Addressing health disparities among African Americans: using the stages of change model to document attitudes and decisions about nutrition and physical activity.

Physical activity (PA) and poor fruit/vegetable intake are contributors of health disparities among African Americans (AA). In order to design effective interventions to address these behaviors, it is essential to assess where individuals are in terms of their attitudes and decisions. The aim of this study was to use the Stages of Change Model to assess AA's attitudes and decisions regarding pertinent health behaviors and provide suggestions about how to address them. A survey was administered to 242 low-income, medically underserved adults (47% AA, 27% White, and 26% "Others"). The majority was in the SOC's: "contemplation" stage for PA (they were considering PA); "maintenance" stage for vegetable intake (they had consumed > or =3 vegetable servings daily for > or =6 months); and in the "contemplation" stage for fruit intake (those grouped as "Others" were significantly more likely to be in the "maintenance" stage). Although education and awareness are important, this study has implications for interventions with greater emphasis on creating environments or providing resources to promote or support behavioral change.

Examining the theory of planned behavior applied to condom use: the effect-indicator vs. causal-indicator models.

The authors investigated whether a causal-indicator model or an effect-indicator model of the theory of planned behavior (TPB) is more suitable for predicting behavioral intention and for which behaviors. No previous studies have evaluated this question using the same sample and same behavior. In this study, African American adolescents ages 12-17 participating in risk reduction classes were assessed on their initial attitudes, norms, perceived control, and intention regarding condom use. Second-order structural equation modeling indicated that the effect-indicator model exhibited superior fit above the causal-indicator model. Furthermore, modeling the behavioral antecedents in a causal way may not be as accurate due to the underlying uni-dimensional nature of attitudes, subjective norms, and control. The TPB was not disconfirmed as a suitable model for African American adolescents' regarding condom use. Prevention programs may benefit by focusing on adolescent behavior change with regard to the global components in order to influence more specific concepts of these social cognitions. Editors' Strategic Implications: Despite limitations including correlational data, this study yields implications for prevention programming and, more broadly, an important theoretical elaboration on effect-indicator and causal-indicator models of the TPB.

Health attitudes and behaviors of African American adolescents.

African Americans continue to die disproportionately from chronic diseases such as diabetes, hypertension and heart disease. Eating fruits and vegetables have been shown to reduce those risks yet little is known about the health attitudes of African American adolescents and their eating habits and engagement in physical activity. A survey was administered to African American adolescents in a Midwestern city to determine the health attitudes and behaviors related to dietary intake and physical activity. The total sample consisted of 448 African American adolescents aged 12-17. Forty-seven percent were males and 53% were females. The findings show that African American adolescents did have poor fruit and vegetable intake and fairly low rates of exercise. The study also showed there were statistically significant differences between males and females regarding eating a balanced diet, reducing the amount of fat in diets and engaging in physical activity. African American females were more likely to eat a balanced diet and have reduced the fat in their diets than males but African American males were more likely to engage in physical activity in the past 7 days than females. Findings suggest more efforts are needed to curb the poor eating and exercising habits of African American adolescents if a reduction in chronic disease is to be met for this population.