Obesity in the Caribbean: comparative gender analysis of dietary and exercise behaviour [abstract]

OBJECTIVE: The study was initiated to establish guidelines for the application of theory-based health promotion strategies in diet and exercise behaviour. The selected theory is the Trans-theoretical Model of Behaviour Change. The study utilizes three of the core constructs of the trans-theoretical model: the stages of change (the central organizing construct); decisional balance; and self-efficacy in examining fruit and vegetable consumption and exercise participation among adults 18 to 65 years old. The qualitative results are highlighted in this report. METHODS: The qualitative phase of the study was conducted in four countries: Belize, Jamaica, St.Kitts/Nevis and Trinidad and Tobago. Between 7 and 10 focus group discussions were conducted in each country. The variables for selecion of participants were: age range, gender, obesity stage, residential location and socio-economic status. RESULTS: The qualitative phase results indicated that, in the population studied, size was a very important determinant of perceived beauty, social adequacy, functioning and responsiveness. Knowledge relating to lifestyle is high but there is reluctance to effect lifestyle changes in dietary intake and physical activity. Cable television was identified as contributing to these current perceptions. Men were less concerned than women about their weight. Neither fruits nor vegetables were frequently mentioned as forming a part of daily diets of the majority of participants. Physical exercise was generally regarded ad hard work. CONCLUSIONS: The qualitative results of this study show that our approach to obesity prevention requires radical change. (AU)

A case-control study of aggressive and pro-social Jamaican school boys

The study examined the correlates of behavior of 102 aggressive and 103 prosocial boys, selected by peer and teacher ratings, from grades 5 and 6 in 10 schools in urban Kingston and St. Andrew. The children were given in-depth questionnaires, school achievement tests (WRAT) and verbal ability tests (Peabody Picture Vocabulary Test). Their parents were also given questionnaires. Interobserver and test-retest reliabilities were established for all questionnaires and tests. Interviewers were unaware of the boys' group. The aggressive group was significantly older (mean 11.4 years) than the pro-social boys (mean 11.1 years; t-test p,0.01). The aggressive group had significantly lower scores on both the number of possessions and the housing rating (proxies for socio-economic status), they showed significantly lower scores on spelling, arithmetic, reading and verbal IQ, and considered themselves less bright than the pro-social boys. Preliminary analyses indicate that, as expected, the aggressive boys fought more and used knives in fights more compared with the pro-social boys. They reported receiving significantly more punishments at home. The aggressive group indicated that they saw significantly more family quarrels, threats between family members and family fights. All differences remained significant when socio-economic status was controlled in analyses of covariance except that the differences in the arithmetic scores was no longer significant. Many of these patterns are similar to those reported elsewhere. (AU)

Neuro-behavioural correlates as predictors of drug abuse in the Jamaican population current evidence

There is growing recognition that pharmacological agents, when abused, significantly affect the central nervous system (CNS) and as a consequence neuropsychological functions. This makes it necessary to devise procedures to identify inter-alia the neurophysiological, behavioural, cognitive and emotional patterns of CNS dysfunction induced by substance abuse. The National Survey of Substance Abuse in Jamaica (1994), indicated that 2.4 percent of respondents endorsed greater than 50 percent of items on the Drug Involvement Scale (DIS). The DIS characterizes the severity of drug abuse, assessing how it dominates the persons life, inflicts behavioural disruption, thus reflecting the severity of drug dependence. Drug abusers endorsing <50 percent of DIS-items also manifested tendencies of attentional deficit hyperactivity disorder (ADHD), memory loss, severe bouts of aggression, mood-swings and other behavioural problems. Furthermore, this group of people endorsed inter-alia 37 percent of the items of domains concerned with behaviour patterns, family systems and behaviour disorders indicating a generalized psychosocial-functional-disruption. Evidence will be adduced indicating the trigger effects of drugs on certain brain mechanisms producing specific neuropsychological correlates. The data generated behavioural and social correlates associated with substance abuse. These features indicated those persons who could be regarded as vulnerable to a variety of risky behaviours, including substance abuse. This observation led to the formulation of a screening strategy to tease out drug abusers and those people likely to be vulnerable. Thus, the neuro-drug diagnostic procedure (NIDEP), a computerized device, was established to assess the population for addictions and related psychological disabilities. The NIDEP consisted of twenty-one components selected from various domains covering a complex of dysfunctional behaviours and experiences (e.g. problems of memory, cognition, emotions, conduct disorders and disturbed family situations). NIDEP was programmed to select respondents with a score of greater than 66.6 percent endorsements. In this regard, the procedure selected 6,986 people. Following the application of DIS 4,455 persons were assessed as being heavily involved with drugs. These population estimations were calculated utilizing the National Sample age range of 15-50 years. (AU)

