Health promotion in the city: A structured review of the literature on interventions to prevent heart disease, substance abuse, violence and HIV infection in us metropolitan areas, 1980–1995

To achieve its national public health goals, the US must improve the health of low-income urban populations. To contribute to this process, this study reviewed published reports of health promotion interventions designed to prevent heart disease, HIV infection, substance abuse, and violence in US cities. The study's objectives were to describe the target populations, settings, and program characteristics of these interventions and to assess the extent to which these programs followed accepted principles for health promotion. Investigators searched five computerized databases and references of selected articles for articles published in peer-reviewed journals between 1980 and 1995. Selected articles listed as a main goal primary prevention of one of four index conditions; were carried out within a US city; included sufficient information to characterize the intervention; and organized at least 25% of its activities within a community setting. In general, programs reached a diverse population of low-income city residents in a variety of settings, employed multiple strategies, and recognized at least some of the principles of effective health promotion. Most programs reported a systematic evaluation. However, many programs did not involve participants in planning, intervene to change underlying social causes, last more than a year, or tailor for the subpopulations they targeted, limiting their potential effectiveness. Few programs addressed the unique characteristics of urban communities. Mr. Lancaster is with the Division of Adult and Community Health, National Center for Health Promotion and Disease Prevention, and Dr. Speers is with the Office of the Associate Director for Science, US Centers for Disease Control and Prevention. The research described in this report was supported by the US Centers for Disease Control and Prevention. All views expressed are those of the authors and do not necessarily reflect the views of their institution.     

Changes in Psychosocial Factors and Physical Activity Frequency Among Third- to Eighth-Grade Girls Who Participated in a Developmentally Focused Youth Sport Program: A Preliminary Study

BACKGROUND: Despite the numerous physiological, psychological, and academic benefits of physical activity (PA), declines in PA levels among girls have been observed over the last decade. The purpose of this preliminary study was to assess the short-term changes pertaining to Girls on the Run and Girls on Track developmentally focused youth sport programs (DYS) on global self-esteem, body image, commitment to PA, and PA frequency.
METHODS: This preliminary study employed a nonexperimental, one-group, pre- and postintervention study design using a 29-item paper-and-pencil assessment tool (n = 1034).
RESULTS: Paired sample t -tests from pre- to postintervention revealed statistically significant differences in self-esteem (p < .001), body size satisfaction (p < .001), and vigorous PA frequency (p < .001). Stratification by the number of times participating in the intervention revealed the greatest changes at first participation followed with continued improvements in self-esteem (p = .013) and body size satisfaction (p < .001) for those participating in a second time. Age differences were also observed between participants ≤10 years old and 11–15 years; in that significant improvements in commitment to PA (p = .003) were observed for the older girls.
CONCLUSIONS: Findings suggest DYS programs Girls on the Run and Girls on Track may produce beneficial changes in self-esteem, body size satisfaction, PA commitment, and PA frequency. Although the findings from the current report are preliminary, they suggest that DYS programs designed exclusively for girls may provide the necessary framework to promote PA to achieve the numerous associated benefits.     

County Workforce,Reimbursement, and Organizational Factors Associated with Behavioral Health Capacity in Health Centers

This study describes on-site behavioral health treatment capacity in health centers in 2007 and examines whether capacity was associated with health center characteristics, county-level behavioral health workforce, and same-day billing restrictions. Cross-sectional data from the 2007 Area Resource File and Uniform Data System were linked with data on Medicaid same-day billing restrictions. Mental health treatment capacity was common; almost four in five health centers provided on-site mental health services. Additional services such as crisis counseling (20 %), treatment from a psychiatrist (29 %), and substance abuse treatment were offered by fewer health centers (51 % provide on-site services and only 20 % employ substance abuse specialists). In multivariate analysis, larger health centers, health centers located in counties with a larger behavioral health workforce per capita, and those located in the West and Northeast were more likely to have behavioral health capacity. Same-day billing restrictions were associated with lower odds of substance use treatment capacity and providing 24 hr crisis counseling services.