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1.
Pediatr Obes ; 15(4): e12602, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32003947

RESUMO

BACKGROUND: Fast food is cross-sectionally associated with having overweight and obesity in young children. OBJECTIVES: To examine whether fast food intake independently contributes to the development of overweight and obesity among preschool-age children. METHODS: Prospective cohort of 3- to 5-year-old children (n = 541) followed for 1 year. Children's height and weight were objectively measured at baseline and study end. Parents reported their child's fast food intake frequency in the past week from 11 chain fast food restaurants in six online follow-up surveys, completed approximately 8 weeks apart. Poisson regression with robust standard errors modelled the risk of a child increasing in weight status (ie, transitioning from a having a healthy weight to having overweight or from having overweight to having obesity) over the study period in relation to their average weekly fast food intake, adjusted for sociodemographics, child obesogenic behaviours, and parent weight status. RESULTS: At baseline, 18.1% of children had overweight and 9.8% had obesity; 8.1% of children transitioned to a greater weight status over the 1-year period. Mean fast food intake frequency among consumers was 2.1 (SD: 1.4) times per week. The risk of increasing in weight status increased linearly with each additional time fast food was consumed in an average week over the study year (RR: 1.38; 95% CI, 1.13-1.67; P < .01). CONCLUSIONS: Greater fast food intake over 1 year was associated with increasing weight status during that time in this preschool-age cohort.

2.
Appetite ; 140: 134-141, 2019 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-31078700

RESUMO

INTRODUCTION: Fast food (FF) advertising is a potential risk factor for FF consumption among children, yet the impact of such advertising on children's FF intake has not been assessed in a longitudinal, naturalistic study. Whether parents' FF consumption mitigates advertising effects is also unknown. METHODS: One-year, longitudinal study among 624 preschool-age children, 3-5 years old, and one parent each recruited from New Hampshire, 2014-2015. Parents completed six online surveys every eight weeks and, at each, reported the number of times their children consumed FF in the past week. Each child's advertisement exposure was determined by counting the brand-specific FF advertisements aired within the programs they viewed on children's TV networks during the study. At baseline, parents reported the frequency of their own FF consumption. Data were analyzed in 2017-2018. RESULTS: Three FF brands targeted TV advertising to children during the study: McDonald's, Wendy's and Subway. Few children were exposed to child-targeted advertising for Wendy's or Subway. Results from adjusted Poisson regression models focused on McDonald's showed a differential effect of advertisement exposure on children's McDonald's intake in the past week (any or mean intake) by parental FF consumption (P < 0.01). Specifically, McDonald's intake was consistently high among children whose parents consumed FF more frequently (≥monthly), regardless of children's advertisement exposure. However, advertisement exposure increased the risk of McDonald's intake among children nearly two-fold when parents consumed FF less frequently (

3.
Reprod Toxicol ; 84: 32-38, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30594671

RESUMO

BACKGROUND: Animal studies suggest that prenatal exposure to diethylstilbestrol (DES) causes epigenetic alterations in primordial germ cells that affect the next generation, but human studies are sparse. METHODS: We assessed hormonally mediated outcomes in third generation women whose mothers were prenatally DES-exposed and unexposed. RESULTS: Compared to the unexposed, DES-exposed third generation women had an increased risk of irregular menses and amenorrhea; the respective prevalence ratios and 95% confidence intervals (CI) in follow-up data were 1.32 (95% CI: 1.10, 1.60) and 1.26 (95% CI: 1.06, 1.49); associations were more apparent in third generation women whose prenatally DES-exposed mothers were affected by vaginal epithelial changes. The follow-up data also indicated an association with preterm delivery (relative risk (RR): 1.54; 95% CI: 1.35, 1.75). CONCLUSION: DES third generation women may have an increased risk of irregular menstrual cycles, amenorrhea, and preterm delivery, consistent with inter-generational effects of endocrine disrupting chemical exposure in humans.


