Provider reported implementation of nutrition-related practices in childcare centers and family childcare homes in rural and urban Nebraska

Approximately 15 million children under age 6 are in childcare settings, offering childcare providers an opportunity to influence children’s dietary intake. Childcare settings vary in organizational structure – childcare centers (CCCs) vs. family childcare homes (FCCHs) – and in geographical location – urban vs. rural. Research on the nutrition-related best practices across these childcare settings is scarce. The objective of this study is to compare nutrition-related best practices of CCCs and FCCHs that participate in the Child and Adult Care Food Program (CACFP) in rural and urban Nebraska. Nebraska providers (urban n = 591; rural n = 579) reported implementation level, implementation difficulty and barriers to implementing evidence-informed food served and mealtime practices. Chi-square tests comparing CCCs and FCCHs in urban Nebraska and CCCs and FCCHs in rural Nebraska showed sub-optimal implementation for some practices across all groups, including limiting fried meats and high sugar/ high fat foods, using healthier foods or non-food treats for celebrations and serving meals family style. Significant differences (p \u3c .05) between CCCs and FCCHs also emerged, especially with regard to perceived barriers to implementing best practices. For example, CCCs reported not having enough money to cover the cost of meals for providers, lack of control over foods served and storage problems, whereas FCCHs reported lack of time to prepare healthier foods and sit with children during mealtimes. Findings suggest that policy and public health interventions may need to be targeted to address the unique challenges of implementing evidence-informed practices within different organizational structures and geographic locations

Fundraising, celebrations and classroom rewards are substantial sources of unhealthy foods and beverages on public school campuses

Objective: The emphasis in school nutrition policy has been on vending and competitive items. Our study was designed to characterize and quantify the amount and source of other foods and beverages on school campuses. Design: A cross-sectional observational study was conducted using a specially designed objective nutrition observation system. Setting: One low-income school district in southern California with six elementary and two middle schools. Subjects: Data were not collected from individual children. A total of 4033 students, 42 % of whom were Hispanic/Latino, 26 % African American and 21 % non-Hispanic white, were observed across school settings. Results: Data were collected continuously from 9 January 2008 to 16 June 2010. Healthy foods had, per serving, total energy ≤732 kJ (≤175 kcal), total fat content ≤35 %, total saturated fat ≤10 %, sugar less ≤15 g, sodium <200 mg and trans-fat ≤0·5 g. Healthy beverages were only 100 % juice or water, and unflavoured non-fat, 1 %, 2 % milk and soya or rice milk. The system had high inter-rater reliability (r = 0·78 to 0·99), percentage agreement (83 % to 100 %) and test–retest reliability (r = 0·81 to 0·98). Significantly more unhealthy foods and beverages than healthy items were observed on all campuses (P < 0·001). An average of 1·26 (sd 0·46) items per student per week was found with an average of 0·86 (sd 0·34) unhealthy items per child per week. Conclusions: There were substantial amounts of unhealthy foods and beverages brought onto campuses for classroom rewards, celebrations and fundraising that should be targeted for intervention

Standardising the after-school period for children\u27s physical activity and sedentary behaviour

Published online 21 March 2013ISSUE ADDRESSED: Studies examining children's after-school physical activity (PA) and sedentary behaviours (SB) often use arbitrary times to signify the period start and end. A standardised time is required for future research examining this period. The aim of the present study was to compare children's after-school behaviour using three definitions of the after-school period, namely (1) end of school to 6 pm; (2) end of school to dinner time; and (3) end of school to sunset, to determine the extent of variability in PA and SB during the after-school period depending on the definition used. METHODS: Children (n=308; aged 8 years) from the Melbourne Transform-Us! intervention wore an accelerometer and a subsample (n=112) wore an activPAL inclinometer in 2010. The end of school bell time was obtained from the child's school, parents completed a 2-day log reporting their child's dinner time and sunset times were obtained from Geoscience Australia. ActiGraph accelerometers assessed the proportion of time spent sedentary (SED) and that spent in light (LPA), moderate (MPA) and moderate-to-vigorous (MVPA) PA during the three time periods; activPAL inclinometers assessed the proportion of time spent sitting (SIT). RESULTS: Apart from the end of school time (3:30 pm), dinner (range 3:30 pm-8:40 pm) and sunset (range 5:07 pm-7:34 pm) times varied. Despite this, there were no significant differences in estimates of the proportions of time children spent in SED, LPA, MPA, MVPA or SIT between the three after-school periods examined. CONCLUSION: Given the small differences in SED, PA and SIT during the after-school period regardless of the definition (6 pm, sunset or dinner time), it appears that applying a standardised definition of end of school to 6 pm is acceptable for defining children's PA and SB during the after-school period. So what? The use of a standardised after-school definition (end of school to 6 pm), will enable future studies exploring children's after-school PA and SB to be more comparable.Lauren Arundell, Jo Salmon, Jenny Veitch, Eoin O'Connell, Trina Hinkley and Clare Hum

