Healthy Out of School Time: Developing National Quality Standards for Healthy Eating and Physical Activity

Afternoon programs are an important venue for promoting healthy eating and physical activity in children and youth. This project, co-led by investigators at the Institute on Out-of-School Time (NIOST), UMass Boston, and YMCA of the USA, used quantitative and qualitative methods to assess and respond to the need for national standards for healthy eating and physical activity in afterschool programs. This presentation provides an overview of this translational research with emphasis on development and dissemination of the evidence-based national guidelines for health eating and physical activity in afterschool programs

Role of inflammatory monocytes in adolescent metabolic syndrome

Metabolic syndrome (MetSyn) is a cluster of risk factors for cardiovascular disease and diabetes that affects 1 in 3 obese children. Inflammatory cytokines secreted from macrophages are thought to be partly responsible for the metabolic abnormalities associated with MetSyn. This study aimed to determine whether peripheral blood monocytes (macrophage precursors) from overweight individuals with MetSyn (Overwt-MetSyn) demonstrate enhanced activation of inflammatory signaling pathways when compared to metabolically normal overweight (Overwt-Healthy) or lean individuals. We conducted a cross sectional pilot study involving 24 adolescents (six boys and eighteen girls) recruited from the University of Massachusetts Boston and Worcester campuses. Six subjects were classified as Overwt-MetSyn using a modified definition proposed by the International Diabetes Federation. The Overwt-MetSyn group demonstrated an elevated expression of TLR2 and TLR4 in peripheral monocytes, and increased circulating levels of TNFa and IL6. Expression of TLR2 and TLR4 showed a positive correlation with circulating cytokines, and expression of TNFa correlated with waist circumference and BMI. Metabolic syndrome in adolescents is associated with increased activation of the TLR signaling pathway in monocytes. The knowledge gained from this study will advance our understanding of the contribution of monocytes to the pathophysiology of MetSyn

Developing a Tool to Assess the Capacity of Out-of-School Time Program Providers to Implement Policy, Systems, and Environmental Change

BACKGROUND: Little is known about public health practitioners' capacity to change policies, systems, or environments (PSEs), in part due to the absence of measures. To address this need, we partnered with the Alliance for a Healthier Generation (Alliance) to develop and test a theory-derived measure of the capacity of out-of-school time program providers to improve students' level of nutrition and physical activity through changes in PSEs. COMMUNITY CONTEXT: The measure was developed and tested through an engaged partnership with staff working on the Alliance's Healthy Out-of-School Time (HOST) Initiative. In total, approximately 2,000 sites nationwide are engaged in the HOST Initiative, which serves predominantly high-need children and youths. METHODS: We partnered with the Alliance to conduct formative work that would help develop a survey that assessed attitudes/beliefs, social norms, external resources/supports, and self-efficacy. The survey was administered to providers of out-of-school time programs who were implementing the Alliance's HOST Initiative. OUTCOME: Survey respondents were 185 out-of-school time program providers (53% response rate). Exploratory factor analysis yielded a 4-factor model that explained 44.7% of the variance. Factors pertained to perceptions of social norms (6 items) and self-efficacy to build support and engage a team (4 items) and create (5 items) and implement (3 items) an action plan. INTERPRETATION: We report initial development and factor analysis of a tool that the Alliance can use to assess the capacity of after-school time program providers, which is critical to targeting capacity-building interventions and assessing their effectiveness. Study findings also will inform the development of measures to assess individual capacity to plan and implement other PSE interventions

Development of Healthy Eating and Physical Activity Quality Standards for Out-of-School Time Programs

Abstract Background: Out-of-school time (Ost) programs serve over 8 million children per year and have ample opportunity to promote health through menu and physical activity choices. Until recently, however, the field has lacked a comprehensive set of operationalizable standards for healthy eating and physical activity. the National Afterschool Association adopted voluntary healthy eating and physical activity quality standards (HePAQs) in April, 2011. Methods: We describe the development of HePAQs. this work reflects a social ecological model for changing children's eating and activity behaviors through program-level interventions. the standards were developed using a national, mixed-methods needs assessment, review of existing standards and expert recommendations, and a participatory process of discussion, review, and consensus engaging 19 influential service and policy organizations and agencies in the Healthy Out-of-school time (HOst) coalition, which we convened in 2009. Results: the HOst coalition approved a final version of the HePAQs in January, 2011. the 11 standards address content, curriculum selection, staff training, program support, and environmental support for healthy eating and physical activity. in April, 2011, the HePAQs were adopted by the National Afterschool Association, and have subsequently been widely disseminated. extensive adoption and implementation efforts are underway. Conclusions: the availability of a comprehensive set of standards for healthy eating and physical activity in Ost provides practical information to help community-based youth-serving organizations participate in obesity and chronic disease prevention. A working awareness of their content will be useful to scientists undertaking health promotion studies in the out-of-school time setting

Play Across Boston: A Community Initiative to Reduce Disparities in Access to After-School Physical Activity Programs for Inner-City Youths

