A-B-C-1-2-3 Healthy Kids in Tennessee - Let's Eat Well, Play, and Be Aware Every Day: a preliminary report.

The "A-B-C-1-2-3 Healthy Kids in Tennessee - Let's Eat Well, Play, and Be Aware Every Day" project is a hands-on educational program emphasizing healthy living that targets childcare providers, the children they care for, and their families. The program was initially implemented as a pilot project in 6 middle Tennessee childcare centers. Materials were organized and developed by the Middle Tennessee Cancer Coalition's childhood action team in conjunction with staff from Middle Tennessee State University (MTSU) Center for Health and Human Services and the MTSU Center for Physical Activity and Health in Youth. The A-B-C-1-2-3 initiative served as a feasibility project to inform the conduct of field operations. Through the MTSU Center for Physical Activity and Health in Youth, an expanded 12-week pilot program took place during 2010 in 2 childcare centers. The purpose of the program is to educate childcare providers who, in turn, educate children and their parents and promote healthy lifestyles and decrease the risk of developing cancer, obesity, and other lifestyle-associated diseases and health conditions. The overall goal of the project is to decrease lifestyle and environmental cancer risk factors among Tennesseans by 2012 as detailed in the 2009-2012 Tennessee Comprehensive Cancer Control Plan and to provide educational opportunities in healthy eating and healthy weight to childcare providers detailed in the 2010-2015 Tennessee Statewide Nutrition and Physical Activity Plan using a "train the trainer approach" along with classroom and family education. In 2012, the project will partner with a statewide Tennessee Department of Health initiative, Gold Sneakers, which provides a policy piece to the A-B-C-1-2-3 Healthy Kids in Tennessee's approach to disseminate nutritional and physical activity education to childcare providers, children, and their families, offering a full-circle approach to health promotion in a childcare setting.

Developing a parsimonious model for predicting completion of advance directives.

PURPOSE: To develop a theory-based model to assist nurses in promoting self-determination for completion of an advance directive (AD). DESIGN AND METHODS: This descriptive study included data from a convenience sample of 118 community-dwelling older adults in Tennessee, USA. Multinomial logistic regression was used to estimate the influence of 15 factors and covariates on completion of an AD. FINDINGS: The parsimonious model had three significant factors: receiving AD information; attitude index; and health literacy score. Participants were highly likely to complete ADs if they had positive attitudes toward ADs and had received information on ADs. As health literacy increased, the likelihood that participants completed ADs was reduced. This model explained 25% of the variation in AD completion. Chi-square fit for the parsimonious model was highly significant. CONCLUSIONS: Of 15 factors and covariates that could influence completion of an AD, only receiving information about ADs, having positive attitudes toward ADs, and health literacy significantly affected the likelihood of participants completing ADs. More study is needed on this model and how nurses can assist patients with end-of-life decisions.

Health promotion and disease prevention through sanitation education in South African Zulu and Xhosa women.

Poor sanitation and hygiene facilitate transmission of environmental diseases and pose a threat to the health of South African residents. This study focused on identifying sanitation needs from the perspective of informal community residents, addressing need related issues, and empowering Zulu and Xhosa women. The study used a multistep approach to identify and access communities of interest, reflexive critique during data collection from 300 heads of households, and a reiterative process to identify major themes. A process, which impacted 1,467 residents, was developed; it included culturally sensitive presentation styles and educational materials that facilitated understanding of sanitation concepts. Main sanitation themes were health knowledge and community role models. Educational sessions incorporated women. Using women as educators elevated their status and validated their community importance. Project participation added to the educational background of the Zulu and Xhosa women. It empowered them and provided an opportunity for them to articulate community needs.