Bibliography
Bibliography — Nutrition
This section contains articles that address
factors associated with health behavior and health status
and school-based strategies to improve healthy eating among
children and adolescents.
Research
Ethnicity and Diet of Children: Development of Culturally Sensitive Measures
Mozhdeh B. Bruss, Brooks Applegate, Jackie Quitugua, Rosa T. Palacios, and Joseph R. Morris
Health Education & Behavior, Oct 2007; vol. 34: 735 - 747.
Obesity is a growing global concern. Examining dietary habits of individuals can facilitate the development of important prevention approaches, which are needed to decrease the incidence of obesity and other related diseases and improve quality of life indices. Because food preferences and dietary habits vary across cultures, it is essential that prevention programs are based on specific populations. Using both ethnographic and quantitative methods, food-consumption patterns were investigated among 1,125 children in the Commonwealth of the Northern Mariana Islands. Differences were observed related to food frequency, age of children, and grade level. Exploratory factor analyses suggested that the individual foods were best organized into food-consumption groups that reflected cultural characteristics rather than more commonly referenced food organizational systems. In addition to developmental differences in food consumption patterns, results suggest that the ethnicity of parents may play a role in the diet of children.
Healthy Youth Places: A Randomized Controlled Trial to Determine the Effectiveness of Facilitating Adult and Youth Leaders to Promote Physical Activity and Fruit and Vegetable Consumption in Middle Schools
David A. Dzewaltowski, Paul A. Estabrooks, Greg Welk, Jennie Hill, George Milliken, Kostas Karteroliotis, and Judy A. Johnston
Health Education & Behavior, Jun 2009; vol. 36: 583 - 600.
The Healthy Youth Places (HYP) intervention targeted increased fruit and vegetable consumption (FV) and physical activity (PA) through building the environmental change skills and efficacy of adults and youth. HYP included group training for adult school site leaders, environmental change skill curriculum, and youth-led FV and PA environment change teams. Sixteen schools were randomized to either implement the HYP program or not. Participants (N =1,582) were assessed on FV and PA and hypothesized HYP program mediators (e.g., proxy efficacy) at the end of sixth grade (baseline), seventh grade (Postintervention Year 1), and eighth grade (Postintervention Year 2). After intervention, HYP schools did not change in FV but did significantly change in PA compared to control schools. Proxy efficacy to influence school PA environments mediated the program effects. Building the skills and efficacy of adults and youth to lead school environmental change may be an effective method to promote youth PA.
Coaching Process Outcomes of a Family Visit Nutrition and Physical Activity Intervention
Jerianne Heimendinger, Terry Uyeki, Aurielle Andhara, Julie A. Marshall, Sharon Scarbro, Elaine Belansky, and Lori Crane
Health Education & Behavior, Feb 2007; vol. 34: 71 - 89.
The purpose of this article is to report the process outcomes of a coaching methodology used in a study designed to increase fruit and vegetable consumption and physical activity in families. Eighty-eight families with second graders were recruited from a rural, biethnic community in Colorado and randomized to intervention and delayed intervention conditions. This article reports on the 27 families in the delayed intervention group. Families received up to 10 home visits over 10 months from a family advisor and completed activities to improve their dietary and physical activity behaviors. Coaching conversations took place during each home visit. Coaching process outcomes were evaluated by analysis of visit documentation, participant survey, and qualitative interviews. Results indicated that coaching, in conjunction with family activities, engaged families in the process of change and facilitated movement toward the achievement of their weekly nutrition or physical activity goals. Coaching methodology may be particularly useful for participatory research.
Developing School-Based BMI Screening and Parent Notification Programs: Findings From Focus Groups With Parents of Elementary School Students
Martha Young Kubik, Mary Story, Gayle Rieland
Health Education & Behavior, 2007; vol. 34, (4): 622-633.
