Continuous Stakeholder Engagement: Expanding the Role of Pharmacists in Prevention of Type 2 Diabetes Through the National Diabetes Prevention Program.

The pharmacy sector is a key partner in the National Diabetes Prevention Program (National DPP), as pharmacists frequently care for patients at high risk for type 2 diabetes. The Centers for Disease Control and Prevention aimed to increase pharmacist involvement in the program by leveraging partnerships with national pharmacy stakeholders. Continuous stakeholder engagement helped us to better understand the pharmacy sector and its needs. With stakeholders, we developed a guide and promotional campaign. By following a systematic process and including key stakeholders at every step of development, we successfully engaged these valuable partners in national type 2 diabetes prevention efforts. More pharmacy sites (n = 87) are now offering the National DPP lifestyle change program compared to before release of the guide (n = 27).

Attitudes, practices, and concerns about child feeding and child weight status among socioeconomically diverse white, Hispanic, and African-American mothers.

Parents play an important role in the development of their children's eating behaviors. We conducted 12 focus groups (three white, three African-American, and three Hispanic-American low-income groups; three white middle-income groups) of mothers (N=101) of 2- to less than 5-year-old children to explore maternal attitudes, concerns, and practices related to child feeding and perceptions about child weight. We identified the following major themes from responses to our standardized focus group guide: 12 groups wanted to provide good nutrition, and most wanted children to avoid eating too many sweets and processed foods; 12 groups prepared foods their children liked, accommodated specific requests, and used bribes and rewards to accomplish their feeding goals (sweets were commonly used as bribes, rewards, or pacifiers); and 11 of 12 groups believed their children were prevaricating when they said they were full and mothers encouraged them to eat more. The common use of strategies that may not promote healthful weight suggests work is needed to develop culturally and socioeconomically effective overweight prevention programs. Further study is needed to verify racial/ethnic or income differences in attitudes, practices, and concerns about child feeding and perceptions of child weight.

Knowledge of physical activity guidelines among adults in the United States, HealthStyles 2003-2005.

BACKGROUND: We estimated percentages of US adults (>/=18 years) who knew that prior federal physical activity (PA) guidelines call for a minimum of 30 minutes of moderate-intensity PA most days (>/=5)/week using 2003 to 2005 HealthStyles, an annual mail survey. METHODS: 10,117 participants identified "the minimum amount of moderate-intensity PA the government recommends to get overall health benefits." Response options included 30/>/=5, 20/>/=3, 30/7, and 60/7 (minutes/days per week), "none of these," and "don't know." The odds of correctly identifying the guideline was modeled by participant sex, age, race/ethnicity, income, education, marital status, body mass index, physical activity level, and survey year using logistic regression. RESULTS: 25.6% of respondents correctly identified the guideline. Women were 30% more likely to identify the guideline than men (Odds Ratio [95% Confidence Limits] (OR) = 1.28 [1.15, 1.44]). Regular PA was positively associated with identifying the guideline versus inactivity (OR = 2.08 [1.73, 2.50]). Blacks and those earning <$15,000 annually were 24% to 32% less likely to identify the guideline than whites and those earning >$60,000, respectively. CONCLUSIONS: Most adults did not know the previous moderate-intensity PA recommendation, which indicates a need for effective communication strategies for the new 2008 Physical Activity Guidelines for Adults.

Correlates of weight-bearing physical activity among adolescent girls: results from a national survey of girls and their parents.

BACKGROUND: Despite the potential benefits of reducing the risk of osteoporosis in later life, research on adolescent girls' weight-bearing physical activity (WBPA) is limited. This study explores correlates for WBPA in this population. METHODS: A nationally representative telephone survey sponsored by the National Bone Health Campaign was conducted with 1000 girls age 9 to 12 years and a parent. Girls' physical activities were coded as weight bearing or not and correlated with cognitive, social, and environmental variables. RESULTS: Regression analysis revealed that WBPA was significantly associated with self-reported parents' education, parental self-efficacy, girls' normative beliefs about time spent in physical activity, being physically active with a parent, having physically active friends, and perceived availability of after-school physical activities. CONCLUSIONS: Interventions encouraging parents to participate in WBPA with their daughters and increasing parents' positive attitudes and self-efficacy in getting their daughters to be physically active should be tested.

Reducing children's television-viewing time: a qualitative study of parents and their children.

OBJECTIVES: The American Academy of Pediatrics recommends that children over age 2 years spend < or = 2 hours per day with screen media, because excessive viewing has been linked to a plethora of physical, academic, and behavioral problems. The primary goal of this study was to qualitatively explore how a recommendation to limit television viewing might be received and responded to by a diverse sample of parents and their school-age children. METHODS: The study collected background data about media use, gathered a household media inventory, and conducted in-depth individual and small group interviews with 180 parents and children ages 6 to 13 years old. RESULTS: Most of the children reported spending approximately 3 hours per day watching television. The average home in this sample had 4 television sets; nearly two thirds had a television in the child's bedroom, and nearly half had a television set in the kitchen or dining room. Although virtually all of the parents reported having guidelines for children's television viewing, few had rules restricting the time children spend watching television. Data from this exploratory study suggest several potential barriers to implementing a 2-hour limit, including: parents' need to use television as a safe and affordable distraction, parents' own heavy television viewing patterns, the role that television plays in the family's day-to-day routine, and a belief that children should spend their weekend leisure time as they wish. Interviews revealed that for many of these families there is a lack of concern that television viewing is a problem for their child, and there remains confusion about the boundaries of the recommendation of the American Academy of Pediatrics. CONCLUSIONS: Parents in this study expressed interest in taking steps toward reducing children's television time but also uncertainty about how to go about doing so. Results suggest possible strategies to reduce the amount of time children spend in front of the screen.