Factors impacting implementation of nutrition and physical activity policies in rural schools.

BACKGROUND: Rural Latino children have higher rates of obesity compared to non-Latino Whites. Schools are in a unique position to address rural childhood obesity through policies. While evidence exists on factors that promote or impede school-based physical activity (PA) and nutrition policies, only a fraction has been in rural communities. This study seeks to understand 1) the knowledge and perceptions of school nutrition and PA policies and 2) barriers and facilitators to their implementation among rural school stakeholders from Washington State. METHODS: We conducted 20 semi-structured, in-depth interviews with school stakeholders (e.g., principals and school nutrition directors) from four K-12 school districts in the Lower Yakima Valley of Eastern Washington State. Thematic analysis was conducted using inductive, constant comparison approach to identify themes around knowledge and perceptions of policies and barriers and facilitators of policy implementation. RESULTS: Three main themes were identified: perceptions and knowledge of school PA and nutrition policies, barriers to policy implementation, and facilitators of policy implementation. The majority of stakeholders were supportive of school-based policies promoting PA and a healthy diet, even when lacking a specific understanding of these policies. Four subthemes were identified as barriers to policy implementation: viewing PA as a low priority, misuse of recess time, funding constraints, and lack of strong leadership. Facilitators of implementation included strong leadership at the district level, creating healthy norms through school-community linkages and pooling community resources to improve nutrition and PA among children. CONCLUSIONS: Schools provide a unique setting to promote healthy diet and PA behaviors among children and their families. Study findings show that while knowledge of specific nutrition and PA policies may vary, support for such policies were high among rural stakeholders. Study findings can inform policy development and support strategies for policy implementation in rural settings. Future studies may want to examine whether implementation of strategies addressing the barriers and enhancing facilitators lead to success in rural school settings.

Investigating the effects of rurality on stress, subjective well-being, and weight-related outcomes.

Purpose: Rates of obesity are significantly higher for those living in a rural versus urban setting. High levels of stress and low levels of subjective well-being (SWB) have been linked to poor weight-related behaviors and outcomes, but it is unclear if these relationships differ as a function of rurality. This study investigated the extent to which living in a rural versus urban county ("rurality") moderated associations between stress / subjective wellbeing (predictors) and diet quality, dietary intake of added sugars, physical activity, and BMI (outcomes). Methods: Participants were recruited from urban (n = 355) and rural (n = 347) counties in Washington State and self-reported psychological, demographic, and food frequency questionnaires while physical activity behavior was measured objectively. Findings: After controlling for relevant covariates, levels of stress were positively associated with added sugar intake for those living in the urban county while this relationship was non-significant for those residing in the rural county. Similarly, SWB was negatively associated with added sugar intake, but only for urban residents. County of residence was also found to moderate the relationship between SWB and BMI. Higher SWB was inversely associated with BMI for those living in the urban county while no relationship was observed for rural county residents. Conclusions: These findings support the hypothesis that the relationships between stress / SWB and weight function differentially based on the rurality of the residing county. This work adds to the growing body of literature highlighting the role stress and SWB play in the rural obesity disparity.

Investigating the relationship between parental weight stigma and feeding practices.

Promoting a healthy diet in children remains a prominent public health priority. Parents have been shown to be a major influence on their children's eating behaviors, but limited research has been devoted to exploring the factors that lead parents to select certain feeding practices over others. Past research has demonstrated a link between weight stigma (i.e., prejudicial attitudes or discriminatory behavior targeted at individuals who carry excess weight) and an individual's own weight-related behaviors and outcomes, but no study has examined how parental levels of weight stigma maybe associated with a parent's preferred feeding practices. The primary objective of this study was to examine the cross-sectional associations between parental levels of weight-based stigmatization with parental feeding practices. Responses were collected on Amazon's Mechanical Turk website for n = 406 parents who 1) had at least one child aged 5-10 and 2) perceived themselves to be overweight or obese. After adjusting for relevant covariates, parental weight stigma was shown to be significantly associated with restrictive feeding practices, and verbal modeling of eating behaviors (all ps < .05). A priori exploratory mediation analysis identified concern about child weight as a significant mediator between weight stigma and parental feeding practices. A discussion of the potential limitations of this study, future directions of research, and implications of these findings are included.

Conscientiousness in weight loss maintainers and regainers.

OBJECTIVE: The role of personality in weight loss maintenance (WLM) is poorly understood. Although the personality trait of conscientiousness has been associated with health-promoting behaviors in general, no study has specifically evaluated the importance of conscientiousness for WLM. This study compared conscientiousness (both in aggregate and on the facet level) and control over healthy lifestyle behaviors (e.g., food quantity and temptations, consistent meal and sleep timing, exercise adherence, and psychosocial health and stress coping) in successful weight loss maintainers and regainers. METHOD: The sample included 869 National Weight Control Registry participants who reported maintaining ≥ 30-lb weight loss for ≥ 1 year (maintainers) and 484 participants from Amazon's MTurk crowdsourcing marketplace who reported trying but failing to maintain weight loss for 1 year (regainers). Both groups self-reported the Cherynshenko Conscientiousness Scale, the Healthy Lifestyle & Personal Control Questionnaire, body mass index, and demographics in an online survey. RESULTS: Maintainers reported higher levels of total conscientiousness (p = .005), order, virtue, responsibility, and industriousness (ps ≤ .05), but not self-control, compared with regainers after controlling for basic demographic differences. Unexpectedly, regainers scored significantly higher on the facet of traditionalism (p < .001). Maintainers also reported greater degree of control over food quantity and temptations, consistent meal and sleep timing, and exercise adherence (ps < .001), but not psychosocial health and stress coping, compared to with regainers. CONCLUSIONS: Successful weight loss maintainers reported small-to-moderately higher levels of conscientiousness compared with regainers. Evaluating whether conscientiousness can be incorporated into WLM treatment is warranted. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

The unintended impact of smoking-risk information on concerns about radon: A randomized controlled trial.

OBJECTIVE: Health communications are often viewed by people with varying levels of risk. This project examined, in the context of radon risk messages, whether information relevant to high-risk individuals can have an unintended influence on lower-risk individuals. Two studies assessed whether information about lung cancer risk from smoking reduced concerns about lung cancer risk from radon among nonsmokers. METHOD: American nonsmokers viewed radon messages that varied in what they communicated about smoking's effect on lung cancer risk. Study 1 used a 4-arm factorial, randomized, controlled design in which smoking information was included or excluded from messages assembled from 2 existing radon pamphlets. Study 2 used a 3-arm parallel, randomized, controlled design in which a new radon message excluded smoking information, described smoking as a lung cancer risk, or also described smoking's synergistic effect with radon. RESULTS: In Study 1, the inclusion of smoking information reduced nonsmokers' (n = 462) concern-related reactions to possible radon exposure. In Study 2, nonsmokers' (n = 583) concern-related reactions were reduced in both smoking-information conditions; intentions to test their home for radon and perceived importance of testing were reduced in the synergistic condition. CONCLUSION: People reading health-risk information contextualize their risk relative to the risk of others. For people at midlevel risk, concern and related reactions prompted by a health message may be dampened when the message includes information about others who are more at risk. In the case of radon and smoking risks, the inclusion of smoking information can reduce the impact that radon messages have on nonsmokers. (PsycINFO Database Record (c) 2018 APA, all rights reserved).