Recruitment to mail and telephone interventions for obesity in a managed care environment: the Weigh-To-Be project.

OBJECTIVE: To evaluate the success of mail- and telephone-based weight loss programs in recruiting a representative sample of overweight members of a managed care organization (MCO). STUDY DESIGN: Cross-sectional. PATIENTS AND METHODS: A total of 1801 members of an MCO were recruited by direct mail, clinic flier, and physician referral for a research study evaluating mail- and telephone-based weight loss programs; 412 additional overweight members of the same MCO were identified in a general member survey for comparison purposes. Body mass index, demographics, diet, and exercise habits were measured. RESULTS: Study volunteers were heavier, more likely to be women, more likely to be minorities, more educated, and younger than the general sample of overweight members. They also had a more extensive history of dieting, ate a diet higher in fat and lower in fruit and vegetables, and were more likely to report binge eating than the general sample. However, study volunteers reported a higher level of physical activity. CONCLUSIONS: Invitations to participate in weight loss programs can attract large numbers of people in a managed care setting. However, the participation bias in recruitment to such programs is similar to that seen in traditional face-to-face interventions. Women of higher socioeconomic status who are severely obese and who have an extensive history of weight control efforts are more likely to participate. Additional research is needed to find ways to reach more men and older adults.

Prevalence and correlates of weight-control behaviors among Caribbean adolescent students.

Adolescent students from nine English-speaking Caribbean countries completed a survey that assessed weight-control behaviors. Weight-control behaviors were prevalent and similar across gender. Extreme weight-control behaviors were related to several psychosocial factors and compromising health behaviors. Future interventions should target adolescents who are using weight-controlling behaviors to prevent future eating disturbances and psychosocial and health morbidities.

Adolescent vegetarians: how well do their dietary patterns meet the healthy people 2010 objectives?

OBJECTIVES: To examine whether adolescent vegetarians were more likely than nonvegetarian peers to meet the dietary recommendations of the Healthy People 2010 objectives and to examine differences in other nutrients between these 2 groups. DESIGN: A total of 4746 adolescents from 31 middle and high schools in the Twin Cities area of Minnesota. Data were collected via self-report surveys, with a student response rate of 81.5%. SETTING: Urban secondary schools. PARTICIPANTS: Participants were equally divided by sex. The mean age was 14.9 years; 34.3% were in junior high school and 65.7% in high school. The racial/ethnic distribution was 48.5% white, 19.0% African American, 19.2% Asian American, 5.8% Hispanic, 3.5% American Indian, and 3.9% mixed or other. MAIN OUTCOME MEASURES: Questions on vegetarian status and whether particular foods (eggs, dairy foods, chicken, fish) were excluded. Dietary intake was assessed using the Youth and Adolescent Food Frequency Questionnaire. RESULTS: Vegetarian adolescents were significantly more likely than nonvegetarian adolescents to meet the Healthy People 2010 objectives. This was particularly noteworthy for total fat (70% vs 48%), saturated fat (65% vs 39%), daily servings of vegetables (26% vs 14%), and 5 or more servings of fruits and vegetables (39% vs 28%). Vegetarians were also less likely to eat fast food or drink regular soda and fruit drinks. Vegetarians consumed less vitamin B(12), more diet soda, more caffeine, and more iron. CONCLUSION: Adolescent vegetarians have a dietary pattern that is more likely than nonvegetarians to meet the Healthy People 2010 objectives.

Parental correlates of physical activity in a racially/ethnically diverse adolescent sample.

PURPOSE: To evaluate relationships between parents' and adolescents' physical activity and television usage and whether these relationships differed among adolescents from different racial/ethnic backgrounds. METHODS: Adolescents and their parents were separately asked to report information about their eating, exercising, and weight-related behaviors. Among the 900 adolescents, 477 were girls and 423 were boys; 60% were in high school; 29% were white, 23% were black, 21% were Asian, 14% were Hispanic, and 13% were considered mixed or other race/ethnicity. RESULTS: Parents' reported encouragement was positively related to physical activity in white (r = 0.39; p <.001) and black boys (r = 0.26; p =.007), and girls (all race/ethnic groups combined: r = 0.15; p <.001). Parents' television time was positively related to television time in Hispanic boys (r = 0.40; p =.009) but negatively related to television time in black boys (r = -0.23; p =.036). Parents' concern about their own fitness was negatively related to television time in white girls (r = -0.19; p =.029) but positively related in black girls (r = 0.23; p =.030). CONCLUSION: This study found significant, although modest, relationships between parents' and adolescents' physical activity attitudes and behaviors. Many of these relationships differed by race/ethnicity. Results from the present and previous studies suggest that factors other than parents' behavior and support explain adolescents' physical activity behaviors.