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OBJECTIVE: This study assessed how parental nativity and perceived environment are associated with physical activity and screen time of U.S. children and adolescents. METHODS: Data originated from the 2020-21 U.S. National Survey of Children's Health. We conducted multivariable Poisson regression to assess the cross-sectional association of parental nativity and perceived neighborhood environment variables on parental reports of youth meeting national physical activity and screen time guidelines. We tested interactions of parental nativity and neighborhood environment variables on both outcomes. Analyses were conducted using STATA v17 and p < 0.05 indicated statistical significance. RESULTS: The sample of 24,928 children and 30,951 adolescents was 11.6 years of age, on average, with approximately 39% under 200% of the federal poverty level. About one-third of the sample (27.5%) had foreign-born parents. In adjusted models, we found that compared to youth with U.S.-born parents, those with foreign-born parents had a lower prevalence of meeting physical activity guidelines. Youth whose parents reported living in safe neighborhoods had a higher prevalence of meeting guidelines for physical activity (children: PR = 1.20, 95%CI 1.14, 1.27; adolescents: PR = 1.23, 95%CI 1.14, 1.32) and screen time (children: PR = 1.19, 95%CI 1.13, 1.26; adolescents: PR = 1.16, 95%CI 1.06, 1.28) than youth whose parents reported unsafe neighborhoods. We found similar associations between neighborhoods considered supportive or with many amenities and meeting physical activity and screen time guidelines. CONCLUSIONS: Youth whose parents are foreign-born have a lower prevalence of sufficient activity, and perceived parental neighborhood safety and support may be significant influences on youth physical activity and screen time.
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Ejercicio Físico , Padres , Tiempo de Pantalla , Humanos , Masculino , Femenino , Estados Unidos , Estudios Transversales , Niño , Adolescente , Padres/psicología , Características de la Residencia , Características del VecindarioRESUMEN
INTRODUCTION: The synergistic negative effects of type 2 diabetes (T2DM) and hypertension increases all-cause mortality and the medical complexity of management, which disproportionately impact Hispanics who face barriers to healthcare access. The Salud y Vida intervention was delivered to Hispanic adults living along the Texas-Mexico Border with comorbid poorly controlled T2DM and hypertension. The Salud y Vida multicomponent intervention incorporated community health workers (CHWs) into an expanded chronic care management model to deliver home-based follow-up visits and provided community-based diabetes self-management education. METHODS: We conducted multivariable longitudinal analysis to examine the longitudinal intervention effect on reducing systolic and diastolic blood pressure among 3806 participants enrolled between 2013 and 2019. Participants were compared according to their program participation as either higher (≥ 10 combined educational classes and CHW visits) or lower engagement (<10 encounters). Data was collected between 2013 and 2020. RESULTS: Baseline mean systolic and diastolic blood pressure were 138 and 81 mmHg respectively. There were overall improvements in systolic (-6.49; 95% CI = [-7.13, -5.85]; p < 0.001) and diastolic blood pressure (-3.97; 95% CI = [-4.37, -3.56]; p < 0.001). The higher engagement group had greater systolic blood pressure reduction at 3 months (adjusted mean difference = -1.8 mmHg; 95% CI = [-3.2, -0.3]; p = 0.016) and at 15 month follow-up (adjusted mean difference = -2.3 mmHg; 95% CI = [-4.2, -0.39]; p = 0.0225) compared to the lower engagement group. CONCLUSION: This intervention, tested and delivered in a real-world setting, provides an example of how CHW integration into an expanded chronic care model can improve blood pressure outcomes for individuals with co-morbidities.
