Building the Worksite Wellness Foundation Infrastructure: A Critical Component of the WorkWell KS Strategic Framework.

OBJECTIVE: Workplace health programs can be ineffective, and changes are likely to be temporary without first establishing a wellness infrastructure. This study sought to determine whether attending a WorkWell KS Building the Worksite Wellness Foundation (Foundation) workshop enabled worksites to develop this infrastructure. METHODS: Survey data were collected from worksites before attending a workshop and approximately 1 year later. Survey items were designed to assess whether the worksite was implementing best practices. RESULTS: In total, 212 worksites participated in a workshop and completed both a baseline and follow-up assessments. At follow-up, more worksites reported having a wellness committee (89.6% vs 59.7%, P < 0.001) and having wellness committee duties included in position descriptions (26.2% vs 6.4%, P < 0.001). CONCLUSIONS: This study suggests that Foundation workshops can support worksites' implementation of best practices to establish worksite wellness infrastructure.

An Overview of Tobacco Policies in Kansas Unified School Districts.

Introduction: In 2019, 25.8% of Kansas high school youth reported using any form of tobacco product. Schools can prevent and reduce youth tobacco use by adopting comprehensive tobacco policies, which include all tobacco products, on school grounds and at school-sponsored, off-campus events, for all individuals at all times, and integrate cessation services for students who violate the tobacco policy. The purpose of this study was to determine the prevalence of comprehensive tobacco policies in unified school districts (USD) across Kansas to determine how many schools have adopted such policies. Methods: All 286 USDs in Kansas were eligible to participate in this study including elementary, middle, and high schools. Participating schools were asked to upload their policies to a website developed by the Kansas Department of Health and Environment (KDHE). Frequencies and percentages were computed to identify the type of tobacco products prohibited, the locations where tobacco use is prohibited, who is prohibited from using tobacco, when tobacco is prohibited, and consequences of students' violation of the tobacco policy. Results: Several USD policies met some of these comprehensive recommendations; however, 97.9% (n = 280) did not. In other words, 2.1% of USD policies (n = 6) were comprehensive in Kansas. Most districts (98.3%, n = 281) presented policies prohibiting use of all forms of tobacco for students, but policies often offered more leniency for faculty/staff and visitors. Fewer districts presented policies prohibiting use of all tobacco products for staff/faculty (73.1%, n = 209) and visitors (45.8%, n = 131) of policies. Conclusions: Nearly all USDs in Kansas have an opportunity to strengthen their tobacco policies. Relatively simple edits can be made to prohibit all tobacco products, prohibit use on school grounds and at school-sponsored, off-campus events, ensure these policies apply to everyone, at all times, and integrate cessation resources for students who violate the tobacco policy.

An Evaluation of a Kansas Open Streets Event's Impact on Businesses.

INTRODUCTION: Open Streets is an event that promotes physical activity among populations by encouraging city residents to walk and bicycle in streets blocked from motor vehicles. Engagement of businesses is a critical component of Open Streets. This study sought to evaluate the Open Streets ICT 2019 event's impact on adjacent businesses. METHODS: A 12-item novel survey was developed for this study. Businesses eligible for study participation included retail and non-retail (e.g., non-profits, churches) sites along the Open Streets ICT route in Wichita, Kansas. To understand how Open Streets ICT impacted businesses, the survey used Likert scale questions to prompt respondents to report sales and visitors experiences during the event. Additionally, respondents reported a percent difference in sales compared to a typical Sunday. A phenomenological approach was used to convey the experiences among study participants during Open Streets ICT. RESULTS: A total of 102 surveys were completed, a 42% response rate. Most businesses (56%, n = 56) reported being open during Open Streets ICT. Many businesses (72%) reported having "more" visitors compared to a typical Sunday. More than half reported they experienced new and regular visitors (54%, n = 30) from the event. Most businesses (64%, n = 36) reported a positive financial impact, and (52%, n = 29) having more sales than a typical Sunday. CONCLUSIONS: Open Streets ICT increased sales and the number of visitors among businesses. Respondents reported they plan to participate in the 2020 Open Streets ICT, and if Open Streets ICT was offered twice a year. Finally, most participating businesses reported they recommend that other businesses participate in Open Streets ICT.

A Cross-Sectional Examination of Physical Activity, Sedentary Time, and Sleep Between Adults With and Without Children in the Home Using the National Health and Nutrition Examination Survey.

