Leveraging Household Structure for Increasing Adult Physical Activity in a Low-Income, African American Community.

Health behavior changes often require focusing on factors beyond the individual, particularly in low-income and underresourced areas. The purpose of this article was to assess associations between household structure and adult physical activity levels. Data were collected using Community Assessment for Public Health Emergency Response methodology to administer a household survey (n = 100). Household structure was calculated from summing the number of adults (⩾18 years) and children (<18 years) reported living in the house. Physical activity was measured using the International Physical Activity Questionnaire-Short Form. Adults living in households with two or more adults reported more MET (metabolic equivalent of task) minutes of physical activity per week than adults from households with only one adult. Adults living in households with two or more adults were twice as likely to meet aerobic guidelines for physical activity compared to adults living in households with only adult. Findings suggest the need for developing ecologic approaches in low-income communities to increase social support for physical activity in adults.

Relationships among self-esteem, stress, and physical activity in college students.

The purpose of this study was to identify population and sex-specific relationships between perceived stress, self-esteem, and physical activity in college students. 90 students, ages 18 and older and enrolled in five sections of a health and human behavior class during the spring 2010 semester, were contacted for this study with 74 consenting to serve as study participants. Each participant completed three surveys: the Rosenberg Self-Esteem Scale, the Perceived Stress Scale, and the International Physical Activity Questionnaire. Significant correlations were observed between perceived stress and self-esteem in men, and in women. Physical activity was not significantly correlated with perceived stress or self-esteem.

Maternity Nurses' Perceptions of Implementation of the Ten Steps to Successful Breastfeeding.

OBJECTIVE: The purpose of this study was to determine maternity nurses' perceptions of implementing the Ten Steps to Successful Breastfeeding. METHODS: An online survey and a focus group were used to evaluate perceptions of maternity nurses of implementing the Ten Steps to Successful Breastfeeding in an urban Texas hospital at the onset of the project initiation. Responses were transcribed and coded using Nvivo software. Thematic analysis was conducted and consensus was reached among the research team to validate themes. RESULTS: Twenty-eight maternity nurses participated. Nurses perceived a number of barriers to implementing the Ten Steps to Successful Breastfeeding including nurse staffing shortages, variations in practice among nurses, different levels of nurse education and knowledge about breastfeeding, lack of parental awareness and knowledge about breastfeeding, culture, and postpartum issues such as maternal fatigue, visitors, and routine required procedures during recovery care that interfered with skin-to-skin positioning. Maternity nurses desired more education about breastfeeding; specifically, a hands-on approach, rather than formal classroom instruction, to be able to promote successful implementation of the Ten Steps. CONCLUSIONS: More education on breastfeeding for new mothers, their families, and healthcare providers was recommended. Nurse staffing should be adequate to support nurses in their efforts to promote breastfeeding. Skin-to-skin positioning should be integrated into the recovery period. Hospital leadership support for full implementation and policy adherence is essential. Challenges in implementing the Ten Steps were identified along with potential solutions.

Systemic glucose level changes with a carbohydrate-restricted and higher protein diet combined with exercise.

OBJECTIVE: The authors' purpose in this study was to compare the effects of macronutrient intake on systemic glucose levels in previously sedentary participants who followed 1 of 4 diets that were either higher protein or high carbohydrate, while initiating an exercise program. PARTICIPANTS AND METHODS: The authors randomly assigned 94 sedentary participants to 1 of 4 diet groups consisting of Diet 1 (55% carbohydrate, 30% fat, 15% protein), Diet 2 (55% carbohydrate, 30% fat, 15% protein and caloric restriction), Diet 3 (40% carbohydrate, 30% fat, 25% protein), and Diet 4 (40% carbohydrate, 30% fat, 25% protein and caloric restriction) and followed recommended aerobic exercise prescriptions. RESULTS: Repeated measures analyses of variance (ANOVA) revealed a significant time factor (p=.021) but no significant differences between diet groups (p=.207). A trend was evident in the higher protein groups, with a 5.2% decrease in glucose levels with Diet 3 and 5.0% with Diet 4. Although glucose levels changed over time with the greatest changes in the 2 higher protein diets, levels were not significantly different within participants. CONCLUSIONS: The results of the study indicate that systemic glucose availability was affected by higher protein consumption in Diet 3 participants, with the same trend in Diet 4 participants, although nonsignificant. These findings demonstrate that consuming a lower carbohydrate diet for 12 weeks can possibly change systemic glucose levels.

Using the Community Assessment for Public Health Emergency Response (CASPER) to assess barriers to healthy eating and active living in a low-income community.

Insufficient physical activity and unhealthy eating behaviors are major contributors to the obesity epidemic in the United States. Identifying health behaviors and disparities in underserved communities is needed to guide the development of targeted interventions. The Community Assessment for Public Health Emergency Response (CASPER) is a set of tools designed for public health emergencies, but the utility of CASPER in non-emergency settings has not been explored. The purpose of this study was to use CASPER to obtain information on household-based behaviors of and barriers to fruit/vegetable consumption and physical activity, and explore the utility of these methods for future health assessments. Cross-sectional survey data included households (n=100) in a low-income neighborhood. Half of adults did not meet recommendations for fruit/vegetable consumption and 20% reported no physical activity during the previous week. Cost was significantly associated with healthy eating and physical activity in our community. Four primary advantages of using CASPER methodology included a user-friendly CDC toolkit, yield of a representative community sample with a relatively low sample size, low-cost/low-tech requirements for implementation, and the strengthening of an academic-practice-community partnership. Our work demonstrates the utility of CASPER for assessing healthy living in a geographically-defined community where household health behaviors and barriers are unknown.