Assuntos
Dietilestilbestrol/toxicidade , Disruptores Endócrinos/toxicidade , Distúrbios Menstruais/epidemiologia , Nascimento Prematuro/epidemiologia , Efeitos Tardios da Exposição Pré-Natal/epidemiologia , Adulto , Feminino , Humanos , Troca Materno-Fetal , Mães , National Cancer Institute (U.S.) , Gravidez , Reprodução , Risco , Estados Unidos , Adulto Jovem
4.
Am J Prev Med ; 56(2): e35-e43, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30573338

RESUMO

INTRODUCTION: Child-directed TV advertising is believed to influence children's diets, yet prospective studies in naturalistic settings are absent. This study examined if child-directed TV advertisement exposure for ten brands of high-sugar breakfast cereals was associated with children's intake of those brands prospectively. METHODS: Observational study of 624 preschool-age children and their parents conducted in New Hampshire, 2014-2015. Over 1 year, parents completed a baseline and six online follow-up surveys, one every 8 weeks. Children's exposure to high-sugar breakfast cereal TV advertisements was based on the network-specific TV programs children watched in the 7 days prior to each follow-up assessment, and parents reported children's intake of each advertised high-sugar breakfast cereal brand during that same 7-day period. Data were analyzed in 2017-2018. RESULTS: In the fully adjusted Poisson regression model accounting for repeated measures and brand-specific effects, children with high-sugar breakfast cereal advertisement exposure in the past 7 days (i.e., recent exposure; RR=1.34, 95% CI=1.04, 1.72), at any assessment in the past (RR=1.23, 95% CI=1.06, 1.42), or recent and past exposure (RR=1.37, 95% CI=1.15, 1.63) combined had an increased risk of brand-specific high-sugar breakfast cereal intake. Absolute risk difference of children's high-sugar breakfast cereal intake because of high-sugar breakfast cereal TV advertisement exposure varied by brand. CONCLUSIONS: This naturalistic study demonstrates that child-directed high-sugar breakfast cereal TV advertising was prospectively associated with brand-specific high-sugar breakfast cereal intake among preschoolers. Findings indicate that child-directed advertising influences begin earlier and last longer than previously demonstrated, highlighting limitations of current industry guidelines regarding the marketing of high-sugar foods to children under age 6 years.

5.
Public Health Nutr ; 20(9): 1548-1556, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28416041

RESUMO

OBJECTIVE: To determine whether exposure to child-targeted fast-food (FF) television (TV) advertising is associated with children's FF intake in a non-experimental setting. DESIGN: Cross-sectional survey conducted April-December 2013. Parents reported their pre-school child's TV viewing time, channels watched and past-week FF consumption. Responses were combined with a list of FF commercials (ads) aired on children's TV channels during the same period to calculate children's exposure to child-targeted TV ads for the following chain FF restaurants: McDonald's, Subway and Wendy's (MSW). SETTING: Paediatric and Women, Infants, and Children (WIC) clinics in New Hampshire, USA. SUBJECTS: Parents (n 548) with a child of pre-school age. RESULTS: Children's mean age was 4·4 years; 43·2 % ate MSW in the past week. Among the 40·8 % exposed to MSW ads, 23·3 % had low, 34·2 % moderate and 42·5 % high exposure. McDonald's accounted for over 70 % of children's MSW ad exposure and consumption. Children's MSW consumption was significantly associated with their ad exposure, but not overall TV viewing time. After adjusting for demographics, socio-economic status and other screen time, moderate MSW ad exposure was associated with a 31 % (95 % CI 1·12, 1·53) increase and high MSW ad exposure with a 26 % (95 % CI 1·13, 1·41) increase in the likelihood of consuming MSW in the past week. Further adjustment for parent FF consumption did not change the findings substantially. CONCLUSIONS: Exposure to child-targeted FF TV advertising is positively associated with FF consumption among children of pre-school age, highlighting the vulnerability of young children to persuasive advertising and supporting recommendations to limit child-directed FF marketing.


