Ready to be physically active? The effects of a course preparing low-income multiethnic women to be more physically active.

The purpose of this study is to evaluate the effect of a preintervention physical activity preparatory course on physical activity, and social, cognitive, and transtheoretical constructs. The sample included 82 low-income, multiethnic women (75% Latina) who completed an 8-week course designed to prepare them to become more active prior to randomization into a 10-month physical activity intervention. Participants completed precourse and postcourse measures. Paired-comparison t tests showed increases in knowledge, perceived social support for exercise, minutes of walking per week, and total cognitive and behavioral processes following the preparatory course. Perceived barriers and self-efficacy for exercise did not change from precourse to postcourse. Preintervention preparatory courses may be an effective way to increase social and cognitive constructs associated with physical activity behavior, potentially yielding a greater effect from subsequent interventions.     

Physical capacity in physically active and non-active adolescents

Aim  

The aim of this study was to investigate differences in physical capacity between physically active and non-active men and women among graduates from upper secondary school.     

Influence of an interpersonal laboratory stressor on youths' choice to be physically active

OBJECTIVE: To determine whether interpersonal stress reduces youths' motivation to exercise in a laboratory setting. RESEARCH METHODS AND PROCEDURES: Physical activity and sedentary behavior were measured in boys and girls across a control day, after reading children's magazines, and on a stress day, after giving a videotaped speech. For one analysis, children were divided into low (n = 12) and high (n = 13) heart-rate reactivity groups based on changes in heart rate to stress. In a second analysis, children were divided into low and high perceived level of stress based on changes in perceived stress. To determine differences in choice of exercise or sedentary behavior across the control and stress conditions, subjects chose either to exercise for progressively longer periods to earn a monetary reinforcer or to engage in a high-rated sedentary behavior. RESULTS: The choice to exercise was influenced by stress reactivity differently in the stress and control conditions. Low heart-rate reactive children participated in similar (p > 0.50) amounts of exercise on the stress and control days, but high heart-rate reactive children participated in less (p < 0.01) exercise (22.0 +/- 2.5 vs. 26.3 +/- 2.2 minutes) on the stress than control days. When grouped by change in perceived stress, there were no group differences, but subjects exercised longer (p < 0.01) on the control day than the stress day. DISCUSSION: Interpersonal stress decreased exercise in children susceptible to interpersonal stress. Stress-induced alterations in health behaviors may lead to weight gain in children.     

Empowering students to respond to alcohol advertisements: results from a pilot study of an Australian media literacy intervention

Objective : Alcohol media literacy programs in the United States have increased students' media literacy skills and lowered pre‐drinking behaviour. In Australia, no such programs have yet been implemented or evaluated. This pilot study aimed to examine the feasibility and potential impact of an alcohol media literacy program for Australian upper‐primary school children. Methods : Thirty‐seven Year 5 and 6 students (aged 10–12) from one school in the Sydney region participated in 10 one‐hour media lessons. Teacher interviews, student exit slips, teacher observations and a researcher reflective journal were analysed to examine the implementation process, while a pre‐ and post‐questionnaire was analysed to measure outcome. Results : Key factors in implementation were the importance of school context; attainment of English and PDHPE learning outcomes to differing extents; program's useability provided flexibility; perceived complexity and achievability of the lessons and program's engagement and relevance for the students. The program significantly increased media literacy skills and understanding of persuasive intent; decreased interest in alcohol branded merchandise; and lowered perception of drinking norms. Conclusion and implications : An Australian alcohol media literacy program for upper‐primary school children appears feasible, and has potential to lead to measurable outcomes.     

Recommendations by Queensland GPs to be more physically active: which patients were recommended which activities and what action they took

Objective: To ascertain the extent to which general practitioners in Queensland recommend physical activity to their patients, the types of patients they target, types of activities they suggest and how patients respond to the recommendations. Methods: Questions designed to answer the research objectives were included in the Queensland Social Survey. Univariate, bivariate and logistic regression analyses were employed linking relevant variables with demographic data from the survey. Results: The survey was completed by 1,261 (35.2%) people. In the previous year, 225 (18%) of them were recommended by a general practitioner to do more physical activity. These people were more likely to have a higher body mass index and rate their general health as fair or poor. Walking was the most common activity recommended (75%). Only 18% of people were not pleased to be recommended to take more exercise and most (67%) reported following the advice. Blue‐collar workers and older people were less likely to follow the recommendations. Conclusions: General practitioners in Queensland are recommending increased physical activity to patients with weight problems and with medical problems. Patients are usually pleased to receive the advice and act upon it. Implications: General practitioners should be aware that physical activity recommendations are received favourably by most patients and there is potential to improve public health by giving physical activity advice to sedentary and/or overweight patients when appropriate.     

