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1.
Artigo em Inglês | MEDLINE | ID: mdl-31718019

RESUMO

BACKGROUND: School physical activity (PA) policy, physical education curriculum, teacher training, knowledge of physical fitness, and parental support are among the key issues underlying the declining trend of physical fitness in children and adolescents. The Chinese CHAMPS was a multi-faceted intervention program to maximize the opportunities for moderate and vigorous physical activity (MVPA), and increase physical fitness in middle school students. The purpose of the study was to test whether the levels of modification in school physical education policy and curriculum incrementally influenced the changes in cardiorespiratory fitness and other physical fitness outcomes. METHODS: This 8-month study was a clustered randomized controlled trial using a 2 × 2 factorial design. The participants were 680 7th grade students (mean age = 12.66 years) enrolled in 12 middle schools that were randomly assigned to one of four treatment conditions: school physical education intervention (SPE), afterschool program intervention (ASP), SPE+ASP, and control. Targeted behaviors of the Chinese CHAMPS were the student's sedentary behavior and MVPA. The study outcomes were assessed by a test battery of physical fitness at the baseline and posttest. Sedentary behavior and MVPA were measured in randomly selected students using observations and accelerometry. RESULTS: The terms contrasting the pooled effect of SPE, ASP, and SPE+ASP vs. Control, the pooled effect of SPE and SPE+ASP vs. ASP only, and the effect of SPE+ASP vs. ASP on CRF and other physical fitness outcomes were all significant after adjusting for covariates, supporting the study hypothesis. Process evaluation demonstrated high fidelity of the intervention in the targeted students' behaviors. CONCLUSIONS: Chinese CHAMPS demonstrated the impact of varying the amount of MVPA and vigorous physical activity (VPA) on the physical fitness in middle school students in support of the need to increase the opportunity for PA in schools and to introduce high-intensity exercises in school-based PA programs. Modification of school policy, quality of physical education curriculum, and teacher training were important moderators of the improvement in physical fitness. (Trial registration: ChiCTR-IOR-14005388, the Childhood Health; Activity and Motor Performance Study.).

2.
Health Educ Res ; 34(5): 521-531, 2019 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-31373658

RESUMO

High prevalence of diabetes and prediabetes has emerged as a concern in China. The Pathway to Health Program was designed to prevent type 2 diabetes onset in prediabetic women in a north China urban community. This process evaluation of a randomized controlled trial analysed participant surveys at the 6- and 12-month assessment times, participant weekly logs, class attendance records and post-study participant focus group results. The reported levels of participant engagement in physical activity (PA)-related behaviors were higher than diet-related behaviors at the 6-month assessment. The engagement in both PA- and diet-related behaviors declined during the 6-month follow-up period. Step counts from the participants' pedometers indicated an increase in PA in the first 6 months of the intervention. Study participants expressed high levels of satisfaction with the intervention and increased their scores on diabetes-related knowledge. Conflicts with work and family responsibilities were the main barriers for missing health lessons, likely contributing to minimal weight loss. There was good fidelity in program implementation. Intensive lifestyle modification programs are difficult to sustain once the program is complete. A more structured 6-month follow-up phase may have provided needed support to enable participants to maintain their lifestyle changes.

3.
BMC Pediatr ; 19(1): 190, 2019 06 10.
Artigo em Inglês | MEDLINE | ID: mdl-31179916

RESUMO

BACKGROUND: One in three Head Start children is either overweight or obese. We will test the efficacy of an early childhood obesity prevention program, "¡Míranos! Look at Us, We Are Healthy!" (¡Míranos!), which promotes healthy growth and targets multiple energy balance-related behaviors in predominantly Latino children in Head Start. The ¡Míranos! intervention includes center-based (policy changes, staff development, gross motor program, and nutrition education) and home-based (parent engagement/education and home visits) interventions to address key enablers and barriers in obesity prevention in childcare. In partnership with Head Start, we have demonstrated the feasibility and acceptability of the proposed interventions to influence energy balance-related behaviors favorably in Head Start children. METHODS: Using a three-arm cluster randomized controlled design, 12 Head Start centers will be randomly assigned in equal number to one of three conditions: 1) a combined center- and home-based intervention, 2) center-based intervention only, or 3) comparison. The interventions will be delivered by trained Head Start staff during the academic year. A total of 444 3-year-old children (52% females; n = 37 per center at baseline) in two cohorts will be enrolled in the study and followed prospectively 1 year post-intervention. Data collection will be conducted at baseline, immediately post-intervention, and at the one-year follow-up and will include height, weight, physical activity (PA) and sedentary behaviors, sleep duration and screen time, gross motor development, dietary intake and food and activity preferences. Information on family background, parental weight, PA- and nutrition-related practices and behaviors, PA and nutrition policy and environment at center and home, intervention program costs, and treatment fidelity will also be collected. DISCUSSION: With endorsement and collaboration of two local Head Start administrators, ¡Míranos!, as a culturally tailored obesity prevention program, is poised to provide evidence of efficacy and cost-effectiveness of a policy and environmental approach to prevent early onset of obesity in low-income Latino preschool children. ¡Míranos! can be disseminated to various organized childcare settings, as it is built on the Head Start program and its infrastructure, which set a gold standard for early childhood education, as well as current PA and nutrition recommendations for preschool children. TRIAL REGISTRATION: ClinicalTrials.Gov ( NCT03590834 ) July 18, 2018.