Pharmaceutical therapy in midwifery practice: a culturally competent approach.

The profession of midwifery can be part of the solution in America's quest for a culturally sensitive and competent health care system. Midwives who are familiar with a variety of health-related cultural beliefs and practice culturally sensitive inquiry, particularly when using pharmaceutical therapies, can effectively understand and respond to the cultural complexities that impact a client's health. This article describes needed cultural competencies, reviews a variety of health-related cultural beliefs, and relates how these beliefs impact the use and acceptability of pharmaceutical therapies. Specific examples related to culturally sensitive inquiry are discussed along with recommendations.

The National Health Educator Job Analysis 2010: process and outcomes.

The National Health Educator Job Analysis 2010 was conducted to update the competencies model for entry- and advanced-level health educators. Qualitative and quantitative methods were used. Structured interviews, focus groups, and a modified Delphi technique were implemented to engage 59 health educators from diverse work settings and experience levels in a seven-step instrument development process. An online survey was then completed by 1,022 practicing health educators. Survey participants used 4-point ordinal scales to rank subcompetencies by frequency of use and importance and related knowledge items by cognitive levels based on the Revised Bloom's Taxonomy. Composite scores were calculated and subgroup comparisons conducted to validate 223 subcompetencies at entry (162), advanced-1 (42), and advanced-2 (19) levels of practice, along with 113 knowledge items. Advanced-level versus entry-level competencies and a comparison with the Competency Update Project model of 2006 are discussed. Implications and recommendations for the profession are provided.

The Effects of Lowering Uric Acid Levels Using Allopurinol on Components of Metabolic Syndrome.

BACKGROUND: Researchers have reported an independent direct relationship between lipid levels and hyperuricemia with MetS. The purpose of this study was to determine the relationship between serum uric acid levels and lipids among patients on allopurinol. METHODS: A retrospective secondary data analysis was conducted on 66 adult patients from a family health clinic in Central Texas. Medical records used were recorded during a nine year period (2002 - 2010) ascertaining the relationship between uric acid and lipids. RESULTS: Spearman correlations revealed a weak correlation between uric acid and total cholesterol, a weak correlation between uric acid and triglycerides and LDL-C. A weak inverse correlation was discovered between uric acid and HDL-C. A moderate correlation was discovered when all lipid variables combined were compared to uric acid. CONCLUSIONS: We discovered LDL-C and triglycerides to be significant predictors of uric acid with weak correlations. Additionally, weak correlations existed between uric acid and total cholesterol and HDL-C with an inverse relationship discovered with HDL-C. These findings support the literature suggesting that uric acid is more likely to be associated with total cholesterol and triglycerides. In addition, new discoveries serve as an indication that LDL-C may also be associated with uric acids levels. The mechanism by which uric acid may regulate lipids is elusive but suggestions have included suppression of lipid peroxidase and decreases in critical lipase activity.

Cultural effectiveness in research: a summary report of a panel session entitled "Engaging Populations at Risk".

This paper summarizes two presentations and a panel discussion engaging health scientists, educators, and community outreach professionals who have drawn upon their experiences as researchers and agricultural workers to describe research challenges related to access, trust, language, culture, and participant benefit. These presentations and discussion took place at the New Paths: Health and Safety in Western Agriculture conference, November 11-13, 2008. An overview of changing demographics of the western agricultural workforce was provided followed by a presentation of the application of community-based participatory research (CBPR) principles including cultural considerations. Using an interview format, the panel participants discussed challenges related to involving members of vulnerable agricultural worker populations throughout the research process. Lessons learned and recommendations were explored and successes identified.

Factors affecting nutrition behavior among middle-class adolescents in urban area of Northern region of Brazil

O Brasil tem sido considerado um país em transiçäo nutricional em razäo dos recentes aumentos na prevalência de obesidade e doenças crônicas na classe média, sendo importante identificar os fatores que influenciam as preferências nutricionais desse grupo. Foi realizado estudo com estudantes de classe média de um colégio secundário, particular, em Manaus, AM, Brasil. Com o objetivo de determinar a disponibilidade e a acessibilidade das merendas e analisar as atitudes e preferências dos estudantes e a influência de vários fatores na escolha de merendas nutritivas. O estudo incluiu quatro fases: (a) discussäo em um grupo de especialistas em nutriçäo sobre a disponibilidade e acessibilidade das merendas em Manaus; (b) inquérito junto a um grupo dos adolescentes (n=63) sobre suas preferências e hábitos nutricionais; (c) inquérito junto a supermercado selecionado para identificar a disponibilidade e acessibilidade das merendas preferidas; (d) um grupo acompanhado de um subamostra dos adolescentes (n=55) para identificar as preferências e atitudes sobre o custo e disponibilidade das merendas. Foi constatado que os estudantes possuíam condiçöes financeiras para comprar merendas e que as merendas nutritivas näo custam mais do que as näo nutritivas. A preferência dos adolescentes foi por merendas näo nutritivas. Os fatores que, principalmente, influenciam na escolha originam-se da família e da televisäo. As implicaçöes para futuras pesquisas e programas nutricionais säo discutidos, recomendando-se campanha de educaçäo nutricional para famílias, visto a importância desta na escolha de merendas entre esses adolescentes.