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Agentes Comunitarios de Salud , Diabetes Mellitus Tipo 2 , Hispánicos o Latinos , Hipertensión , Humanos , Texas , Masculino , Femenino , Diabetes Mellitus Tipo 2/terapia , Persona de Mediana Edad , Hispánicos o Latinos/estadística & datos numéricos , Hipertensión/terapia , Hipertensión/etnología , Estudios Longitudinales , Afecciones Crónicas Múltiples/terapia , Adulto , Presión Sanguínea , AncianoRESUMEN
BACKGROUND: Schools are a key setting for supporting youth physical activity, given their broad reach and diverse student populations. Organizational readiness is a precursor to the successful implementation of school-based physical activity opportunities. The R = MC2 heuristic (Readiness = Motivation x Innovation-Specific Capacity x General Capacity) describes readiness as a function of an organization's motivation and capacity to implement an innovation and can be applied to better understand the implementation process. The purpose of this study was to explore the barriers to and facilitators of implementing school-based physical activity opportunities in the context of organizational readiness. METHODS: We analyzed interview data from 15 elementary school staff (principals, assistant principals, physical education teachers, and classroom teachers) from a school district in Texas. We focused on factors related to adopting, implementing, and sustaining a variety of school-based physical activity opportunities. We used the Framework Method to guide the analysis and coded data using deductive (informed by the R = MC2 heuristic) and inductive approaches. Themes were generated using the frequency, depth, and richness of participant responses. RESULTS: Four themes emerged from the data: (1) implementation is aided by the presence of internal and external relationships; (2) physical activity opportunities compete with other school priorities; (3) seeing the benefits of physical activity opportunities motivates school staff toward implementation; and (4) staff buy-in is critical to the implementation process. Themes 1-3 aligned with subcomponents of the R = MC2 heuristic (intra- and inter-organizational relationships, priority, and observability), whereas Theme 4 (staff buy-in) related to multiple subcomponents within the Motivation component but was ultimately viewed as a distinct construct. CONCLUSION: Our results highlight and explain how key readiness constructs impact the implementation of school-based physical activity opportunities. They also highlight the importance of obtaining staff buy-in when implementing in the school setting. This information is critical to developing readiness-building strategies that help schools improve their capacity to deliver physical activity opportunities effectively. TRIAL REGISTRATION: Not applicable.
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Ejercicio Físico , Heurística , Adolescente , Humanos , Investigación Cualitativa , Estudiantes , MotivaciónRESUMEN
OBJECTIVES: Non-alcoholic fatty liver disease (NAFLD) is a highly prevalent liver disease, with the highest prevalence observed in the U.S. among Hispanic/Latino adults. While physical activity and dietary behaviors have established protective associations with NAFLD and its severity, these associations have not been well-characterized in Hispanic/Latino adults. The purpose of this study was to assess the association of lifestyle behaviors with NAFLD and advanced fibrosis in US Hispanic/Latino adults. DESIGN: We selected all Hispanic/Latino adults from the 2017-2018 National Health and Nutrition Examination Survey (NHANES). NAFLD was defined as CAP ≥285â dB/m, and advanced fibrosis as liver stiffness measurements ≥8.6â kPa. Multivariate-adjusted logistic regression models assessed associations of physical activity and sedentary behavior (Global Physical Activity Questionnaire), as well as diet quality (Healthy Eating Index [HEI]-2015) and total energy intake (24-hour recall) with NAFLD and advanced fibrosis. RESULTS: In Hispanic/Latino adults, the overall prevalence of NAFLD was 41.5%, while the prevalence of advanced fibrosis among those with NAFLD was 17.2%. We found that higher levels of physical activity and high diet quality were associated with lower risk of NAFLD. Compared to those reporting on average 0 metabolic equivalent (MET) hours/week of physical activity, participants reporting high levels of physical activity (≥32 MET hours/week) had 40% lower risk of NAFLD (Adjusted OR = 0.60, 95%CI 0.38, 0.93). High diet quality (HEI-2015) was associated with a 30% lower risk of NAFLD (Adjusted OR = 0.70, 95% CI 0.51, 0.97) and 72% lower risk of advanced fibrosis (Adjusted OR = 0.28, 95% CI 0.12, 0.66), as compared to those with low diet quality. CONCLUSIONS: In this population-based study, high levels of physical activity and diet quality were associated with lower risk of NAFLD in Hispanic/Latino adults. Public health and medical professionals need to concentrate efforts on lifestyle behavior change in Hispanic/Latino adults who are at high risk for serious liver disease.