Creating a physically active society: the next great challenge

The U.S. National Physical Activity Plan was launched in May 2010 with the goal of weaving physical activity into our culture.Physical inactivity has been shown to be a better predictor of death than traditional medical risk factors, costs employers morein lost productivity than tobacco use, causes more deaths than obesity, and affects more people than high cholesterol, acondition that produces more drug sales than any other condition. Despite its impact on society, it is largely neglected in policyarenas. The authors describe strategies to create a national culture of physical activity.     

Smoking and smokeless tobacco use among adolescents: trends and intervention results.

Data from a 2-year study describe tobacco use trends, perceptions, and prevention effects for 1,281 5th and 6th graders enrolled in 12 randomly selected Washington State elementary schools. Youths were pretested, then randomly divided by school into skills, discussion, and control groups. Preventive intervention curriculums for the skills and discussion groups included age-relevant information on smoked and smokeless tobacco use, peer testimonials, debates, games, and homework. Youths in the skills group also learned communication and problem-solving methods for handling difficult situations around tobacco use. Following intervention, youths were posttested, then retested semiannually for 2 years. During the 2-year study, three-quarters of all smokers and nonusers and half of all smokeless tobacco users maintained their statuses. Only 10 percent of all smokers and 3 percent of all smokeless users quit their habits. One in six reported new tobacco use, one-third of smokers began using smokeless tobacco, and two-thirds of all smokeless users began smoking during the study. Most youths at final measurement perceived smokeless tobacco as less of a health risk than smoking. Nearly one in two of all smokeless users intended to smoke, and two-thirds were actually smoking at 24-month followup. Both smoked and smokeless tobacco use rates increased in all groups, and youths in the skills intervention group consistently showed the lowest rates relative to the other groups. These findings demonstrate the potential of skills intervention methods for lowering tobacco use rates among adolescents.     

Improving weight status in childhood: results from the eat well be active community programs

Objectives

The eat well be active Community Programs (ewba) aimed to prevent obesity among children aged 0–18 years in two Australian communities from 2006 to 2010.

Methods

ewba was a multi-strategy intervention in children’s settings. The evaluation was quasi-experimental, including a before and after survey with intervention (INT) and non-randomised comparison (COMP) communities. Outcome measures included BMI-z score (zBMI) and overweight/obesity prevalence in children aged 4–5 years; and zBMI, waist circumference (WC) z-score and overweight/obesity prevalence in children aged10–12 years.

Results

After 3 years, among the 4–5 years old, mean zBMI was significantly lower in both INT (?0.20, p < 0.05) and COMP (?0.15, p < 0.05), however, changes were not significantly different between INT and COMP. There was a larger reduction in overweight/obesity prevalence in INT (?6.3 %) compared to COMP (?3.7 %) (p < 0.05, χ ² test). In the 10–12 years old, mean zBMI did not change significantly in INT or COMP. There was a significant reduction in WC z-score in INT (?0.17, p < 0.05) but not in COMP (?0.10, p = NS), although not significantly different between INT and COMP (p = 0.092).

Conclusions

These findings suggest that the ewba community intervention had a moderate impact, showing modest improvements in weight status at 3-year follow-up.     