Assuntos
Fast Foods , Televisão , Comportamento Infantil/psicologia , Pré-Escolar , Estudos Transversais , Ingestão de Alimentos/psicologia , Feminino , Assistência Alimentar , Humanos , Masculino , New Hampshire , Pais/psicologia , Restaurantes , Fatores Socioeconômicos
6.
Appetite ; 108: 295-302, 2017 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-27746213

RESUMO

Breakfast cereals represent the most highly advertised packaged food on child-targeted television, and most ads are for cereals high in sugar. This study examined whether children's TV exposure to child-targeted, high-sugar breakfast cereal (SBC) ads was associated with their consumption of those SBC brands. Parents of 3- to 5-year-old children were recruited from pediatric and Women, Infants, and Children (WIC) clinics in Southern New Hampshire, USA, and completed a cross-sectional survey between April-December 2013. Parents reported their child's consumption of SBC brands; whether their child had watched any of 11 kids' channels in the past week; their child's TV viewing time; and socio-demographics. Children's exposure to child-targeted SBC TV ads was calculated by combining TV channel and viewing time with advertising data for SBC ads aired on kids' TV channels during the same timeframe. Five hundred forty-eight parents completed surveys; 52.7% had an annual household income of $50,000 or less. Children's mean age was 4.4 years, 51.6% were female, and 72.5% were non-Hispanic white. In the past week, 56.9% (N = 312) of children ate SBCs advertised on kids' channels. Overall, 40.6% of children were exposed to child-targeted SBC TV ads in the past week. In fully adjusted analyses, the number of SBC brands children consumed was positively associated with their exposure to child-targeted SBC ads. Children consumed 14% (RR = 1.14, 95% CI: 1.02, 1.27) more SBC brands for every 10 SBC ads seen in the past 7 days. Exposure to child-targeted SBC TV advertising is positively associated with SBC brand consumption among preschool-aged children. These findings support recommendations to limit the marketing of high-sugar foods to young children.


Assuntos
Desjejum , Comportamento Infantil , Fenômenos Fisiológicos da Nutrição Infantil , Açúcares da Dieta/administração & dosagem , Grão Comestível , Fast Foods , Televisão , Assistência Ambulatorial , Pré-Escolar , Estudos Transversais , Açúcares da Dieta/efeitos adversos , Grão Comestível/efeitos adversos , Grão Comestível/química , Grão Comestível/economia , Fast Foods/efeitos adversos , Fast Foods/análise , Fast Foods/economia , Comportamento Alimentar , Feminino , Assistência Alimentar , Preferências Alimentares , Humanos , Masculino , New Hampshire , Inquéritos Nutricionais , Pais , Autorrelato , Televisão/economia
7.
Appetite ; 96: 473-480, 2016 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-26471803

RESUMO

Fast food restaurants spend millions of dollars annually on child-targeted marketing, a substantial portion of which is allocated to toy premiums for kids' meals. The objectives of this study were to describe fast food toy premiums, and examine whether young children's knowledge of fast food toy premiums was associated with their fast food consumption. Parents of 3- to 5-year old children were recruited from pediatric and WIC clinics in Southern New Hampshire, and completed a cross-sectional survey between April 2013-March 2014. Parents reported whether their children usually knew what toys were being offered at fast food restaurants, and whether children had eaten at any of four restaurants that offer toy premiums with kids' meals (McDonald's, Burger King, Subway, Wendy's) during the 7 days preceding the survey. Seventy-one percent of eligible parents participated (N = 583); 48.4% did not receive any education beyond high school, and 27.1% of children were non-white. Half (49.7%) the children had eaten at one or more of the four fast food restaurants in the past week; one-third (33.9%) had eaten at McDonald's. The four restaurants released 49 unique toy premiums during the survey period; McDonald's released half of these. Even after controlling for parent fast food consumption and sociodemographics, children were 1.38 (95% CI = 1.04, 1.82) times more likely to have consumed McDonald's if they usually knew what toys were offered by fast food restaurants. We did not detect a relationship between children's toy knowledge and their intake of fast food from the other restaurants. In this community-based sample, young children's knowledge of fast food toys was associated with a greater frequency of eating at McDonald's, providing evidence in support of regulating child-directed marketing of unhealthy foods using toys.


