Validating fourth-grade students' self-report of dietary intake: results from the 5 A Day Power Plus program.
Explore the source record for details and available documents.
Child↗
Biomedical subjects
C L Perry
Publications and source records attributed to C L Perry.
Predictors of overweight and overfatness in a multiethnic pediatric population. Child and Adolescent Trial for Cardiovascular Health Collaborative Research Group.
The goal of the study was to determine whether overweight or overfatness were predicted from sex, race or ethnicity, school site, and intervention or control status for children who were 9 y old at the outset of the Child and Adolescent Trial for Cardiovascular Health (CATCH). In this ethnically and geographically diverse group of 5106 students, height, weight, and triceps skinfold thickness were measured at 9 (baseline) and 11 y (follow-up) of age. The strongest predictors of status at follow-up were baseline overweight (odds ratio: 69.0; 95% CI: 54.9, 96.3) and overfatness (odds ratio: 27.4; 95% CI: 22.4, 33.4); site, African American race or ethnicity, and male sex were also significant independent associations. Children in the overweight (> 85th percentile for body mass index) group had significantly higher adjusted means for total blood cholesterol, higher apolipoprotein B concentrations, lower mean HDL-cholesterol concentrations, and lower performance on the 9-min run than those in other groups (< 15th, 15-49th, or 50-85th body mass index percentiles). Similar results were found for these factors for those subjects with greater triceps skinfold-thickness measurements. Groups of children who were overweight and overfat at baseline were more likely to be overweight and overfat at follow-up and to have more cardiovascular risk factors than their peers.
Apolipoproteins B↗
A novel PCR-based methodology to determine TAP allele frequencies in population studies.
The TAP genes have been extensively studied as candidate susceptibility genes for autoimmune and infectious diseases. TAP1 and TAP2 have two and three polymorphic sites respectively which are used for the allele assignment following WHO nomenclature. The usual techniques employed to determine the TAP alleles cannot unequivocally ascertain the alleles present in subjects which are heterozygous at more than one polymorphic position within the genes. This results in an inability to determine absolute TAP allele frequencies in population studies. The aim of this study was to devise a PCR-based method to unambiguously assign TAP alleles to all subjects. The novel method was tested in Oriental Type I diabetic and control subjects. The technique is a valuable tool for allele assignment in heterozygous subjects solely using PCR.
Alleles↗
Changing fruit and vegetable consumption among children: the 5-a-Day Power Plus program in St. Paul, Minnesota.
OBJECTIVES: A randomized school based trial sought to increase fruit and vegetable consumption among children using a multicomponent approach. METHODS: The intervention, conducted in 20 elementary schools in St. Paul, targeted a multiethnic group of children who were in the fourth grade in spring 1995 and the fifth grade in fall 1995. The intervention consisted of behavioral curricula in classrooms, parental involvement, school food service changes, and industry support and involvement. Lunchroom observations and 24-hour food recalls measured food consumption. Parent telephone surveys and a health behavior questionnaire measured psychosocial factors. RESULTS: The intervention increased lunchtime fruit consumption and combined fruit and vegetable consumption, lunchtime vegetable consumption among girls, and daily fruit consumption as well as the proportion of total daily calories attributable to fruits and vegetables. CONCLUSIONS: Multicomponent school-based programs can increase fruit and vegetable consumption among children. Greater involvement of parents and more attention to increasing vegetable consumption, especially among boys, remain challenges in future intervention research.
Child↗
School and community influences on adolescent alcohol and drug use.
Social environment risk factors present in schools and communities have not been thoroughly investigated. This study cross-sectionally examined the social environments of schools and communities, and their influence on adolescent alcohol and drug use. Survey responses of eighth grade students (N = 2309), a random half of their parents (n = 943), community leaders (n = 118), school principals (n = 30), school counselors (n = 30) and chemical health providers (n = 14) were pooled to create indices of social environmental norms, role models, social support and opportunities for non-use of alcohol. Each index was examined for its association with prevalences from 30 schools of alcohol use onset, last-month alcohol use, heavy alcohol use and last-year marijuana use in univariate and stepwise regression analyses. Increases in the levels of norms, role models and opportunities for non-use predicted decreases in alcohol use prevalences. The explanatory power of the examined constructs in multivariate analyses was acceptably high (R2: 38-53%). These findings further support the notion that community-wide efforts need to be launched to affect changes in the normative, role model and opportunity structures of adolescents' social environments in order to curb adolescent alcohol and drug use.
Adolescent↗
The Child and Adolescent Trial for Cardiovascular Health (CATCH): intervention, implementation, and feasibility for elementary schools in the United States.
The Child and Adolescent Trial for Cardiovascular Health (CATCH) was the largest school-based field trial ever sponsored by the National Institutes of Health. The trial demonstrated positive changes in the school food service and physical education program, as well as in students' cardiovascular health behaviors. Because the CATCH intervention programs were implemented in 56 schools (in four states) that were typical of schools throughout the United States, their reception by schools and degree of implementation provide evidence about their feasibility for schools nationally. Extensive process evaluation data were collected from students, teachers, school food service personnel, and physical education specialists throughout the three school years of the CATCH intervention. Four of the CATCH programs--school food service, physical education, classroom curricula, and home programs--were assessed over the three school years. The process data provide information on participation, dose, fidelity, and compatibility of the CATCH programs in the intervention schools for these programs. High levels of participation, dose, fidelity, and compatibility were observed for the four programs during the 3 school years. CATCH emerges as a model of a feasible multilevel health promotion program to improve eating and exercise behaviors for elementary schools in the United States.
