Advocacy and Public Policy Perceptions and Involvement of College Health Promotion Students.

Understanding the advocacy and public policy training needs of our future health promotion workforce is crucial if we are to prepare them to meet their professional responsibilities. The purpose of this study was to examine health promotion students' advocacy/public policy involvement, training, and perceptions. Electronic surveys were disseminated nationwide to college students in health education and closely related programs. Of 477 student respondents, the most frequently indicated advocacy/public policy activity engaged in was voting (56%). The greatest benefit to advocacy was indicated as creating public awareness, while the most prevalent barrier reported was lack of familiarity with the legislation process. Less than one third of students reported receiving any training; however, training and the number of training sources were associated with greater involvement (p < .05). Comparisons by academic classification indicated that graduate students participated in more advocacy activities and reported significantly more benefits, barriers, knowledge, and self-efficacy compared with undergraduates. Regression analysis indicated that knowledge, self-efficacy, perceived benefits, and total number of training sources were significant predictors of advocacy involvement in both graduate and undergraduate student models, with age also contributing significantly to the graduate student model. Findings emphasize the need for increased training at earlier education levels to increase knowledge, self-efficacy, and advocacy/public policy involvement.

What proportion of preschool-aged children consume sweetened beverages?

BACKGROUND: Obesity affects nearly 17% of US children and youth 2-19 years old and 10% of infants and toddlers under the age of 2 years. One strategy for addressing obesity is to discourage sugar-sweetened beverage (SSB) consumption. Compared with their older school-aged counterparts, children ≤ 5 years depend largely on parents for the purchase and serving of SSBs. Therefore, recognizing parental factors associated with children's intake of SSBs is important. METHODS: This study used cross-sectional data from parents of children ≤ 5 years old to examine SSB consumption and associated factors. Elements of the Health Belief Model and Theory of Reasoned Action facilitated data analysis and interpretation. RESULTS: The most consistent predictor of SSB intake was child age. Nearly 94% of children aged 3-5 years consumed sweetened milk products, 88% consumed fruity drinks, 63% consumed sodas, and 56% consumed sports drinks and sweet tea. Adjusting for all other factors, the only parental psychosocial factor associated with SSB intake was self-efficacy (predicting fruity drinks consumption). CONCLUSIONS: More children drink SSBs as they get older. Interventions designed to prevent SSB consumption should occur early, before children reach preschool age. Additional study of parental factors influencing SSB intake in early childhood is recommended.

A modified obesity proneness model predicts adolescent weight concerns and inability to self-regulate eating.

BACKGROUND: The prevalence of obesity among high school students has risen in recent decades. Many high school students report trying to lose weight and some engage in disordered eating to do so. The obesity proneness model suggests that parents may influence their offspring's development of disordered eating. This study examined the viability of a modified obesity proneness model in a high school population. METHODS: Cross-sectional survey data from a random cluster sample of 1533 students in grades 9-12 from a Florida school district were analyzed using structural equation modeling. Variables included adolescents' weight concerns; inability to self-regulate eating; and perceptions about maternal comments about adolescents' weight, restrictive feeding practices, and maternal weight-related concern and values. RESULTS: All the model's originally proposed relationships were statistically significant, for example perceived maternal weight comments were associated with adolescents' weight concerns (ß = 0.64; p < .0001), and perceived maternal restrictive feeding practices were associated with adolescents' inability to self-regulate eating (ß = 0.22; p < .001). CONCLUSION: Some points of intervention should be subjected to empirical study. These interventions should give mothers guidance about appropriate feeding practices and discourage mothers from making weight-related comments to their offspring. Together, as 1 component of a multilevel intervention, these behaviors may help prevent disordered eating and obesity.

Characteristics of 'tween' participants and non-participants in the VERB™ summer scorecard physical activity promotion program.

Creating community-based opportunities for youth to be physically active is challenging for many municipalities. A Lexington, Kentucky community coalition designed and piloted a physical activity program, 'VERB™ summer scorecard (VSS)', leveraging the brand equity of the national VERB™--It's What You Do! campaign. Key elements of VSS subsequently were adopted in Sarasota County, FL. This study identified characteristics of Sarasota's VSS participants and non-participants. Students in Grades 5-8 from six randomly selected public schools completed a survey assessing VSS participation, physical activity level, psychosocial variables, parental support for physical activity and demographics. Logistic regression showed that VSS participants were more likely to be from Grades 5 to 6 versus Grades 7 and 8 [odds ratio (OR) = 6.055] and perceive high versus low parental support for physical activity (OR = 4.627). Moreover, for each unit rise in self-efficacy, the odds of VSS participation rose by 1.839. Chi-squared automatic interaction detector (CHAID) analysis suggested an interaction effect between grade and school socioeconomic status (SES), with a large proportion of seventh and eighth graders from high SES schools being non-participants (76.6%). A VSS-style program can be expected to be more effective with tweens who are younger, in a middle SES school, having high self-efficacy and high parental support for physical activity.

Promoting physical activity among youth through community-based prevention marketing.

BACKGROUND: Community-based prevention marketing (CBPM) is a program planning framework that blends community-organizing principles with a social marketing mind-set to design, implement, and evaluate public health interventions. A community coalition used CBPM to create a physical activity promotion program for tweens (youth 9-13 years of age) called VERB Summer Scorecard. Based on the national VERB media campaign, the program offered opportunities for tweens to try new types of physical activity during the summer months. METHODS: The VERB Summer Scorecard was implemented and monitored between 2004 and 2007 using the 9-step CBPM framework. Program performance was assessed through in-depth interviews and a school-based survey of youth. RESULTS: The CBPM process and principles used by school and community personnel to promote physical activity among tweens are presented. Observed declines may become less steep if school officials adopt a marketing mind-set to encourage youth physical activity: deemphasizing health benefits but promoting activity as something fun that fosters spending time with friends while trying and mastering new skills. CONCLUSIONS: Community-based programs can augment and provide continuity to school-based prevention programs to increase physical activity among tweens.

