Ethnic-racial differences in feelings of embarrassment associated with binge eating and fear of losing control

OBJECTIVE: Limited research exists on ethnic-racial differences in the objective and subjective experiences of binge eating among women in the United States. The present study examined binge eating related psychopathology in a nationally representative sample of White, Black, Native American, Asian, and Hispanic women. METHOD: A subsample of 5,726 women between the ages of 19 and 27 years were selected from the National Longitudinal Study of Adolescent Health. RESULTS: Ethnic-racial differences in binge eating related psychopathology were found. Asians and Native Americans were more likely than Whites to report they would feel embarrassment related to binge eating. Hispanics were more likely than Whites and Blacks to report they would be afraid to start eating for fear of losing control. CONCLUSION: Findings suggest that the affective dimensions associated with binge eating are differentially represented among ethnic-racial groups. Implications for treatment and prevention programs are discussed.     

Statement: Multisectoral actions to build trust at the local and community level to promote vaccine acceptance

On 12 September 2022, attendees of the 16th Vaccine Congress in Riva del Garda, Italy were invited to attend a roundtable session entitled multi-sectoral actions to build trust at the local and community level to promote vaccine acceptance to participate in a discussion aimed at defining strategies and recommendations to support efforts that build community vaccine confidence. Presenters from the Vaccine Confidence Project and the New York Vaccine Literacy Campaign shared research and data point on the current state of vaccine confidence worldwide as well as global examples of “success stories” to prompt discussion. The group’s key recommendations include prioritizing multi-sectoral responses and trust-building through policy and legislation, engaging with trusted local stakeholders, improving convenience, combating misinformation and empowering healthcare professionals to improve vaccine confidence. This report summarizes the considerations, recommendations, and suggested strategies discussed during the session, as prepared by the presenters.     

Childhood obesity prevention and treatment: recommendations for future research

This report summarizes the National Heart, Lung, and Blood Institute Working Group's recommendations on future research directions in childhood obesity prevention and treatment. The Working Group consisted of leaders and representatives from public and private academic and medical institutions with expertise in a variety of health specialties. They reviewed the literature and discussed the findings as well as their own experiences in the prevention and treatment of childhood obesity. The Working Group made recommendations that were based on scientific importance, the potential likelihood of public health impact, and the feasibility and timeliness for childhood obesity prevention and treatment research. These recommendations are intended to assist investigators in the development of research agendas to advance the knowledge of effective childhood obesity prevention and treatment.     

Population-based prevention of eating disorders: an application of the Rose prevention model

BACKGROUND: Several decades of concerted research on eating disorders have generated a broad range of proposed causal influences, but much of this etiologic research does not elucidate practical avenues for preventive interventions. Translating etiologic theory into community health interventions depends on the identification of key leverage points, factors that are amenable to public health intervention and provide an opportunity to maximize impact on the outcome of interest. Population-based preventive strategies, elaborated by epidemiologist Geoffrey Rose, can maximize the impact of public health interventions. In the case of eating disorders, Rose's model is instructive: Dieting stands out as risk behavior that may both fit Rose's model well and be a key leverage point for preventive intervention. METHODS: Grounded in Rose's work, this article lodges a theoretical argument for the population-based prevention of eating disorders. In the introductory section, existing research on the epidemiology of dieting is reviewed, showing that it is extremely common among adolescent girls and women and that the behavior has been implicated as a causal factor for disordered eating. Next, new evidence is offered to build a case for how a population-wide reduction in dieting may be an effective strategy for prevention of eating pathology. Finally Rose's prevention framework is used to introduce a unique and provocative perspective on the prevention of eating disorders. RESULTS: Dieting is a normative behavior in our culture with psychological and physiological effects in the causal chain leading to eating pathology. This behavior may represent an ideal target for population-based prevention. CONCLUSIONS: Theoretical and empirical evidence suggests that a population-wide reduction in dieting may be a justifiable and effective strategy for prevention of eating pathology.     