4.
Pain Med ; 2018 Oct 11.
Artigo em Inglês | MEDLINE | ID: mdl-30312459

RESUMO

Objective: To examine factors influencing initial engagement, ongoing participation, learned behaviors, and subjective functional outcomes after a trial of the Living Better Beyond Pain (LBBP) chronic pain self-management program. Design: Qualitative study using the Grounded Theory approach. Setting: Two 60-minute focus groups and phone interviews in May 2017. Subjects: Focus groups with 18 participants who completed LBBP and six-month measures; telephone interviews with 17 participants who stopped attending. Methods: Study coordinators randomly selected program completers for focus groups and conducted phone interviews with noncompleters. Inductive thematic analysis was used to identify patterns in semantic content with a recursive process applied to focus group transcripts and interview transcriptions to codify into themes. Themes were categorized according to the Theory of Planned Behavior. Results: Focus group and telephone interview participants were primarily Hispanic and unemployed. Attitudes fostering participation in LBBP included dissatisfaction with the status quo, need to reduce pain medication, and lack of training and knowledge about chronic pain. Positive social norms from meeting others with chronic pain and support from the LBBP team encouraged attendance and adoption of behaviors. Transportation, pain, and competing activities were barriers, whereas adapting activities for the disabled was a facilitator. Maintaining behaviors and activities at home was challenging but ultimately rewarding due to improvement in daily function with less pain medication. Conclusions: This qualitative study complements quantitative results showing clinically significant improvements in function after the LBBP program by adding practical insights into ways to increase participation and outcomes. Participants strongly endorsed the need for chronic pain self-management training.

5.
J Pain ; 19(12): 1471-1479, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30012494

RESUMO

Based on input of rural, largely Hispanic persons with chronic pain, a low-literacy, 6-month self-management program was developed, drawing on elements of existing pain toolkits. In a randomized trial, low-income, primarily Hispanic patients with chronic pain received the program in 6 sessions of 1-on-1 meetings with a trained health educator in clinic or in 8 group lectures by experts in the community. Intention-to-treat analyses in linear mixed-effects models were conducted for 5 secondary outcomes at 6 months, including Brief Pain Inventory pain severity and interference, Patient Health Questionnaire-9, 12-Item Short-Form Survey Mental Component Summary, and Tampa Scale for Kinesiophobia-11. A total of 111 participants were randomized (15.9% of 700 initially eligible from 3 clinics), and 67 (60.4%) completed 6-month measures. Among completers, the clinic arm improved on 4 measures and community arm on 3 measures (all P < .05). Effect sizes were small to moderate (.41-.52). In intention-to-treat analyses, both arms improved on 4 of 5 measures (all P ≤ .001) versus baseline, with clinically significant changes in Brief Pain Inventory pain severity and interference. Improvement in multiple outcomes after this chronic pain self-management program for low-income patients warrants further study. PERSPECTIVE: In an evaluation of a low-literacy, 6-month chronic pain self-management program, similar improvements were observed among primarily Hispanic participants whether the intervention was delivered by a health educator or in groups with lectures from experts.

6.
Artigo em Inglês | MEDLINE | ID: mdl-29757933

RESUMO

Background: Sedentary lifestyles and their associated harmful consequences are public health concerns that impact more than half of the world's youth population in both developed and developing countries. Methods: The Chinese Childhood Health; Activity and Motor Performance Study (Chinese CHAMPS) was a cluster randomized controlled trial to modify school physical activity policies and the physical education (PE) curriculum; using teacher training and parent engagement to increase opportunities and support students' physical activity and healthy eating. Using a 2 × 2 factorial design, the study tested the incremental effects of increasing the amount and intensity of physical activity, alongside adding support for healthy eating, on health-related and cognitive function outcomes in Chinese middle school students. Results: The intervention was implemented by PE teachers in 12 middle schools in three Chinese cities, with a targeted enrollment of 650 students from August 2015⁻June 2016. The assessment of the outcomes involved a test battery of physical fitness and cognitive functioning at both baseline and at the end of the intervention. Process information on implementation was also collected. Discussion: The Chinese CHAMPS is a multi-level intervention that is designed to test the influences of policy and environmental modifications on the physical activity and eating behaviors of middle school students. It also addresses some key weaknesses in school-based physical activity interventions.