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Hispánicos o Latinos , Estilo de Vida , Enfermedad del Hígado Graso no Alcohólico , Humanos , Diagnóstico por Imagen de Elasticidad , Fibrosis , Enfermedad del Hígado Graso no Alcohólico/epidemiología , Enfermedad del Hígado Graso no Alcohólico/complicaciones , Enfermedad del Hígado Graso no Alcohólico/metabolismo , Encuestas Nutricionales , Prevalencia , Estados UnidosRESUMEN
The association of physical activity (PA) and diet quality with non-alcoholic fatty liver disease (NAFLD) and NAFLD-related fibrosis have never been examined in a representative sample of U.S. adults using a more precise form of measuring NAFLD. The purpose of this study was to assess the associations of PA and diet quality (Healthy Eating Index [HEI]-2015) with NAFLD and a subset with advanced fibrosis (F3-4) as assessed by vibration-controlled transient elastography with controlled attenuation parameter in a representative sample of U.S. adults. This cross-sectional analysis uses data from 2017-2018 National Health and Nutrition Examination Survey. NAFLD was defined as controlled attenuation parameter ≥285 dB/m, and high likelihood of advanced fibrosis as liver stiffness measurements ≥8.6 kPa. Associations of HEI-2015 from 24-h dietary recalls and self-reported PA and sedentary behavior were estimated in multivariable-adjusted logistic regression models of NAFLD and advanced fibrosis. In 2892 adults, the prevalence of NAFLD and advanced fibrosis was 35.6% and 5.6%, respectively. We found that high adherence to U.S. dietary recommendations (highest vs. lowest HEI-2015 tertile) and more PA (middle tertile vs. lowest) were associated with reduced odds of NAFLD (Adjusted OR and 95% CI; 0.60 (0.44, 0.84) and 0.65 (0.42, 0.99), respectively). More PA was inversely associated with advanced fibrosis (Adjusted OR = 0.35, 95%CI 0.16, 0.75). Diet quality and PA are associated with reduced odds of NAFLD, and PA may be critical even for those with advanced liver disease. These behaviors should be the focus of targeted public health interventions.
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Enfermedad del Hígado Graso no Alcohólico , Adulto , Estudios Transversales , Dieta , Ejercicio Físico , Fibrosis , Humanos , Cirrosis Hepática/complicaciones , Cirrosis Hepática/diagnóstico , Cirrosis Hepática/epidemiología , Enfermedad del Hígado Graso no Alcohólico/epidemiología , Encuestas NutricionalesRESUMEN
INTRODUCTION: The COVID-19 pandemic impacted individual physical activity levels. Less is known regarding how factors such as sociodemographic and built environment were associated with physical activity engagement during the pandemic. Understanding these factors is critical to informing future infectious disease mitigation policies that promote, rather than hinder physical activity. The purpose of this study was to assess predictors of physical activity levels during the beginning of the pandemic (April-June 2020), including Stay-at-Home length and orders, neighborhood safety, and sociodemographic characteristics. METHODS: Data included 517 participants who responded to an anonymous online survey. Physical activity was assessed with a modified Godin Leisure-time exercise questionnaire. We used logistic regression models to estimate unadjusted and adjusted odds ratios (aOR) and their 95% confidence intervals (CI) for the associations between independent variables (e.g., demographic variables, neighborhood safety, COVID Stay-at-Home order and length of time) and physical activity levels that did not meet (i.e., < 600 metabolic equivalents of task [MET]-minutes/week) or met guidelines (i.e., ≥ 600 MET-minutes/week). We used R-Studio open-source edition to clean and code data and SAS V9.4 for analyses. RESULTS: Most participants were 18-45 years old (58%), female (79%), Hispanic (58%), and college/post-graduates (76%). Most (70%) reported meeting physical activity guidelines. In multivariate-adjusted analyses stratified by income, in the highest income bracket (≥ $70,000) pet ownership was associated with higher odds of meeting physical activity guidelines (aOR = 2.37, 95% CI: 1.23, 4.55), but this association did not persist for other income groups. We also found lower perceived neighborhood safety was associated with significantly lower odds of meeting physical activity guidelines (aOR = 0.15, 95% CI:0.04-0.61), but only among individuals in the lowest income bracket (< $40,000). Within this lowest income bracket, we also found that a lower level of education was associated with reduced odds of meeting physical activity guidelines. DISCUSSION: We found that perceived neighborhood safety, education and pet ownership were associated with meeting physical activity guidelines during the early months of the COVID-19 pandemic, but associations differed by income. These findings can inform targeted approaches to promoting physical activity during subsequent waves of COVID-19 or future pandemics.