Background: In 1999, the Centers for Disease Control and Prevention (CDC) funded Play Across Boston to address disparities in access to physical activity facilities and programs for Boston, Mass, inner-city youths. Context: Local stakeholders worked with the Harvard School of Public Health Prevention Research Center and Northeastern University's Center for the Study of Sport in Society to improve opportunities for youth physical activity through censuses of facilities and programs and dissemination of results. Methods: Play Across Boston staff conducted a facility census among 230 public recreational complexes and a program census of 86% of 274 physical activity programs for Boston inner-city youths aged 5 to 18 years during nonschool hours for the 1999 to 2000 school year and summer of 2000. Comparison data were collected from three suburban communities: one low income, one medium income, and one high income. Consequences: Although Boston has a substantial sports and recreational infrastructure, the ratio of youths to facilities in inner-city Boston was twice the ratio found in the medium- and high-income suburban comparison communities. The low-income suburban comparison community had the highest number of youths per recreational facility with 137 youths per facility, followed by Boston with 117 youths per facility. The ratio of youths to facilities differed among Boston neighborhoods. Boston youths participated less in school-year physical activities than youths in medium- and high-income communities, and less advantaged Boston neighborhoods had lower levels of participation than more advantaged Boston neighborhoods. Girls participated less than boys. Interpretation: Play Across Boston successfully developed and implemented a rigorous needs assessment with local relevance and important implications for public health research on physical activity and the environment. Boston Mayor Thomas M. Menino called the Play Across Boston report a "playbook" for future sports and recreation planning by the city of Boston and its community partners

Directional silicon nano-antennas for quantum emitter control designed by evolutionary optimization

We optimize silicon nano-antennas to enhance and steer the emission of local quantum sources. We combine global evolutionary optimization (EO) with frequency domain electrodynamical simulations, and compare design strategies based on resonant and non-resonant building blocks. Specifically, we investigate the performance of models with different degrees of freedom but comparable amount of available material. We find that simpler geometric models allow significantly faster convergence of the optimizer, which, expectedly, comes at the cost of a reduced optical performance. We finally analyze the physical mechanisms underlying the directional emission that also comes with an emission rate enhancement, and find a surprising robustness against perturbations of the source emitter location. This makes the structures highly interesting for actual nano-fabrication. We believe that optimized, all-dielectric silicon nano-antennas have high potential for genuine breakthroughs in a multitude of applications in nanophotonics and quantum technologies.Comment: 8 pages, 6 figure

School-Based Programs: Lessons Learned from CATCH, Planet Health, and Not-On-Tobacco

Establishing healthy habits in youth can help prevent many chronic health problems later in life that are attributable to unhealthy eating, sedentary lifestyle, and overweight. For this reason, many public health professionals are interested in working with school systems to reach children in school settings. However, a lack of familiarity with how schools operate can be a substantial impediment to developing effective partnerships with schools. We describe lessons learned from three successful school health promotion programs that were developed and disseminated through collaborations between public health professionals, academic institutions, and school personnel. The programs include two focused on physical activity and good nutrition for elementary and middle school children — Coordinated Approach to Child Health (CATCH) and Planet Health — and one focused on smoking cessation among adolescents — Not-On-Tobacco (N-O-T). Important features of these school health programs include 1) identification of staff and resources required for program implementation and dissemination; 2) involvement of stakeholders (e.g., teachers, students, other school personnel, parents, nonprofit organizations, professional organizations) during all phases of program development and dissemination; 3) planning for dissemination of programs early in the development and testing process; and 4) rigorous evaluation of interventions to determine their effectiveness. The authors provide advice based on lessons learned from these programs to those who wish to work with young people in schools

Effects of a multicomponent wellness intervention on dyslipidemia in an overweight adolescent population

Epidemiologic studies suggest that atherosclerotic processes begin in childhood and are associated with abnormal lipid levels. Behavioral changes are the first line of treatment for dyslipidemia in adolescents but outcome data on the effectiveness of this approach are inconsistent. This study aimed to assess the effect of a 13-week multicomponent wellness intervention program on dyslipidemia in lean and overweight/obese adolescents enrolled at a public high school in Boston, Massachusetts. The intervention was conducted at a university-based youth fitness center where 9 overweight/obese adolescents (body mass index [BMI]≥85th percentile for age and sex) and 9 lean adolescents (BMIsex) participated in weekly nutrition classes and structured cardiovascular, flexibility and strength training 2 times/week for 5 weeks, followed by up to 4 times/week for 8 weeks. Clinical measurements (BMI, percent body fat, blood pressure [BP]) and lipid profile assessment (total cholesterol [TC], high-density lipoprotein cholesterol [HDL-C], triglycerides [TG], and low-density lipoprotein cholesterol [LDL-C]) were performed at baseline and at completion of the intervention. At the completion of the study, the overweight/obese adolescents demonstrated a 15% increase in HDL-C levels (mean, 47 mg/dL vs 54 mg/dL) while there was no improvement in BMI, percent body fat, BP,TG, TC and LDL-C. The participants in the lean group showed no change in their anthropometric and serum parameters. A multicomponent wellness intervention resulted in a significant increase of cardioprotective HDL-C levels which has been associated with coronary health in adulthood. The long-term effects of this intervention on indicators of cardiometabolic health and others like it require further study