Parental and environmental factors associated with physical activity among children participating in an active video game.

PURPOSE: Parental and intervention-specific environmental supports were examined as potential reinforcers for physical activity and use of a video game, Dance Dance Revolution (DDR), among a cohort of 7- to 8-year-old children. METHODS: Sixty children were randomized to an intervention (n = 40) or a control (n = 20) group. Physical activity was measured with accelerometry and DDR logs. Parental support for their child's physical activity was assessed via a questionnaire. DDR-specific environmental supports were captured on an environmental home screen and the DDR log. RESULTS: At baseline, the absence of other video games and parent DDR participation was associated with child participation in DDR. At follow-up, DDR participation of siblings and friends was associated with child participation in DDR. CONCLUSION: The primary findings of this study suggest that parental and peer participation in DDR may play a role in children's initial and sustained participation in DDR.

"Una mujer trabaja doble aqui": Vignette-based focus groups on stress and work for Latina blue-collar women in eastern North Carolina.

Latina women are a growing percentage of the working population, and very little is known about their health needs and interests. The purpose of this article is to share qualitative research results gathered from Latina women with a particular focus on exploring stress and health. This project was a substudy of Health Works in the Community, a 5-year CDC-funded multiple risk-factor reduction trial using participatory action research approaches to address smoking, healthy eating, stress, and physical activity among blue-collar women from 12 manufacturing work sites in rural, eastern North Carolina. Five focus groups were conducted with trained, bilingual facilitators using a vignette-based moderator guide that appeared particularly effective with this population. Results from the focus groups are used to make recommendations for future research with Latinas and for developing effective work-site-based interventions to address issues of stress and health within this population.

Positive affect, exercise and self-reported health in blue-collar women.

OBJECTIVES: To determine if positive affect is related to the self-reported health and health behaviors of blue-collar women. METHODS: Analysis of baseline survey data of 1093 women participating in a worksite health promotion intervention at 12 workplaces in 5 rural counties. RESULTS: Positive affect was related to women's self-reported health and exercise. Also, positive coping behaviors were related to exercise. CONCLUSIONS: These findings suggest that incorporating strategies to encourage positive emotional states and positive coping into health promotion interventions might be helpful for improving women's levels of physical activity and overall reported health.

Blood docosahexaenoic acid and eicosapentaenoic acid in vegans: Associations with age and gender and effects of an algal-derived omega-3 fatty acid supplement.

BACKGROUND & AIMS: Several studies have demonstrated that vegetarians and vegans have much lower plasma concentrations of omega-3 fatty acids (i.e., docosahexaenoic and eicosapentaenoic acids) when compared to those who eat fish. The purposes of this study were 1) to define the age and/or sex-specific docosahexaenoic plus eicosapentaenoic acids levels in red blood cell membranes (expressed as a percent of total fatty acids; hereafter the omega-3 index) in long-term vegans, and 2) to determine the effects of a vegetarian omega-3 supplement (254 mg docosahexaenoic plus eicosapentaenoic acids/day for 4 months) on the omega-3 index. METHODS: A sample (n = 165) of vegans was recruited, and their omega-3 index was determined using a dried blood spot methodology. A subset of 46 subjects with a baseline omega-3 index of <4% was given a vegetarian omega-3 supplement for 4 months and then retested. RESULTS: The mean ± SD omega-3 index was 3.7 ± 1.0% which was similar to that of a cohort of omnivores (deployed US soldiers) from a recently-reported study. Among the vegan cohort, the index was significantly higher in females than males (3.9 ± 1.0% vs. 3.5 ± 1.0%; p = 0.026) and was directly related to age (p for trend = 0.009). The omega-3 index increased from 3.1 ± 0.6% to 4.8 ± 0.8% (p = 0.009) in the supplementation study. CONCLUSIONS: We conclude that vegans have low baseline omega-3 levels, but not lower than omnivores who also consume very little docosahexaenoic and eicosapentaenoic acids. The vegans responded robustly to a relatively low dose of a vegetarian omega-3 supplement.

Barriers to physical activity: qualitative data on caregiver-daughter perceptions and practices.