Assuntos
Cognição , Educação Física e Treinamento/métodos , Aptidão Física , Serviços de Saúde Escolar , Adolescente , Criança , China , Currículo , Dieta/psicologia , Exercício/psicologia , Feminino , Promoção da Saúde/métodos , Estilo de Vida Saudável , Humanos , Masculino , Comportamento Sedentário , Método Simples-Cego
7.
Int J Exerc Sci ; 11(5): 137-151, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29795736

RESUMO

Afterschool youth physical activity (PA) programs provide opportunities for increasing children's time engaged in moderate-to-vigorous physical activity (MVPA). However, low program attendance reduces the benefits of participating in these programs. The purpose of this study was to determine if enjoyment, athletic competence and motivation for PA predict youth attendance at a free afterschool PA program from 3rd to 5th grade. Data were collected from a larger randomized community trial examining the effectiveness of an afterschool program for increasing opportunities to engage in MVPA. Data were collected twice annually (fall/spring) over 3 school years (3rd - 5th grade) in 9 schools. Analyses were stratified by grade and sex, and a series of multi-level linear regression models were utilized to determine if baseline levels of the psychosocial determinants predicted annual attendance as a percentage of afterschool sessions attended. Amotivation for PA was negatively associated with attendance in boys and non-self-determined extrinsic motivation was positively associated with attendance in girls in the 5th grade. Age was associated with a 13.72% reduction in attendance in the 3rd grade, a 12.87% attendance reduction in the 4th grade, and a 7.93% attendance in reduction in the 5th grade. Race was also associated with attendance. Non-White youth attended the program 13.56% less in the 3rd grade, 17.35% less in the 4th grade, and 21.53% less in the 5th grade than White youth. The findings suggest that attendance to PA afterschool programming may be associated with children's motivational characteristics, but that other variables should be identified for further research.

8.
Int Health ; 10(5): 391-400, 2018 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-29447347

RESUMO

Background: The prevalence of both obesity and type 2 diabetes has been on the rise in China. This randomized controlled trial was conducted to test the feasibility and effectiveness of an evidence-based diabetes prevention program in Yuci, Shanxi Province, China from 2012 to 2014. Methods: Women with pre-diabetes, ages 25-65 y, were assigned randomly to a comparison (n=75) or 6-mo lifestyle intervention condition (n=109). Weight, fasting glucose, hemoglobin A1c and self-reported diet and physical activity were measured at baseline, 6 mo and 12 mo. Results: All measures except fasting glucose improved favorably in both comparison and intervention participants at the 6- and 12-mo follow-ups. Participants in the intervention group lost more weight (-0.91 kg, p<0.05) and had a lower body mass index (-0.39 kg/m2, p<0.05) than the comparison group at follow-up. A total of 31.6% (31/98) and 16.2% (11/68) of the participants in the intervention and comparison groups, respectively, achieved the weight loss goal of 5% at follow-up. There was no significant group difference in outcome measures at the 12-mo follow-up. Participants in the intervention group also showed favorable changes in self-reported diet and physical activity measures. Conclusions: A lifestyle intervention to prevent diabetes in at-risk women in community health centers in China is feasible and acceptable but effect sizes were small.


Assuntos
Diabetes Mellitus Tipo 2/prevenção & controle , Estilo de Vida , Obesidade/prevenção & controle , Estado Pré-Diabético/prevenção & controle , Apoio Social , Saúde da Mulher/estatística & dados numéricos , Adulto , Idoso , China , Feminino , Humanos , Pessoa de Meia-Idade , Autorrelato , Mudança Social
9.
J Gen Intern Med ; 33(5): 668-677, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29299814

