN 55454 Phone: 612-626-8594
| | - Mary K. Buller
- Klein Buendel, Inc. 1667 Cole Boulevard, Suite 225 Golden, CO 80401 Phone: 303-565-4330 Fax: 303-565-4320
| | - Jeff L. Ashley
- Sun Safety for Kids 2625 W. Alameda Ave., Ste. 517 Burbank, CA 91505 Phone: 818-845-8538
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Reynolds KD, Trinidad DR. Comments on the use of alternative designs in dissemination research. Am J Prev Med 2012; 42:105-6. [PMID: 22176856 DOI: 10.1016/j.amepre.2011.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2011] [Revised: 10/14/2011] [Accepted: 10/17/2011] [Indexed: 10/14/2022]
Affiliation(s)
- Kim D Reynolds
- School of Community and Global Health, Claremont Graduate University, Claremont, California 91711, USA.
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Andreeva VA, Cockburn MG, Yaroch AL, Unger JB, Rueda R, Reynolds KD. Preliminary evidence for mediation of the association between acculturation and sun-safe behaviors. ACTA ACUST UNITED AC 2011; 147:814-9. [PMID: 21768480 DOI: 10.1001/archdermatol.2011.145] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVES To identify and test mediators of the relationship between acculturation and sun-safe behaviors among Latinos in the United States. We hypothesized that the effect of acculturation on use of sunscreen, shade, and sun-protective clothing would be mediated by perceived health status, educational level, access to health care, and contact with social networks regarding health matters. DESIGN The 2005 Health Information National Trends Survey, implemented by the National Cancer Institute. SETTING Nationwide survey. PARTICIPANTS A probability-based sample of the US civilian, noninstitutionalized adult population, comprising 496 Latino respondents. MAIN OUTCOME MEASURES Use of sunscreen, shade, and sun-protective clothing when outdoors on sunny days, assessed by self-report on frequency scales. RESULTS The positive association between acculturation and sunscreen use and the negative association between acculturation and use of sun-protective clothing were mediated by educational level (P < .05 for both). Perceived health status and contact with social networks regarding health matters were supported as mediators for sunscreen use only (P < .05). Health care access was not supported as a mediator for any of the outcomes. CONCLUSIONS Structural equation models revealed distinct direct and indirect paths between acculturation and each sun-safe practice. Our findings emphasize behavior-specific mediated associations and could inform sun safety programming for Latinos with low and high levels of acculturation. The models support educational level, contact with social networks regarding health matters, and perceived health status as mediators primarily for sunscreen use. Future research should test different mediators for use of shade or sun-protective clothing.
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Affiliation(s)
- Valentina A Andreeva
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, USA.
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Buller DB, Reynolds KD, Ashley JL, Buller MK, Kane IL, Stabell CL, Massie KL, Liu X, Cutter GR. Motivating public school districts to adopt sun protection policies: a randomized controlled trial. Am J Prev Med 2011; 41:309-16. [PMID: 21855746 PMCID: PMC3167690 DOI: 10.1016/j.amepre.2011.04.019] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2010] [Revised: 03/17/2011] [Accepted: 04/26/2011] [Indexed: 11/19/2022]
Abstract
BACKGROUND In 2002, CDC recommended that the nation's schools establish policies that reduce sun exposure to decrease students' risk of skin cancer. PURPOSE A program to convince public school districts to adopt such a policy was evaluated. DESIGN RCT. SETTING/PARTICIPANTS Public school districts in Colorado (n=56) and Southern California (n=56). INTERVENTION Policy information, tools, and technical assistance were provided through printed materials, a website, meetings with administrators, and presentations to school boards. An RCT enrolled public school districts from 2005 to 2010. Policy adoption was promoted over 2 years at districts randomized to the intervention. MAIN OUTCOME MEASURES School board-approved policies were obtained from 106 districts and coded at baseline and 2-year follow-up. Analyses were conducted in 2010. RESULTS There was no difference in the percentage of districts adopting a policy (24% in intervention; 12% in control; p=0.142); however, intervention districts (adjusted M=3.10 of 21 total score) adopted stronger sun safety policies than control districts (adjusted M=1.79; p=0.035). Policy categories improved on sun safety education for students (intervention adjusted M=0.76; control adjusted M=0.43, p=0.048); provision of outdoor shade (intervention adjusted M=0.79; control adjusted M=0.28, p=0.029); and outreach to parents (intervention adjusted M=0.59; control adjusted M=0.20, p=0.027). CONCLUSIONS Multifaceted promotion can increase adoption of stronger policies for reducing sun exposure of students by public school districts. Future research should explore how policies are implemented by schools.
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Affiliation(s)
- David B Buller
- Research, Klein Buendel Inc., 1667 Cole Boulevard, Denver, CO 80401, USA.
