The change in weight perception of weight status among the overweight: comparison of NHANES III (1988-1994) and 1999-2004 NHANES.

OBJECTIVES: This study seeks to determine whether perception of weight status among the overweight has changed with the increasing overweight/obesity prevalence. METHODS: The perception of weight status was compared between overweight participants (BMI between 25.0-29.9 kg/m2) from NHANES III (1988-1994) and overweight participants from NHANES 1999-2004. Perception of weight status was assessed by asking participants to classify their weight as about the right weight, underweight or overweight. Comparisons were made across age groups, genders, race/ethnicities and various income levels. RESULTS: Fewer overweight people during the NHANES 1999-2004 survey perceived themselves as overweight when compared to overweight people during the NHANES III survey. The change in distortion between the survey periods was greatest among persons with lower income, males and African-Americans. CONCLUSION: The increase in overweight/obesity between the survey years (NHANES III and NHANES 1999-2004 has been accompanied with fewer overweight people perceiving themselves as overweight.

Enhancing measurement in health outcomes research supported by Agencies within the US Department of Health and Human Services.

Many of the Institutes, Agencies and Centers that make up the US Department of Health and Human Services (DHHS) have recognized the need for better instrumentation in health outcomes research, and provide support, both internally and externally, for research utilizing advances in measurement theory and computer technology (informatics). In this paper, representatives from several DHHS agencies and institutes will discuss their need for better instruments within their discipline and describe current or future initiatives for exploring the benefits of these technologies. Together, the perspectives underscore the importance of developing valid, precise, and efficient measures to capture the full burden of disease and treatment on patients. Initiatives, like the Patient-Reported Outcomes Measurement Information System (PROMIS) to create health-related quality of life item banks, represent a trans-DHHS effort to develop a standard set of measures for informing decision making in clinical research, practice, and health policy.

What can communication science tell us about promoting optimal dietary behavior?

Four of the 10 leading causes of death can be attributed to poor dietary behaviors. Nutrition professionals continue to struggle with the most effective ways to deliver nutrition messages that will result in changes in dietary behavior. On July 14-15, 2005, the National Cancer Institute and the Division of Nutrition Research Coordination, both of the National Institutes of Health, hosted a meeting to explore the state of the science concerning this issue. This paper provides an introduction to that meeting and the articles that resulted from it.

News coverage of diet-related health disparities experienced by black Americans: a steady diet of misinformation.

Compared to their white counterparts, black Americans experience greater morbidity and mortality across a range of diet-related diseases and conditions, including heart disease, type II diabetes, cancer, stroke, and obesity. Many factors influence dietary behaviors among blacks, including those associated with socioeconomics, culture, racism, psychology, and health care quality and access. However, when reporting about the health status and dietary behavior of black Americans, the mainstream print media pursues a largely one-dimensional focus on behavioral and cultural factors. This approach tends to disregard or minimize other factors that influence health behaviors. Health scientists and journalists must be careful to include discussion of the other factors if they want to become a part of the solution to minimize diet-related disparities.

Communicating healthy eating: lessons learned and future directions.

Achieving and maintaining wide-scale positive dietary change is a complex and formidable endeavor, given the current food environment. Moreover, for positive change to occur, nutrition messages should be communicated in a scientifically precise, yet practical and motivating manner. This challenge was the impetus for the organization of a 2-day workshop hosted by the National Cancer Institute (NCI) and the Division of Nutrition Research Coordination (DNRC), both of the National Institutes of Health (NIH). The conference included communication, nutrition, and behavioral scientists, market researchers, media advocates, journalists, and public policy experts. Discussions regarding communication efforts and the best methods to craft, deliver, and evaluate the impact of nutrition messages illustrated both the challenges and the opportunities we face. During the discussions, important recommendations for nutrition communicators and interventionists emerged, based on existing knowledge from the communications field, lessons learned thus far, and noted gaps in our knowledge.

Modifiable environmental and behavioral determinants of overweight among children and adolescents: report of a workshop.

The number of children at risk for overweight and the number of overweight children are increasing and have become a serious public health concern. Interventions that could be applied at the population level have not been proven effective. The development of effective strategies is thought to be hampered by the lack of understanding of which behavioral and environmental factors need to be modified. On June 14 and 15, 2004, the NIH held a meeting of experts to discuss the issue of modifiable determinants of obesity in children and adolescents. Included were presentations on interventions among children that have been proven effective, dietary and physical activity behavioral determinants, physical, social, and family environmental determinants, and the quality of measures of determinants and correlates of overweight.

Formative evaluation of a men's health center.

We describe an innovative approach for evaluating a men's health center. Using observation and interview, we assessed patient flow, referral patterns, patient satisfaction, and perceptions of the services' usefulness. Student assistants designed evaluation tools, hired and trained research assistants, supervised data collection, interacted with city and center officials, analyzed data, and drafted a report. To ensure patient confidentiality and anonymity, we designed an innovative observation system. The men had unique perceptions of family, requiring culturally sensitive approaches to engage them in the study. Of patients reporting to the center, 20.3% received referral services. Average satisfaction level was 5.2 (scale = 1-10). Perceived benefits to the family for 23% of respondents included cost savings, improved access, and higher service quality.

Summary of the 2000 Surgeon General's listening session: toward a national action plan on overweight and obesity.

OBJECTIVE: To provide insight into discussions at the Surgeon General's Listening Session, "Toward a National Action Plan on Overweight and Obesity," and to complement The Surgeon General's Call to Action to Prevent and Decrease Overweight and Obesity. RESEARCH METHODS AND PROCEDURES: On December 7 and 8, 2000, representatives from federal, state, academic, and private sectors attended the Surgeon General's Listening Session and were given an opportunity to recommend what to include in a national plan to address overweight and obesity. The public was invited to comment during a corresponding public comment period. The Surgeon General's Listening Session was also broadcast on the Internet, allowing others to view the deliberations live or access the archived files. Significant discussion points from the Listening Session have been reviewed by representatives of the federal agencies and are the basis of this complementary document. RESULTS: Examples of issues, strategies, and barriers to change are discussed within five thematic areas: schools, health care, family and community, worksite, and media. Suggested cooperative or collaborative actions for preventing and decreasing overweight and obesity are described. An annotated list of some programmatic partnerships is included. DISCUSSION: The Surgeon General's Listening Session provided an opportunity for representatives from family and community groups, schools, the media, the health-care environment, and worksites to become partners and to unite around the common goal of preventing and decreasing overweight and obesity. The combination of approaches from these perspectives offers a rich resource of opportunity to combat the public health epidemic of overweight and obesity.