RESUMO

BACKGROUND: Patients with chronic pain often lack the skills and resources necessary to manage this disease. OBJECTIVE: To develop a chronic pain self-management program reflecting community stakeholders' priorities and to compare functional outcomes from training in two settings. DESIGN: A parallel-group randomized trial. PARTICIPANTS: Eligible subjects were 35-70 years of age, with chronic non-cancer pain treated with opioids for >2 months at two primary care and one HIV clinic serving low-income Hispanics. INTERVENTIONS: In one study arm, the 6-month program was delivered in monthly one-on-one clinic meetings by a community health worker (CHW) trained as a chronic pain health educator, and in the second arm, content experts gave eight group lectures in a nearby library. MAIN MEASURES: Five times Sit-to-Stand test (5XSTS) assessed at baseline and 3 and 6 months. Other reported physical and cognitive measures include the 6-Min Walk (6 MW), Borg Perceived Effort Test (Borg Effort), 50-ft Speed Walk (50FtSW), SF-12 Physical Component Summary (SF-12 PCS), Patient-Specific Functional Scale (PSFS), and Symbol-Digit Modalities Test (SDMT). Intention-to-treat (ITT) analyses in mixed-effects models adjust for demographics, body mass index, maximum pain, study arm, and measurement time. Multiple imputation was used for sensitivity analyses. KEY RESULTS: Among 111 subjects, 53 were in the clinic arm and 58 in the community arm. In ITT analyses at 6 months, subjects in both arms performed the 5XSTS test faster (-4.9 s, P = 0.001) and improved scores on Borg Effort (-1, P = 0.02), PSFS (1.6, P < 0.001), and SDMT (5.9, P < 0.001). Only the clinic arm increased the 6 MW (172.4 ft, P = 0.02) and SF-12 PCS (6.2 points, P < 0.001). 50ftSW did not change (P = 0.15). Results were similar with multiple imputation. Five falls were possible adverse events. CONCLUSIONS: In low-income subjects with chronic pain, physical and cognitive function improved significantly after self-management training from expert lectures in the community and in-clinic meetings with a trained health educator.

10.
Acta Paediatr ; 106(1): 120-127, 2017 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-27759894

RESUMO

AIM: This study examined the relationships between energy balance-related behaviours (EBRBs) outside school hours and obesity in Chinese primary school students. We also explored the influence of gender on those relationships. METHODS: The study sample was a cross-sectional cohort of 5032 Chinese children who were enrolled in grades 1-6 in primary schools in five Chinese cities and whose mean ages ranged from seven years and three months to 11.9 years. The children's parents completed a survey on their child's height, weight and EBRBs outside school hours. RESULTS: The response rate was 97%, and the reported rates of overweight and obesity were 13.6% and 13.8%, respectively. The obesity rates were higher in boys and lower grade children. Most EBRBs varied between boys and girls and with increased grade levels. The amount of time spent on academic-related activities, screen viewing, outdoor activities and sleep was mostly associated with obesity on weekdays and varied by gender. CONCLUSION: Rate of obesity was alarmingly high in the primary school Chinese children in this cohort, especially in younger children. Excessive time spent on academic-related activities outside school hours, inadequate sleep, physical inactivity and higher levels of screen viewing were major contributors to obesity in these Chinese children.


Assuntos
Currículo , Obesidade Pediátrica/etiologia , Recreação , Comportamento Sedentário , Privação do Sono , Televisão/estatística & dados numéricos , Criança , China/epidemiologia , Estudos Transversais , Exercício , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Obesidade Pediátrica/diagnóstico , Obesidade Pediátrica/epidemiologia , Fatores de Risco , Fatores Sexuais , Fatores de Tempo , Jogos de Vídeo/estatística & dados numéricos
11.
J Occup Environ Med ; 58(4): e117-23, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-27058488

RESUMO

OBJECTIVE: The purpose of the study was to examine the longitudinal influence of sedentary behavior on the development of metabolic syndrome (MS) and cardiometabolic risk in professional workers. METHODS: Study participants were 203 professional workers (55.6% female; mean age = 41.9, SD = 11.2,) in low physical activity occupations. Participants' height, weight, waist circumference, fasting plasma glucose, triglycerides, high-density lipoprotein, total cholesterol, and low-density lipoprotein were measured at the baseline and follow-up over 12 months. Accelerometry was used to assess the sedentary time and moderate and vigorous physical activity. RESULTS: High level of sedentary behavior at baseline significantly predicted incident MS (odds ratio 4.07, 95% confidence interval 1.69 to 9.76) at follow-up. Similarly, the change in sedentary behavior significantly predicted the change in the cardiometabolic risk score (B = 0.12, SE = 0.06, P = 0.03) from baseline to the follow-up. CONCLUSION: Professional workers in low physical activity occupations were engaged in an excessive amount of sedentary behavior that predisposed them to an increased risk of developing cardiometabolic disorders.