Virtual reality jogging as a novel exposure paradigm for the acute urge to be physically active in patients with eating disorders: Implications for treatment

The acute urge to be physically active is a relevant clinical phenomenon in patients suffering from eating disorders. In this study with n = 20 female patients with anorexia nervosa and n = 10 female patients with bulimia nervosa, a virtual reality (VR) jogging paradigm was applied as a novel highly immersive 3D exposure paradigm. Patients were asked to rate their acute urge to be physically active during the exposure procedure. A 10‐item self‐report questionnaire (smQ) was developed to capture the cognitive, emotional, and behavioral aspects of the acute urge to move. We hypothesized that exposure would lead to habituation of the urge to be physically active. We also hypothesized that leptin levels would be associated with the degree of the subjective urge to be physically active, while habituation would be associated with a decrease in stress hormones (α‐amylase, cortisol, and cortisone in saliva). A statistically significant change in subjective scores in the smQ from baseline to postexposure was seen. Our novel VR paradigm may serve as a therapeutic tool for exposure and habituation of the urge of acutely engaging in physical activity in patients with eating disorders.     

Empowering elderly Iranians through a social group work intervention: A trial study to assess the effect of the intervention on participants' quality of life

We designed and ran an empowerment‐oriented social group work intervention to assess whether the intervention could improve the quality of life of older Iranians. The intervention consisted of nine group sessions that focused on capacity building and increasing individual competences, environmental resources and opportunities. Using a randomised controlled trial (RCT), 60 elderly people (30 men and 30 women in the intervention and control groups) from Social Services Centres in Tehran Municipality participated in this study. The WHOQOL‐BREF instrument was used to measure quality of life, comparing before, after and follow‐up measures between the groups and within each group. ANOVA and GEE tests were applied to analyse the data. The results showed significant progress in overall quality of life of the participants, particularly in the domains of physical health, psychological health, social relationships and environmental health. In pretest, there were no significant differences between the groups in terms of quality of life and its domains, but there were significant differences in the post‐ and follow‐up tests. This study provides support for the empowerment‐oriented social group work intervention with Iranian elderly people. This kind of intervention can be a useful model for empowering older people, especially in countries where social support and health services for seniors are not yet freely available.     

Effect of a school-based educational intervention on HPV and HPV vaccine knowledge and willingness to be vaccinated among Chinese adolescents : a multi-center intervention follow-up study

BackgroundMiddle school students are recommended as the primary target population for human papillomavirus (HPV) vaccination. This study aimed to assess HPV and HPV vaccine knowledge, and to evaluate the effect of a school-based educational intervention, immediately and one year later, on HPV knowledge and vaccine acceptability among adolescents in mainland China.MethodsA school-based interventional follow-up study was conducted in seven representative cities in mainland China from May 2015 to May 2017. “Train-the-trainer” strategy was employed to educate school teachers in this study. Students aged 13 to 14 years old were assigned to intervention classes and control classes. All students were required to complete the baseline questionnaire. Students in the intervention classes were given a 45-minute lecture regarding HPV and HPV vaccine knowledge and were then asked to complete a post-education questionnaire. One year later, all students were asked to complete the post-education questionnaire again.ResultsBaseline HPV knowledge was low among Chinese adolescents, with only 12.6% and 15.7% of students having heard of HPV and HPV vaccines, respectively. After the intervention, the level of HPV-related knowledge increased immediately, and students with higher knowledge levels of HPV and HPV vaccines were more willing to get vaccinated. One year after the intervention, the knowledge of HPV and HPV vaccines was dramatically diminished. However, knowledge was significantly higher in intervention classes compared to control classes.ConclusionsKnowledge and awareness of HPV and vaccination are generally deficient among Chinese adolescents. School-based health education was very effective in improving awareness and positive attitudes about HPV and HPV vaccines within a short time. Integrating health education on HPV into the existing school-based sexual health curriculum could be an effective way to increase HPV vaccination coverage and help to eliminate preventable HPV-associated cancers in China.     

Sexual behaviors of physically disabled adolescents in the United States.

