Psychosocial and environmental determinants of physical activity in elementary school children : implications for interventions to reduce childhood obesity.

Introduction: Childhood obesity has become a national public health crisis in America. Physical activity has been shown to be one key for controlling childhood obesity, but little is known about the mediators and moderators in physical activity promotion models. In particular, the immediate time afterschool provides an important opportunity for children to be active, only 20% of their afterschool time is used for physical activity. Purpose: The purposes of this study were to explore the psychosocial and environmental determinants of physical activity, and to examine the influence of wearing pedometers on the hypothesized determinants (physical activity self-efficacy, physical activity enjoyment, perceived parental influence, and perceived environment) of physical activity, among elementary school children attending afterschool programs, Methods: A cross-sectional correlational design was used to explore the determinants of physical activity in 133 children enrolled in afterschool programs. In addition, a pretest-posttest study was conducted to examine the influence of wearing pedometers on the hypothesized determinants of physical activity among a subsample of 50 randomly selected children. Children\u27s physical activity levels were assessed by a seven-day recall scale, and seven consecutive days’ pedometer steps. Results: Approximately 49% of the children were overweight or obese, but only 13% of the children met national physical activity recommendations. Overweight or obese children took fewer pedometer steps than non-overweight children, and pedometer steps were negatively related to children\u27s BMI. Wearing pedometers did not have a significant influence on the hypothesized determinants of physical activity. No evidence of the reactivity of wearing pedometers was found. Perceived parental influence partially mediated the relationships of physical activity self-efficacy and physical activity enjoyment with physical activity. For self-reported physical activity levels, physical activity enjoyment had the strongest effect on physical activity followed by physical activity self-efficacy. Perceived parental influence had the strongest effect on physical activity measured by pedometers. Conclusions: Pedometers are a reliable measurement instrument to assess elementary school children\u27s physical activity. Perceived parental influence has the primary effect on children\u27s self-reported physical activity levels and number of pedometer steps. Future physical activity interventions should target parental influence to improve children\u27s physical activity levels and control childhood obesity

Preliminary assessment of a school-based healthy lifestyle program among rural children.

Introduction: Childhood obesity has become a national public health crisis in America. Physical inactivity and unhealthy eating behavior may contribute to childhood obesity. School-based programs focusing on healthy lifestyles play a promising role in preventing and controlling childhood obesity. Purpose: To assess the preliminary effects of a school-based program on physical activity and eating behavior among rural children. Methods: A quasi-experimental study design with repeated measures (intervention group only) was utilized. Children from kindergarten to fifth grade in four rural elementary schools in Kentucky participated in the study. A variety of strategies were implemented to obtain four goals: (1) improving physical activity level, (2) improving health and nutrition education, (3) promoting family/community involvement through Family Fitness Fun Nights, and (4) realigning school’s wellness policy with HealthierUS School Challenge. Physical activity was assessed by pedometer logs of step counts (4 consecutive days), while fruits and vegetables consumption were assessed by a previous day recall survey. Data were collected in January (baseline), February (t1), March (t2), April (t3) and May (t4) of 2010. Repeated measures ANOVA and mixed-effects regression models were used. Results: A total of 1,508 children, 814 boys and 679 girls (15 missing sex), participated in this study. The program had significant effects on increasing the percentage of children meeting nutrition (14.8% vs. 25.9%, p \u3c 0.01) and physical activity recommendations (1.4% vs. 5.0%, p \u3c 0.01). There were significant main effects of school, time, sex and grade on physical activity and eating behavior. The effects of the program on physical activity and eating behavior depended on school, grade and age of the children. Children’s physical activity level was positively correlated with their grade level. Generally, there was an increasing linear trend of physical activity and an increasing quadratic trend of eating behavior over time. Conclusions: The school-based healthy lifestyle program had beneficial effects on improving healthy behaviors among children. Further studies are needed to assess the long-term health effects and cost-effectiveness of this program

Successful aging in the United States and China : a theoretical basis to guide nursing research, practice, and policy.

Successful aging is an idea gaining increasing attention given the exponential growth in the older adult population. Criteria and definitions within multiple disciplines vary greatly in Western literature, with no consensus on its meaning. Moreover, sociocultural, economic and political differences between the Western view of successful aging and its use in China – with the world’s largest older adult population – add to the confusion. Similarities and differences in the meaning of successful aging in the United States and China are examined and the potential for a common definition that is useful to nursing in both countries is explored. Using the process of concept analysis, shared criteria for successful aging were: decreased or delayed incidence of disease and disability, life satisfaction, a sense of meaning and purpose in life, and the ability to cope effectively to achieve goals based on personal values and priorities. A comprehensive, multidimensional definition of successful aging for nursing, and a mid-range nursing theory of Theory of Successful Aging, were identified and may be useful to guide nursing research, practice and development of aging policy and programs

Smoking behavior and social contexts associated with smoking among dual‐smoker couples