Assuntos
Exercício , Comportamentos Relacionados com a Saúde , Síndrome Metabólica/epidemiologia , Comportamento Sedentário , Acelerometria , Adulto , Glicemia/metabolismo , Pressão Sanguínea , Peso Corporal , HDL-Colesterol/sangue , LDL-Colesterol/sangue , Exercício/fisiologia , Feminino , Humanos , Incidência , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Ocupações , Estudos Prospectivos , Fatores de Risco , Triglicerídeos/sangue , Circunferência da Cintura , Adulto Jovem
12.
Health Promot Pract ; 17(5): 675-81, 2016 09.
Artigo em Inglês | MEDLINE | ID: mdl-26895848

RESUMO

Parent interventions for childhood obesity prevention have traditionally experienced low participation rates or used passive methods such as newsletters. In contrast, the ¡Miranos! intervention home-based activities included parent-led face-to-face meetings delivered after school, take-home bags with educational materials, and scavenger hunt games to deliver health information to Head Start families regarding nutrition, physical activity, and healthy growth promotion for their preschooler. This study employed a quasi-experimental design with three intervention centers (two that received only center-based activities and one that received center- and home-based activities) and one comparison center. Data were collected on participating Head Start children and their parents/guardians and included parent attendance, parent health message recall through intercept interviews, parent knowledge through pre- and posttests, and family supportive behaviors and child health behaviors through a parent questionnaire. Parents/guardians that received both center- and home-based activities significantly increased knowledge scores (t = 2.50, degrees of freedom = 123, p < .05) and family supportive behaviors from baseline to follow-up (t = 2.12, degrees of freedom = 122, p < .05). This study demonstrates the effects home-based interventions can have when coupled with center-based activities and implemented in the center at the end of the school day.


Assuntos
Aconselhamento/organização & administração , Promoção da Saúde/organização & administração , Hispano-Americanos , Pais/educação , Obesidade Pediátrica/etnologia , Obesidade Pediátrica/prevenção & controle , Comportamento Infantil , Pré-Escolar , Competência Cultural , Exercício , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Masculino , Instituições Acadêmicas/organização & administração , Fatores de Tempo
13.
Prev Chronic Dis ; 12: E219, 2015 Dec 10.
Artigo em Inglês | MEDLINE | ID: mdl-26652219

RESUMO

INTRODUCTION: US Latinos have disproportionately higher rates of obesity and physical inactivity than the general US population, putting them at greater risk for chronic disease. This evaluation aimed to examine the impact of the Y Living Program (Y Living), a 12-week family-focused healthy lifestyle program, on the weight status of adult and child (aged ≥7 years) participants. METHODS: In this pretest-posttest evaluation, participants attended twice-weekly group education sessions and engaged in physical activity at least 3 times per week. Primary outcome measures were body mass index ([BMI], zBMI and BMI percentile for children), weight, waist circumference, and percentage body fat. Wilcoxon signed-rank tests and mixed effects models were used to evaluate pretest-posttest differences (ie, absolute change and relative change) for adults and children separately. RESULTS: BMI, weight, waist circumference, and percentage body fat improved significantly (both absolutely and relatively) among adults who completed the program (n = 180; all P ≤ .001). Conversely, child participants that completed the program (n = 72) showed no improvements. Intervention effects varied across subgroups. Among adults, women and participants who were obese at baseline had larger improvements than did children who were obese at baseline or who were in families that had an annual household income of $15,000 or more. CONCLUSION: Significant improvements in weight were observed among adult participants but not children. This family-focused intervention has potential to prevent excess weight gain among high-risk Latino families.


Assuntos
Exercício , Saúde da Família , Educação em Saúde , Hispano-Americanos , Estilo de Vida , Obesidade/etnologia , Adolescente , Adulto , Peso Corporal , Criança , Feminino , Humanos , Renda , Obesidade/prevenção & controle , Resultado do Tratamento , Perda de Peso , Adulto Jovem
14.
Eur J Appl Physiol ; 115(10): 2149-57, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26032570