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COVID-19 , Humanos , Femenino , Adolescente , Adulto Joven , Adulto , Persona de Mediana Edad , COVID-19/epidemiología , COVID-19/prevención & control , Pandemias/prevención & control , Ejercicio Físico , Entorno Construido , RentaRESUMEN
BACKGROUND: Because physical activity (PA) and sedentary behavior (SB) are two distinct, interdependent behaviors, increases in PA may influence SB. As a limited number of SB interventions have been tested in Latino/Hispanic samples,. The purpose of this study is to assess if there was more PA and less SB in a Hispanic border community where there had been a PA-targeted community-wide campaign since 2005. METHODS: This cross-sectional study included Hispanic adults (N = 676) sampled from both intervention and comparison Texas-Mexico border communities in 2010. Our dependent variable was four-categories based on meeting PA guidelines and excessive SB (≥540 mins/day) cut-points. We conducted adjusted multivariable analysis to assess the association of intervention group with the PA/SB groupings. RESULTS: In 2010, most adults were in the Low PA/Low SB group. Compared to the comparison group, the intervention group had 6.45 (p < 0.001) times the adjusted odds of being in the High PA/Low SB vs. Low PA/High SB group. CONCLUSIONS: Five years into the campaign, more PA and less SB were more likely in the intervention community, indicating the association of some PA interventions with SB. PA-targeted interventions should capture effects on SB to expand the literature on effective SB interventions for Hispanic adults.
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Ejercicio Físico , Conducta Sedentaria , Adulto , Estudios Transversales , Hispánicos o Latinos , Humanos , México , Estudios Prospectivos , Texas/epidemiologíaRESUMEN
Mexican-origin adolescents have a high prevalence of obesity. Research is needed to understand how family context may shape adolescent BMI. This study examined longitudinal associations of family functioning variables with the Centers for Disease Control and Prevention's modified BMI z-score (BMIaz) in 1175 Mexican-origin adolescents, and explored interactions with acculturation. Adolescents (50% female, aged 11-13â¯y in 2005-06) were identified from an ongoing cohort study of Mexican-origin adults in Houston, TX, and were assessed three times from 2005-06 to 2010-11. In multivariate linear mixed models stratified by gender, we assessed longitudinal associations of family cohesion and family conflict with adolescent BMIaz and explored interactions with language acculturation. We disaggregated the between- (mean) and within-person (individual deviation) components of family cohesion and family conflict to assess the effects on BMIaz. Approximately one-third of adolescents were obese at baseline, and BMIaz declined during the study. In girls, higher mean family cohesion and conflict were associated with steeper declines in BMIaz. Parental linguistic acculturation modified the relationship between within-person deviation in family cohesion and BMIaz in girls, such that high parental U.S. acculturation was associated with a stronger inverse association. There were no significant associations in boys. These findings highlight the potential importance of the family context to female adolescent BMI and the promise of addressing family context in obesity-related interventions.
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Aculturación , Índice de Masa Corporal , Conflicto Familiar/psicología , Americanos Mexicanos/estadística & datos numéricos , Obesidad/epidemiología , Adolescente , Niño , Femenino , Humanos , Estudios Longitudinales , Masculino , México/etnología , Factores Sexuales , Estados Unidos/epidemiologíaRESUMEN
BACKGROUND: Physical activity and sedentary behavior are considered independent risk factors for chronic disease. However, we do not fully understand their interrelation with key health outcomes such as subclinical atherosclerosis. This study examines the combined effects of sedentary behavior and physical activity on carotid intima-media thickness (cIMT) and presence of carotid plaque in a Mexican American population on the Texas-Mexico border. METHODS: This cross-sectional study was conducted using retrospective data from a sample (n = 612) of participants from the Cameron County Hispanic Cohort. Carotid ultrasound was used to measure cIMT and presence of carotid plaque. Self-reported questionnaires were used to assess leisure time physical activity and sedentary behavior (TV/movie sitting and total sitting). A series of multivariable regression models were used to assess study aims. An interaction term between physical activity and sedentary behavior was included in models for each respective outcome. Models were controlled for demographic and health-related variables. RESULTS: There were no significant associations found between physical activity, sedentary behavior and mean cIMT, or cIMT thickness ≥ 75th percentile for age and gender. However, there was a significant interaction between physical activity and TV/movie sitting with presence of carotid plaque. Participants who reported moderate levels of physical activity had significantly lower odds for presence of plaque compared to participants with no activity when TV/movie sitting time was ≤3 h per day. However, there was no significant difference in odds for presence of plaque between physical activity groups when TV/movie sitting exceeded 3 h/day. These results were consistent with models examining total sitting time. CONCLUSIONS: Our results indicate that for Mexican Americans, there is a combined effect of sedentary behavior and physical activity on presence of carotid plaque. Participating in moderate physical activity is optimal for having lower levels of carotid plaque in addition to avoiding excessive levels of TV/movie sitting (≥3 h/day) and/or total sitting (≥8.5 h/day).