Secondary prevention for eating disorders: the impact of education, screening, and referral in a college-based screening program

OBJECTIVE: The first National Eating Disorders Screening Program (NEDSP), conducted on more than 400 college campuses in 1996, was an educational and two-stage screening program designed to detect potentially clinically significant disordered eating attitudes and behaviors and offer referrals for further evaluation when warranted. The current study assessed the impact of the NEDSP on participants. METHOD: A randomly selected subset of this sample (n = 289) was contacted approximately 2 years after the NEDSP to assess the impact of the program on knowledge and treatment-seeking behaviors for eating disorders. RESULTS: For greater than 80% of the participants, the program made participants aware of the danger of eating disorders and the availability of treatment. Of those who received a recommendation for further clinical evaluation of disordered eating (n = 109), nearly one half (47.7%) followed up on this recommendation and kept at least a first appointment and 39.4% actually sought treatment subsequent to the NEDSP. DISCUSSION: The results of the current study suggest that educational and screening programs may be a promising strategy for secondary prevention of eating disorders. They also suggest that awareness of the risks of disordered eating and available treatment may not be sufficient to motivate individuals to adhere to recommendations to seek treatment. Clinicians should, therefore, be vigilant for nonadherence to treatment recommendations and proactive in facilitating treatment.     

Perceived ambiguity about cancer prevention recommendations: associations with cancer-related perceptions and behaviours in a US population survey

BACKGROUND: Health information reaching the public today is often characterized by what decision theorists have termed 'ambiguity'- i.e. uncertainty regarding the information's reliability, credibility or adequacy. This is a critical problem, as growing research suggests that ambiguity has important effects-promoting pessimistic judgments about risks and potential outcomes of risk-reducing behaviours, and lowering adoption of these behaviours. However, little is known about the public's perceptions of ambiguity in the health information domain, the effects of these perceptions, and the factors that influence these effects. OBJECTIVE: To examine associations between perceived ambiguity regarding cancer prevention recommendations and prevention-related perceptions and behaviours, and to explore how these associations differ by cancer type. STUDY DESIGN AND PARTICIPANTS: Cross-sectional analysis of data on 4,070 adults participating in the 2005 US Health Information National Trends Survey. MAIN VARIABLES AND OUTCOME MEASURES: We examined associations between perceived ambiguity about colon, skin and lung cancer prevention recommendations and two main outcome variables: (i) risk-related cognitions (perceived cancer risk and preventability, cancer-related worry) and (ii) risk-modifying behaviours (colon cancer screening, sunscreen use and smoking abstinence). RESULTS: Perceived ambiguity was inversely associated with perceptions of the preventability of all three cancers, and with cancer-specific risk-modifying behaviours including sigmoidoscopy-colonoscopy testing, sunscreen use and smoking abstinence. Relationships with cancer risk perceptions and worry varied across different cancer types. CONCLUSIONS: Perceived ambiguity about cancer prevention recommendations has significant and predictable associations with cancer prevention-related cognitions and behaviours, and some associations differ by cancer type. These findings have implications for future research and communication efforts.     

Prostate cancer prevention: a review of the literature

This study analyzes recommendations for the prevention of prostate cancer reported in the specific literature on this topic. The method consisted of a review of this matter, adopting a qualitative approach, examined through the theme content analysis technique. Based on the following analysis categories: primary prevention, secondary prevention and masculinity and prevention, the discussion of the study findings concludes that: (a) the recommendations are either diverse or present some controversies among the various viewpoints; (b) the output of scientific papers in the collective health field is sparse on this matter; (c) the development of a more interdisciplinary approach is required for dealing with this matter and (d) few sources take the specific characteristic of maleness into account for recommendations on the prevention of prostate cancer.     

Advancing Clinical Trials in Nursing Homes: A Proposed Roadmap to Success

An effective clinical research effort in nursing homes to address prevention and treatment of COVID-19 faced overwhelming challenges. Under the Health Care Systems Research Network-Older Americans Independence Centers AGING Initiative, a multidisciplinary Stakeholder Advisory Panel was convened to develop recommendations to improve the capability of the clinical research enterprise in US nursing homes. The Panel considered the nursing home as a setting for clinical trials, reviewed the current state of clinical trials in nursing homes, and ultimately developed recommendations for the establishment of a nursing home clinical trials research network that would be centrally supported and administered. This report summarizes the Panel’s recommendations, which were developed in alignment with the following core principles: build on available research infrastructure where appropriate; leverage existing productive partnerships of researchers with groups of nursing homes and nursing home corporations; encompass both efficacy and effectiveness clinical trials; be responsive to a broad range of stakeholders including nursing home residents and their care partners; be relevant to an expansive range of clinical and health care delivery research questions; be able to pivot as necessary to changing research priorities and circumstances; create a pathway for industry-sponsored research as appropriate; invest in strategies to increase diversity in study populations and the research workforce; and foster the development of the next generation of nursing home researchers.     