COLLISION WORK PERFORMED BY PATIENTS WITH PERIPHERAL ARTERY DISEASE

The goal of this study was to assess the differences in collision work performed by healthy, aged-matched controls compared to patients with peripheral artery disease (PAD) to provide foundations for an eventual exoskeleton design. Collision work is energy dissipated into the surrounding environment from impact, in this study’s case, upon heel strike. When designing an exoskeleton for patients with PAD, harvesting energy lost to collision work could be a valuable mechanism to improve walking performance. Devices designed to utilize the normally dissipated energy for assisting propulsion to improve walking performance are under-explored [1, 2]. The purpose of this study was to assess the validity of healthy, older individuals as a model for patients with PAD when investigating collision work as a primary exoskeleton design consideration. References [1] Kuo, A., et al. (2005). Exerc. Sport Sci. Rev.,33: 88-97 [2] Li, Q., et al. (2009). J. Neuroeng. Rehabil., 6: 22-22 [3] Donelan, J., et al.(2002). A. D. J. Biomech., 35: 117-12

Does self-determined motivation interact with environmental contexts to influence moderate-to-vigorous physical activity during a girls' youth sport camp?

Objective: To explore whether basketball player's self-determined motivation interacts with environmental contexts and coach training to influence percentage time in moderate-to-vigorous physical activity (%MVPA). Methods: A secondary analysis of data from 76 girls (mean ± SD, 10.5 ± 1.0 years) was conducted. Players were classified as high self-determined motivation (HSDM) or low self-determined motivation (LSDM) and randomised to trained (intervention) or untrained (control) coaches. Training included 2 workshops on strategies for activity-promoting practices. Girls were exposed to environmental contexts (practices and games) led by a trained/untrained coach (depending on arm) and one without coaches (free time) daily. Girls wore accelerometers each day. Using mixed random-effects models, the influence of motivation, context and training on %MVPA was analysed. Results: Trained coaches' practices were associated with the greatest %MVPA with no difference between HSDM and LSDM players (38.28 ± 1.77%; 37.64 ± 1.80%; p = 0.66). HSDM players had significantly greater %MVPA versus LSDM players during untrained coaches' practices (23.58 ± 1.77%; 20.51 ± 1.78%; p = 0.03). During games with trained coaches, HSDM players had greater %MVPA compared to LSDM players (23.79 ± 1.76%; 18.56 ± 1.74%; p < 0.001). No between-group difference in %MVPA during free time was found (12.85 ± 0.82%; 13.39 ± 0.84%; p = 0.64). Conclusion: The impact of individual differences in self-determined motivation on %MVPA during practices was attenuated when coaches were trained to implement activity-promoting practices

Is the process of delivery of an individually tailored lifestyle intervention associated with improvements in LDL cholesterol and multiple lifestyle behaviours in people with Familial Hypercholesterolemia?

<p>Abstract</p> <p>Background</p> <p>More insight in the association between reach, dose and fidelity of intervention components and effects is needed. In the current study, we aimed to evaluate reach, dose and fidelity of an individually tailored lifestyle intervention in people with Familial Hypercholesterolemia (FH) and the association between intervention dose and changes in LDL-Cholesterol (LDL-C), and multiple lifestyle behaviours at 12-months follow-up.</p> <p>Methods</p> <p>Participants (n = 181) randomly allocated to the intervention group received the PRO-FIT intervention consisting of computer-tailored lifestyle advice (<it>PRO-FIT*advice</it>) and counselling (face-to-face and telephone booster calls) using Motivational Interviewing (MI). According to a process evaluation plan, intervention reach, dose delivered and received, and MI fidelity were assessed using the recruitment database, website/counselling logs and the Motivational Interviewing Treatment Integrity (MITI 3.1.1.) code. Regression analyses were conducted to explore differences between participant and non-participant characteristics, and the association between intervention dose and change in LDL-C, and multiple lifestyle behaviours.</p> <p>Results</p> <p>A 34% (n = 181) representative proportion of the intended intervention group was reached during the recruitment phase; participants did not differ from non-participants (n = 623) on age, gender and LDL-C levels. Of the participants, 95% received a <it>PRO-FIT*advice</it> log on account, of which 49% actually logged on and completed at least one advice module. Nearly all participants received a face-to-face counselling session and on average, 4.2 telephone booster calls were delivered. None of the face-to-face sessions were implemented according to MI guidelines. Overall, weak non-significant positive associations were found between intervention dose and LDL-C and lifestyle behaviours.</p> <p>Conclusions</p> <p>Implementation of the PRO-FIT intervention in practice appears feasible, particularly <it>PRO-FIT*advice</it>, since it can be relative easily implemented with a high dose delivered. However, only less than half of the intervention group received the complete intervention-package as intended. Strategies to let participants optimally engage in using web-based computer-tailored interventions like <it>PRO-FIT*advice</it> are needed. Further, more emphasis should be put on more extensive MI training and monitoring/supervision.</p> <p>Trial registration</p> <p>NTR1899 at ww.trialregister.nl.</p