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Aterosclerosis/etnología , Ejercicio Físico , Americanos Mexicanos/estadística & datos numéricos , Conducta Sedentaria/etnología , Adulto , Aterosclerosis/diagnóstico , Grosor Intima-Media Carotídeo , Estudios Transversales , Femenino , Humanos , Actividades Recreativas , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Factores de Riesgo , Autoinforme , Texas , UltrasonografíaRESUMEN
Hispanics are under-represented in clinical research. To ensure that the Hispanic population benefits from advances in public health and medicine, including personalized medicine, there is a need to increase their participation in clinical trials and biobanking. There is a great need for improving awareness and addressing concerns individuals may have about participation. The purpose of this study was to adapt, implement, and evaluate educational materials about clinical trials and biobanking for Hispanic individuals. We adapted existing materials based on focus group data. We then trained four promotoras de salud to deliver education to Hispanic adults in community settings in Houston, TX. The promotoras educated 101 Hispanic adults, 51 on biobanking and 50 on clinical trials. Study staff administered brief pre- and post-test questionnaires that measured benefits, barriers, norms, self-efficacy, and intention to participate in either clinical trials or biobanking. Our sample was predominately female (83%) and Spanish-speaking (69%) and made less than $25,000 a year (87%). This intervention increased perceived benefits of participating in biobanking and clinical trials, self-efficacy for donating biospecimens, and intention to participate in biobanking if invited. Perceived barriers to participating declined. This study demonstrated that brief education can result in improved perceptions and attitudes related to participation in biobanking and clinical trials, and could increase participation. Researchers and practitioners could use these educational materials to educate Hispanic community members on clinical research potentially increasing participation rates in the future.
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Bancos de Muestras Biológicas/estadística & datos numéricos , Investigación Biomédica/educación , Ensayos Clínicos como Asunto/estadística & datos numéricos , Conocimientos, Actitudes y Práctica en Salud , Hispánicos o Latinos/psicología , Educación del Paciente como Asunto , Participación del Paciente/estadística & datos numéricos , Adolescente , Adulto , Anciano , Actitud Frente a la Salud , Femenino , Grupos Focales , Humanos , Intención , Masculino , Persona de Mediana Edad , Participación del Paciente/psicología , Proyectos de Investigación , Autoeficacia , Encuestas y Cuestionarios , Adulto JovenRESUMEN
The Social Support for Exercise Subscales are commonly used among Hispanic populations. The aims of this study were to test the validity and reliability of the Spanish-language version of the Social Support for Exercise Subscales, and test the invariance of the Spanish- and English-language versions. Data were from a subsample of Hispanic adults in the Cameron County Hispanic Cohort (n=1,447). A series of confirmatory factor analysis (CFA) models were used to assess the validity and reliability of the Spanish-language version of the subscales. A multi group CFA approach was used to test measurement invariance. Results indicated the Spanish-language versions of family and friend support subscales had good validity and reliability (RMSEA<.07, CFI>0.95, TLI>0.94, and SRMR<0.05). There was also evidence of measurement invariance between the Spanish- and English-language versions. These findings indicate the Spanish-language family and friend support subscales are valid and can be compared between Spanish- and English-language Hispanic respondents.
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BACKGROUND: Low income and uninsured individuals often have lower adherence to cancer screening for breast, cervical and colorectal cancer. Health fairs are a common community outreach strategy used to provide cancer-related health education and services. METHODS: This study was a process evaluation of seven health fairs focused on cancer screening across the U.S. We conducted key-informant interviews with the fair coordinator and conducted baseline and follow-up surveys with fair participants to describe characteristics of participants as well as their experiences. We collected baseline data with participants at the health fairs and telephone follow-up surveys 6 months following the fair. RESULTS: Attendance across the seven health fairs ranged from 41 to 212 participants. Most fairs provided group or individual education, print materials and cancer screening during the event. Overall, participants rated health fairs as very good and participants reported that the staff was knowledgeable and that they liked the materials distributed. After the fairs, about 60% of participants, who were reached at follow-up, had read the materials provided and had conversations with others about cancer screening, and 41% talked to their doctors about screening. Based on findings from evaluation including participant data and coordinator interviews, we describe 6 areas in planning for health fairs that may increase their effectiveness. These include: 1) use of a theoretical framework for health promotion to guide educational content and activities provided, 2) considering the community characteristics, 3) choosing a relevant setting, 4) promotion of the event, 5) considerations of the types of services to deliver, and 6) evaluation of the health fair. CONCLUSIONS: The events reported varied in reach and the participants represented diverse races and lower income populations overall. Most health fairs offered education, print materials and onsite cancer screening. Participants reported general satisfaction with these events and were motivated through their participation to read educational materials or discuss screening with providers. Public health professionals can benefit from this process evaluation and recommendations for designing and evaluating health fairs.
