Demographic factors, workplace factors and active transportation use in the USA: a secondary analysis of 2009 NHTS data.

BACKGROUND: While active transportation has health, economic and environmental benefits, participation within the USA is low. The purpose of this study is to examine relationships of demographic and workplace factors with health-enhancing active transportation and commuting. METHODS: Participants in the 2009 National Household Travel Survey reported demographics, workplace factors (time/distance to work, flextime availability, option to work from home and work start time) and active transportation (for any purpose) or commuting (to and from work, workers only) as walking or biking (≥10 min bouts only). Multiple logistic regression examined cross-sectional relationships between demographics and workplace factors with active transportation and commuting. RESULTS: Among 152 573 participants, active transportation was reported by 1.11% by biking and 11.74% by walking. Among 111 808 working participants, active commuting was reported by 0.80% by biking and 2.76% by walking. Increased odds (p<0.05) of active commuting and transportation were associated with younger age, lower income, urban dwelling, and the highest and lowest education categories. Males had greater odds of commuting and transporting by bike but decreased odds of walk transporting. Inconsistent patterns were observed by race, but whites had greater odds of any biking (p<0.05). Odds of active commuting were higher with a flexible schedule (p<0.001), the option to work from home (p<0.05), shorter time and distance to work (both p<0.001), and work arrival time between 11:00 and 15:59 (walking only, p=0.001). CONCLUSIONS: Active transportation differed across demographic and workplace factors. These relationships could inform infrastructure policy decisions and workplace wellness programming targeting increased active transportation.

Self-efficacy and enjoyment of middle school children performing the progressive aerobic cardiovascular endurance run (PACER).

Self-efficacy and enjoyment were examined among 34 middle school children (M age = 12.5 yr.) performing the Progressive Aerobic Cardiovascular Endurance Run (PACER). Exercise self-efficacy (running) and physical activity enjoyment were measured after viewing a video illustrating the PACER, and subsequently following a PACER test. Significantly greater pre- than post-exercise self-efficacy was reported; enjoyment scores did not differ. Ratings of self-efficacy were higher before exercise than after, but enjoyment scores were not significantly different. A significant correlation was found between post-exercise self-efficacy and enjoyment, but not between pre-exercise self-efficacy and enjoyment. Although positive correlations were found between PACER laps and pre-/post-exercise self-efficacy, correlations with ratings of enjoyment were not significant. Exercise self-efficacy was associated with children's beliefs about the task-specific PACER aerobic exercise; however, exercise enjoyment was stable. Children's self-efficacy and enjoyment beliefs should be considered when developing interventional strategies to promote aerobic exercise participation.

Waterpipe and cigarette smoking among college athletes in the United States.

PURPOSE: Tobacco use using a waterpipe is an emerging trend among college students. Although cigarette smoking is low among college athletes, waterpipe tobacco smoking may appeal to this population. The purpose of this study was to compare cigarette and waterpipe tobacco smoking in terms of their associations with organized sport participation. METHODS: In the spring of 2008, we conducted an online survey of 8,745 college students at eight institutions as part of the revised National College Health Assessment. We used multivariable regression models to assess the associations between tobacco use (cigarette and waterpipe) and organized sports participation. RESULTS: Participants reported participation in varsity (5.2%), club (11.9%), and intramural (24.9%) athletics. Varsity athletes and individuals who were not varsity athletes had similar rates of waterpipe tobacco smoking (27.6% vs. 29.5%, p=.41). However, other types of athletes were more likely than their counterparts to have smoked waterpipe tobacco (35.1% vs. 28.7%, p < .001 for club sports and 34.8% vs. 27.7%, p < .001 for intramural sports). In fully-adjusted multivariable models, sports participants of any type had lower odds of having smoked cigarettes, whereas participants who played intramural sports (odds ratio=1.15, 95% confidence interval=1.03, 1.29) or club sports (odds ratio=1.15, 95% confidence interval=1.001, 1.33) had significantly higher odds of having smoked waterpipe tobacco. CONCLUSIONS: College athletes are susceptible to waterpipe tobacco use. In fact, compared with their nonathletic counterparts, club sports participants and intramural sports participants generally had higher odds of waterpipe tobacco smoking. Allure for waterpipe tobacco smoking may exist even for individuals who are traditionally considered at low risk for tobacco use.

