Improving healthy dietary behaviors, nutrition knowledge, and self-efficacy among underserved school children with parent and community involvement.

BACKGROUND: University­community partnerships through coordinated school health programs (CSHP) can play a key role in decreasing child obesity. The main objective of this study was to measure over a 1-year period whether a CSHP with parental, school, and home-based components to promote optimal nutrition will reduce BMI percentiles and z-scores and improve dietary behaviors in a sample of low-income, school-aged children. METHODS: The intervention included, Kids Nutrition and Fitness, a 6-week nutrition, physical activity educational after-school program, and school activities, including creation of an Advisory Committee that made wellness policies. A randomized controlled pilot study evaluated the effectiveness of the intervention that contrasts 251 (n = 251) predominantly Mexican-American 8 to 12 year olds from low-income Los Angeles­based schools. A mixed model of repeated measures analysis assessed changes in BMI percentiles and z-scores, dietary behaviors, food preferences, knowledge, and self-efficacy measured by a reliable/valid questionnaire. These data were collected at baseline and at 4 and 12 months postintervention. Process measures, collected via focus groups with parents, evaluated parent/community involvement. RESULTS: At the 12-month follow-up, children in the intervention group decreased their BMI on average by 2.80 (p = 0.04) and BMI z-scores on average by 0.48 (p = 0.03) and they increased their daily dietary intake of vegetables on average by 1.51 (p = 0.03), fruit on average by 2.00 (P = 0.001), and 100% fruit juice by 1.12 (p = 0.05). An increase of 1.02 (p = 0.03) was seen in self-efficacy of healthy food choices (p = 0.03). Parent (P = 0.04) and community (p = 0.001) involvement significantly increased to 100% participation by the 12-month follow-up. CONCLUSIONS: A CSHP using parent and community involvement was effective in reducing the risk of obesity in school-aged Mexican- American children attending low-income schools. The findings need to be examined in a larger, more diverse sample of children.

Eliminating health disparities: understanding this important phenomenon.

Since the formation of the United States in early times, diversity has always been a reality. With the immigration of diverse whites from Europe, the importation of black slaves from Africa, and the presence of the preexisting Native American populations, diversity has long been a fact of life in this country. However, one of the long-standing priorities of the United States has been "good health" for all the people. The broad diversity of the population has presented a tremendous challenge to health care. This article addresses this important topic by looking at the concept of health disparity from a biopsychosocial perspective and further by describing disparities that are present in the United States among the 2 major ethnic minority groups, African Americans and Mexican Americans. Many other health disparities could be considered in other groups, but space limits of article allow only the 2 major ethnic minority groups to be addressed.

Sociodemographic, physical and psychosocial factors associated with depressive behaviour in family caregivers of stroke survivors in the acute care phase.

PRIMARY OBJECTIVE: This study examined sociodemographic, physical and psychosocial characteristics of family caregivers of stroke survivors at risk for depression. RESEARCH DESIGN: A correlational study. METHODS AND PROCEDURES: Data were collected from 52 family caregivers and care recipients with ischemic stroke. Data were collected 1-2 days before discharge from a rehabilitative facility and at 5, 9 and 13 weeks post-discharge. MAIN OUTCOMES AND RESULTS: Compared to African Americans, Caucasians had approximately 3.7 times higher odds of being at risk. The odds of being at risk for depressive behaviour decreased by 30% for each unit increase in belonging and increased by 5% for each unit increase in burden. CONCLUSIONS: Family caregivers who are isolated from others may benefit from therapeutic interventions that facilitate social interaction and decrease caregiver burden. Ethnic differences in caregiver depression merit further research.

Duplicate publication Part 1. Consideration of the issues.

Although duplicate publication is a significant problem for the nursing community, it can be prevented by teamwork between the author and editor.