Strategies for Effective Eating Development-SEEDS: Design of an Obesity Prevention Program to Promote Healthy Food Preferences and Eating Self-Regulation in Children From Low-Income Families.

OBJECTIVE: To develop a scientifically based childhood obesity prevention program supporting child eating self-regulation and taste preferences. This article describes the research methods for the Strategies for Effective Eating Development program. A logic model is provided that depicts a visual presentation of the activities that will be used to guide the development of the prevention program. DESIGN: Randomized, controlled prevention program, pretest, posttest, 6 months, and 12 months. SETTING: Two sites: Houston, TX and Pasco, WA. Each trial will last 7 weeks with 8-10 mother-child dyads in each arm (prevention and control). PARTICIPANTS: Recruitment at Head Start districts (Texas; n = 160) and Inspire Child Development Center including Early Childhood Education and Head Start (Washington; n = 160). Sixteen trials with 16-20 parent-child dyads per trial will provide adequate power to detect moderate effects. INTERVENTION: Multicomponent family-based prevention program incorporating a dialogue approach to adult learning and self-determination theory. MAIN OUTCOME MEASURES: Child assessments will include observed taste preferences, caloric compensation, and eating in the absence of hunger. Parent assessments will include parent-reported feeding, feeding emotions, acculturation, child eating behaviors, child food preferences, and child dietary intake. Heights and weights will be measured for parent and child. ANALYSIS: A multilevel growth modeling analysis will be employed to consider the nested nature of the data: time points (level 1) within families (level 2) within trials (level 3).

Correlates of long-term participation in a physical activity-based positive youth development program for low-income youth: sustained involvement and psychosocial outcomes.

This study examined correlates of long-term participation in a positive youth development (PYD) program. Low-income youth (N = 215) age 8-13 of diverse ethnicity participating in a summer physical activity-based PYD program completed questionnaires at the beginning and end of the program (year 1) and at the beginning of year 2. Those with lower BMI and higher attendance and leader support perceptions were more likely to return to the program the following year. Self-worth and leader support perceptions at time 2 were higher for returners compared to non-returners. Among returners, hope increased from year 1 to year 2 and increases in global self-worth across the first year were maintained over one year. Social support is linked to continued PYD participation. Returners had increased and/or sustained positive perceptions of self-worth and hope. Programs are encouraged to foster staff-participant relationships and self-worth, and minimize barriers associated with weight status.

Using educational outreach and a financial incentive to increase general practices' contribution to chlamydia screening in South-East London 2003-2011.

BACKGROUND: The London Boroughs of Lambeth and Southwark have high levels of sexually transmitted infections including Chlamydia trachomatis. Modelling studies suggest that reductions in the prevalence of chlamydia infection will require a high level of population screening coverage and positivity among those screened. General practice has a potentially important role to play in delivering these levels of coverage since large numbers (up to 60%) of young people visit their general practice every year but previous work suggests that there are barriers to delivering screening in this setting. The aim of this study was to evaluate an intervention to increase chlamydia screening in general practice within Primary Care Trusts (PCTs) of Lambeth and Southwark, a strategy combining financial incentives and supportive practice visits to raise awareness and solve problems. METHODS: Data on age, gender, venue and chlamydia result for tests on under 25 s in Lambeth from 2003-11 was obtained from the National Chlamydia Screening Programme. We analysed the number and percentage of tests generated in general practice, and looked at the number of practices screening more than 10% of their practice cohort of 15-24 year olds, male/female ratio and positivity rates across other screening venues. We also looked at practices screening less than 10% and studied change over time. We compared data from Lambeth and Southwark with London and England. We also studied features of the level and type of educational and financial incentive interventions employed. RESULTS: Chlamydia tests performed in general practice increased from 23 tests in 2003-4 to 4813 tests in 2010-11 in Lambeth. In Southwark they increased from 5 tests in 2003/04 to 4321 in 2010/11. In 2011, 44.6% of tests came from GPs in Lambeth and 46% from GP's in Southwark. In Lambeth 62.7% of practices tested more than 10% of their cohort and in Southwark this was 55.8%. In Lambeth, postivity rate in 2010/11 was 5.8% in men and 6.0% in women. In Southwark positivity rate was 3.9% in men and 5.3% in women. In 2003/04 13% tests in general practice (Lambeth) were from men, this increased to 25% in 2010/11. In Southwark this increased from 20% in 2003/04 to 27.6% in 2010/11. We compared the results with London and national data and showed significant differences between GP testing in Lambeth and Southwark, and GP testing in London and the rest of England. CONCLUSIONS: General practices can be important potential providers of chlamydia tests.With a combination of sustained support, financial incentives and feedback on performance, general practice may be able to test a large percentage of 15-24 year olds. General practice is also a potentially important provider of chlamydia tests to young men.