Key issues in generating a psychological-testing protocol

An individual's behavior is created by an amalgam of genetic, environmental, cultural, and historical variables working in concert and changing over time. Variations in nutrition are one class of environmental factors. Linking these to outcome effects requires carefully designed studies. Many considerations are involved, and this paper draws attention to some of the fundamental ones. Psychological and behavioral functions tend to be complex, in part because they are affected by a wide range of variables. Almost any given state-a particular constellation of psychological characteristics displayed by an individual at a given time-can be produced in a variety of ways (AU)

Assessments of the effects of nutrition on mental development and behaviour in Jamaican studies

Methodological issues and problems in studies of the effects of protein-energy malnutrition (PEM) and child development are discussed with reference to our experience in Jamaica. The usefulness of defining PEM by stunting, wasting, and edema is stressed. Difficulties in achieving reliable and valid measurements of mental development and behavior in third world children, and allowing for the confounding and possibly interacting effects of social background, are discussed. Problems associated with different approaches are outlined. (AU)

Measurement and relationship between intelligence and behaviour patterns among Jamaican children

Motivation for this research was prompted by the need to identify suitable instruments for the measurement of intelligence and behaviour and to investigate their relationship in 10- and 11-year olds. Research questions probed the suitability of the Wechsler Intelligence Scale for Children-Revised (WISC-R) and the Revised Behavior Problem Checklist (RBPC) in Jamaica and local patterns of student functioning. The total sample of 386 children consisted of 2 major target groups of Normal (N) and Behaviour Disordered (BD) children, and dichotomous subgroups created by sex, age, family size, residence location, parental occupation and school type differences. Major findings were as follows: (i) Item and scale analyses supported the use of the WISC-R with minor adjustments pending development of Jamaican intelligence tests. (ii) Factor analysis identified 4 major subscales of the RBPC but correlations yielded a substantial relationship between the current and the U.S. factor structure thus supporting its use in Jamaica. Local norms are necessary however. (iii) Student's 't' revealed no significant RBPC differences for age, sex and family size but elevated behaviour disorder was linked significantly with Primary school attendance, poor residential setting, and lower skilled mothers. (iv) Student's 't' on WISC-R dimensions revealed highly significant differences, with large family size, poor residence location, lower skilled parents and Primary school placement linked with depressed intellectual functioning. (v) WISC-R subgroup score pattern analysis yielded no significant pattern such as Verbal-greater-than-Nonverbal functioning. Differential diagnosis based on pattern analysis seems unsupported. (vi) Product moment correlations yielded only low negative correlations between intelligence and behaviour disorder, with Attention Problem achieving significant values with all areas of intellectual functioning. (vii) Major findings generally support local use of the instruments and demand intervention when interactional effects of behavioural functioning and socio-environmental factors depress intellectual performance. (AU)

The status of school health instruction in primary schools of the metropolitan area of Kingston and St. Andrew, Jamaica