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Andreeva VA, Yaroch AL, Unger JB, Cockburn MG, Rueda R, Reynolds KD. Moderated mediation regarding the sun-safe behaviors of U.S. Latinos: advancing the theory and evidence for acculturation-focused research and interventions. J Immigr Minor Health 2010; 12:691-8. [PMID: 19937384 DOI: 10.1007/s10903-009-9302-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Recent studies revealed a negative association between acculturation and sun-safe behaviors, possibly mediated by education level, health status, and social networks. We sought to elucidate this relationship by exploring the moderating effects of gender and health insurance on each mediated path. We used data from 496 Latino respondents to the 2005 Health Information National Trends Survey. Acculturation, assessed by a four-item index, was the primary predictor; use of sunscreen and protective clothing were the primary outcomes, assessed by frequency scales. Moderated mediation was tested with an established causal moderation method. The mediated association between acculturation, education level and sunscreen use might be stronger among women than men (P < 0.08). We found no evidence of moderated mediation for use of protective clothing. The findings suggest ways of refining the theoretical and empirical rationale for sun safety research and interventions with Latinos. Studies should replicate these models with longitudinal data.
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Affiliation(s)
- Valentina A Andreeva
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
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Spruijt-Metz D, Wolch J, Jerrett M, Byrne J, Hsieh S, Myles R, Xie B, Wang L, Chou CP, Reynolds KD. Development, Reliability, and Validity of an Urban Trail Use Survey. Am J Health Promot 2010; 25:2-11. [PMID: 20809825 DOI: 10.4278/ajhp.071105119] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose. To evaluate the psychometric characteristics of the Research on Urban Trail Environments (ROUTES) Trail Use Questionnaire. Design. Test-retest reliability was assessed by repeated measures (study 1); validity was assessed by comparing reported trail use to self-reported and objectively measured physical activity (PA) levels (study 2). Setting. Study 1: a religious institution situated near a Los Angeles trail. Study 2: 1-mile buffer zones surrounding three urban trails (Chicago, Dallas, and Los Angeles). Subjects. Thirty-four adults between 40 and 60 years of age (10 men and 24 women) completed the ROUTES questionnaire twice (study 1). Study 2 participants were 490 adults (48% female and 73% white), mean age 48 years. Measures. Trail use for recreation and transportation purposes, time and distance spent on trails, and characteristics of the trail and other trail users. PA was measured using the International Physical Activity Questionnaire and accelerometry. Analyses. Pearson correlation coefficients and κ statistics were used for test-retest reliability for continuous and categorical variables, respectively. Generalized linear models were used to evaluate hypotheses on PA comparing trail users and nonusers. Results. Test-retest statistics were acceptable (κ = .57, r 5 .66). Validity was supported by correlations between indices of trail use with self-reported PA and accelerometry, and significant group differences between trail users and nonusers in PA levels. Conclusions. The ROUTES Trail Use Questionnaire demonstrated good reliability and validity.
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Affiliation(s)
- Donna Spruijt-Metz
- Donna Spruijt-Metz, PhD; Chih-Ping Chou, PhD; and Kim D. Reynolds, PhD, are with the Institute of Health Promotion and Disease Prevention, University of Southern California, Alhambra, California. Jennifer Wolch, PhD, is a Professor of Geography and Director, Center for Sustainable Cities, University of Southern California, Los Angeles, California. Michael Jerrett, PhD, is with the Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, California. Jason
| | - Jennifer Wolch
- Donna Spruijt-Metz, PhD; Chih-Ping Chou, PhD; and Kim D. Reynolds, PhD, are with the Institute of Health Promotion and Disease Prevention, University of Southern California, Alhambra, California. Jennifer Wolch, PhD, is a Professor of Geography and Director, Center for Sustainable Cities, University of Southern California, Los Angeles, California. Michael Jerrett, PhD, is with the Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, California. Jason
| | - Michael Jerrett
- Donna Spruijt-Metz, PhD; Chih-Ping Chou, PhD; and Kim D. Reynolds, PhD, are with the Institute of Health Promotion and Disease Prevention, University of Southern California, Alhambra, California. Jennifer Wolch, PhD, is a Professor of Geography and Director, Center for Sustainable Cities, University of Southern California, Los Angeles, California. Michael Jerrett, PhD, is with the Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, California. Jason
| | - Jason Byrne
- Donna Spruijt-Metz, PhD; Chih-Ping Chou, PhD; and Kim D. Reynolds, PhD, are with the Institute of Health Promotion and Disease Prevention, University of Southern California, Alhambra, California. Jennifer Wolch, PhD, is a Professor of Geography and Director, Center for Sustainable Cities, University of Southern California, Los Angeles, California. Michael Jerrett, PhD, is with the Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, California. Jason
| | - Stephanie Hsieh
- Donna Spruijt-Metz, PhD; Chih-Ping Chou, PhD; and Kim D. Reynolds, PhD, are with the Institute of Health Promotion and Disease Prevention, University of Southern California, Alhambra, California. Jennifer Wolch, PhD, is a Professor of Geography and Director, Center for Sustainable Cities, University of Southern California, Los Angeles, California. Michael Jerrett, PhD, is with the Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, California. Jason