RESUMO

PURPOSE: To examine and compare the acute effects of moderate-intensity continuous and accumulated exercise in three bouts with different intervals on arterial stiffness. METHOD: Nineteen healthy young males (mean age = 24.7 years) were randomized to no-exercise control (CON), continuous exercise (CE, 30-min cycling), accumulated exercise with 10-min intervals (AE10, 3 × 10-min cycling, 10-min interval), and accumulated exercise with 60-min intervals (AE60, 3 × 10-min cycling, 60-min interval) trial in balanced self-control crossover design. The intensity in all the exercise trials was set at 50% heart rate reserve. Cardio-ankle vascular index (CAVI), an index of arterial stiffness, was measured at baseline (BL), immediately after (0 min) and 60 min after the completion of the exercise. RESULTS: CAVI remained stable (6.8 ± 0.1, 6.8 ± 0.2, 6.9 ± 0.1 at BL, 0 and 60 min, respectively) in CON trial. Immediately after exercise, CAVI in CE, AE10 and AE60 trials all decreased significantly to similar degree compared to CON trial (P < 0.05 for CE, AE10 and AE60 vs. CON). Though CAVI in CE trial returned to baseline level after 60 min of recovery, CAVI in both AE10 and AE60 trials remained significantly low compared to CON trial (P < 0.01 for AE10 and AE60 vs. CON). CONCLUSION: When the total duration and relative intensity were matched, the effects of accumulated exercise in three bouts were superior to continuous exercise. Elongation of intervals between bouts did not attenuate the superior effects of accumulated exercise on arterial stiffness. TRIAL REGISTRATION: ChiCTR-OTRCC-14005229.


Assuntos
Exercício/fisiologia , Rigidez Vascular , Adulto , Humanos , Masculino , Descanso/fisiologia
15.
J Phys Act Health ; 12(4): 462-9, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-24905054

RESUMO

BACKGROUND: Park features' association with physical activity among predominantly Hispanic communities is not extensively researched. The purpose of this study was to assess factors associated with park use and physical activity among park users in predominantly Hispanic neighborhoods. METHODS: Data were collected across 6 parks and included park environmental assessments to evaluate park features, physical activity observations to estimate physical activity energy expenditure as kcal/kg/ minute per person, and park user interviews to assess motivators for park use. Quantitative data analysis included independent t tests and ANOVA. Thematic analysis of park user interviews was conducted collectively and by parks. RESULTS: Parks that were renovated had higher physical activity energy expenditure scores (mean = .086 ± .027) than nonrenovated parks (mean = .077 ± .028; t = -3.804; P < .01). Basketball courts had a significantly higher number of vigorously active park users (mean = 1.84 ± .08) than tennis courts (mean = .15 ± .01; F = 21.9, η(2) = 6.1%, P < .01). Thematic analysis of qualitative data revealed 4 emerging themes-motivation to be physically active, using the play spaces in the park, parks as the main place for physical activity, and social support for using parks. CONCLUSION: Renovations to park amenities, such as increasing basketball courts and trail availability, could potentially increase physical activity among low-socioeconomic-status populations.


Assuntos
Comportamentos Relacionados com a Saúde/etnologia , Hispano-Americanos/psicologia , Atividade Motora , Áreas de Pobreza , Logradouros Públicos , Recreação , Adolescente , Adulto , Criança , Metabolismo Energético , Feminino , Hispano-Americanos/estatística & dados numéricos , Humanos , Renda , Masculino , Motivação , Jogos e Brinquedos , Pobreza , Características de Residência , Meio Social , Apoio Social , Adulto Jovem
16.
BMC Pediatr ; 14: 118, 2014 May 05.
Artigo em Inglês | MEDLINE | ID: mdl-24886119

RESUMO

BACKGROUND: The prevalence of obesity increased while certain measures of physical fitness deteriorated in preschool children in China over the past decade. This study tested the effectiveness of a multifaceted intervention that integrated childcare center, families, and community to promote healthy growth and physical fitness in preschool Chinese children. METHODS: This 12-month study was conducted using a quasi-experimental pretest/posttest design with comparison group. The participants were 357 children (mean age = 4.5 year) enrolled in three grade levels in two childcare centers in Beijing, China. The intervention included: 1) childcare center intervention (physical activity policy changes, teacher training, physical education curriculum and food services training), 2) family intervention (parent education, internet website for support, and family events), and 3) community intervention (playground renovation and community health promotion events). The study outcome measures included body composition (percent body fat, fat mass, and muscle mass), Body Mass Index (BMI) and BMI z-score and physical fitness scores in 20-meter agility run (20M-AR), broad jump for distance (BJ), timed 10-jumps, tennis ball throwing (TBT), sit and reach (SR), balance beam walk (BBW), 20-meter crawl (20M-C)), 30-meter sprint (30M-S)) from a norm referenced test. Measures of process evaluation included monitoring of children's physical activity (activity time and intensity) and food preparation records, and fidelity of intervention protocol implementation. RESULTS: Children in the intervention center significantly lowered their body fat percent (-1.2%, p < 0.0001), fat mass (-0.55 kg, p <0.0001), and body weight (0.36 kg, p <0.02) and increased muscle mass (0.48 kg, p <0.0001), compared to children in the control center. They also improved all measures of physical fitness except timed 10-jumps (20M-AR: -0.74 seconds, p < 0.0001; BJ: 8.09 cm, p < 0.0001; TBT: 0.52 meters, p < 0.006; SR: 0.88 cm, p < 0.03; BBW: -2.02 seconds, p <0.0001; 30M-S: -0.45 seconds, p < 0.02; 20M-C: -3.36 seconds, p < 0.0001). Process evaluation data showed that the intervention protocol was implemented with high fidelity. CONCLUSIONS: The study demonstrated that a policy-driven multi-faceted intervention can improve preschool children's body composition and physical fitness. Program efficacy should be tested in a randomized trial. TRIAL REGISTRATION: ChiCTR-ONRC-14004143.