In search of cultural sensitivity and inclusiveness: communication strategies used in rural HIV prevention campaigns designed for African Americans

Recently, rates of HIV and AIDS are rapidly and disproportionately increasing among minority communities in the rural South. Culturally specific health communication about HIV and inclusion of minority voices in the administration and implementation of HIV programs have been found to be the most effective methods for prevention. The purpose of this discussion is to examine these health communication strategies in HIV prevention programs designed for African American communities in rural Alabama. Effective, culturally sensitive, and inclusive prevention efforts documented in health communication literature are identified, and the use of these efforts through a case study of rural Alabama's minority-focused HIV prevention programs is examined The research reveals that, although the state is making use of culturally tailored communication strategies, educators continue to encounter problems connecting with and involving target populations. Reasons for these problems and recommendations for changes are discussed.     

Comprehensiveness of substance use prevention programs in U.S. middle schools

Purpose: To assess how current practice in middle school substance use prevention programs compares with seven recommended guidelines adapted from the Centers for Disease Control and Prevention guidelines for school-based tobacco use prevention programs.Methods: Substance use prevention practice was analyzed using data from a 1999 mailed questionnaire of a nationally representative sample of 1496 public and private schools with middle school grades that reported having a substance use prevention program. Respondents answered questions about substance use prevention education and activities in the whole school and in their own classroom. Weighted prevalence estimates for the seven recommendations are presented, and multiple regression was used to analyze correlates of implementation of the recommendations.Results: An estimated 64.2% of schools met four or more of the recommendations for school-based substance use prevention practice; 4.0% met all seven recommendations. Schools were most likely to report having and enforcing substance use prevention policies (84.3%) and least likely to report training teachers in substance use prevention (17.9%). More recommendations were implemented in schools that were public and had larger enrollments, greater perceived availability of resources, greater school board and parental support for substance use prevention, and had hired a school substance use prevention coordinator.Conclusions: The low prevalence of comprehensive substance use prevention programs in U.S. middle schools may limit the potential impact of school programs on the prevalence of youth substance use.     

Guidelines for School Health Programs to Promote Lifelong Healthy Eating

ABSTRACT: Healthy eating patterns in childhood and adolescence promote optimal childhood health, growth, and intellectual development; prevent immediate health problems, such as iron deficiency anemia, obesity, eating disorders, and dental caries; and may prevent long-term health problems, such as coronary heart disease, cancer, and stroke. School health programs can help children and adolescents attain full educational potential and good health by providing them with the skills, social support, and environmental reinforcement they need to adopt long-term, healthy eating behaviors. This report summarizes strategies most likely to be effective in promoting healthy eating among school-age youths and provides nutrition education guidelines for a comprehensive school health program. These guidelines are based on a review of research, theory, and current practice, and they were developed by CDC in collaboration with experts from universities and from national, federal, and voluntary agencies. The guidelines include recommendations on seven aspects of a school-based program to promote healthy eating: school policy on nutrition, a sequential, coordinated curriculum, appropriate instruction for students, integration of school food service and nutrition education, staff training, family and community involvement, and program evaluation.     

The relationship among violence victimization, witnessing violence, and youth distress

Purpose: To assess how current practice in middle school substance use prevention programs compares with seven recommended guidelines adapted from the Centers for Disease Control and Prevention guidelines for school-based tobacco use prevention programs.

Methods: Substance use prevention practice was analyzed using data from a 1999 mailed questionnaire of a nationally representative sample of 1496 public and private schools with middle school grades that reported having a substance use prevention program. Respondents answered questions about substance use prevention education and activities in the whole school and in their own classroom. Weighted prevalence estimates for the seven recommendations are presented, and multiple regression was used to analyze correlates of implementation of the recommendations.

Results: An estimated 64.2% of schools met four or more of the recommendations for school-based substance use prevention practice; 4.0% met all seven recommendations. Schools were most likely to report having and enforcing substance use prevention policies (84.3%) and least likely to report training teachers in substance use prevention (17.9%). More recommendations were implemented in schools that were public and had larger enrollments, greater perceived availability of resources, greater school board and parental support for substance use prevention, and had hired a school substance use prevention coordinator.

