A systematic review of existing observational tools to measure the food and physical activity environment in schools.

Objective measures of schools' wellness-promoting environments are commonly used in obesity prevention studies; however, the extent to which findings from these measures translate to policy and practice is unknown. This systematic review describes the comprehensiveness and usability (practicality, quality, and applicability) of existing objective measures to assess schools' food and physical activity environments. A structured keyword search and standard protocol in electronic databases yielded 30 publications reporting on 23 measures that were deemed eligible to include in this review. Findings provide details to guide researchers and practitioners in selecting the best tool for use in policy and program evaluations.

Dietary Practices Among Stroke-survivors-Racial/Ethnic Differences.

BACKGROUND: Healthy lifestyle choices, particularly optimal nutrition, are crucial to stroke prevention and reducing risk of recurrent stroke. Racial differences exist in poststroke outcomes; however, few studies have examined the influence of race on poststroke diet or nutrition practices, despite nutrition being critical to stroke recovery. The objective of this analyzes was therefore to examine racial/ ethnic differences in nutrition activities among stroke survivors using data from the National Health and Nutrition Examination Surveys. METHODS: Cross-sectional data from National Health and Nutrition Examination Surveys (2011-2014) were analyzed for adults (n = 431) who responded "yes" that they had been told by a health professional that they had a stroke. The main outcome measure was food consumption/nutrition behavior. Descriptive statistics were conducted for demographic characteristics. Pearson Chi square statistics were performed for baseline demographic and clinical comparisons. A negative binomial regression analysis was utilized for racial/ethnic comparisons of dietary/nutrition behaviors. RESULTS: The mean age of the sample was 66.6 years (Standard Deviation, 12.7) but the mean age of stroke onset was 57.9 years (Standard Deviation, 15.8), with Mexican American/Hispanics experiencing their strokes at a younger age than other racial groups (P < .007). After controlling for baseline differences in key demographic and clinical covariates variables, Blacks consumed a higher number of ready-to-eat foods (P = .000) in the past 30 days while Mexican American/Hispanics consumed a higher number of frozen meals/pizza in the past 30 days (P = .004). CONCLUSIONS: Racial/ethnic differences in poststroke nutrition practices, highlight a potential need for focused nutrition counseling for minority population at higher risk of poor poststroke outcomes.

Osteoporosis Knowledge and Health Beliefs Among Men in Midlife Years.

OBJECTIVE: To examine the role of socioeconomic variables on middle-aged adult men's knowledge and health beliefs about osteoporosis. METHODS: An anonymous survey used validated scales to assess osteoporosis knowledge and health beliefs in a sample of 262 men aged 36-55 years. Descriptive and group-differences statistics (MANOVA and ANOVA) were used. RESULTS: Total osteoporosis knowledge was low (mean, 11.1 of 22) and mean scores on perceived susceptibility and seriousness health belief domains were also low: 13.2 and 17.2, respectively out of 30. Multivariate ANOVA revealed that perceived seriousness, barriers to calcium intake, and health motivation varied significantly with level of formal education attained (P < .05). There was no significant difference with income. CONCLUSIONS AND IMPLICATIONS: Results of this convenience sample of predominantly white men found that level of osteoporosis knowledge and perceived susceptibility were low. Given the increased prevalence of osteoporosis-related fracture in men, methods to increase knowledge and awareness are needed.

Theory-driven intervention improves calcium intake, osteoporosis knowledge, and self-efficacy in community-dwelling older Black adults.

OBJECTIVE: To assess the effectiveness of an osteoporosis education program to improve calcium intake, knowledge, and self-efficacy in community-dwelling older Black adults. DESIGN: Randomized repeated measures experimental design. SETTING: Churches and community-based organizations. PARTICIPANTS: Men and women (n = 110) 50 years old and older from 3 south Florida counties. INTERVENTION: Participants randomly assigned to either of 2 groups: Group 1 (experimental group) or Group 2 (wait-list control group). Group 1 participated in 6 weekly education program sessions immediately following baseline assessment, and Group 2 started the program following Group 1's program completion. A tested curriculum was adapted to meet the needs of the target population. MAIN OUTCOME MEASURES: Dietary calcium intake, osteoporosis knowledge, health beliefs, and self-efficacy. ANALYSIS: Descriptive and summary statistics, repeated measures analysis of variance, and regression analysis. RESULTS: Of the total participants, 84.6% completed the study (mean age = 70.2 years). Overall, an educational program developed with a theoretical background was associated with improvement in calcium intake, knowledge, and self-efficacy, with no effect on most health belief subscales. Assigned group was the major predictor of change in calcium intake. CONCLUSIONS AND IMPLICATIONS: A theory-driven approach is valuable in improving behavior to promote bone health in this population. Health professionals should consider using more theory-driven approaches in intervention studies.