School-based body mass index (BMI) screening and parent notification programs have been advanced as an obesity prevention strategy. However, little is known about how to develop and implement programs. This qualitative study explored the opinions and beliefs of parents of elementary school students concerning school-based BMI screening programs, notification methods, message content, and health information needs related to promoting healthy weight for school-aged children. Ten focus groups were conducted with 71 participants. Parents were generally supportive of school-based BMI screening. However, they wanted assurance that student privacy and respect would be maintained during measurement and that BMI results would be provided to parents in a neutral manner that avoided weight labeling. They also believed that aggregate results should be disseminated to the larger school community to support healthy change in the nutrition and physical activity environments of schools. Implications for practitioners and researchers are discussed.
Influence of Social Context on Eating, Physical Activity, and Sedentary Behaviors of Latina Mothers and Their Preschool-Age Children
Ana C. Lindsay, Katarina M. Sussner, Mary L. Greaney, and Karen E. Peterson
Health Education & Behavior, Feb 2009; vol. 36: 81 - 96.
As more U.S. children grow up in Latino families, understanding how social class, culture, and environment influence feeding practices is key to preventing obesity. The authors conducted six focus groups and 20 in-depth interviews among immigrant, low-income Latina mothers in the Northeast United States and classified 17 emergent themes from content analysis according to ecologic frameworks for behavior change. Respondents related environmental influences to child feeding, diet, and activity, namely, supermarket proximity, food cost, access to recreational facilities, neighborhood safety, and weather. Television watching was seen as integral to family life, including watching during meals and using TV as babysitter and tool to learn English. Participation in the WIC program helped families address food insecurity, and child care provided healthy eating and physical activity opportunities. Health promotion efforts addressing obesity trends in Latino children must account for organizational and environmental influences on the day-to-day social context of young immigrant families.
Lunchtime Practices and Problem Behaviors Among Multiethnic Urban Youth
Tracy R. Nichols, Amanda S. Birnbaum, Kylie Bryant, and Gilbert J. Botvin
Health Education & Behavior, Jun 2009; vol. 36: 570 - 582.
Research has begun to show associations between adolescents' mealtime practices and their engagement in problem behaviors. Few studies have addressed this longitudinally and/or examined lunchtime practices during the school day. This study tests for associations between urban multiethnic middle school students' (N = 1498) lunchtime practices in the sixth grade and their engagement in problem behaviors by eighth grade. Positive associations were found between not eating lunch at school in the sixth grade and increased drug use and delinquency by eighth grade. Eating lunch outside of school was found to be significantly associated with smoking and marijuana use only. Gender differences in associations between lunchtime practices and problem behaviors were suggested. Implications for school policy and prevention efforts are discussed.
The Effects of School Gardens on Students and Schools: Conceptualization and Considerations for Maximizing Healthy Development
Emily J. Ozer
Health Education & Behavior, 2007; vol. 34, (6): 846-863.
There are thousands of school gardens in the United States, and there is anecdotal evidence that school garden programs can enhance students' learning in academic, social, and health-related domains. There has been little rigorous research, however, on the effects of school gardens or on the factors that promote the sustainability of these programs. This review draws on ecological theory to conceptualize school gardens as systemic interventions with the potential for promoting the health and well-being of individual students in multiple interdependent domains and for strengthening the school environment as a setting for positive youth development. This review (a) summarizes the small literature regarding the impact of school garden curricula on student or school functioning, (b) provides a conceptual framework to guide future inquiry, (c) discusses implications of this conceptualization for practice, and (d) suggests further research needed to better inform practice.
A Validation and Reliability Study of the Physical Activity and Healthy Food Efficacy Scale for Children (PAHFE)
Christina M. Perry, R.J. De Ayala, Ryan Lebow, and Emily Hayden
Health Education & Behavior, Jun 2008; vol. 35: 346 - 360.
The purpose of this study was to obtain validity evidence for the Physical Activity and Healthy Food Efficacy Scale for Children (PAHFE). Construct validity evidence identifies four subscales: Goal-Setting for Physical Activity, Goal-Setting for Healthy Food Choices, Decision-Making for Physical Activity, and Decision-Making for Healthy Food Choices. The scores on each of these subscales show a moderate to high degree of internal consistency (0.59    0.87). The Decision-Making for Healthy Food Choice subscale and the Decision-Making for Physical Activity subscale scores show significant convergent validity evidence. These results provide support for using this self-efficacy scale to measure children's perceived confidence to make decisions about healthy eating and physical activity. The PAHFE may be considered to be a useful predictor of both physical activity and eating behaviors.