Predicted and actual exercise discomfort in middle school children.

PURPOSE: The purpose of this study was to use a match-mismatch paradigm to examine children's exercise discomfort during an aerobic shuttle run. METHODS: Thirty-four middle school females (n = 18) and males (n = 16) aged 11-14 yr participated. An Exercise Discomfort Index (EDI) was calculated as a rating of perceived exertion for the overall body (Children's OMNI Scale) x a rating of perceived muscle hurt (Children's OMNI Muscle Hurt Scale). Measurements were obtained immediately before (i.e., predicted) and after (i.e., actual) performance of the nationally standardized Progressive Aerobic Cardiovascular Endurance Run (PACER) shuttle test of aerobic fitness. Self-report physical activity and sport participation history were obtained before PACER performance. RESULTS: Two-way ANOVA (gender x assessment time point) showed a significant main effect for assessment time point: predicted EDI (means +/- SD = 25.9 +/- 20.1) was greater than actual EDI (means +/- SD = 19.4 +/- 17.8) for the total group (P = 0.021). However, neither the main effect of gender nor the gender x assessment time point interaction was significant. Idiographic analysis showed that overpredictors of discomfort reported less time (5.25 median h x wk(-1)) and engaged in less recreational activity than underpredictors (11.14 median h x wk(-1)). However, no significant relation (P = 0.508) was observed between PACER laps completed and exercise discomfort. CONCLUSIONS: The sample of middle school children in this study predicted greater exercise discomfort than actually experienced when performing a PACER test. It is possible that a discomfort construct plays an important role in the initiation and maintenance of children's aerobic exercise, providing a basis for physical activity interventions.

Elementary student self efficacy scale development and validation focused on student learning, peer relations, and resisting drug use.

The purpose of this study was to investigate the psychometric properties of a child self efficacy scale for learning, peer interactions, and resisting pressure to use drugs, to use in an elementary school drug prevention education program based on social cognitive theory. A diverse cohort of 392 4th and 5th grade students completed the 20-item self efficacy scale and social support and social skills instruments. The results provide evidence for a valid and reliable 3-factor self efficacy scale. Subscale internal consistency reliability was good to excellent (Cronbach's alpha = 0.75, 0.83, 0.91). Construct validity was supported by correlations between each subscale and social skills, social support, and demographic data. The scale has potential as a tool to measure self efficacy in children related to learning, peer interactions, and resisting peer pressure to use drugs and to help shape drug education programs.

A public health training center experience: professional continuing education at schools of public health.

The Public Health Training Center (PHTC) national program was first established at accredited schools of public health in 2000. The PHTC program used the US Health Resources and Services Administration's grants to build workforce development programs, attracting schools as training providers and the workforce as training clients. This article is a reflection on the experience of two schools, whose partnership supported one of the PHTCs, for the purpose of opening a conversation about the future of continuing education throughout schools and degree programs of public health. This partnership, the Pennsylvania & Ohio Public Health Training Center (POPHTC), concentrated its funding on more intensive training of public healthcare workers through a relatively narrow inventory of courses that were delivered typically in-person rather than by distance-learning technologies. This approach responded to the assessed needs and preferences of the POPHTC's workforce population. POPHTC's experience may not be typical among the PHTCs nationally, but the collective experience of all PHTCs is instructive to schools of public health as they work to meet an increasing demand for continuing education from the public health workforce.

Social marketing meets health literacy: Innovative improvement of health care providers' comfort with patient interaction.

OBJECTIVE: It is essential to train health care providers to deliver care sensitive to the needs of diverse individuals with varying degrees of health literacy. We aimed to evaluate an innovative, theory-based, educational intervention involving social marketing and health literacy. METHODS: In 2006 at a large medical school, all first-year students were exposed to the intervention. They completed pre- and post-test anonymous surveys including demographic data, covariates, and key outcome variables. Paired t-tests and multiple linear regression were used to evaluate the intervention and to determine independent associations among the key outcome variables. RESULTS: Post-intervention scores were significantly higher than pre-intervention scores for social marketing (3.31 versus 1.90, p<0.001), health literacy (3.41 versus 2.98, p<0.001), and comfort in brochure development (3.11 versus 2.52, p<0.001) (N=83). After controlling for demographic and covariate data, health literacy and comfort in brochure development were independent predictors of comfort interacting with diverse populations. CONCLUSION: A brief intervention involving social marketing and health literacy can improve skills that improve medical students' comfort with patients of diverse backgrounds. PRACTICE IMPLICATIONS: Health care providers can be taught educational principles and skills involved in developing effective patient education materials. These skills may improve providers' comfort with direct patient interaction.

