Latent class analysis identifies a promising combination of Supplemental Nutrition Assistance Program-Education interventions for improving student cardiorespiratory fitness.

OBJECTIVE: To inform Supplemental Nutrition Assistance Program Education (SNAP-Ed) and other school-based interventions aiming to improve youth cardiorespiratory fitness, this study aimed to identify which SNAP-Ed school-based physical activity intervention combinations were associated with better student cardiorespiratory fitness. METHODS: This study, utilizing cross-sectional secondary data, included 5th and 7th grade students who attended SNAP-Ed-eligible public schools in California (n = 442,743 students; 4271 schools) and had complete 2016-17 state-mandated fitness test results. Latent class analysis was used to identify underlying school-based intervention combinations. Propensity score methods were used to ensure comparability of intervention and comparison schools, by calculating inverse probability weights. Multilevel models, using those inverse probability weights, assessed the associations between the identified intervention combinations and student cardiorespiratory fitness, as measured by VO2max. The models were adjusted for school-level variables (urbanicity, percent of students eligible for free- or reduced-price meals, total enrollment, and school type), child-level variables (age, gender, and race/ethnicity), and for clustering of students within schools. RESULTS: We found that students attending schools with interventions focusing on comprehensive policy changes along with improving opportunities for physical activity had, on average, 1.17 mL/kg/min (95% CI: 0.72, 1.62) greater VO2max than students attending schools without any intervention. They also had statistically significantly greater VO2max compared to students attending schools with any other type of intervention combination. CONCLUSION: Our results suggest that comprehensive school-based physical activity interventions that include policy changes along with improving physical activity opportunities may be the most effective approach for improving fitness and may warrant prioritization in SNAP-Ed efforts.

COVIDNearTerm: A simple method to forecast COVID-19 hospitalizations.

Introduction: COVID-19 has caused tremendous death and suffering since it first emerged in 2019. Soon after its emergence, models were developed to help predict the course of various disease metrics, and these models have been relied upon to help guide public health policy. Methods: Here we present a method called COVIDNearTerm to "forecast" hospitalizations in the short term, two to four weeks from the time of prediction. COVIDNearTerm is based on an autoregressive model and utilizes a parametric bootstrap approach to make predictions. It is easy to use as it requires only previous hospitalization data, and there is an open-source R package that implements the algorithm. We evaluated COVIDNearTerm on San Francisco Bay Area hospitalizations and compared it to models from the California COVID Assessment Tool (CalCAT). Results: We found that COVIDNearTerm predictions were more accurate than the CalCAT ensemble predictions for all comparisons and any CalCAT component for a majority of comparisons. For instance, at the county level our 14-day hospitalization median absolute percentage errors ranged from 16 to 36%. For those same comparisons, the CalCAT ensemble errors were between 30 and 59%. Conclusion: COVIDNearTerm is a simple and useful tool for predicting near-term COVID-19 hospitalizations.

Perceptual Access Reasoning (PAR) in Developing a Representational Theory of Mind.