| | - Ranell Myles
- Donna Spruijt-Metz, PhD; Chih-Ping Chou, PhD; and Kim D. Reynolds, PhD, are with the Institute of Health Promotion and Disease Prevention, University of Southern California, Alhambra, California. Jennifer Wolch, PhD, is a Professor of Geography and Director, Center for Sustainable Cities, University of Southern California, Los Angeles, California. Michael Jerrett, PhD, is with the Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, California. Jason
| | - Bin Xie
- Donna Spruijt-Metz, PhD; Chih-Ping Chou, PhD; and Kim D. Reynolds, PhD, are with the Institute of Health Promotion and Disease Prevention, University of Southern California, Alhambra, California. Jennifer Wolch, PhD, is a Professor of Geography and Director, Center for Sustainable Cities, University of Southern California, Los Angeles, California. Michael Jerrett, PhD, is with the Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, California. Jason
| | - Lili Wang
- Donna Spruijt-Metz, PhD; Chih-Ping Chou, PhD; and Kim D. Reynolds, PhD, are with the Institute of Health Promotion and Disease Prevention, University of Southern California, Alhambra, California. Jennifer Wolch, PhD, is a Professor of Geography and Director, Center for Sustainable Cities, University of Southern California, Los Angeles, California. Michael Jerrett, PhD, is with the Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, California. Jason
| | - Chih-Ping Chou
- Donna Spruijt-Metz, PhD; Chih-Ping Chou, PhD; and Kim D. Reynolds, PhD, are with the Institute of Health Promotion and Disease Prevention, University of Southern California, Alhambra, California. Jennifer Wolch, PhD, is a Professor of Geography and Director, Center for Sustainable Cities, University of Southern California, Los Angeles, California. Michael Jerrett, PhD, is with the Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, California. Jason
| | - Kim D. Reynolds
- Donna Spruijt-Metz, PhD; Chih-Ping Chou, PhD; and Kim D. Reynolds, PhD, are with the Institute of Health Promotion and Disease Prevention, University of Southern California, Alhambra, California. Jennifer Wolch, PhD, is a Professor of Geography and Director, Center for Sustainable Cities, University of Southern California, Los Angeles, California. Michael Jerrett, PhD, is with the Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, California. Jason
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Reynolds KD, West SG. Attributional constructs: Their Role in the Organization of Social Information in Memory. Basic and Applied Social Psychology 2010. [DOI: 10.1207/s15324834basp1002_2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Abstract
Increasing rates of childhood obesity in the USA and other Western countries are a cause for serious public health concern. Neighborhood and community environments are thought to play a contributing role in the development of obesity among youth, but it is not well understood which types of physical environmental characteristics have the most potential to influence obesity outcomes. This paper reports the results of a systematic review of quantitative research examining built and biophysical environmental variables associated with obesity in children and adolescents through physical activity. Literature searches in PubMed, PsychInfo and Geobase were conducted. Fifteen quantitative studies met the inclusion criteria for this systematic review. The majority of studies were cross-sectional and published after 2005. Overall, few consistent findings emerged. For children, associations between physical environmental variables and obesity differed by gender, age, socioeconomic status, population density and whether reports were made by the parent or child. Access to equipment and facilities, neighborhood pattern (e.g. rural, exurban, suburban) and urban sprawl were associated with obesity outcomes in adolescents. For most environmental variables considered, strong empirical evidence is not yet available. Conceptual gaps, methodological limitations and future research directions are discussed.
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Affiliation(s)
- G F Dunton
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Alhambra, CA 91803, USA.
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Andreeva VA, Unger JB, Yaroch AL, Cockburn MG, Baezconde-Garbanati L, Reynolds KD. Acculturation and sun-safe behaviors among US Latinos: findings from the 2005 Health Information National Trends Survey. Am J Public Health 2009; 99:734-41. [PMID: 19150918 DOI: 10.2105/ajph.2007.122796] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES We examined the relationship between acculturation and sun safety among US Latinos. METHODS We used linear regression models to analyze data from 496 Latino respondents to the 2005 Health Information National Trends Survey. Using sunscreen, seeking shade, and wearing protective clothing were the primary outcomes and were assessed by frequency scales. Acculturation was assessed with a composite index. RESULTS In bivariate models, acculturation was negatively associated with use of shade and protective clothing and positively associated with sunscreen use (all, P < .004). In adjusted models, acculturation was negatively associated with seeking shade and wearing protective clothing across gender and region of residence (all, P < .05). CONCLUSIONS Our results demonstrated both adverse and beneficial effects of acculturation on Latinos' risk behaviors relating to skin cancer. Education about sun safety is needed for all Latinos and should be tailored to different levels of acculturation. Initiatives for Latinos who are not yet acculturated could focus on reinforcing existing sun-safe behaviors and presenting new ones, such as use of sunscreen; initiatives for highly acculturated Latinos might require more resources because the objective is behavior modification.