Assuntos
Composição Corporal , Promoção da Saúde/organização & administração , Política Organizacional , Aptidão Física , Pré-Escolar , China , Currículo , Dieta , Meio Ambiente , Feminino , Humanos , Masculino , Atividade Motora , Ensaios Clínicos Controlados não Aleatórios como Assunto , Pais/educação , Jogos e Brinquedos , Instituições Acadêmicas
17.
Health Promot Pract ; 15(4): 548-55, 2014 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-24357863

RESUMO

Increasing physical activity (PA) during preadolescence and adolescence is critical to reversing the obesity epidemic. A recent report described the promising role of eHealth--the use of new media for purposes of health promotion--in reducing and preventing childhood obesity. This study assessed access/use of various media (cell phones, computers, gaming systems, Internet) among adolescent Latino girls and examined the relationship between PA and media access/use. A convenience sample of 110 Latino girls ages 11 to 14 was recruited from Girl Scouts of Southwest Texas and other groups. The media survey was self-administered (April-July 2010) on personal digital assistants. Of the girls, 55% reported owning a cell phone and spending 40 (SD = 4.2) hours per week talking, texting, listening to music, and browsing the Internet. Cell phone access increased significantly with age (p = .029). Compared to those with no cell phone, girls with a cell phone have greater odds of reporting more than 5 days of PA in the past week (odds ratio = 5.5, 95% confidence interval [CI] = 2.1, 14) and engaging in daily physical education classes (odds ratio = 2.6, 95% CI = 1.1, 5.9). Since girls with cell phones report greater PA, cell phones may be an effective strategy for communicating with girls about engaging in PA.


Assuntos
Telefone Celular/estatística & dados numéricos , Exercício , Promoção da Saúde/métodos , Hispano-Americanos , Internet/estatística & dados numéricos , Meios de Comunicação de Massa/estatística & dados numéricos , Adolescente , Fatores Etários , Criança , Feminino , Humanos , Educação Física e Treinamento/estatística & dados numéricos , Texas , Mensagem de Texto/estatística & dados numéricos , Fatores de Tempo
18.
Am J Prev Med ; 44(3 Suppl 3): S232-9, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-23415188

RESUMO

BACKGROUND: The prevalence of obesity among Latino children is an increasing concern. Churches are settings that a majority of Latino families frequent on a regular basis. In addition to religious worship, churches supply social, emotional, and material support. Therefore, churches may be promising venues for obesity-prevention interventions engaging families and communities. PURPOSE: To qualitatively examine Latino church leaders' perspectives on childhood obesity and insights on obesity-prevention programming in faith-based community settings in South Texas. METHODS: In-depth interviews were conducted between 2009 and 2011 with a purposive sample of 35 Latino church leaders from 18 churches in San Antonio, Texas. Interviews were audiotaped and transcribed verbatim. Inductive analysis was performed to identify themes. RESULTS: The results revealed that participants were knowledgeable about the severity and health consequences of childhood obesity, and the extent to which it was affecting members of their congregations. Participants discussed the interconnection between one's faith and health (i.e., one's body as "God's Temple"). They suggested that churches could serve as a conduit for obesity-prevention programs that offer faith-oriented health education, cooking classes, and fun physical activity opportunities for both parents and children. CONCLUSIONS: This study reveals the strong potential of faith-based communities to serve as an intervention setting with the needed infrastructure for implementing effective obesity-prevention strategies.