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Neoplasias Colorrectales/diagnóstico , Neoplasias Colorrectales/epidemiología , Detección Precoz del Cáncer/economía , Adolescente , Adulto , Anciano , Neoplasias Colorrectales/economía , Neoplasias Colorrectales/patología , Detección Precoz del Cáncer/métodos , Femenino , Exposiciones Educacionales en Salud/economía , Humanos , Masculino , Tamizaje Masivo/economía , Persona de Mediana Edad , Salud Pública/economía , Encuestas y Cuestionarios , Adulto JovenRESUMEN
CORRECTION: After publication of the article [1], it has been brought to our attention that there is an acknowledgement missing. The authors would like to add the following - "The authors would like to thank the staff and community partners who work to implement the activities of the community wide campaign. In particular we would like to thank Lisa Mitchell-Bennett, Vanessa Saldana, Jennifer Mota, Sister Phylis Peters and the team of community health workers at UT Health and Proyecto Juan Diego who were involved in planning and gathering data."
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BACKGROUND: Despite evidence for the use of community-wide campaigns to promote physical activity, few evaluations of community-wide campaigns in Hispanic communities exist. This study assessed the associations of exposure to a community-wide campaign with physical activity and sedentary behavior among Hispanic adults living on the Texas-Mexico border. METHODS: The intervention, Tu Salud ¡Si Cuenta! (Your Health Matters!; TSSC), included a newsletter, community health worker discussion, TV and radio segments, which were conducted from 2005 to 2010. We matched an intervention (N = 399) and a control community (N = 400) on demographics and used a cross-sectional assessment in 2010 with randomly sampled adults from both communities. We collected exposure to the campaign, as well as physical activity and sedentary behavior with the International Physical Activity Questionnaire. We conducted bivariate analyses and multivariable logistic regression models to assess the association of TSSC exposure and its components with meeting moderate-to-vigorous intensity physical activity (MVPA) guidelines and exhibiting excessive sedentary behavior, controlling for covariates. RESULTS: As compared to the control community, the intervention community has 3 times the odds of meeting MVPA guidelines (Adjusted OR [AOR] = 3.01, 95% CI = 1.85-4.88, p < .05) and 2 times lower odds of excessive sedentary behavior ((AOR = 0.46, 95% CI = 0.30-0.70, p < .05). Exposure in the intervention group to any component was associated with five times the odds of meeting MVPA guidelines (AOR = 5.10, 95% CI 2.88-9.03, p < .001) and 3 times lower odds of excessive sedentary behavior (AOR = 0.32, 95% CI 0.17-0.60, p < .001), compared with those unexposed in the control community. Exposure to newsletters, CHW discussions and TV segments were associated with significantly lower odds of excessive sedentary behavior and higher odds of meeting MVPA guidelines. Exposure to radio segments was only associated with a significantly higher odds of meeting MVPA guidelines (AOR = 4.21, 95% CI = 1.17-15.09). CONCLUSIONS: This study provides some evidence of the association of community-wide campaigns and its components in Hispanic communities with higher levels of MVPA and lower levels of excessive sedentary behavior. TRIAL REGISTRATION NUMBER: NCT00788879 Date: November 11, 2008.
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Ejercicio Físico , Promoción de la Salud/estadística & datos numéricos , Hispánicos o Latinos/psicología , Conducta Sedentaria/etnología , Adulto , Estudios Transversales , Femenino , Hispánicos o Latinos/estadística & datos numéricos , Humanos , Modelos Logísticos , Masculino , México , Persona de Mediana Edad , Evaluación de Programas y Proyectos de Salud , TexasRESUMEN
BACKGROUND: Parents play an important role in providing their children with social support for healthy eating and physical activity. However, different types of social support (e.g., instrumental, emotional, modeling, rules) might have different results on children's actual behavior. The purpose of this study was to assess the association of the different types of social support with children's physical activity and eating behaviors, as well as to examine whether these associations differ across racial/ethnic groups. METHODS: We surveyed 1169 low-income, ethnically diverse third graders and their caregivers to assess how children's physical activity and eating behaviors (fruit and vegetable and sugar-sweetened beverage intake) were associated with instrumental social support, emotional social support, modeling, rules and availability of certain foods in the home. We used sequential linear regression to test the association of parental social support with a child's physical activity and eating behaviors, adjusting for covariates, and then stratified to assess the differences in this association between racial/ethnic groups. RESULTS: Parental social support and covariates explained 9-13% of the variance in children's energy balance-related behaviors. Family food culture was significantly associated with fruit and vegetable and sugar-sweetened beverage intake, with availability of sugar-sweetened beverages in the home also associated with sugar-sweetened beverage intake. Instrumental and emotional support for physical activity were significantly associated with the child's physical activity. Results indicate that the association of various types of social support with children's physical activity and eating behaviors differ across racial/ethnic groups. CONCLUSIONS: These results provide considerations for future interventions that aim to enhance parental support to improve children's energy balance-related behaviors.