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Affiliation(s)
- Valentina A Andreeva
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California,Los Angeles, CA, USA.
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Reynolds KD, Buller DB, Yaroch AL, Maloy J, Geno CR, Cutter GR. Effects of program exposure and engagement with tailored prevention communication on sun protection by young adolescents. J Health Commun 2008; 13:619-636. [PMID: 18958776 PMCID: PMC4278428 DOI: 10.1080/10810730802412149] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Few family-based interventions to increase sun safe behavior among adolescents have been evaluated. The present study tested an intervention that included tailored and nontailored print communications delivered by mail to adolescents (age 11 to 15) and their parents who were also participating in an evaluation of an in-school intervention. The use of sunscreen, protective clothing, and avoidance of the sun were promoted, and family communication and environmental change strategies were fostered. Adolescents and their parents were pretested in May of 2002 and posttested from August to October. Adolescents (N = 599) were stratified on experimental condition in the in-school study (in-school intervention vs control) and randomly were assigned from within strata to receive (N = 288) or not receive (N = 311) the summer intervention materials. No statistically significant effects were found for adolescents between the randomized experimental conditions. Parents' had increased knowledge (F = 5.52, p < .05) and propensity to have their child wear sunglasses (F = 4.07, p < .05). Greater program exposure/engagement led to enhanced sun protection behavior (e.g., fewer sunburns) and psychosocial factors among adolescents and parents. Greater exposure/engagement led to improvements in family interaction and home environment (e.g., shade audit completed). Future research is needed on exposure/engagement with family-based health messaging and on family-based sun safety programs for adolescents.
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Affiliation(s)
- Kim D Reynolds
- Claremont Graduate University, Claremont, California, USA.
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Abstract
BACKGROUND Sun-induced skin damage, which increases skin cancer risk, is initiated in early life and promoted through later sun exposure patterns. If sun safety determinants are well understood and addressed during the school years, skin cancer incidence might be reduced. This study tested psychosocial influences on youth's sun safety and assessed their strength within and across gender and ethnicity in a sample of 1782 middle school students. METHODS Predictors included sunburn and skin cancer knowledge, tanning attitudes, peer norms, and barriers regarding sun exposure and were assessed with a self-administered, validated questionnaire. The hypothesized relationships were tested with structural equation models and confirmed with multilevel regression. RESULTS Across gender and ethnicity, knowledge emerged as an important sun safety predictor with both direct and indirect effects mediated through tanning attitudes. The relationship with barriers did not reach statistical significance within any of the subgroups, possibly due to measurement limitations. An indirect effect of peer norms on sun safety, mediated through tanning attitudes, was confirmed only among girls. Also, an indication that peer norms operate differently within the ethnic groups was found, since this predictor had a statistically significantly stronger relationship with sun safety among non-Hispanics. CONCLUSIONS Youth's sun safety is a multifactorial practice, partially determined by ethnicity- and gender-based standards. In order to ensure health-promoting school environments, needed are multicomponent programs where peer norms and knowledge are salient and where sun safety is addressed individually and together with other health risk behaviors.
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Affiliation(s)
- Valentina A. Andreeva
- Institute for Health Promotion and Disease Prevention Research, Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 1000 S Fremont Ave, Alhambra, CA 91803
| | - Kim D. Reynolds
- Institute for Health Promotion and Disease Prevention Research, Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 1000 S Fremont Ave, Alhambra, CA 91803
| | - David B. Buller
- Klein Buendel, Inc., 1667 Cole Blvd, Suite 225, Golden, CO 80401
| | - Chih-Ping Chou
- Institute for Health Promotion and Disease Prevention Research, Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 1000 S Fremont Ave, Alhambra, CA 91803
| | - Amy L. Yaroch
- Health Promotion Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, 6130 Executive Blvd, Rm 4074/MSC 7335, Bethesda, MD 20892
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Hartstein J, Cullen KW, Reynolds KD, Harrell J, Resnicow K, Kennel P. Impact of portion-size control for school a la carte items: changes in kilocalories and macronutrients purchased by middle school students. ACTA ACUST UNITED AC 2008; 108:140-4. [PMID: 18156001 DOI: 10.1016/j.jada.2007.10.005] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2007] [Indexed: 11/30/2022]
Abstract
We assessed the impact of a pilot middle school a la carte intervention on food and beverage purchases, kilocalories, fat, carbohydrate, and protein sold per student, and nutrient density of the foods sold. A la carte sales were obtained from six middle schools in three states for 1 baseline week and daily during the 6-week intervention. Intervention goals included reducing sizes of sweetened beverages and chips, and increasing the availability of water and reduced-fat/baked chips. Nutrients sold per day were computed and weekly nutrient means per student and per number of items sold were calculated and compared between baseline and week 6. Five schools achieved all goals at 6 weeks. Four schools showed increases in the percentage of kilocalories from protein and decreases in the amount of sweetened beverages sold; five showed substantial increases in water sales. Changes in regular chips varied by school. There were significant changes in energy density of foods sold. School foodservice changes in middle school snack bar/a la carte lines can be implemented and can lead to a reduction in the caloric density of foods purchased.