BACKGROUND: There is little research on household and physical environment barriers to physical activity, particularly in minority populations at high risk for obesity and inactivity. Few studies include data on caregiver and daughter dyads. Formative data were used to develop intervention strategies and pathways for the Girls Rule! obesity prevention intervention, in under-studied high-risk pre-adolescents. METHODS: Participants included 12 African-American girls (mean age 7.8 years) and their 11 primary female caregivers (mean age 41.8 years)--eight mother-daughter dyads and three grandmother-granddaughter dyads--for a total of 51 interviews across 23 participants interviewed from April to October 2000.A qualitative approach was used for 51 semistructured in-depth interviews with 11 dyads (female caregiver and girl), consisting of up to three interviews per respondent (mean=2.4 interviews per respondent). Interviews were transcribed, coded, and systematically analyzed between January 2002 and January 2003 to identify recurrent patterns and themes related to physical activity. RESULTS: Findings indicate clear preference of the girls for sedentary, rather than active, behaviors. Caregivers were unaware of the amount of TV viewed and found positive benefits of TV viewing, including safe supervision of their daughters. Barriers to physical activity include perceived lack of affordable and accessible recreation facilities and low caregiver motivation. Potential intervention strategies identified by respondents include walking for exercise and transportation and several low-cost, favored physical activities, such as hopscotch, jumping rope, and dance. CONCLUSIONS: These findings point toward several physical activity and obesity intervention strategies that can guide obesity prevention efforts.

Clarifying concepts about macronutrients' effects on satiation and satiety.

It seems that many people, including dietetics professionals and other nutrition experts, are unclear about some of the fundamental yet complex concepts behind the influence of dietary macronutrients (ie, protein, carbohydrate, and fat) on appetite regulation. Recent research has begun to unravel some of the more complicated physiological processes of appetite control and regulation generated by hormones such as leptin, ghrelin, and the gut hormone peptide YY3-35. Although the processes by which the macronutrients in our foods influence appetite regulation have been a topic of study for decades, they remain confusing and are often misunderstood. The objective of this article is to define the terminology commonly used to discuss the macronutrients' roles in appetite regulation and to discuss the interrelated concepts and roles of taste, palatability, and energy density.

Extending the reach of public health nutrition: training community practitioners in multilevel approaches.

BACKGROUND: Cardiovascular disease (CVD) is a major public health concern in the United States. We developed an annual training course, Nutrition and Public Health, A Course for Community Practitioners (NPH), to address the identified training needs of state staff responsible for designing and implementing the Well-Integrated Screening and Evaluation for Women Across the Nation (WISEWOMAN) program and to support other health professionals working in programs that address chronic disease prevention and management. METHODS: After conducting a needs assessment with state-level WISEWOMAN staff in 2001 to identify topics of interest, we formed an advisory committee to provide guidance on topics, theoretical frameworks, training concerns, and multilevel intervention approaches. The first week-long training course, which included an intensive field practicum, was implemented in the fall of 2002. RESULTS: Participants rated three fourths of the elements listed in a posttraining evaluation as a course strength, giving particularly high ratings to various indicators of course quality (100%) and networking opportunities (95%). Just over half (55%) rated the field practicum as a course strength. Four fifths (83%) of participants responded to a 6-month follow-up evaluation, and most indicated that the course had increased their knowledge and skills and increased their confidence in planning programs. CONCLUSIONS: Unique features of the course include its suitability for public health practitioners not previously trained in nutrition, its promotion of multilevel interventions, and its focus on CVD risk reduction and nutrition interventions for underinsured and uninsured populations.

Disaster down East: using participatory action research to explore intimate partner violence in eastern North Carolina.

In the aftermath of Hurricane Floyd in 1999, a Community Advisory Committee requested assistance from its university partners (University of North Carolina) to address stress and increased risk for intimate partner violence (IPV). Collected from 12 study work sites, baseline data indicated that IPV rates were higher among blue-collar women in eastern North Carolina than national population-based rates suggest. IPV victims reported higher levels of perceived stress, psychological distress, somatic complaints, and post-traumatic stress disorder (PTSD) symptoms than did nonvictimized coworkers. As for the relationship of the flood to IPV, no significant increase in IPV incidence occurred after the flood. Regardless of their flood experience, however, IPV victims consistently reported greater stress, PTSD symptoms, and somatic and psychological problems. Moreover, IPV victims may be at higher risk for stress-mediated chronic illnesses and for using negative coping behaviors. This study uses an established trusting relationship between researchers and community members to explore community needs and inform intervention design.

"Does skinny mean healthy?" Perceived ideal, current, and healthy body sizes among African-American girls and their female caregivers.