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Ejercicio Físico , Conducta Alimentaria , Padres/psicología , Obesidad Infantil/prevención & control , Adulto , Niño , Estudios Transversales , Etnicidad , Femenino , Humanos , Masculino , Responsabilidad Parental , Pobreza , Apoyo Social , TexasRESUMEN
Key modifiable risk behaviors such as smoking, poor diet and physical inactivity often cluster and may have multiplicative adverse effects on health. This study investigated barriers and facilitators to healthy eating and physical activity (PA) in overweight Mexican-origin smokers to inform the adaptation of an evidence-based smoking cessation program into a multiple health behavior change intervention. Five focus groups were conducted with overweight Mexican-origin men (n = 9) and women (n = 21) who smoked. Barriers and facilitators of healthy eating and PA were identified, and gender differences were assessed. Participants expressed some motivation to eat healthfully and identified strategies for doing so, yet many women experienced difficulties related to personal, family and work-related circumstances. Barriers to healthy eating among men were related to food preferences and lack of familiarity with fruits and vegetables. Participants performed PA primarily within the context of work and domestic responsibilities. Stress/depressed mood, lack of motivation and concern for physical well-being limited further PA engagement. Routines involving eating, PA and smoking highlight how these behaviors may be intertwined. Findings emphasize the importance of social, structural and cultural contexts and call for additional investigation into how to integrate healthy eating and PA into smoking cessation interventions for overweight Mexican-origin smokers.
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Dieta Saludable/etnología , Ejercicio Físico , Americanos Mexicanos/psicología , Fumar/etnología , Adulto , Actitud Frente a la Salud , Ejercicio Físico/psicología , Femenino , Grupos Focales , Humanos , Masculino , Persona de Mediana Edad , Factores Sexuales , Fumar/psicologíaRESUMEN
School-based physical activity (PA) opportunities can help students engage in greater amounts of daily PA, meet PA guidelines, and lead to improved health and educational outcomes. However, we do not completely understand the organizational challenges to implementing these opportunities successfully. This exploratory study examined associations between school-level determinants and the implementation of school-based PA opportunities. We analyzed cross-sectional survey data from schools (n = 46) participating in the Healthy Zone School Program (HZSP) (Dallas, Texas, USA) during 2019-2020. Respondents completed an electronic survey that included measures of school-level determinants (e.g. culture, leadership, priority) and the implementation of school-based PA opportunities. We used linear regression models to examine associations between determinants and implementation outcomes (number of PA opportunities delivered, perceived overall success of each PA program/activity used). After adjusting for campus type (i.e. elementary, middle, high, K-12), student race/ethnicity, and percentage of economically disadvantaged students, no constructs were associated with the number of PA opportunities implemented. Linear regression models suggest access to knowledge and information (ß = 0.39, P = .012, 95% CI = 0.24-1.44) and implementation climate (ß = 0.34, P = .045, 95% CI = 0.02-1.59) were positively associated with the success of school-based PA opportunities. Our findings provide suggestive evidence that access to knowledge and information and a supportive school climate may improve the overall success of PA opportunities provided to students. Future research should examine additional school-level determinants to understand their importance to implementation and inform the development of strategies to improve schools' capacity for implementing PA opportunities successfully.
School-based physical activity (PA) opportunities (e.g. programs, activities, policies) help students engage in greater amounts of daily PA, meet national PA guidelines, and lead to improved health and educational outcomes. However, we do not completely understand the organizational challenges to implementing these opportunities successfully. This study explored what factors contribute to schools' ability to provide PA opportunities throughout the school year. We administered a survey to schools participating in the Healthy Zone Schools program during the 201920 academic year to assess the relationship between school-level determinants (e.g. culture, leadership, priority) and implementation outcomes related to school-based PA opportunities (e.g. number of programs and activities implemented, overall success of programs/activities implemented). We found no evidence of an association between determinants and the number of PA programs and activities implemented. However, we identified implementation climate and access to knowledge and information as key drivers of implementation success. This information can be used to develop implementation strategies that improve PA opportunities offered by schools.