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Cullen KW, Hartstein J, Reynolds KD, Vu M, Resnicow K, Greene N, White MA. Improving the school food environment: results from a pilot study in middle schools. ACTA ACUST UNITED AC 2007; 107:484-9. [PMID: 17324667 PMCID: PMC2716557 DOI: 10.1016/j.jada.2006.12.004] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2006] [Indexed: 10/23/2022]
Abstract
Our objective for this study was to examine the feasibility of instituting environmental changes during a 6-week pilot in school foodservice programs, with long-term goals of improving dietary quality and preventing obesity and type 2 diabetes in youth. Participants included students and staff from six middle schools in three states. Formative assessment with students and school staff was conducted in the spring of 2003 to inform the development of school foodservice policy changes. Thirteen potential policy goals were delineated. These formed the basis for the environmental change pilot intervention implemented during the winter/spring of 2004. Questionnaires were used to assess the extent to which the 13 foodservice goals were achieved. Success was defined as achieving 75% of goals not met at baseline. Daily data were collected on goal achievement using the schools' daily food production and sales records. Qualitative data were also collected after the pilot study to obtain feedback from students and staff. Formative research with staff and students identified potential environmental changes. Most schools made substantial changes in the National School Lunch Program meal and snack bar/a la carte offerings. Vending goals were least likely to be achieved. Only one school did not meet the 75% goal achievement objective. Based on the objective data as well as qualitative feedback from student focus groups and interviews with students and school staff, healthful school foodservice changes in the cafeteria and snack bar can be implemented and were acceptable to the staff and students. Implementing longer-term and more ambitious changes and assessing cost issues and the potential enduring impact of these changes on student dietary change and disease risk reduction merits investigation.
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Affiliation(s)
- Karen W Cullen
- Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030-2600, USA.
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Abstract
This study tested potential mediators of a school-based skin cancer prevention intervention for middle school children (6th-8th grades; N = 1,788). Ten variables were tested on 4 criteria to establish mediation, including (a) intervention related to outcome, (b) intervention related to mediators, (c) mediators related to outcome, and (d) mediated effect statistically significant. Sun-safe behaviors (e.g., sunscreen use) and potential mediators were measured with a self-report questionnaire. All criteria were met for Barriers--Sunscreen, Perceived Self-Efficacy, and Knowledge when the mediators were tested separately. In multiple mediator analyses, barriers to sunscreen use and self-efficacy satisfied Criteria 1-3 but were not statistically significant (Criterion 4). Barriers to sunscreen use, perceived self-efficacy for sun-safe behavior, and knowledge may serve as mediators.
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Affiliation(s)
- Kim D Reynolds
- Institute for Health Promotion and Disease Prevention, University of Southern California, Alhambra, CA 91803, USA.
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Johnson CA, Xie B, Liu C, Reynolds KD, Chou CP, Koprowski C, Gallaher P, Spruitj-Metz D, Guo Q, Sun P, Gong J, Palmer P. Socio-demographic and cultural comparison of overweight and obesity risk and prevalence in adolescents in Southern California and Wuhan, China. J Adolesc Health 2006; 39:925.e1-8. [PMID: 17116525 DOI: 10.1016/j.jadohealth.2006.07.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2005] [Revised: 06/17/2006] [Accepted: 07/10/2006] [Indexed: 10/24/2022]
Abstract
PURPOSE This study performed parallel analyses on two large samples of seventh graders living in Los Angeles, California and in Wuhan, China to make direct comparisons of overweight and obesity risks in Western and Eastern cultural environments. METHODS Two representative samples of 1772 and 1896 seventh grade students were randomly selected from the public or parochial middle schools in the greater Los Angeles area of Southern California in the United States, and public schools in Wuhan city of China. Two body mass index (BMI) references recently established by the U.S. National Center for Health Statistics (NCHS) and the International Obesity Task Force (IOTF), respectively, were used to define overweight (85th < or = BMI < 95th percentile) and obesity (BMI > or = 95th percentile). Logistic regressions were conducted to examine relationships between socioeconomic status (SES) and obesity risk. RESULTS The prevalence rates of combined overweight and obesity in Los Angeles and in Wuhan were 43.1% and 12.1%, respectively, by the US-NCHS reference, and 45.8% and 11.9%, respectively, by the IOTF reference. Chinese-American adolescents had higher prevalence rates for overweight and obesity than those from China. SES was positively related to the risk of overweight and obesity in the Chinese sample, whereas a negative association was found in Southern California adolescents. Urbanicity was significantly positively related to higher overweight and obesity prevalence. CONCLUSION Different overweight and obesity prevalence estimates and SES effects were observed for American and Chinese adolescent samples. Research on the underlying mechanisms is needed to help us to set up a tailored program for obesity prevention in Eastern and Western cultural environments.