PURPOSE: To examine differences in some aspects of sexual behavior between physically disabled and nondisabled adolescents in the United States.METHODS: The 1994-1995 Wave I data from the National Longitudinal Study of Adolescent Health (Add Health), a stratified, multistage cluster, school-based sample of 7th to 12th graders, were used. Physical disabilities were measured in terms of functional limitation and activity restriction. A total of 1153 adolescents were identified as physically disabled, mainly with limb difficulties. We studied their exposure on school sex education, contraceptive knowledge, sex attitudes, and popularity. Their experiences in romantic attraction and sex were analyzed by multinomial logistic regression methods, controlling for age, pubertal development, and other sociodemographic variables.RESULTS: Although disabled adolescents are slower in pubertal development and more socially isolated, they are as sexually experienced as their nondisabled counterparts. Their exposure to school sex education is largely similar to that of the nondisabled, yet disabled boys are somewhat less knowledgeable about birth control. Severely disabled boys who are sexually active are popular among their same-sex peers, much like nondisabled boys. Although disabled adolescents are as sexually experienced, severely disabled boys and girls have less opposite-sex romantic attraction and are less sure about their sexual preference. Adolescents with mild disabilities have a higher tendency for same-sex attraction than do the nondisabled. Adolescent girls with physical disabilities consistently have higher odds of experiencing forced sex.CONCLUSIONS: Physically disabled adolescents' sexual development and their specific needs for sex education and guidance should not be overlooked. More attention should be paid to protect physically disabled girls from sexual abuses and exploitations.     

Can the results of pulmonary function tests and evidence of tobacco-related respiratory symptoms be used to dissuade adolescents from smoking?

The purpose of this paper is to review arguments recently used to dissuade youth from smoking, nd to propose new ones based on the results obtained in an epidemiological study carried out between 1978 and 1980 among young people attending school. A questionnaire focused on respiratory symptoms and smoking habits was filled out by 2,269 students between 10 and 19 years of age. Among them, a representative sample of 971 underwent a respiratory function test. Two years later, the students who had shown an impaired respiratory function were again examined--along with a representative control group--using the same protocol. During the first examination, we had found a very meaningful relationship between smoking and respiratory symptoms. MOreover, girl smokers evidenced significantly diminished expiratory flows. The students were informed of the results at the time. When the second examination was carried out, some smokers had increased their cigarette consumption, while others had cut back- and it was the latter group that, during the first examination, had had a significantly higher proportion of symptoms and lower respiratory function values. This suggests that showing proof of the real problems caused by smoking could be used as an element in antismoking campaigns among school-attending youth.     

Analysis of quality-of-care indicators for physically abused children and adolescents

There has still been limited evaluation in Brazil on the care provided to physically abused children and adolescents. The current study aimed to analyze indicators used in research on services that provide care to such children and adolescents. An exploratory study was conducted, selecting five studies in four services: two nongovernmental organizations in two cities in the interior of S?o Paulo State and two organizations, one nongovernmental and the other governmental, in the city of Rio de Janeiro. The analysis aimed to identify the indicators used (structure, process, or result) and which aspect of care they proposed to measure (dynamics of care, treatment adherence, case-resolving capacity, and integration with the network). Eighteen process indicators and nine results indicators were identified. A minimum set of essential indicators is recommended to evaluate care for children and adolescents and their families.     

Empowering primary care workers to improve health services: results from Mozambique's leadership and management development program

This article is the third article in the Human Resources for Health journal's feature on the theme of leadership and management in public health. The series of six articles has been contributed by Management Sciences for Health (MSH) and will be published article-by-article over the next few weeks.     

Empowering employees with chronic diseases: process evaluation of an intervention aimed at job retention

Purpose  

Employees with a chronic disease may experience work-related problems that contribute to the risk of job loss. We developed a group-based intervention programme aimed at clarifying problems, making these a subject of discussion at work, and realizing solutions. This process evaluation investigates the intervention’s feasibility and the satisfaction of 64 participants in eight groups.     

Physical activity intervention: a transtheoretical model-based intervention designed to help sedentary young adults become active

Physical activity levels in young adults are low. Research supports the use of the Transtheoretical Model of behaviour change (TM) in designing physical activity interventions. This study used a pre-post randomized control design to investigate the effectiveness of a self-instructional intervention for helping sedentary young adults to initiate physical activity. Post-intervention, significantly more of the experimental group (80%), in comparison to the control group (68%), improved their exercise stage of change (SOC) from baseline (P < 0.05). Discriminant analyses revealed that discrimination between stage improvement/non-improvement was possible using the processes of change data. Stage improvers scored significantly higher on all of the behavioral and four out of five of the cognitive processes of change. For stage improvers, the processes of self-re-evaluation and self-liberation were most frequently used, whilst social liberation was used significantly more by the experimental than the control group. This inexpensive, self-instructional intervention, based on the TM and the 'active living message', is an effective method of assisting sedentary young adults to progress through the exercise SOC.