School Based Mental Health Promotion: Nursing Interventions for Depressive Symptoms in Rural Adolescents.

Integrating health education and health promotion into practice is routinely done by nurses. According to a national survey, the need for mental health services has increased in over two thirds of school districts.This article describes the screening of 193 adolescents in Rural Western Pennsylvania's 9th, 10th, and 11th graders for depressive symptoms. Ten percent (N=19) of students had depressive symptoms, the majority of which were female. These students were interviewed by the research team. The outcome themes and referrals are reported as well as the discussion of implications for nurses in screening for depression and health promotion.

Challenges of preparing allied health professionals for interdisciplinary practice in rural areas.

Meeting the health needs of individuals in rural communities involves addressing the challenges of complex multifaceted health problems, limited local health resources and services, isolation, and distance. Interdisciplinary collaboration can create solutions to health care problems that transcend conventional, discipline-specific methods, procedures, and techniques. This paper reports on the four-pronged approach of the Western Maryland Area Health Education Center used to prepare allied health students to be interdisciplinary team members in rural areas. It describes the development of four interdisciplinary instructional team member training venues (in-class instruction, Web-based modules, service-learning programs, and faculty development workshops) that integrate opportunities to develop and practice interdisciplinary health promotion skills in rural communities. Challenges to implementing the model are described, including developing faculty and student training participation, integrating training venues into existing programs at participating institutions, and designing a unified program evaluation.

Evaluating workforce development: perspectives, processes, and lessons learned.

Evaluating workforce development for public health is a high priority for federal funders, public health agencies, trainees, trainers, and academic researchers. But each of these stakeholders has a different set of interests. Thus, the evolving science of training evaluation in the public health sector is being pulled simultaneously in a number of different directions, each emphasizing different methods, indicators, data-collection instruments, and reporting priorities. We pilot-tested the evaluation of a 30-hour, competency-based training course in a large urban health department. The evaluation processes included strategic, baseline assessment of organizational capacity by the agency; demographic data on trainees as required by the funder; a pre- and posttraining inventory of beliefs and attitudes followed by a posttraining trainee satisfaction survey as required by the trainers and the agency; and a 9-month posttraining follow-up survey and discussion of learning usefulness and organizational impact as desired by the academic researchers and the trainers. Routinely requiring all of these processes in training programs would be overly burdensome, time-consuming, and expensive. This pilot experience offers some important practical lessons for training evaluations in the future.

Health educators are leaders: meeting the leadership challenge.

Each of the certified health education specialist responsibilities and competencies for health educators has a leadership element. Health educators demonstrate leadership in a variety of roles with individuals, organizations, and programs. In this article, transformational and transactional leadership qualities are presented as reflection points on leadership for health educators.

Differences in the use of a school mental health program in secondary schools.

OBJECTIVE: To examine the use of a school-based mental health program that works to prevent drug and alcohol problems and promote student mental health. METHODS: Students' presenting concerns, services used, service format and people to whom students were referred for services were investigated. Student use among schools was compared using chi-square analyses. RESULTS: The program was highly used, with a range of concerns differentiated by school type. Student concerns, service format, and student referral and follow-up varied significantly. CONCLUSION: Student use is a product of student need, school structure, and mental health educator.

A capacity mapping approach to public health training resources.

The capacity mapping approach can be used to identify existing community resources. As part of this approach, inventories are used to provide information for a capacity map. The authors describe the development of two inventories and a capacity map for public health workforce development. For the first inventory, the authors contacted 754 institutions to determine available public health training resources; 191 institutions reported resources, including 126 directly providing distance learning technologies and courses or modules addressing important competency domains. Distance learning technologies included video conferencing facilities (61%) and satellite download facilities (50%). For the second inventory, the authors obtained information on 129 distance-accessible public health training modules. The workforce development capacity map produced from these two inventories revealed substantial resources available for use by individuals or agencies wishing to improve training in public health competencies.