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Affiliation(s)
- C Anderson Johnson
- Institute for Health Promotion and Disease Prevention Research, University of Southern California Keck School of Medicine, Alhambra, California, USA
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Abstract
This article explores the state of translational research in childhood obesity prevention. Five phases of translational research and emerging findings from basic science that could be useful in the design of obesity prevention programs are described. Few intervention studies have been published, and these are dominated by Phase 3 trials (efficacy), conducted in school settings, with a limited number of studies finding significant effects on Body Mass Index or adiposity. Cost-benefit analyses are lacking. Research is needed to translate basic science findings into novel interventions (Phases 1 and 2) and to translate programs with known behavior change capability into dissemination trials (Phase 5). Translation can be facilitated by enhanced communication between basic science and prevention science researchers, the development of interventions for underused settings, using novel strategies, support by institutions and funding agencies for translation, and the design of interventions with translation in mind.
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Affiliation(s)
- Kim D Reynolds
- University of Southern California, Institute for Health Promotion and Disease Prevention Research, Alhambra, CA 91803, USA.
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Buller DB, Buller MK, Reynolds KD. A survey of sun protection policy and education in secondary schools. J Am Acad Dermatol 2006; 54:427-32. [PMID: 16488293 PMCID: PMC1448612 DOI: 10.1016/j.jaad.2005.11.1030] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2004] [Revised: 10/24/2005] [Accepted: 11/01/2005] [Indexed: 10/25/2022]
Abstract
BACKGROUND The Centers for Disease Control and Prevention (CDC) issued recommendations for school programs to reduce skin cancer. OBJECTIVE Personnel at US secondary schools were surveyed to describe sun protection policy and education before the CDC recommendations. METHODS School principals or other personnel at 484 secondary schools in 27 cities responded to a telephone survey in January and February 2002 (response rate = 31%). RESULTS A sun protection policy was reported at 10% of the schools, but sun protection education occurred at nearly all schools (96%). Policies were more prevalent in regions with high ultraviolet radiation (P < .0001), but education was not. Many personnel were willing to adopt a policy (41%) and interested in obtaining a sun safety curriculum (96%). LIMITATIONS Self-report measures, nonresponse, and new schools not in the sampling frame. CONCLUSION Sun protection was a low policy priority for US schools. Sun safety education was prevalent, but written materials were used infrequently. A substantial proportion of school personnel were receptive to the CDC's advice.
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Buller DB, Reynolds KD, Yaroch A, Cutter GR, Hines JM, Geno CR, Maloy JA, Brown M, Woodall WG, Grandpre J. Effects of the Sunny Days, Healthy Ways curriculum on students in grades 6 to 8. Am J Prev Med 2006; 30:13-22. [PMID: 16414419 PMCID: PMC1448611 DOI: 10.1016/j.amepre.2005.08.046] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2004] [Revised: 07/20/2005] [Accepted: 08/25/2005] [Indexed: 10/25/2022]
Abstract
BACKGROUND There are few effective sun-safety education programs for use in secondary schools. Project aims were to create a sun-safety curriculum for grades 6 to 8, and to test whether exposure to the curriculum would increase children's sun-protection behavior. DESIGN A pair-matched, group-randomized, pre--post test, controlled trial was performed with middle schools as the unit of randomization. Teachers implemented the six-unit sun-safety curriculum in 2001-2003, and analyses were performed in 2003-2004. SETTING/PARTICIPANTS A total of 2038 children from 30 middle schools in Colorado, New Mexico, and Arizona. MAIN OUTCOME MEASURES Self-reported sun-protection behavior using frequency ratings and diary. RESULTS Compared to control schools, children receiving the curriculum reported more frequent sun protection (p=0.0035), and a greater proportion wore long-sleeved shirts during recess (p<0.0001) and applied sunscreen (p<0.0001). Exposure to the curriculum improved knowledge (p<0.0001), decreased perceived barriers to using sunscreen (p=0.0046), enhanced self-efficacy expectations (p=0.0577) about sun safety, and reduced favorable attitudes toward sun tanning (p=0.0026 to <0.0001). In intent-to-treat analyses, the treatment effect was eliminated only under the most conservative assumptions about dropouts. CONCLUSIONS Educational approaches to sun safety in middle school may be effective for improving children's sun safety. Potential trial limitations include measuring short-term outcomes, focusing on young adolescents, using active parental consent, and testing in the American Southwest.