Conclusions: The low prevalence of comprehensive substance use prevention programs in U.S. middle schools may limit the potential impact of school programs on the prevalence of youth substance use.     

Research workshop on prevention of depression with recommendations for future research

The Prevention Research Branch of the National Institute of Mental Health held a research workshop on the prevention of unipolar depression. This workshop, held in April 1987, was part of an effort to develop further research on the prevention of depression. Researchers representing a variety of disciplines reviewed the state of the art, discussed methodological issues, and made recommendations for future research. Major issues discussed included (a) criteria for the target disorder, (b) priorities for target populations, (c) methodological problems including recruitment and retention, and (d) recommendations for future research.     

Obesity Prevention Opinions of School Stakeholders: A Qualitative Study

BACKGROUND: In general, schools are an important setting to implement current recommendations for obesity prevention in children because the vast majority of children attend school. This study investigated the opinions of different school stakeholders on the feasibility and acceptability of current obesity prevention strategies that could be implemented in Swiss schools. METHODS: Research methods were comprised of a qualitative study which included school directors, physical education teachers, catering staff, school nurses and health educators, parents of young adolescents, and young adolescents interviewed (N = 40) categorized into 6 focus groups. Open-ended questions were used to determine the participants' opinion regarding current obesity prevention recommendations, and healthy eating and physical activity promotion strategies. RESULTS: All participants approved the implementation of nutritional standards for food and drinks sold in schools, but thought that increasing the attractiveness of healthy options was the best strategy to improve eating habits. Enjoying participation in physical activity classes or after-school activities was stressed. Participants suggested offering classes for all students with poor physical condition, independent of weight status. Stakeholders called for governmental support and global coordination of interventions balanced with providing schools with enough autonomy to adapt programs relevant to their individual circumstances. They recommended integrating all school stakeholders in obesity prevention initiatives, with special attention to students and local authorities. CONCLUSIONS: Participants agreed that schools are a crucial setting to implement childhood obesity prevention strategies. They called on school stakeholders to join efforts aiming to encourage healthy behaviors and to support and reinforce parents' efforts by spreading consistent and coherent health messages.     

Effects of eating frequency, snacking, and breakfast skipping on energy regulation: symposium overview

The ASN hosted a symposium entitled "Eating Patterns and Energy Balance: A Look at Eating Frequency, Snacking, and Breakfast Omission" at the Experimental Biology 2009 annual meeting on April 19, 2009, in New Orleans, LA. The symposium was chaired by Megan McCrory and co-chaired by Wayne Campbell, both from Purdue University. The goal of the symposium was to bring together experts to provide an overview of research on the potential role of eating patterns in the development of overweight and obesity. Studies on eating frequency, snacking, and breakfast skipping were highlighted. In particular, evidence both for and against their roles were discussed, methodological issues that underlie controversies were addressed, and suggested future directions for research were outlined. Appetite regulation and hormonal effects were also reviewed. Megan McCrory introduced the session then discussed studies on eating frequency and energy regulation in free-living adults consuming self-selected diets. Heather Leidy summarized the state of the research on eating frequency and energy regulation in adults from controlled feedings studies. Didier Chapelot discussed various usages of "snack" and argued for a physiological basis to distinguish snacks from meals. Mark Pereira presented information on the effects of breakfast skipping and the macronutrient composition of breakfast in energy regulation and mood. A panel discussion/question and answer session ended the symposium. The symposium was videotaped and can be viewed at www.nutrition.org.     

Healthy eating, activity and obesity prevention: a qualitative study of parent and child perceptions in Australia