An important part of children's social and cognitive development is their understanding that people are psychological beings with internal, mental states including desire, intention, perception, and belief. A full understanding of people as psychological beings requires a representational theory of mind (ToM), which is an understanding that mental states can faithfully represent reality, or misrepresent reality. For the last 35 years, researchers have relied on false-belief tasks as the gold standard to test children's understanding that beliefs can misrepresent reality. In false-belief tasks, children are asked to reason about the behavior of agents who have false beliefs about situations. Although a large body of evidence indicates that most children pass false-belief tasks by the end of the preschool years, the evidence we present in this monograph suggests that most children do not understand false beliefs or, surprisingly, even true beliefs until middle childhood. We argue that young children pass false-belief tasks without understanding false beliefs by using perceptual access reasoning (PAR). With PAR, children understand that seeing leads to knowing in the moment, but not that knowing also arises from thinking or persists as memory and belief after the situation changes. By the same token, PAR leads children to fail true-belief tasks. PAR theory can account for performance on other traditional tests of representational ToM and related tasks, and can account for the factors that have been found to correlate with or affect both true- and false-belief performance. The theory provides a new laboratory measure which we label the belief understanding scale (BUS). This scale can distinguish between a child who is operating with PAR versus a child who is understanding beliefs. This scale provides a method needed to allow the study of the development of representational ToM. In this monograph, we report the outcome of the tests that we have conducted of predictions generated by PAR theory. The findings demonstrated signature PAR limitations in reasoning about the mind during the ages when children are hypothesized to be using PAR. In Chapter II, secondary analyses of the published true-belief literature revealed that children failed several types of true-belief tasks. Chapters III through IX describe new empirical data collected across multiple studies between 2003 and 2014 from 580 children aged 4-7 years, as well as from a small sample of 14 adults. Participants were recruited from the Phoenix, Arizona metropolitan area. All participants were native English-speakers. Children were recruited from university-sponsored and community preschools and daycare centers, and from hospital maternity wards. Adults were university students who participated to partially fulfill course requirements for research participation. Sociometric data were collected only in Chapter IX, and are fully reported there. In Chapter III, minor alterations in task procedures produced wide variations in children's performance in 3-option false-belief tasks. In Chapter IV, we report findings which show that the developmental lag between children's understanding ignorance and understanding false belief is longer than the lag reported in previous studies. In Chapter V, children did not distinguish between agents who have false beliefs versus agents who have no beliefs. In Chapter VI, findings showed that children found it no easier to reason about true beliefs than to reason about false beliefs. In Chapter VII, when children were asked to justify their correct answers in false-belief tasks, they did not reference agents' false beliefs. Similarly, in Chapter VIII, when children were asked to explain agents' actions in false-belief tasks, they did not reference agents' false beliefs. In Chapter IX, children who were identified as using PAR differed from children who understood beliefs along three dimensions-in levels of social development, inhibitory control, and kindergarten adjustment. Although the findings need replication and additional studies of alternative interpretations, the collection of results reported in this monograph challenges the prevailing view that representational ToM is in place by the end of the preschool years. Furthermore, the pattern of findings is consistent with the proposal that PAR is the developmental precursor of representational ToM. The current findings also raise questions about claims that infants and toddlers demonstrate ToM-related abilities, and that representational ToM is innate.

Three-year trends in dietary behaviours among mothers, teenagers and children from SNAP-Ed (Supplemental Nutrition Assistance Program-Education) eligible households across California.

OBJECTIVE: To examine trends from 2015 to 2017 in dietary behaviours and diet quality among low-income mothers, teenagers and children. DESIGN: Cross-sectional telephone surveys using a validated 24 h dietary assessment. SETTING: Randomly sampled households with incomes ≤185 % of the US federal poverty level across California. PARTICIPANTS: Survey participants were 13 247 mothers (≥18 years), 3293 teenagers (12-17 years) and 6043 children (5-11 years). Respondents were mostly Latino. RESULTS: Over the 3-year study period, consumption of fruits and vegetables with and without 100 % fruit juice increased (P ≤ 0·05) by at least 0·3 cups/d for mothers, teenagers and children. Intake of water also increased (P ≤ 0·001) by more than 1 cup/d for mothers and children and 2 cups/d for teenagers. Sugar-sweetened beverage (SSB) consumption was unchanged over the 3 years. Overall diet quality, as assessed by the Healthy Eating Index-2015, improved (P ≤ 0·01) for mothers, teenagers and children. Covariates for the fifteen regression models (three age groups by five outcome variables) included race/ethnicity, age, education for mothers, and gender for teenagers and children. CONCLUSIONS: The observed increases in fruit and vegetable intake and improvements in overall diet quality during the 3-year period suggest that low-income Californians may have lowered their risk of preventable diseases. However, more intense or strategic SSB-reduction interventions are required. Regional- or state-level, population-based surveillance of dietary behaviours is useful for public health nutrition policy and programme decision making, and can be used to assess potential trends in future negative health outcomes and related costs associated with poor dietary behaviours within at-risk populations.

Psychosocial Correlates of Clinicians' Prescription Drug Monitoring Program Utilization.

INTRODUCTION: The purpose of this study is to extend prior research on barriers to use of a prescription drug monitoring program by examining psychosocial correlates of intended use among physicians and pharmacists. METHODS: Overall, 1,904 California physicians and pharmacists responded to a statewide survey (24.1% response rate) from August 2016 to January 2017. Participants completed an online survey examining attitudes toward prescription drug misuse and abuse, prescribing practices, prescription drug monitoring program design and ease of use, professional obligations, and normative beliefs regarding prescription drug monitoring program use. Data were analyzed in 2017. RESULTS: Perceived prescription drug monitoring program usefulness and normative beliefs fully mediated the relationship between concern about prescription drug abuse and intentions to use the prescription drug monitoring program. Clinicians' sense of professional and moral obligation to use the prescription drug monitoring program was unrelated to intention to use the prescription drug monitoring program despite a positive relationship with concern about misuse and abuse. Compared with physicians, pharmacists reported greater concern about prescription drug misuse, greater professional and moral obligation to use prescription drug monitoring program, and greater rating of prescription drug monitoring program usefulness. CONCLUSIONS: Interventions that target normative beliefs surrounding prescription drug monitoring program use and how to use prescription drug monitoring programs effectively are likely to be more effective than those that target professional obligations or moralize to the medical community.