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Abstract
BACKGROUND Researchers have advocated mediational analysis for behavioral intervention studies to link the supporting theory used in an intervention with the mediating variables and with its ultimate success or failure. Few mediational analyses have been reported for school-based nutrition studies. The conduct of mediational analyses within multi-site studies may provide advantages for the standardization of methods and for the replication and generalizability of findings. METHODS This study identified mediators of two school-based nutrition interventions for 4th graders. Three variables were tested on the four criteria necessary to establish mediation of intervention effects on changes in fruit and vegetable consumption (FVC) in 4th graders (Alabama, N = 1584; Minnesota, N = 522). FVC was measured in children using 24-h dietary recalls. Mediators were assessed using questionnaires completed by children and parents. RESULTS All criteria were met in Alabama for a single-item measure of knowledge of the 5-a-day daily consumption guideline. Knowledge and parent consumption satisfied one criterion in Minnesota. Knowledge accounted for 9.78% of the total intervention effect in Alabama. CONCLUSIONS Knowledge of the 5-a-day guideline for fruit and vegetable consumption may mediate intervention effects. Future work should include tests of mediational models in multi-site studies.
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Affiliation(s)
- Kim D Reynolds
- University of Southern California, Institute for Health Promotion and Disease Prevention Research, Alhambra, CA 91803, USA.
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Reynolds KD, Skipper SL, Cobb GP, McMurry ST. Relationship between DDE concentrations and laying sequence in eggs of two passerine species. Arch Environ Contam Toxicol 2004; 47:396-401. [PMID: 15386134 DOI: 10.1007/s00244-004-3157-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Passerine eggs make useful biomonitors of environmental pollutants. Among passerines, it is not known whether organochlorine contaminants in eggs within the same clutch are independent observations or follow a laying order effect. Intraclutch variation of DDE (1,1-dichloro-2,2-bis[(p-chlorophenyl)]ethylene) concentrations was studied in eggs collected from prothonotary warblers (Protonotaria citrea) and European starlings (Sturnus vulgaris) nesting on National Priority List sites in lower Alabama and central Colorado, respectively. All 209 eggs collected for this study contained detectable levels of DDE. Mean concentration of DDE across all prothonotary warbler eggs (mean 8.71 microg/g +/- 1.19, n = 20) was almost two orders of magnitude greater than mean concentrations of DDE in all starling eggs (mean 0.70 microg/g +/- 0.06, n = 189). In both species, there was a large amount of variability among individual eggs of the same clutch and no significant relationship between laying order and DDE concentration. Variation among eggs laid in the same sequential order was high and effectively masked any potential trends in laying order effect. We hypothesized that the variability was caused by the spatial heterogeneity of DDE on our study sites, the nature of egg development within a female passerine, or a combination of these factors. Investigators focusing on lipophilic contaminants should exercise caution when making inferences about contaminant concentrations in an entire clutch of passerine eggs after the collection and analysis of a single egg because our data show that DDE levels in a single egg collected for analysis do not consistently reflect DDE levels in the eggs remaining in the nest.
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Affiliation(s)
- K D Reynolds
- The Institute of Environmental and Human Health, Texas Tech University Health Sciences Center, Texas Tech University, Box 41163, Lubbock, Texas, USA.
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Reynolds KD, Yaroch AL, Franklin FA, Maloy J. Testing mediating variables in a school-based nutrition intervention program. Health Psychol 2002; 21:51-60. [PMID: 11846345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
This study identified mediators of a school-based nutrition intervention for 4th graders and their parents. Nine variables were tested for satisfying 4 conclusions necessary to establish mediation of intervention effects on changes in fruit and vegetable consumption (FVC) in 4th graders (N = 1,676). FVC was measured in children by the use of 24-hr dietary recalls. Mediators were assessed by the use of questionnaires completed by children and parents. All 4 conclusions were met for positive outcome expectancies. Knowledge, self-efficacy, and parent consumption satisfied the first 3 conclusions for mediation but the mediating effects were not statistically significant (Conclusion 4). Future mediational analyses and the creation of a national database of mediators are crucial for increasing strength and efficiency of school-based nutrition programs.
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Affiliation(s)
- Kim D Reynolds
- Center for Behavioral and Community Studies, AMC Cancer Research Center, Lakewood, Colorado 80214, USA.