OBJECTIVES: To qualitatively and quantitatively examine body image ideals and perceived weight-related health among African-American girls and their female caregivers to inform intervention development for Girls Rule!, an obesity prevention pilot program. DESIGN, SETTING, AND PARTICIPANTS: Formative study using qualitative data from semi-structured interviews and validated quantitative body image silhouette assessment among girls (N=47) and caregivers (N=44). The participants were a convenience sample of African-American church members from North Carolina. Differences were evaluated between perceived: 1) current and ideal body size; 2) current and unhealthy body size; and 3) ideal and unhealthy body size. RESULTS: Thirty-seven percent of the girls and 77% of the caregivers were overweight or obese. Three body image themes emerged from the qualitative interviews: 1) being fat is unhealthy; 2) caregivers are role models (positive and negative) for body image ideals; and 3) smaller body size is important for wearing fashionable clothing. A series of 9 body silhouettes were used to assess perceptions of both girls and caregivers. Overall, both girls (2.9 +/- 1.4) and caregivers (4.4 +/- 1.4) ideal body size was significantly (P<.01) smaller than their current body size (3.7 +/- 1.3 girls; 6.3 +/- 2.2 caregivers). Both girls (3.7 +/- 1.4) and caregivers (6.7 +/- 2.0) indicated that their current body sizes were statistically significantly (P<.05) smaller that what they considered to be unhealthy (7.9 +/- 1.4 girls; 7.9 +/- 1.2 caregivers). CONCLUSIONS: Results suggest that most of these African-American participants were not satisfied with their current body size and desired a smaller body. At the same time, both girls and caregivers failed to recognize the potential health consequences associated with their current body size. Critical issues for designing obesity prevention programs include positive role modeling within the family and addressing the association of body size with health risk.

A pilot of a video game (DDR) to promote physical activity and decrease sedentary screen time.

OBJECTIVE: We examined the feasibility of Dance Dance Revolution (DDR), a dance video game, in participants' homes, to increase physical activity (PA) and to decrease sedentary screen time (SST). METHODS AND PROCEDURES: Sixty children (7.5 +/- 0.5 years) were randomized in a 2:1 ratio to DDR or to wait-list control (10-week delay). DDR use was logged, PA was measured objectively by accelerometry. SST was self-reported at weeks 0 and 10. At week 28, after both groups had access to DDR, accelerometry and SST were repeated. RESULTS: Mean use of DDR was 89 +/- 82 (range 0-660 min) min per week (mpw). The DDR group showed increased vigorous PA and a reduction in light PA; the control group showed no increase in moderate and/or vigorous PA (MVPA) although they also had a reduction in light PA. Differences between the groups were not observed. The DDR group also reported a decrease in SST of -1.2 +/- 3.7 h per week (hpw) (P < 0.05), whereas the controls reported an increase of +3.0 +/- 7.7 hpw (nonsignificant). The difference in SST between the groups was significant, with less SST in the DDR group. Between weeks 10 and 28, numeric reductions in SST were reported in both groups. In the DDR group, SST at week 28 (8.8 +/- 6.0 hpw) was lower than baseline (10.5 +/- 5.5 hpw; P < 0.03). DISCUSSION: This pilot study suggests that DDR reduces SST and may facilitate slight increases in vigorous PA. Further study is needed to better characterize children and contexts in which DDR may promote a healthy lifestyle.

Effects of a tailored health promotion program for female blue-collar workers: health works for women.

BACKGROUND: This study assessed the effects of the Health Works for Women (HWW) intervention on improving multiple behaviors including nutrition and physical activity among rural female blue-collar employees in North Carolina. METHODS: Nine small to mid-size workplaces were randomly assigned to either intervention or delayed intervention conditions. After a baseline survey, an intervention consisting of two computer-tailored magazines and a natural helpers program was conducted over 18 months. Delayed worksites received one tailored magazine. Approximately 77 and 76% of baseline respondents completed follow-up surveys at 6 and 18 months, respectively, and 538 women (63%) completed all three surveys. RESULTS: At the 18-month follow-up, the intervention group had increased fruit and vegetable consumption by 0.7 daily servings compared to no change in the delayed group (P < 0.05). Significant differences in fat intake were observed at 6 months (P < 0.05) but not at 18 months. The intervention group also demonstrated improvements in strengthening and flexibility exercise compared to the delayed group. The rates of smoking cessation and cancer screening did not differ between study groups. CONCLUSIONS: The HWW project was a successful model for achieving certain health behavior changes among blue-collar women.