Assuntos
Ingestão de Alimentos/psicologia , Fast Foods , Jogos e Brinquedos , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Masculino , Refeições/psicologia , Restaurantes , Fatores Socioeconômicos
8.
Prev Med ; 69: 202-7, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25456807

RESUMO

OBJECTIVE: The aim of this study is to examine whether school food attenuates household income-related disparities in adolescents' frequency of fruit and vegetable intake (FVI). METHOD: Telephone surveys were conducted between 2007 and 2008 with adolescent-parent dyads from Northern New England; participants were randomly assigned to be surveyed at different times throughout the year. The main analysis comprised 1542 adolescents who typically obtained breakfast/lunch at school at least once/week. FVI was measured using 7-day recall of the number of times adolescents consumed fruits and vegetables. Fully adjusted linear regression was used to compare FVI among adolescents who were surveyed while school was in session (currently exposed to school food) to those who were surveyed when school was not in session (currently unexposed to school food). RESULTS: Mean FVI was 8.0 (SD=5.9) times/week. Among adolescents unexposed to school food, household income and FVI were strongly, positively associated. In contrast, among adolescents exposed to school food, FVI was similar across all income categories. We found a significant cross-over interaction between school food and household income in which consuming food at school was associated with higher FVI among adolescents from low-income households versus lower FVI among adolescents from high-income households. CONCLUSION: School food may mitigate income disparities in adolescent FVI. The findings suggest that the school food environment positively influences FVI among low-income adolescents.


Assuntos
Serviços de Alimentação , Frutas/economia , Instituições Acadêmicas , Verduras/economia , Adolescente , Comportamento Alimentar , Feminino , Humanos , Entrevistas como Assunto , Modelos Lineares , Estudos Longitudinais , Masculino , Rememoração Mental , Fatores Socioeconômicos , Estados Unidos
9.
Health Serv Res ; 49(4): 1387-99, 2014 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-24471975

RESUMO

OBJECTIVE: To examine how different response scales, methods of survey administration, and survey format affect responses to the CAHPS (Consumer Assessment of Healthcare Providers and Systems) Clinician and Group (CG-CAHPS) survey. STUDY DESIGN: A total of 6,500 patients from a university health center were randomly assigned to receive the following: standard 12-page mail surveys using 4-category or 6-category response scales (on CG-CAHPS composite items), telephone surveys using 4-category or 6-category response scales, or four-page mail surveys. PRINCIPAL FINDINGS: A total of 3,538 patients completed surveys. Composite score means and provider-level reliabilities did not differ between respondents receiving 4-category or 6-category response scale surveys or between 12-page and four-page mail surveys. Telephone respondents gave more positive responses than mail respondents. CONCLUSIONS: We recommend using 4-category response scales and the four-page mail CG-CAHPS survey.


Assuntos
Pesquisas sobre Serviços de Saúde/métodos , Satisfação do Paciente , Inquéritos e Questionários/normas , Centros Médicos Acadêmicos , Adolescente , Adulto , Idoso , Boston , Feminino , Pesquisas sobre Serviços de Saúde/economia , Humanos , Masculino , Pessoa de Meia-Idade , Serviços Postais , Pesquisa Qualitativa , Adulto Jovem
10.
Psychiatr Serv ; 65(2): 242-6, 2014 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-24337339

RESUMO

OBJECTIVE: Psychiatric stigma is a major barrier to the recovery of persons with serious mental illnesses. This study tested the efficacy of an innovative peer-run photography-based intervention, called antistigma photovoice, which targets self-stigma and promotes proactive coping with public stigma. METHODS: A total of 82 individuals with serious mental illnesses enrolled at a university-based recovery center were randomly assigned to the antistigma photovoice program or to a wait-list control group. Mixed-effects regression models were used to examine the impact of photovoice on self-stigma, coping with stigma, empowerment, perceived recovery, self-efficacy, and depression. RESULTS: Participation in the photovoice intervention was associated with significantly reduced self-stigma, greater use of proactive coping with societal stigma, greater increase in a sense of community activism, and perceived recovery and growth. CONCLUSIONS: The photovoice intervention demonstrated promise for reducing self-stigma and enhancing proactive coping with prejudice and discrimination.