Preventative health strategies incorporating the views of target participants have improved the likelihood of success. This qualitative study aimed to elicit child and parent views regarding social and environmental barriers to healthy eating, physical activity and child obesity prevention programmes, acceptable foci, and appropriate modes of delivery. To obtain views across a range of social circumstances three demographically diverse primary schools in Victoria, Australia were selected. Children in Grades 2 (aged 7-8 years) and 5 (aged 10-11 years) participated in focus groups of three to six children. Groups were semi-structured using photo-based activities to initiate discussion. Focus groups with established parent groups were also conducted. Comments were recorded, collated, and themes extracted using grounded theory. 119 children and 17 parents participated. Nine themes emerged: information and awareness, contradiction between knowledge and behaviour, lifestyle balance, local environment, barriers to a healthy lifestyle, contradictory messages, myths, roles of the school and family, and timing and content of prevention strategies for childhood obesity. In conclusion, awareness of food 'healthiness' was high however perceptions of the 'healthiness' of some sedentary activities that are otherwise of benefit (e.g. reading) were uncertain. The contradictions in messages children receive were reported to be a barrier to a healthy lifestyle. Parent recommendations regarding the timing and content of childhood obesity prevention strategies were consistent with quantitative research. Contradictions in the explicit and implicit messages children receive around diet and physical activity need to be prevented. Consistent promotion of healthy food and activity choices across settings is core to population prevention programmes for childhood obesity.     

General recommendations on immunization. Recommendations of the Advisory Committee on Immunization Practices (ACIP) and the American Academy of Family Physicians (AAFP).

This report is a revision of General Recommendations on Immunization and updates the 1994 statement by the Advisory Committee on Immunization Practices (ACIP) (CDC. General recommendations on immunization: recommendations of the Advisory Committee on Immunization Practices [ACIP]. MMWR 1994;43[No. RR-1]:1-38). The principal changes include expansion of the discussion of vaccination spacing and timing, recommendations for vaccinations administered by an incorrect route, information regarding needle-free injection technology, vaccination of children adopted from countries outside the United States, timing of live-virus vaccination and tuberculosis screening, expansion of the discussion and tables of contraindications and precautions regarding vaccinations, and addition of a directory of immunization resources. These recommendations are not comprehensive for each vaccine. The most recent ACIP recommendations for each specific vaccine should be consulted for additional details. This report, ACIP recommendations for each vaccine, and other information regarding immunization can be accessed at CDCs National Immunization Program website at http.//www.cdc.gov/nip (accessed October 11, 2001).     

Dialectical behavior therapy adapted for bulimia: a case report.

OBJECTIVE: This case report describes the application of dialectical behavior therapy (DBT) to the treatment of bulimia nervosa in a 20-session manualized therapy. METHOD: The treatment, based on an affect regulation model of eating disorders, was developed to teach emotion regulation skills to replace eating-disordered behaviors. The patient, a 36-year-old woman, had a long history of binge eating and purging that had not responded to 2 years of counseling. In the 4 weeks before treatment began, she reported 13 objective binges and 21 purging episodes. RESULTS AND DISCUSSION: Upon initiating DBT, her binge eating and purging rapidly declined. She achieved abstinence by the fifth week of treatment and maintained it through treatment. In the 6 months following treatment, she reported a total of two objective binge episodes and two purge episodes.     

Classification of transmission risk in the national HIV/AIDS surveillance system

Risk behavior information is essential for allocating resources and developing effective HIV prevention strategies. Over time, transmission risk information on HIV/AIDS cases has been less likely to be reported to the national surveillance system. The Centers for Disease Control and Prevention (CDC) invited approximately 30 experts in HIV/AIDS and behavioral research from state and local health departments, academia, community-based organizations, and the CDC to participate in a consultation in December 2001 to generate ideas on how best to deal with the lack of risk data. The group was charged with providing recommendations on methods for classifying and reporting risk information and for identifying methods and sources for improving ascertainment of transmission risk behaviors for individuals infected with HIV. This report describes the recommendations and the effects of implementing such recommended procedures on the national HIV/AIDS surveillance database.     

Eating disorders in South Asia: Should we be concerned?

Eating disorders are a group of psychiatric conditions characterised by disturbances in eating behaviour along with severe concern regarding bodyweight and shape, which appear to be on the rise in South Asian countries. These disorders are commonly observed in young individuals and are caused by a complex interaction of genetic, biological, psychological and social factors and associated with a wide range of adverse physical, psychological and social consequences. Treatment of these disorders can be quite expensive as it requires specialised care from a multidisciplinary team. Hence, prevention of eating disorders is essential; this should focus on modifiable risk factors such as the media and low self‐esteem, which contribute to body image dissatisfaction in young people and increases their risk of developing an eating disorder. This article provides recommendations for prevention of eating disorders specifically in the South Asian context.