Adolescent↗
Outcomes of a field trial to improve children's dietary patterns and physical activity. The Child and Adolescent Trial for Cardiovascular Health. CATCH collaborative group.
OBJECTIVE: To assess the outcomes of health behavior interventions, focusing on the elementary school environment, classroom curricula, and home programs, for the primary prevention of cardiovascular disease. DESIGN: A randomized, controlled field trial at four sites with 56 intervention and 40 control elementary schools. Outcomes were assessed using prerandomization measures (fall 1991) and follow-up measures (spring 1994). PARTICIPANTS: A total of 5106 initially third-grade students from ethnically diverse backgrounds in public schools located in California, Louisiana, Minnesota, and Texas. INTERVENTION: Twenty-eight schools participated in a third-grade through fifth-grade intervention including school food service modifications, enhanced physical education (PE), and classroom health curricula. Twenty-eight additional schools received these components plus family education. MAIN OUTCOME MEASURES: At the school level, two primary end points were changes in the fat content of food service lunch offerings and the amount of moderate-to-vigorous physical activity in the PE programs. At the level of the individual student, serum cholesterol change was the primary end point and was used for power calculations for the study. Individual level secondary end points included psychological factors, recall measures of eating and physical activity patterns, and other physiologic measures. RESULTS: In intervention school lunches, the percentage of energy intake from fat fell significantly more (from 38.7% to 31.9%) than in control lunches (from 38.9% to 36.2%)(P<.001). The intensity of physical activity in PE classes during the Child and Adolescent Trial for Cardiovascular Health (CATCH) intervention increased significantly in the intervention schools compared with the control schools (P<.02). Self-reported daily energy intake from fat among students in the intervention schools was significantly reduced (from 32.7% to 30.3%) compared with that among students in the control schools (from 32.6% to 32.2%)(P<.001). Intervention students reported significantly more daily vigorous activity than controls (58.6 minutes vs 46.5 minutes; P<.003). Blood pressure, body size, and cholesterol measures did not differ significantly between treatment groups. No evidence of deleterious effects of this intervention on growth or development was observed. CONCLUSION: The CATCH intervention was able to modify the fat content of school lunches, increase moderate-to-vigorous physical activity in PE, and improve eating and physical activity behaviors in children during 3 school years.
Analysis of Variance↗
Self-esteem and change in body mass index over 3 years in a cohort of adolescents.
Self-esteem has been hypothesized to be lower in obese adolescents relative to their normal weight peers and to be an important factor in preventing or reversing obesity. The present study examined the relationship between obesity and self-esteem cross-sectionally and prospectively over three years in a cohort of 1278 adolescents in grades 7 to 9 at baseline. Cross-sectional analyses revealed an inverse association between physical appearance self-esteem and body mass index in both males and females. In females, body mass index was inversely associated with global self-esteem, close friendship, and behavioral conduct self-esteem. In males, body mass index was inversely associated with athletic and romantic appeal self-esteem. Prospectively, in females, physical appearance and social acceptance self-esteem at baseline were inversely related to body mass index three years later. Baseline self-esteem was unrelated prospectively to change in body mass index in males. All associations were modest in magnitude. These results suggest that in a middle class white sample of adolescents, self-esteem specific to physical appearance is modestly associated with body mass index. Low self-esteem does not appear to predict the development of obesity over time.
Adolescent↗
Peer-planned social activities for preventing alcohol use among young adolescents.
The Project Northland peer participation program tested the feasibility of involving students in the planning and promotion of alcohol-free social activities for their peers and to determine whether such participation was associated with reduced alcohol use. The peer program was offered in 20 northeastern Minnesota schools when the study cohort was in seventh grade; students completed a survey in the beginning of sixth grade and at the end of sixth grade and seventh grade. Nearly 50% of the study cohort participated in the program. At the end of seventh grade, after controlling for confounders, an association was observed between student involvement with planning activities and a lower rate of alcohol use. This association was strongest among students who had reported alcohol use at the beginning of sixth grade. This cohort study suggests adolescent involvement in planning their own alcohol-free activities may be an efficacious strategy to prevent or reduce the prevalence of alcohol use among youth. Future studies are warranted to evaluate this association using experimental research designs.
Adolescent↗
Characteristics, policies and practices of alcohol outlets and sales to underage persons.