Assuntos
Transtornos Mentais/reabilitação , Grupo Associado , Psicoterapia de Grupo/métodos , Estigma Social , Adaptação Psicológica/fisiologia , Adulto , Feminino , Humanos , Masculino , Transtornos Mentais/psicologia , Pessoa de Meia-Idade , Educação de Pacientes como Assunto/métodos , Fotografação/métodos , Recuperação de Função Fisiológica/fisiologia , Autoimagem , Resultado do Tratamento
11.
J Adolesc Health ; 53(3): 322-7, 2013 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-23684216

RESUMO

BACKGROUND: Despite validation studies demonstrating substantial bias, epidemiologic studies typically use self-reported height and weight as primary measures of body mass index because of feasibility and resource limitations. PURPOSE: To demonstrate a method for calculating accurate and precise estimates that use body mass index when objectively measuring height and weight in a full sample is not feasible. METHODS: As part of a longitudinal study of adolescent health, 1,840 adolescents (ages 12-18) self-reported their height and weight during telephone surveys. Height and weight was measured for 407 of these adolescents. Sex-specific, age-adjusted obesity status was calculated from self-reported and from measured height and weight. Prevalence and predictors of obesity were estimated using self-reported data, measured data, and multiple imputation (of measured data). RESULTS: Among adolescents with self-reported and measured data, the obesity prevalence was lower when using self-report compared with actual measurements (p < .001). The obesity prevalence from multiple imputation (20%) was much closer to estimates based solely on measured data (20%) compared with estimates based solely on self-reported data (12%), indicating improved accuracy. In multivariate models, estimates of predictors of obesity were more accurate and approximately as precise (similar confidence intervals) as estimates based solely on self-reported data. CONCLUSIONS: The two-method measurement design offers researchers a technique to reduce the bias typically inherent in self-reported height and weight without needing to collect measurements on the full sample. This technique enhances the ability to detect real, statistically significant differences, while minimizing the need for additional resources.


Assuntos
Estatura , Índice de Massa Corporal , Peso Corporal , Obesidade/epidemiologia , Autorrelato , Adolescente , Viés , Criança , Feminino , Humanos , Estudos Longitudinais , Masculino , Prevalência , Inquéritos e Questionários
12.
Jt Comm J Qual Patient Saf ; 39(3): 136-44, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-23516764

RESUMO

BACKGROUND: Good decision making has been increasingly cited as a core component of good medical care, and shared decision making is one means of achieving high decision quality. If it is to be a standard, good measures and protocols are needed for assessing the quality of decisions. Consistency with patient goals and concerns is one defining characteristic of a good decision. A new method for evaluating decision quality for major surgical decisions was examined, and a methodology for collecting the needed data was developed. METHODS: For a national probability sample of fee-for-service Medicare beneficiaries who had a coronary artery bypass graft (CABG), a lumpectomy or a mastectomy for breast cancer, or surgery for prostate cancer during the last half of 2008, a mail-survey of selected patients was carried out about one year after the procedures. Patients' goals and concerns, knowledge, key aspects of interactions with clinicians, and feelings about the decisions were assessed. A decision dissonance score was created that measured the extent to which patient ratings of goals ran counter to the treatment received. The construct and predictive validity of the decision dissonance score was then assessed. RESULTS: When data were averaged across all four procedures, patients with more knowledge and those who reported more involvement reported significantly lower Decision Dissonance Scores. Patients with lower Decision Dissonance Scores also reported more confidence in their decisions and feeling more positively about how the treatment turned out, and they were more likely to say that they would make the same decision again. CONCLUSIONS: Surveying discharged surgery patients is a feasible way to evaluate decision making, and Decision Dissonance appears to be a promising approach to validly measuring decision quality.