Assuntos
Promoção da Saúde/organização & administração , Hispano-Americanos , Obesidade/etnologia , Obesidade/prevenção & controle , Religião , Adulto , Criança , Cultura , Meio Ambiente , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Fatores Socioeconômicos , Texas
19.
Child Obes ; 8(5): 429-39, 2012 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-23061498

RESUMO

BACKGROUND: Obesity prevention research is sparse in young children at risk for obesity. This study tested the effectiveness of a culturally tailored, multicomponent prevention intervention to promote healthy weight gain and gross motor development in low-income preschool age children. METHODS: Study participants were predominantly Mexican-American children (n = 423; mean age = 4.1; 62% in normal weight range) enrolled in Head Start. The study was conducted using a quasi-experimental pretest/posttest design with two treatment groups and a comparison group. A center-based intervention included an age-appropriate gross motor program with structured outdoor play, supplemental classroom activities, and staff development. A combined center- and home-based intervention added peer-led parent education to create a broad supportive environment in the center and at home. Primary outcomes were weight-based z-scores and raw scores of gross motor skills of the Learning Achievement Profile Version 3. RESULTS: Favorable changes occurred in z-scores for weight (one-tailed p < 0.04) for age and gender among children in the combined center- and home-based intervention compared to comparison children at posttest. Higher gains of gross motor skills were found in children in the combined center- and home-based (p < 0.001) and the center-based intervention (p < 0.01). Children in both intervention groups showed increases in outdoor physical activity and consumption of healthy food. Process evaluation data showed high levels of protocol implementation fidelity and program participation of children, Head Start staff, and parents. CONCLUSION: The study demonstrated great promise in creating a health-conducive environment that positively impacts weight and gross motor skill development in children at risk for obesity. Program efficacy should be tested in a randomized trial.


Assuntos
Promoção da Saúde/métodos , Americanos Mexicanos , Atividade Motora/fisiologia , Obesidade/etnologia , Obesidade/prevenção & controle , Índice de Massa Corporal , Distribuição de Qui-Quadrado , Criança , Pré-Escolar , Competência Cultural , Docentes , Comportamento Alimentar , Feminino , Humanos , Masculino , Americanos Mexicanos/etnologia , Pais/educação , Pobreza/etnologia , Avaliação de Programas e Projetos de Saúde , Texas/etnologia , Perda de Peso
20.
Child Obes ; 8(1): 60-70, 2012 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-22799482

RESUMO

BACKGROUND: Children tend to be sedentary during the after-school hours, and this has deleterious effects on their health. The objective of the present study was to determine the effects of a 3-year after-school physical activity (PA) program, without restriction of dietary energy intake, on percent body fat (%BF), cardiorespiratory fitness (CRF), and cardiometabolic markers in children. METHODS: A cluster randomization design was employed. A total of 574 3rd grade children from 18 elementary schools in the southeastern United States participated. The intervention consisted of 80 minutes of age-appropriate moderate-to-vigorous PA each school day. The main outcomes of interest were %BF measured by dual-energy X-ray absorptiometry; CRF measured by heart rate in response to a submaximal step test; nonfasting total and high-density lipoprotein cholesterol (HDL-C); and resting blood pressure (BP). RESULTS: Intent-to-treat analyses showed significant treatment by time interactions for %BF (p = 0.009) and CRF (p = 0.0003). The change pattern of the means suggested that %BF and CRF in intervention children improved relative to control children during the school months, rebounding to the levels of control children over the summers following years 1 and 2. Year-by-year analyses of what occurred during the months when the program was offered revealed dose­response relations for %BF and CRF, such that the clearest beneficial effects were seen for those youth who attended at least 60% of the after-school sessions. No significant intervention effects were seen for cholesterol or BP. CONCLUSIONS: An after-school PA program was effective in reducing adiposity and improving CRF, especially in the children who attended the sessions at least 3 days/week. However, the favorable effects on %BF and CRF were lost over the summer. Thus, it is critical to incorporate strategies that attract and retain the children to receive an adequate dose of PA year-round.


Assuntos
Atividade Motora/fisiologia , Obesidade , Educação Física e Treinamento/métodos , Aptidão Física/fisiologia , Serviços de Saúde Escolar/organização & administração , Absorciometria de Fóton/métodos , Adiposidade , Adolescente , Pressão Sanguínea , Criança , Comportamento Infantil/fisiologia , HDL-Colesterol/sangue , Teste de Esforço/métodos , Feminino , Frequência Cardíaca , Humanos , Masculino , Obesidade/sangue , Obesidade/diagnóstico , Obesidade/fisiopatologia , Obesidade/prevenção & controle , Obesidade/psicologia , Educação Física e Treinamento/organização & administração , Avaliação de Programas e Projetos de Saúde , Instituições Acadêmicas , Comportamento Sedentário , Sudeste dos Estados Unidos
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