Associations between parental limits, school vending machine purchases, and soft drink consumption among Kentucky middle school students.

OBJECTIVE: To examine associations between parental limits on soft drinks and purchasing soft drinks from school vending machines and consuming soft drinks among middle school students. DESIGN: Secondary analysis of cross-sectional data from the middle school Youth Risk Behavior Survey. SETTING: Eight public middle schools in central Kentucky. PARTICIPANTS: All sixth- through eighth-grade students in 7 schools and all eighth-grade students in 1 school (n = 4,049). VARIABLES MEASURED: Self-reported parental limits on soft drink intake, school vending machine soft drink purchases, soft drink consumption, and control variables. ANALYSIS: Chi-square and binary logistic regression analyses. RESULTS: Compared to students with no parental limits on soft drink consumption, students with the strictest limits were less likely to purchase soft drinks from school vending machines and consume soft drinks; conversely, students with minor parental limitations were more likely to consume soft drinks. The odds of consuming soft drinks were nearly 4 times greater when students purchased soft drinks from school vending machines than when they did not. CONCLUSIONS AND IMPLICATIONS: Further research may enhance understanding of the influence of varying degrees of parental limitations. Efforts to reduce children's soft drink consumption may be augmented by policies limiting soft drink purchases in schools.

VERB summer scorecard: findings from a multi-level community-based physical activity intervention for tweens.

The benefits of physical activity for adolescents are well established. Multi-level interventions may be especially effective in establishing and sustaining health-enhancing behaviors. This study explored the influences of a multi-level community intervention aimed at increasing physical activity among tweens (youth 9-13). Two Florida school districts far apart served as intervention and comparison sites in a quasi-experimental post-test design. Youth in grades 5 through 8 in the intervention community (n = 1,253) and comparison community (n = 866) completed an anonymous post-intervention survey. An intent-to-treat analysis did not show any statistically significant group differences for the physical activity outcomes examined. However, a subset analysis revealed that students who reported participating in the intervention were more likely to be physically active than youth in the comparison group, as well as youth in the intervention community who reported not participating. Participating in the intervention was significantly related to meeting recommendations for vigorous physical activity (OR = 2.08, P = 0.0259), being physically active on weekends (OR = 1.84, P = 0.0017), and reporting more days of trying a new game or sport (OR = 1.49, P = 0.046) after controlling for grade, gender, race/ethnicity, and SES. These findings support the efficacy of multi-level interventions to create effective health behavior change, especially when linkages among community, media, schools, and the home are present.

A community-school district-university partnership for assessing physical activity of tweens.

INTRODUCTION: Obesity among youth is related to a decline in physical activity, and data on physical activity levels among children in elementary and middle schools are limited. METHODS: We leveraged a community-school district-university partnership in Sarasota County, Florida, in May of 2005 to assess physical activity levels among tweens (youth aged 9-13 years) and to measure the relationship between tweens' awareness of the Centers for Disease Control and Prevention's VERB program and participation in physical activity, using a minimally obtrusive survey. After surveying participating schools (4 elementary schools and 3 middle schools), we obtained 1,407 responses from children in grades 5 through 7. RESULTS: In all, 83.1% of students met the federal recommendation for daily participation in vigorous-intensity physical activity (VPA), and 58.6% had tried a new game or sport within the previous 2 months. Mean number of days in the previous week engaging in VPA was significantly higher (P < .001) for boys (5.22) than for girls (4.35). Mean number of days engaging in VPA in the previous week was significantly higher (P = .006) among 6th-grade students (4.93) than 7th-grade students (4.54), but no consistent decline through the grade levels occurred. Activity was significantly correlated with the number of friends reported as playing a game or sport daily (r = .369, P < .001). Most students (88.8%) reported having seen, read, or heard messages or ads about VERB, a tween-centric national social marketing campaign promoting physical activity and participation in new games and sports. CONCLUSION: Although participation in VPA was high, girls reported significantly fewer days spent engaged in VPA than did boys. We found a modest association between engaging in VPA and having active friends. Capitalizing on leadership from multiple community-based organizations to monitor youth physical activity may inspire implementation of strategies for motivating youth to try new games and sports that they can sustain through the adolescent years and beyond.

Assessing local capacity for health intervention.

Because of their location within the practice realm, participatory, community-based public health coalitions offer many lessons about implementing and sustaining local interventions. This paper presents a case study of capacity assessment at the local level. Capacity evaluation methods are presented, with emphasis on the theoretical framework used to guide the evaluation. The capacity evaluation framework presented herein was theoretically based and designed to generate practical information to facilitate the adoption of a locally tailored youth obesity prevention program, VERB Summer Scorecard (VSS). Using multiple methods, four aspects of community capacity were assessed, including community, knowledge and skills, resources, and power. Within each category, factors that facilitated or impeded program implementation were distinguished. The evaluation protocol was designed to generate information increasing community capacity to sustain a community-based obesity prevention program. Capacity tables were used as a program-planning tool and as a system for sharing implementation and sustainability requirements with potential adopters. This case study also explores how to use capacity assessment results to empower coalitions to serve as catalysts for development of local programs in other communities.