The Impact of Removing Snacks of Low Nutritional Value From Middle Schools
Marlene B. Schwartz, Sarah A. Novak, and Susan S. Fiore
Health Education & Behavior, Feb 2009; vol. 0: 1090198108329998v1.
Removing low nutrition snacks from schools is controversial. Although the objective is to decrease the consumption of these foods at school, some critics argue that children will compensate by eating more of these foods at home. Others worry that school-based obesity prevention programs will increase student preoccupation with weight. The present study examines these concerns. Three middle schools replaced snacks and beverages that did not meet nutrition guidelines, whereas three comparison schools made no systematic changes. Students were surveyed about dietary intake and weight concerns before and after implementation of the intervention. Findings indicate that removing low nutrition items from schools decreased students’ consumption with no compensatory increase at home. Furthermore, there were no differences in students’ reported weight concerns. These results support the value of strengthening school nutrition standards to improve student nutrition and provide evidence dispelling concerns that such efforts will have unintended negative consequences.
Association Between Fruit and Vegetable Consumption in Mothers and Children in Low-Income, Urban Neighborhoods
Marie-Pierre Sylvestre, Jennifer O'Loughlin, Katherine Gray-Donald, James Hanley, and Gilles Paradis
Health Education & Behavior, 2007; Vol. 34 (5): 723-734
To understand factors influencing fruit and vegetable (F&V) consumption in children, the authors studied the association between F&V consumption in mothers and children in a sample of 1,106 boys and girls in Grades 4-6 in 24 elementary schools in low-income, multiethnic neighborhoods in Montreal, Canada. Approximately 10% of girls and 19% of boys reported not having eaten any vegetables in the week prior to questionnaire administration; 53% of girls and 63% of boys did not consume whole fruits daily. Each unit increase in F&V consumption in mothers was associated with a 10% to 20% increase in F&V consumption in children. Interventions to improve F&V consumption should aim to improve awareness among parents of the importance of fruits and vegetables and of the impact of their own behavior on their children's F&V consumption.
Practice
This section contains articles addressing the effectiveness and practical application of child and adolescent school health nutrition programs and policies.
Hi5+: Systematic Development of a Family Intervention to Increase Fruit and Vegetable Intake
Susan L. Davies, Kathleen Harrington, Frank A. Franklin, Richard M. Shewchuk, Michelle L. Feese, and Michael Windle
Health Promotion Practice, Apr 2005; Vol. 6 (2): 190-201.
This article describes the development of a peer-led home-based intervention to increase fruit and vegetable (FV) intake and family interaction among fourth graders and their families. Hi5+ intervention content and delivery strategies were developed using two complementary processes: cognitive mapping (CM), a consumer-based approach to identifying salient issues, and intervention mapping (IM), a comprehensive planning model. Step 1 involved creating plans to guide the design, implementation, and evaluation of Hi5+. We delineated our performance objectives and then prioritized those determinants we felt were most salient and changeable. Step 2 involved selecting and utilizing cognitive and behavioral theory constructs to develop intervention methods and strategies. Step 3 involved designing and pilot testing the instructional materials and other intervention components. Step 4 entailed developing plans for program adoption and implementation, while the final step (Step 5) involved creating a comprehensive evaluation plan. Implications of this multi-step approach to intervention development are discussed.
Responses of Health and Physical Educators to Overweight Children in Alabama
Brian F. Geiger, Sandra K. Sims, Retta Evans, Jane Roy, Karen A. Werner, Marilyn Prier, Karen Cochrane, Jason S. Fulmore, Verdell Lett Dawson, Smyly Kirkpatrick, and Dan Brown
Health Promotion Practice, Jan 2009; vol. 10: 111 - 118.
The purpose of this article is to provide an overview of the increasing problem of overweight children in Alabama including clinical definition, risk factors, and prevalence data. Health and physical educators should become familiar with guidelines released by national organizations, such as the Centers for Disease Control and Prevention, the Institute of Medicine, and state departments of education and public health. These guidelines provide direction to health promotion program activities in schools, community, and recreational settings aimed at modifying predisposing, reinforcing, and enabling factors. Four examples are presented in the narrative to illustrate collaborative partnerships among health care organizations, a health insurer, public schools, an academic research university, and state agencies to enhance youth health. The final section provides practical recommendations for professional health and physical educators regarding obesity risk reduction.