ObjectivesTo examine smoking behavior and social contexts related to smoking among dual‐smoker couples.DesignCross‐sectional online survey study.SampleA convenience sample of 183 dual‐smoker couples.MeasurementsInvestigator‐developed survey on smoking and related social contexts.ResultsParticipants smoked 16.0 cigarettes daily for 14.2 years; 48.4% shared more than half of their smoking time with their spouse. More than half made quit attempts in the past year individually (M = 5.3) and jointly (M = 2.5). Couples sharing more smoking time were more likely to be motivated to quit (p = .002), make quit attempts (p < .0001), and be interested in cessation interventions (p = .002); but less likely to implement home smoking bans (p < .001). Among those who reported quit attempts, 41% quit by themselves and 15.3% sought professional assistance. Most common reasons for relapse were chronic stress and crisis, 63.6%, however, were interested in smoking cessation services, preferably technology‐based interventions.ConclusionsWe found smoking interdependence within dual‐smoker couples. Despite high levels of motivation to quit, most did not utilize professional help, leading to low successful quit rates. Technology‐based smoking cessation interventions incorporating spousal support and addressing stress/crisis may best assist dual‐smoker couples.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/154359/1/phn12686.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/154359/2/phn12686_am.pd

Fit Into College II: Physical Activity and Nutrition Behavior Effectiveness and Programming Recommendations

Purpose: To determine whether residency (living on campus versus off campus) was related to the effects of Fit into College on students’ health behaviors, and to understand interns’ perceptions of their roles in mentoring their trainees. Design: Pre-experimental, one-group, pretest-posttest design and a posttest focus group interview. Setting: University-offered health and internship courses. Subjects: Twenty-four students (trainees) participated in the intervention, nine of whom lived on campus. Five student-interns served as their mentors. Intervention: Fit into College was a 14-week intervention in which trainees teamed up with an intern to improve and/or maintain healthy nutrition and physical activity behaviors. Measures: Trainees’ nutrition and physical activity behaviors and perceptions were quantitatively assessed through surveys at preintervention and postintervention. Interns’ mentoring perceptions were qualitatively assessed through a focus group interview after the intervention. Analysis: Two-factor repeated measure ANOVAs and qualitative theme identification. Results: Regardless of their residency location, the trainees’ perceptions of the health benefits of eating fruits and vegetables improved during the intervention. However, for trainees living on campus, the intervention was not effective in increasing the number of fruits and vegetables consumed or the planning for food preparation. The interns perceived that they did not have adequate access to healthy foods, the knowledge or skills to prepare healthy foods, or the competency to teach food preparation strategies to their trainees. For trainees living on campus, the intervention was more effective in decreasing perceived exercise barriers than trainees living off campus. Conclusion: Future iterations of Fit into College may focus on 1) improving college students’ planning and preparation of healthy foods, 2) segmenting trainees into more homogeneous groups for the interns to tailor their areas of expertise (campus vs. off-campus and/or freshman vs. upperclass students), and 3) collaborating with university-partners to improve environmental conditions to promote physical activity and healthy nutrition

The role of self-transcendence : a missing variable in the pursuit of successful aging?

While successful aging is often defined as the absence of disease and disability or as life satisfaction, self-transcendence may also play an important role. The objective of this research was to test a nursing theory of successful aging proposing that transcendence and adaptation predict successful aging. In this cross-sectional exploratory study, a convenience sample of older adults (N = 152) were surveyed about self-transcendence, proactive coping, and successful aging. Using hierarchical multiple regression, self-transcendence, proactive coping, and all control variables (i.e., sex, race, perceived health, place of residence) together explained 50% of the variance in successful aging (p \u3c 0.001). However, proactive coping alone was not a significant predictor of successful aging. Thus, this study did not support the theory that both self-transcendence and proactive coping predict successful aging. Self-transcendence was the only significant contributor to this multidimensional view of successful aging. Self-transcendence is an important variable in the pursuit of successful aging, which merits further investigation

Psychosocial determinants of physical activity in children attending afterschool programs : a path analysis.

Background: Physical activity (PA) is important for controlling childhood obesity, but a comprehensive PA model for school-aged children is lacking. Objectives: Guided by the youth PA promotion (YPAP) model, this study estimated the direct and indirect effects of self-efficacy, enjoyment, parental influence, and environment on self-reported PA and pedometer steps. A secondary purpose was to explore the association between self-reported PA and pedometer steps. Methods: An observational and prospective study was conducted among 133 children, aged 8–11 years old, from 10 elementary schools with afterschool programs in a Midwestern U.S. school district from August through October 2013. PA was assessed by a 7-day recall scale and pedometers. Other variables were assessed by validated questionnaires. Results: Approximately 65 (49%) children were overweight or obese—only 17 (13%) met national PA recommendations—and body mass index z score was negatively correlated with pedometer steps (r = .18, p = .042). A path analysis showed that self-efficacy had a direct effect on self-reported PA and pedometer steps, enjoyment had only a direct effect on self-reported PA, and parental influence had a direct effect on pedometer steps and an indirect effect on self-reported PA through self-efficacy and enjoyment. The association between self-reported PA and pedometer steps was not significant. Discussion: Because this study only partially supports the YPAP model, studies with a larger sample size and longitudinal design are essential to further examine this model. The nonsignificant relationship of self-reported PA with pedometer steps may be due to the systematic error resulted from a common method artifact of self-report. Given the importance of parental influence, enjoyment, and self-efficacy, targeting these three determinants in future interventions to increase PA among children is recommended

Promoting self-transcendence and well-being in community-dwelling older adults : a pilot study of a psychoeducational intervention.