A survey was conducted among 19 primary schools, that is 50 percent of primary schools in the metropolitan area of Kingston and St. Andrew, to assess the status of school health instruction. The reference group was Grade 5 and involved both teachers and students. Structured questionnaires were used for both groups. All schools offered health instruction to students, but to varying degrees. The schools' administration endorsed the inclusion of the subject in the curricula, however there was great disparity in terms of frequency and intensity. Very few schools timetabled the subject. Methods used to incorporate the subject in the school curriculum were mainly as unit of traditional subjects or by infusion. Students' attendance was compulsory in the majority of the institutions. The Ministry of Education's centrally developed syllabus was the guideline used by most teachers. The upper grades of primary schools were more likely to be exposed to health instruction than the lower grades. Talk/discussion was the most popular method of instruction, none-the-less a variety of methods were used including those which offered scope for maximum student participation. Students were most likely to practise what they were taught where they had most control over their behaviour. For example students' behavior was most positive for personal hygiene and least positive in food and nutrition. Few teachers got special training to equip them to discharge their health instruction responibilities and those trained identified areas of weakness in their training. However, the teachers trained rated their capabilities as health instructors higher than their untrained colleagues. The infrastructure in schools to support healthful behaviours needs improvement. Technical, financial and material assistance were given schools by governmental and non-governmental agencies (AU)

Crisis and crisis behaviour

This research project was organized around the following two premises: (1) That the present conceptual models utilized for defining and assessing 'crisis' and 'crisis behaviour' were generally too vague. Each model focussed on predominantly one aspect of the crisis experience at the expense of comprising a comprehensive, holistic frame of reference. (2) That limited staff and large case loads functioned to limit the amount of time that human service personnel could spend with clients in crisis. Hence, it was deemed necessary for a particular understanding of 'crisis' that would facilitate the implementation of management schemes that would effect the greatest degree of change in as many areas of the client's life within the shortest period of time. The investigation was organized in three major parts. Part I presented an overview of the literature, critiquing the traditional approaches to the definition of crisis and tracing the evolution of the concept from its inception as a description of grief reaction, to the diversified concept that it is today. It introduced an alternative conceptual model that presented crisis as a 'process'. It was hypothesised that the process began with the precipitating factors and progressed through six stages. The stages reflected a progressive fragmentation of the components of the individual's identity. Part II focussed on hypotheses suggesting that the ethnic personality of the individual influenced his response-nature and pattern. Ethnic personality was defined as having two elements: (1) A socialised predisposition to act in ways reflecting prescribed behaviour patterns. (2) An innate predisposition to act in ways that express the composites of one's human nature. Human nature was defined as being a mental-spiritual-physical entity. The dominant component within this triad was deemed to be the spiritual element. Part III of the project presents the results of an exploratory study conducted to assess the feasibility of the seven hypotheses that were formulated at the end of Part II of the theoretical overview. Using the clinical method, one and a half hour long interviews were conducted with forty adolescent girls between the ages of twelve and fifteen years old. Results indicated that the crisis could be conceptualized as a six stage process. Whether or not an individual proceeded through these stages depended on the nature of the hazardous event. Subjects did manifest concern about the fragmentation of their social status and identity. They also experienced predominantly hostile feelings. Religious/affective responses reflective of the ethnic personality of the group were not apparent until the last stages of the crisis experience. Another component found to be influencing behaviour, was 'sense of mastery'. Concluding remarks highlighted possible management schemes that might effect a more effective short-term approach to treating patients in crisis (AU)

Smoking habits in University students and student nurses in Suriname

In the seventies, surveys on smoking habits in university students and student nurses were carried out in Suriname. The total smoking rates were approx. 80 per cent. They were higher in Paramaribo than in rural districts. The percentages of homes in which housemates smoked were 65-79 per cent. The percentages of males were highest concerning: smoking, heavy smoking, smokers being offered cigarettes by housemates, occasions of smoking, those purchasing cigarettes, attempt to quit smoking, opinion that a cigarette is tasty. Higher percentages of females were encountered regarding: light smoking, permission and cognizance of their parents about their smoking, opinion that the taste of a cigarette is nasty......(AU)