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Ejercicio Físico , Instituciones Académicas , Humanos , Estudios Transversales , Escolaridad , Promoción de la Salud , Servicios de Salud EscolarRESUMEN
INTRODUCTION: Little research on the association of neighborhood environment with physical activity in resource-poor communities has been done. This study assessed changes in perceptions of the neighborhood environment and the association between those perceptions and physical activity in Mexican Americans on the Texas-Mexico border in an area where there would be community efforts to enhance pedestrian and cycling infrastructure and programming. METHODS: We analyzed data from a population-based cohort of Mexican American individuals on the Texas-Mexico border. From 2008 to 2018, interviewer-administered questionnaires were used to collect perceptions of neighborhood environment and physical activity at baseline, 5- and 10-year follow-ups, and at other ancillary study visits, with an average of 3 data points per participant. We conducted multivariable longitudinal logistic regression analyses to assess if the changes in odds of positive perceptions of the neighborhood environment over the study years differed by physical activity patterns. RESULTS: The sample (n = 1036) was mostly female (71%), born in Mexico (70%), and had no health insurance (69%). We saw improvements in the perceptions of several neighborhood environment attributes from 2008 to 2018, though we saw different longitudinal trajectories in these perceptions based on an individual's longitudinal physical activity patterns. By 2014-2018, we saw significantly higher positive perceptions of the neighborhood environment for those who consistently met physical activity guidelines compared with those who did not (adjusted rate ratio = 1.12, P = .049). DISCUSSION: We found that perceptions of many neighborhood environment attributes improved between 2008 and 2018, and that overall positive perceptions were associated with consistently meeting physical activity guidelines over time.
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Culinary medicine (CM) addresses diseases through nutrition and culinary education. To promote access to educational material for people with diabetes and engagement in virtual classes, we created a virtual culinary medicine toolkit (VCMT) sensitive to literacy levels and language preferences. The VCMT was developed to accompany existing virtual CM programs and help improve participant interaction and retention, offering educational materials for providers and participants. The provider VCMT offers level-setting education to reduce mixed nutrition messaging, including educational resources discussing inclusive nutrition and mindful eating topics. Each handout has a QR code and link to engaging, animated videos that provide further explanation. The participant VCMT offers a range of fundamental cooking skill videos and infographics, including knife skills and preparing whole grains and healthy beverages. Participant handouts and animated videos, which are played during the virtual CM class, allow participants to learn more about diabetes management and food literacy topics, including interpreting nutrition labels, and are employed during a CM to facilitate discussion and reflection. The animated videos replace a traditional slide-based lecture, allowing space for patient-centered facilitated discussions during virtual cooking sessions. The VCMT could guide the development of virtual CM interventions to shift learning from lecture-based to patient-centered discussions via a visual and inclusive medium.
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INTRODUCTION: Schools can support students' participation in physical activity by offering opportunities consistent with a Whole-of-School (WOS) approach; however, the extent to which physical activity opportunities are provided and how school-level characteristics associate with their use remains unclear. This study examined how elementary schools' use a WOS approach to promote physical activity, as well as associations between school-level characteristics and physical activity opportunities provided. METHODS: Survey data was collected from 162 elementary schools participating in the NFL PLAY 60 FitnessGram Project during the 2022-23 school year. A WOS index (ranging from 0-12) was created from responses by school staff on questions about six physical activity practices (physical education, recess, before- and after-school programs, classroom-based approaches, active transport). Multivariable regression models examined associations between school characteristics and WOS index scores. Analyses were completed in Spring 2024. RESULTS: Fully adjusted models indicated a statistically significant difference between the percentage of economically disadvantaged students served and WOS index score. Schools serving between 20-39% (p<0.001), 40-59% (p<0.01), 60-79% (p<0.01) and ≥80% (p<0.001) economically disadvantaged students scored significantly lower on the WOS index compared to schools with 0-19% economically disadvantaged students. CONCLUSION: Studies are needed to examine disparities in physical activity practices consistent with a WOS approach to understand the implications on health, academic performance, and other key outcomes. This information can inform the development of strategies to address disparities and ensure youth have equitable access to school-based physical activity opportunities.