BACKGROUND: Physical activity (PA), sedentary behavior, and sleep are interconnected, promoting optimal health. Few studies have examined these factors holistically. Therefore, the purpose of this study was to capture the 24-hour activity cycles of the US population by examining PA, sedentary behavior, and sleep based on the presence of a child within the home, as well as gender and weight. METHODS: Cross-sectional health-related variables from the National Health and Nutrition Examination Survey were used for analysis. The primary variables were the total and type of PA (recreation, work, and active transportation), sedentary behavior, and sleep. Chi-square and regression models were applied to compare the outcomes across participants' characteristics. RESULTS: The adults with children within the home reported less recreational PA, more work activity, less sedentary activity, and less sleep, but no differences in total PA. The females with children in the home not only had the lowest levels of recreational activity and sleep, but also the lowest levels of sedentary behavior. The obese individuals with children in the home had less sedentary time than the adults without children in the home, regardless of weight status. CONCLUSIONS: Unhealthy sleep and PA behaviors are prevalent in adults with children living at home, and women are particularly impacted.

Effectiveness of a Pilot Breastfeeding Educational Intervention Targeting High BMI Pregnant Women.

INTRODUCTION: Overweight and obesity during pregnancy are associated with adverse health outcomes leading to increased maternal and neonatal morbidity and mortality. Women with a high body mass index (BMI) also experience low breastfeeding rates. There is limited evidence of effective educational programs that aim to improve length of breastfeeding among this population. The main objective of this pilot educational intervention was to determine knowledge and skills retention at six weeks after completion of a breastfeeding class. METHODS: A two-hour breastfeeding class was offered during the second and third trimester of pregnancy targeting high BMI women. A longitudinal, survey study design was conducted using two data collection points. No comparator group was employed. RESULTS: Baseline mean age of respondents was 26.6 years (SD = 5.7). Respondents who completed post-intervention surveys were largely white (69.2%) followed by Hispanic (15.4%) and non-Hispanic black (15.4%), some college (57.1%), earned less than $50,000/year (64.3%), had employer-provided insurance (53.8%), and did not receive WIC benefits (78.6%). Most respondents had a pre-pregnancy BMI category of overweight (28.6%) or obese (57.1%). The intervention appeared to have some impact on responses. The following were observed: an increased understanding that baby may be fussy in the evening hours and wants to nurse more often (p < 0.002), how to bring baby to the breast (p = 0.004), knowing what to do if breastfeeding hurts (p = 0.031), and knowing what to do when baby has trouble breastfeeding (p = 0.021). CONCLUSION: Consistent with previous findings, all participants in our study reported increased knowledge to breastfeed. Thus, women's confidence to breastfeed their infant is enhanced through knowledge obtained from breastfeeding education. Additional studies are underway to assess breastfeeding behaviors.

Nutrition Self-Efficacy and Dietary Patterns among Older African American Women in Kansas.

INTRODUCTION: Nutrition is the key contributor to disparities in many chronic diseases. However, little is known about the dietary habits and nutrition self-efficacy beliefs of older African American women with chronic diseases. This study looked at the relationship between nutrition self-efficacy and dietary patterns among older African American women. METHODS: A total of 115 African American women 55 years and older, with one or more chronic diseases such as hypertension, diabetes, and hyperlipidemia, were recruited from a midwestern city in Kansas. Participants completed a survey comprised of dietary intake items and the Physical Activity and Nutrition Self-Efficacy (PANSE) scale. Data were analyzed with descriptive statistics, Spearman correlation, and Wilcoxon rank sum test (Mann-Whitney U Test). RESULTS: There was a 79% (91/115) participation rate. Participants were confident in their ability to maintain healthy behaviors (57.67/72; SD = 11.22). The mean dietary score for fats and carbohydrate consumption was 32.67 ± 2.48 compared to 5.89 ± 3.52 for fruit and vegetable intake. A significant positive correlation was observed between fruit and vegetable intake and nutrition self-efficacy. A higher fruit and vegetable intake were observed among married women (mean = 7.35; SD = 4.45). CONCLUSION: Our findings shed new light on older African American women's perceptions of healthy eating and the confidence to eat heathy. Based on these results, older African American women met the daily fruit and vegetable recommendations; however, more work is needed to understand how to intervene to improve dietary behaviors regarding fat and carbohydrate consumption in this population. While more research is needed, the findings indicated behavioral theories such as nutrition self-efficacy may have utility in tailoring nutrition interventions in an older African American population.

Incidence and circumstances of pediatric fall-related injuries: Which fall variables matter?

BACKGROUND: This study's purpose was to determine if age, fall height, fall mechanism, landing surface, and landing position are associated with injury severity and hospital outcomes among pediatric fall patients. METHODS: A retrospective review was conducted of patients aged ≤18 years who sustained fall-related injuries admitted to an American College of Surgeons verified Level 1 trauma center from January 1, 2006 through December 31, 2015. RESULTS: Patient age, fall mechanism, landing position, and landing surface were associated with the need for surgery. Patient age, fall mechanism, and landing position were also associated with intensive care unit admissions. Fall mechanism was the only variable associated with injury severity. No variables were associated with the need for mechanical ventilation or mortality. CONCLUSIONS: Patient age, fall mechanism, landing surface, and landing position need to be considered with regard to injury severity and patient outcomes among pediatric fall patients.