Initial Findings of a Multicomponent School Health Intervention in Rural Appalachia: The Greenbrier CHOICES Project.

Background. Schools are an important setting for health promotion because they afford children and adolescents numerous opportunities to accumulate the recommended physical activity (PA) minutes and make other health-related decisions, including healthy eating. Unfortunately, there is little evidence of coordinated school-based health interventions in rural Appalachia. The Greenbrier Children's Health Opportunities Involving Coordinated Efforts in Schools Project was a federally funded, 3-year, multicomponent school-based health intervention focused on PA, healthy eating, and weight management. Aims. The purpose of this study was to evaluate the impact of Greenbrier Children's Health Opportunities Involving Coordinated Efforts in Schools on adolescent PA, dietary behaviors, and weight status. Method. Measures of PA, dietary behaviors, and body mass index were collected across 14 data points throughout the intervention (including a baseline in Year 1). Results. Participants included 4,633 randomly selected middle school students (M = 2,289, F = 2,344) across the intervention. Baseline to Year 3 findings revealed a 12.8 percentage point increase in students achieving 60 minutes of daily PA. There were no significant differences in either dietary behavior or body mass index. Discussion. Findings provide evidence of the positive impact comprehensive school-based health interventions can have on middle school student health-related behaviors. Conclusion. Schools remain an ideal setting for health promotion. Initiatives targeting more than one level of influence on health-related behaviors are more likely to succeed.

Exploring Parents' Participation Decisions on School-Based Health Screenings in Mountainous Regions.

BACKGROUND: Increasing the participation rate in health screenings is a major challenge. In West Virginia, USA, where a statewide, state-funded school-based health screening program has been offered to fifth-grade students and their parents/guardians for nearly 20 years, more than 50% of eligible participants consistently opt-out. Consequently, the purpose of this investigation is to determine a parent/guardian's reasons for deciding whether to participate in a school-based health screening. METHODS: A cross-sectional study design was used and a total of 216 parents/guardians of fourth-grade students from 10 elementary schools in the northeast region of West Virginia participated in the study. The survey, based on the theory of planned behavior (TPB), was used to explore a parent/guardian's intentions when opting in or out of a school-based health screening for their child, and included items that represented direct determinants, indirect determinants, and behavioral intentions. Multiple regression analyses were conducted to measure the questionnaire's potential to predict intentions and identify the predictive strength of each direct determinant. RESULTS: Results show that attitude, subjective norms, and perceived behavioral control in the TPB (43%) provided strong evidence for predicting participation intentions. Specifically, attitude (ß=0.73, P<0.001) was the strongest predictor of intention, followed by subjective norms (ß=-0.17, P<0.01). CONCLUSION: This study suggests that strategies to facilitate positive attitudes and increase parental awareness of health screening initiatives may influence participation rates within community- and school-based programming.

Exercise training increases skeletal muscle strength independent of hypertrophy in older adults aged 75 years and older.

AIM: We investigated whether exercise-mediated acquisition of muscle mass and strength would occur in a concurrent manner in older adults. METHODS: A total of 152 community-dwelling older adults (young-old aged 65-74 years, old-old aged >75 years) were allocated into either 8-week comprehensive exercise training or the control group. Participants (n = 136) completed all pre- and post-intervention testing visits (young-old n = 73, old-old n = 63). Older adults in exercise groups were subjected to a series of programmed elastic band and free exercises twice per week at three to five sets of 15-20 repetitions. Body composition, skeletal muscle mass, knee strength (extensors and flexors) and gait-related physical function were evaluated as main variables. RESULTS: As expected, muscular mass and knee strength (both extensors and flexors) were inversely correlated with age in the old-old group (all P < 0.001). However, knee extensor strength was the only lower limb component inversely correlated with age in the young-old group (P < 0.043). Knee extensor strength was significantly increased by exercise training in both the young-old and old-old groups (young old P < 0.042, old-old P < 0.011). Training-induced muscle hypertrophy was observed only in the young-old group (P < 0.025). the correlation of knee extensor strength against gait-related physical function was the greatest, followed by knee flexor strength and muscle mass. CONCLUSIONS: The present results showed that age-associated strength decline of the knee extensor occurs earlier compared with the knee flexor during the aging process, and exercise training increases muscular strength without significant changes of muscle mass in older adults aged aged ≥75 years. Geriatr Gerontol Int 2019; 19: 265-270.

Relationship Between Adherence to Individual Goals Within the 5-2-1-0 Guidelines for Obesity Prevention and Number of PACER Laps in Adolescents.

BACKGROUND: The purpose of this study was to evaluate the relationship between adolescents' adherence to the 5-2-1-0 goals and the number of completed Progressive Cardiovascular Endurance Run (PACER) laps. METHODS: Participants included 1792 students aged 10 to 16 years who were randomly selected across 9 data collection periods between 2012 and 2014. The Survey of Physical Activity and Nutrition was used to measure time spent in physical activity and sedentary behavior, and dietary intake and the dependent variable was the number of PACER laps achieved. The Kruskal-Wallis test and pairwise post hoc comparisons were conducted. RESULTS: Only 0.95% (N = 17) participants met all 4 goals outlined within the 5-2-1-0 guidelines. Whereas 10.04% met 3 (N = 180), 41.63% met 2 (N = 746), 34.99% met 1 (N = 627), and 12.39% did not meet any goals (N = 222). Pairwise comparisons indicated there were significant differences: between groups not meeting any of the 5-2-1-0 goals and other groups (meeting one goal [p = .000], 2 goals [p = .000], 3 goals [p = .000], and all 4 [p = .008]). CONCLUSIONS: The positive relationship between PACER laps and adherence to the 5-2-1-0 goals suggests targeted and sequential behavioral changes may have positive implications on adolescents' cardiovascular fitness and body mass index.