Implementation of a Family Intervention to Increase Fruit and Vegetable Intake: The Hi5+ Experience
Kathleen F. Harrington, Frank A. Franklin, Susan L. Davies, Richard M. Shewchuk, and Maria Brown Binns
Health Promotion Practice, Apr 2005; vol. 6: 180 - 189.
Family is an important, yet challenging, target for dietary intervention. This article describes the implementation of Hi5+, a family fruit and vegetable (FV) promotion program. Complementing a fourth-grade school curriculum, the seven weekly Family Fun Nites were at-home family meal sharing and game evenings. A sample of families (N = 575; 69% consented) from schools in a southeastern U.S. urban area received tailored intervention materials based on their FV attitudes and family interaction styles. A pyramidal organizational design, using peer leaders, facilitated 71% of families to complete all seven sessions, whereas 84% completed at least one session. Significant independent predictors of program completion were attending an introductory Kick-Off Nite, interactive family style, additional adults in the household, married parents, being African American, earning more than $60,000, and additional children in the household. Family specific issues and initial program experience are important considerations for implementing a family intervention.
Steps to a Healthier New York: Rock on Cafe: Achieving Sustainable Systems Changes in School Lunch Programs
Yvonne Johnston, Ray Denniston, Molly Morgan, and Mark Bordeau
Health Promotion Practice, Apr 2009; vol. 10: 100S - 108S.
The rising rate of overweight poses a significant threat to the health of children. Because roughly one third of a child's dietary intake occurs during school hours and because both health and academic outcomes have been linked to children's nutrition, school nutrition policies and programs have been identified as a key area for intervention. This article describes the components, processes, and initial successes of a grassroots effort and innovative project to improve the nutritional quality of the School Lunch Program through a sustainable systems intervention and policy change across a regional area of upstate New York. The Rock on Cafe intervention was partially funded by the Steps to a Healthier New York program and promises to be a model for creating a school environment that supports healthy dietary behaviors among children.
Participatory Prevention Research Model Promotes Environmental Change for Healthier Schools
Mike Prelip, Wendelin M. Slusser, Linda Lange, Stephanie Vecchiarielli, and Charlotte Neumann
Health Promotion Practice, Dec 2008; vol. 0: 1524839908321608v1.
Barriers exist to healthy eating and physical activity for children in the school environment. Modifiable school environmental factors have led to the development of the Nutrition Friendly Schools and Communities (NFSC) model to prevent the development of overweight in school children and adolescents. The design of the NFSC environmental intervention is to actively engage the school community to prevent overweight in school-aged children. This article presents data measuring the environmental changes achieved by the Los Angeles Unified School District (LAUSD) elementary schools participating in a 3-year participatory research pilot study funded by the Centers for Disease Control and Prevention (CDC). An objective of the pilot study is to determine whether any or all of the 15 steps developed for the NFSC model could be implemented. Further, researchers want to know if any of the study schools could implement the NFSC model as a whole during the allotted time of the pilot study.
Be a Fit Kid: Nutrition and Physical Activity for the Fourth Grade
Jennifer N. Slawta and Daniel DeNeui
Health Promotion Practice, Jan 2009; vol. 0: 1524839908328992v1.
This article describes the inclusion of Be a Fit Kid in the fourth-grade curriculum. Be a Fit Kid is a fitness-emphasized physical activity and heart-healthy nutrition education program for elementary school children. Five parent–education lessons were offered and nutrition workbooks were distributed to parents. Following the 10- week intervention, significant improvements in fitness, body fat, nutrition knowledge, dietary habits, and levels of lipids and lipoproteins were observed in the intervention group compared with baseline levels. Changes in fitness, body fat, and nutrition knowledge were significant compared with the control group. These findings suggest that comprehensive physical activity and nutrition programs included in the school curriculum may be effective for improving cardiovascular health and reducing future risk for lifestyle-related diseases.
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