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Reynolds KD, Rainwater TR, Scollon EJ, Sathe SS, Adair BM, Dixon KR, Cobb GP, McMurry ST. Accumulation of DDT and mercury in prothonotary warblers (Protonotaria citrea) foraging in a heterogeneously contaminated environment. Environ Toxicol Chem 2001; 20:2903-2909. [PMID: 11764178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Foraging areas of adult prothonotary warblers (Protonotaria citrea) were determined using standard radiotelemetry techniques to determine if soil concentrations of p,p'dichlorodiphenyltrichloroethane (p,p'DDT) and mercury in foraging areas could be used to predict contaminant levels in diets and tissues of nestling warblers. Adult warblers were fitted with transmitters and monitored for approximately 2 d while foraging and feeding 6- to 8-d-old nestlings. Foraging ecology data were integrated with contaminant levels of soil, diets, and tissues into a comprehensive analysis of geographic variation in contaminant exposure and uptake using linear regression. Concentrations of 1,1-dichloro-2,2-bis(p-chlorophenyl)ethylene (DDE) and mercury in nestling tissues varied considerably across the study site. Mean concentration of DDE was greater in eggs than all other tissues, with individual samples ranging from 0.24 to 8.12 microgram/kg. In general, concentrations of DDT in soil were effective in describing the variation of contaminants in adipose samples. Concentrations of mercury in soils accounted for 78% of the variation in kidney samples. This was the best relationship of any of the paired variables. All other relationships showed relatively poor predictive ability.
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Affiliation(s)
- K D Reynolds
- The Institute of Environmental and Human Health and Department of Environmental Toxicology, Texas Tech University Health Sciences Center, Lubbock 79409-1163, USA.
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Glasgow RE, McKay HG, Piette JD, Reynolds KD. The RE-AIM framework for evaluating interventions: what can it tell us about approaches to chronic illness management? Patient Educ Couns 2001; 44:119-127. [PMID: 11479052 DOI: 10.1016/s0738-3991(00)00186-5] [Citation(s) in RCA: 436] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
BACKGROUND The RE-AIM framework is used as a method of systematically considering the strengths and weaknesses of chronic illness management interventions in order to guide program planning. METHOD The RE-AIM dimensions of Reach, Efficacy, Adoption, Implementation, and Maintenance are used to rate one-on-one counseling interventions, group sessions, interactive computer-mediated interventions, telephone calls, mail interventions, and health system policies. RESULTS The RE-AIM ratings suggest that, although often efficacious for those participating, traditional face-to-face intervention modalities will have limited impact if they cannot be delivered consistently to large segments of the target population. Interventions using new information technologies may have greater reach, adoption, implementation, and maintenance, and thereby greater public health impact. Policy changes received high ratings across a variety of RE-AIM dimensions. CONCLUSIONS Program planners should make decisions regarding implementing and funding health services based on multiple dimensions, rather than only considering efficacy in randomized clinical trials. Doing so may improve the resulting public health impact. Directions for future chronic illness management research related to RE-AIM, and implications for decision making, are described.
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Affiliation(s)
- R E Glasgow
- AMC Cancer Research Center, Center for Behavioral and Community Studies, 1600 Pierce Street, Denver, CO 80214, USA.
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Reynolds KD, Franklin FA, Binkley D, Raczynski JM, Harrington KF, Kirk KA, Person S. Increasing the fruit and vegetable consumption of fourth-graders: results from the high 5 project. Prev Med 2000; 30:309-19. [PMID: 10731460 DOI: 10.1006/pmed.1999.0630] [Citation(s) in RCA: 176] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND This study evaluated the effects of a school-based dietary intervention program to increase fruit and vegetable consumption among fourth-graders. METHODS Twenty-eight elementary schools were randomized to an immediate intervention condition or to a delayed intervention control condition. Measures of diet and psychosocial variables were collected at base line and 1 and 2 years post-baseline. The intervention included classroom, parent, and cafeteria components. RESULTS Mean daily consumption of fruit and vegetables was higher for the intervention children compared with controls at Follow-up 1 (X(t) = 3.96, X(c) = 2.28) and at Follow-up 2 (X(t) = 3.20, X(c) = 2.21). Macro- and micronutrient changes favoring the intervention children were also observed at both Follow-up 1 and Follow-up 2. Mean daily consumption of fruit and vegetables was higher for intervention parents compared with controls at Follow-up 1 (X(t) = 4.23,X(c) = 3.94) but not at Follow-up 2. CONCLUSIONS Strong effects were found for the High 5 intervention on fruit and vegetable consumption, on macro- and micro-nutrients, and on psychosocial variables. Future work is needed to enhance the intervention effects on parents' consumption and to test the effectiveness of the intervention when delivered by classroom teachers.
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Affiliation(s)
- K D Reynolds
- University of Alabama at Birmingham, Birmingham, Alabama, USA.
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