Promoting better family meals for girls attending summer programs

Numerous cross-sectional studies and some longitudinal studies have identified the positive attributes and protective effects of the traditional family meal. Children and adolescents who frequently eat meals with their families are more likely to eat fruits & vegetables, less likely to consume fried foods, soda, or sweets, less likely to have disordered eating patterns, and less likely to be overweight. However, very few published reports evaluate programs designed to increase the frequency or quality of family meals. Therefore, the purpose of this program was to promote better family meals at home for girls attending a summer program by improving the girls’ food preparation skills, and abilities to be family change agents for more healthful family mealtimes

Results from the dissemination of an evidence-based telephone-delivered intervention for healthy lifestyle and weight loss: the Optimal Health Program

Despite proven efficacy, there are few published evaluations of telephone-delivered interventions targeting physical activity, healthy eating, and weight loss in community dissemination contexts. This study aims to evaluate participant and program outcomes from the Optimal Health Program, a telephone-delivered healthy lifestyle and weight loss program provided by a primary health care organization. Dissemination study used a single-group, repeated measures design; outcomes were assessed at 6-month (mid-program; n = 166) and 12-month (end of program; n = 88) using paired analyses. The program reached a representative sample of at-risk, primary care patients, with 56 % withdrawing before program completion. Among completers, a statistically significant improvement between baseline and end of program was observed for weight [mean change (SE) −5.4 (7.0) kg] and waist circumference [−4.8 (9.7) cm], underpinned by significant physical activity and dietary change. Findings suggest that telephone-delivered weight loss and healthy lifestyle programs can provide an effective model for use in primary care settings, but participant retention remains a challenge

Competitive Orientations Among Intercollegiate Athletes: Is Winning The Only Thing.

Abstract: In this exploratory investigation of competitive orientations, intercollegiate athletes from a highly competitive Division I program and nonathletes from the same university completed Gill&apos;s Sport Orientation Questionnaire (SOQ) which assesses competitiveness, win and goal orientation; Vealey&apos;s Competitive Orientation Inventory (COI) which assesses the relative importance of performing well (performance) and winning (outcome) in competitive sports; and Helmreich and Spence&apos;s Work and Family Orientation Questionnaire (WOFO), a general achievement orientation measure. A Gender X Athlete/Nonathlete MANOVA yielded both gender and athlete/nonathlete main effects and no interaction. The gender difference was most evident for competitiveness scores, with males scoring higher than females on competitiveness and win orientation. Athletes scored higher than nonathletes on most measures, but especially so on the sport-specific competitiveness score. Athletes also placed more emphasis on performance and less on outcome than nonathletes did. A secondary analysis compared the eight athletic teams and revealed considerable variation among teams. Generally the team differences were not gender differences but seemed to reflect the competitive structure of the activity. Article: Individual differences in achievement orientation and competitiveness are quite obvious among sport participants and these differences logically relate to sport achievement behaviors and success. According to both Atkinson&apos;s (1974) achievement motivation theory and more current cognitive approaches, highly achievement-oriented individuals approach achievement situations, try hard and strive for success against achievement standards, and persist in the face of failure. These same achievement behaviors should lead to success in athletics. Highly successful athletes are those who enter competitive sports and accept challenges, who set and strive for high performance standards, and who persist in those efforts until they attain their goals. Thus, highly successful athletes should be characterized by high achievement motivation. Despite the appealing logic of the relationship between achievement orientation and athletic success, sport psychology research has not demonstrated any consistent relationship between global achievement motivation constructs and sport achievement behavior