Assuntos
Tomada de Decisões , Satisfação do Paciente/estatística & dados numéricos , Relações Médico-Paciente , Procedimentos Cirúrgicos Operatórios/normas , Idoso , Idoso de 80 Anos ou mais , Ponte de Artéria Coronária , Interpretação Estatística de Dados , Feminino , Pesquisas sobre Serviços de Saúde , Humanos , Revisão da Utilização de Seguros , Masculino , Mastectomia/métodos , Medicare , Educação de Pacientes como Assunto/normas , Neoplasias da Próstata/cirurgia , Estados Unidos
14.
Pediatrics ; 130(2): e296-304, 2012 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-22802608

RESUMO

OBJECTIVE: To compare the associations between weight status and different forms of physical activity among adolescents. METHODS: We conducted telephone surveys with 1718 New Hampshire and Vermont high school students and their parents as part of a longitudinal study of adolescent health. We surveyed adolescents about their team sports participation, other extracurricular physical activity, active commuting, physical education, recreational activity for fun, screen time, diet quality, and demographics. Overweight/obesity (BMI for age ≥ 85th percentile) and obesity (BMI for age ≥ 95 percentile) were based on self-reported height and weight. RESULTS: Overall, 29.0% (n = 498) of the sample was overweight/obese and 13.0% (n = 223) were obese. After adjustments, sports team participation was inversely related to overweight/obesity (relative risk [RR] = 0.73 [95% confidence interval (CI): 0.61, 0.87] for >2 sports teams versus 0) and obesity (RR = 0.61 [95% CI: 0.45, 0.81] for >2 sports teams versus 0). Additionally, active commuting to school was inversely related to obesity (RR = 0.67 [95% CI: 0.45, 0.99] for >3.5 days per week versus 0). Attributable risk estimates suggest obesity prevalence would decrease by 26.1% (95% CI: 9.4%, 42.8%) if all adolescents played on 2 sports teams per year and by 22.1% (95% CI: 0.1%, 43.3%) if all adolescents walked/biked to school at least 4 days per week. CONCLUSIONS: Team sport participation had the strongest and most consistent inverse association with weight status. Active commuting to school may reduce the risk of obesity, but not necessarily overweight, and should be studied further. Obesity prevention programs should consider strategies to increase team sport participation among all students.


Assuntos
Ciclismo , Peso Corporal , Obesidade/prevenção & controle , Sobrepeso/prevenção & controle , Educação Física e Treinamento , Esportes , Caminhada , Adolescente , Estudos Transversais , Feminino , Futebol Americano , Inquéritos Epidemiológicos , Humanos , Estilo de Vida , Estudos Longitudinais , Masculino , New Hampshire , Obesidade/epidemiologia , Obesidade/etiologia , Sobrepeso/epidemiologia , Sobrepeso/etiologia , Instituições Acadêmicas , Vermont
15.
Am J Prev Med ; 42(6): 579-87, 2012 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-22608373

RESUMO

BACKGROUND: Little is known about the influence of in-town fast-food availability on family-level fast-food intake in nonmetropolitan areas. PURPOSE: The purpose of the current study was to determine whether the presence of chain fast-food outlets was associated with fast-food intake among adolescents and parents, and to assess whether this relationship was moderated by family access to motor vehicles. METHODS: Telephone surveys were conducted with 1547 adolescent-parent dyads in 32 New Hampshire and Vermont communities between 2007 and 2008. Fast-food intake in the past week was measured through self-report. In-town fast-food outlets were located and enumerated using an onsite audit. Family motor vehicle access was categorized based on the number of vehicles per licensed drivers in the household. Poisson regression was used to determine unadjusted and adjusted risk ratios (RRs). Analyses were conducted in 2011. RESULTS: About half (52.1%) of adolescents and 34.7% of parents consumed fast food at least once in the past week. Adolescents and parents who lived in towns with five or more fast-food outlets were about 30% more likely to eat fast food compared to those in towns with no fast-food outlets, even after adjusting for individual, family, and town characteristics (RR=1.29, 95% CI= 1.10, 1.51; RR=1.32, 95% CI=1.07, 1.62, respectively). Interaction models demonstrated that the influence of in-town fast-food outlets on fast-food intake was strongest among families with low motor vehicle access. CONCLUSIONS: In nonmetropolitan areas, household transportation should be considered as an important moderator of the relationship between in-town fast-food outlets and family intake.