Self-transcendence changes how older adults perceive themselves, their relationships with others, the material world, and the metaphysical or spiritual dimension. It is associated with multiple indicators of well-being. The purpose of this pilot study (N = 20) was to examine the feasibility and effectiveness of a psychoeducational intervention to increase self-transcendence and well-being of older adults. Data were analyzed using generalized estimating equations. All variables trended in the directions hypothesized. Self-transcendence increased in the intervention group and decreased in the control group but not significantly. The group × time interaction for life satisfaction was significant (z = 2.89, p = .004). This feasibility study supports further investigation to assess the effectiveness of the intervention in a larger sample

Demographic differences in and correlates of perceived body image discrepancy among urban adolescent girls: a cross-sectional study

Abstract Background Understanding factors related to girls’ body image discrepancy, which is the difference between self-perceived current or actual and ideal body size, is important for addressing body-related issues and preventing adverse sequelae. Two aims were to: 1) examine demographic differences in body image discrepancy; and 2) determine the association of body image discrepancy with weight status, percent body fat, physical activity, sedentary behavior, and cardiovascular (CV) fitness among young adolescent girls. Methods The cross-sectional study included a secondary analysis of baseline data from a group randomized controlled trial including 1519 5th–8th grade girls in 24 U.S. schools. Girls completed physical activity and sedentary behavior surveys. To indicate perceived current/actual and ideal body image, girls selected from nine body figures the one that represented how they look now and another showing how they want to look. Girls wore accelerometers measuring physical activity. Height, weight, and percent body fat were assessed. The Progressive Aerobic CV Endurance Run was used to estimate CV fitness. Independent t-test, one- and two-way ANOVA, correlational analyses, and hierarchical linear regressions were performed. Results The majority (67.5%; n = 1023) chose a smaller ideal than current/actual figure. White girls had higher body image discrepancy than Black girls (p = .035). Body image discrepancy increased with increasing weight status (F3,1506 = 171.32, p < .001). Moderate-to-vigorous physical activity (MVPA) and vigorous physical activity were negatively correlated with body image discrepancy (r = −.10, p < .001; r = −.14, p < .001, respectively), but correlations were not significant after adjusting for race and body mass index (BMI), respectively. Body image discrepancy was moderately correlated with CV fitness (r = −.55, p < .001). After adjusting for demographics, percent body fat, but not CV fitness or MVPA, influenced body image discrepancy. Girls with higher percent body fat had higher body image discrepancy (p < .001). Conclusion This study provided important information to guide interventions for promoting a positive body image among girls. Trial registration ClinicalTrials.gov Identifier NCT01503333 , registration date: January 4, 2012.https://deepblue.lib.umich.edu/bitstream/2027.42/139721/1/12887_2017_Article_952.pd

Biological and Sociocultural Differences in Perceived Barriers to Physical Activity

BACKGROUND:Inadequate physical activity (PA) contributes to the high prevalence of overweight and obesity among U.S. adolescent girls. Barriers preventing adolescent girls from meeting PA guidelines have not been thoroughly examined. OBJECTIVES: The threefold purpose of this study was to (a) determine pubertal stage, racial/ethnic, and socioeconomic status (SES) differences in ratings of interference of barriers to PA; (b) examine relationships between perceived barriers and age, body mass index, recreational screen time, sedentary activity, and PA; and (c) identify girls\u27 top-rated perceived barriers to PA. METHODS: Girls (N = 509) from eight Midwestern U.S. schools participated. Demographic, pubertal stage, perceived barriers, and recreational screen time data were collected via surveys. Height and weight were measured. Accelerometers measured sedentary activity, moderate-to-vigorous PA (MVPA), and light plus MVPA. RESULTS: Girls of low SES reported greater interference of perceived barriers to PA than those who were not of low SES (1.16 vs. 0.97, p = .01). Girls in early/middle puberty had lower perceived barriers than those in late puberty (1.03 vs. 1.24, p \u3c .001). Girls\u27 perceived barriers were negatively related to MVPA (r = -.10, p = .03) and light plus MVPA (r = -.11, p = .02). Girls\u27 top five perceived barriers included lack of skills, hating to sweat, difficulty finding programs, being tired, and having pain. DISCUSSION: Innovative interventions, particularly focusing on skill development, are needed to assist girls in overcoming their perceived barriers to PA