Social control and strenuous exercise among late adolescent college students: parents versus peers as influence agents.

In the context of a model of health-related social control, we compared the associations among social control strategies, affective and behavioral reactions, and exercise for parental and peer influence agents. Late adolescent college students (n = 227) completed questionnaires that focused on social control from a parent or a peer who attempted to increase their exercising. Results from this cross-sectional study revealed that most relationships in the model were similar for parent and peer influence agents, however, (a) negative social control was a stronger predictor of reactance among parents than peers; (b) positive affect was a stronger predictor of attempts to change among peers than parents; and (c) positive affect predicted frequency of strenuous exercise only among parents. Decreasing parents' use of negative social control strategies and increasing adolescents' positive affective reactions to parental social control agents may be keys to promoting positive lifestyle changes in late adolescence.

Psychosocial correlates of chronic pain and depression in young adults: further evidence of the utility of the Profile of Chronic Pain: Screen (PCP: S) and the Profile of Chronic Pain: Extended Assessment (PCP: EA) battery.

OBJECTIVE: The goals of the present studies were 1) to determine the psychometric utility and norms of the Profile of Chronic Pain: Screen (PCP: S) in young adults (ages 17-24) with self-reported pain and 2) to compare non-, mildly-, and clinically-depressed young adults with chronic pain in their patterns of pain attitudes and pain beliefs as assessed by the Profile of Chronic Pain: Extended Assessment (PCP: EA) battery. METHODS: Participants in the first study included 2,475 male and female college students drawn from undergraduate introductory psychology classes in a large western (U.S.) university. Study 2 participants were 275 male and female introductory psychology students, screened for chronic pain and depression from a cohort of 1,266 students. RESULTS: Study 1 results confirmed the utility of the PCP: S as a screening tool for pain problems in young adults. Study 2 revealed that, although not differing in pain severity, clinically depressed participants differed from their nondepressed and mildly depressed peers in terms of enhanced catastrophizing tendencies and greater perceived disability. Both depressed groups scored lower on control beliefs than the nondepressed group. Moreover, the clinically depressed students reported the highest scores on pain-induced fear, differing from both the mildly depressed and the nondepressed. Finally, the three groups did not differ in their belief in a medical cure. CONCLUSIONS: Results suggest that depressed young persons with chronic pain demonstrate a pattern of negative attitudes and beliefs that could compromise their ability to flexibly adjust to changing life circumstances.

Parental socialization of child and adolescent physical activity: a meta-analysis.

Meta-analysis was used to integrate research on the relations between parental socialization behavior and child and adolescent physical activity (PA) levels. Four major databases were examined: PubMED, ERIC, Web of Science, and PsychLit (1960 -2005). Thirty studies met the following inclusion criteria: (a) child age (2-18 years) and (b) statistical information permitting calculation of an effect size between parent socialization behavior and child PA. Mean age of participants across studies ranged from 2.54 to 15.5 years. The unweighted mean and median effect sizes (as indexed by r) were .17 and .13, respectively, indicating that a moderate positive relation exists between parental support and modeling behavior and child and adolescent PA levels. The moderating effect of type of parental socialization behavior, population characteristics, and methodological factors were investigated. Theoretical and methodological implications concern the inclusion of mediated models of parental influence and the use of longitudinal investigations in determining causal direction. From an applied viewpoint, these results are useful for the design of future, more effective childhood obesity prevention programs by suggesting child-age-appropriate parental influences.

Unpacking the Relation between Extraversion and Volunteering in Later Life: The Role of Social Capital.

This study tested the hypothesis that the relation between extraversion and volunteering by older adults is fully mediated by social capital (participation in clubs and organizations, church attendance, and contact with friends). Data for this study come from 888 adults between the ages of 65-90 years old who participated in the Later Life Study of Social Exchanges (LLSSE). In support of our hypothesis, structural equation modeling revealed that extraversion exerted (a) a significant total effect on volunteering (.122), (b) significant indirect effects on volunteering via contact with friends (.042), church attendance (.034), and clubs and organizations (females only: .042), and (c) a non-significant direct effect on volunteering (.010). These findings suggest that social capital provides a viable explanation for the association between extraversion and volunteering.