Assuntos
Fast Foods/estatística & dados numéricos , Comportamento Alimentar , População Rural , População Suburbana , Adolescente , Adulto , Criança , Família , Feminino , Humanos , Entrevistas como Assunto , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , New Hampshire , Vermont
16.
Am J Prev Med ; 40(3): 312-9, 2011 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-21335262

RESUMO

BACKGROUND: Most studies of active travel to school (ATS) have been conducted in urban or suburban areas and focused on young children. Little is known about ATS among rural adolescents. PURPOSE: To describe adolescent ATS in two predominantly rural states and determine if school neighborhood built environment characteristics (BECs) predict ATS after adjusting for school and individual characteristics. METHODS: Sixteen BECs were assessed through census data and onsite observations of 45 school neighborhoods in 2007. ATS and individual characteristics were assessed through telephone surveys with 1552 adolescents and their parents between 2007 and 2008. Active travelers were defined as those who walked/cycled to/from school ≥1 day/week. Hierarchic linear modeling was used for analysis, conducted in 2009. RESULTS: Slightly less than half (n=735) of the sample lived within 3 miles of school, of whom 388 (52.8%) were active travelers. ATS frequency varied by season, ranging from a mean of 1.7 (SD=2.0) days/week in the winter to 3.7 (SD=1.6) in the spring. Adolescents who attended schools in highly dense residential neighborhoods with sidewalks were most likely to be active travelers. ATS frequency was greater in school neighborhoods with high residential and intersection densities, on-street parking, food outlets, and taller and continuous buildings with small setbacks. CONCLUSIONS: The BECs that support safe travel may be necessary to allow for ATS, whereas ATS frequency among adolescents may be influenced by a wider variety of design characteristics. Additional strategies to promote ATS and physical activity are needed in rural areas because of long commuting distances for many students.


Assuntos
Características de Residência , Estudantes/estatística & dados numéricos , Transportes/estatística & dados numéricos , Adolescente , Ciclismo/estatística & dados numéricos , Criança , Coleta de Dados , Feminino , Humanos , Modelos Lineares , Masculino , População Rural , Instituições Acadêmicas , Estações do Ano , Vermont , Caminhada/estatística & dados numéricos
17.
J Womens Health (Larchmt) ; 19(12): 2197-202, 2010 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-20973674

RESUMO

BACKGROUND: The purpose of this study was to identify and determine the influence of perceived intrinsic barriers to physical activity among mothers living in rural areas. METHODS: Mothers were identified through a study of child-parent dyads in the predominantly rural states of New Hampshire and Vermont. Using a telephone interview, we asked mothers (n = 1691) about their level of physical activity and assessed eight potential barriers to physical activity. Data were analyzed using chi-square tests, t tests, and analysis of variance (ANOVA) comparisons for groups within each variable. We used multiple regression analysis to assess associations between perceived barriers to physical activity and self-reported levels of physical activity. RESULTS: Each barrier was inversely associated with physical activity. Multivariate models that included terms for all potential barriers and covariates identified three barriers associated with lower levels of physical activity: lack of self-discipline, lack of time, and lack of interest. CONCLUSIONS: Rural mothers are less likely to be physically active if they identify lack of self-discipline, time, or interest as barriers, suggesting that they have difficulty prioritizing exercise for themselves. Interventions aimed at increasing physical activity for mothers should specifically consider these barriers. One possible solution may be to support infrastructure that facilitates active living as the default option, to remove the issue of having to purposefully engage in physical activity as a separate aspect of a mother's life.


Assuntos
Exercício/psicologia , Comportamentos Relacionados com a Saúde , Mães/psicologia , População Rural/estatística & dados numéricos , Adulto , Análise de Variância , Distribuição de Qui-Quadrado , Feminino , Humanos , Pessoa de Meia-Idade , Mães/estatística & dados numéricos , New Hampshire , Análise de Regressão , Fatores Socioeconômicos , Inquéritos e Questionários , Fatores de Tempo , Vermont , Adulto Jovem
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