OBJECTIVE: A recent study found that many alcohol outlets sold alcohol to youthful-appearing study confederates. This article expands upon that work by exploring the linkages between the policies, practices and characteristics of outlets and their propensity to sell alcohol to persons under the legal drinking age. METHODS: Data on alcohol outlets are from a telephone survey of 100 establishments located in 28 communities in northeastern Minnesota that hold off-sale licenses for the sale of distilled spirits and/or full strength beer and wine. Alcohol purchase attempts were conducted in each outlet to provide a measure of propensity to sell alcohol to underage persons. Youthful-appearing study confederates conducted three separate purchase attempts in each outlet. Multiple linear regression was used to estimate the effects of outlet characteristics and policies on the purchase success rate. RESULTS: Bars were less likely than liquor stores or bar/liquor stores to sell to study confederates. Having a manager on the premises at all times was associated with a 15% lower purchase success rate in bars. Requiring formal training of bar staff involved in alcohol sales was associated with a 19% lower purchase success rate. No outlet characteristics or practices were associated with the purchase success rate in liquor stores and bar/liquor stores. CONCLUSIONS: These results underscore the importance of research and intervention focusing on alcohol outlet policies and practices that affect the propensity to sell alcohol to persons under the legal drinking age.
Adult↗
Project Northland: outcomes of a communitywide alcohol use prevention program during early adolescence.
OBJECTIVES: Project Northland is an efficacy trial with the goal of preventing or reducing alcohol use among young adolescents by using a multilevel, communitywide approach. METHODS: Conducted in 24 school districts and adjacent communities in northeastern Minnesota since 1991, the intervention targets the class of 1998 (sixth-grade students in 1991) and has been implemented for 3 school years (1991 to 1994). The intervention consists of social-behavioral curricula in schools, peer leadership, parental involvement/education, and communitywide task force activities. Annual surveys of the class of 1998 measure alcohol use, tobacco use, and psychosocial factors. RESULTS: At the end of 3 years, students in the intervention school districts report less onset and prevalence of alcohol use than students in the reference districts. The differences were particularly notable among those who were nonusers at baseline. CONCLUSIONS: The results of Project Northland suggest that multilevel, targeted prevention programs for young adolescents are effective in reducing alcohol use.
Adolescent↗
Cardiovascular risk factors among third grade children in four regions of the United States. The CATCH Study. Child and Adolescent Trial for Cardiovascular Health.
Data on cardiovascular risk factors (body mass index, triceps and subscapular skinfolds, blood pressure, serum total cholesterol, high density lipoprotein (HDL) cholesterol, and apolipoprotein B) were collected as part of the baseline examination (fall 1991) of the Child and Adolescent Trial for Cardiovascular Health, a multicenter school-based intervention study for promoting healthful behaviors. A total of 5,106 third grade children (mean age, 8.76 years) in four states (California, Louisiana, Minnesota, and Texas) were examined. After excluding 194 children of other or unknown origin, the study population consisted of 3,530 Anglo-American children, 674 African-American children, and 708 Latino children. African-American children were the tallest by 1-3 cm (p < 0.0001), while Latino children had the largest body mass index (p < 0.05). Blood pressure levels were similar for boys and girls and among the three races, but systolic levels were 2 mmHg higher in Texas than at the other sites. Serum total cholesterol levels were 5 mg/dl higher in girls than in boys (p < 0.05), while HDL cholesterol levels were 2 mg/dl higher in boys (p < 0.05). HDL cholesterol levels were highest in African-Americans (55.5 mg/dl) compared with Anglo-Americans (50.7 mg/dl) and Latinos (51.3 mg/dl) (p < 0.0001).
Analysis of Variance↗
Self-esteem and obesity in children and adolescents: a literature review.
The relationship between self-esteem and obesity has not received a great deal of empirical evaluation using strong research methodologies. Thus, it is not clear whether self-esteem is consistently related to obesity, whether the relationship is global or specific to physical appearance, whether the relationship differs by demographic variables such as age, gender or race/ethnicity, or whether self-esteem moderates weight changes during weight loss treatment programs. This review examines these questions using empirical evidence from 35 studies on the relationship between self-esteem and obesity in children and adolescents. Thirteen of 25 cross sectional studies clearly showed lower self-esteem in obese adolescents and children. Five of the six cross-sectional studies that included a measure of body esteem found lower body esteem in obese compared to normal weight children and adolescents. Results from two prospective studies examining initial self-esteem and later obesity were inconsistent. Results from six of eight treatment studies showed that weight loss treatment programs appear to improve self-esteem. However, it is unclear whether increases in self-esteem are related to enhanced weight loss. Many studies were methodologically weak primarily due to small and select samples and lack of appropriate comparison groups. Implications for prevention and treatment of childhood obesity are discussed.
Adolescent↗
Changes in psychological variables and health behaviors by dieting status over a three-year period in a cohort of adolescent females.
PURPOSE: Psychologic and behavioral changes associated with frequent dieting were examined. Compared to nondieters, frequent dieters were hypothesized to show more adverse psychologic changes and increased use of unhealthy weight control behaviors, but possibly healthier eating and exercise behavior changes, over the three-year period of observation. METHODS: A prospective study of female students, in grades 7-10 at baseline completed a health behavior survey in school once a year for a total of three years. RESULTS: Restrained eating, body dissatisfaction and drive for thinness, self-induced vomiting, laxative use, diet pill use, and alcohol use, significantly increased, and physical appearance and self-concept significantly decreased among frequent dieters, compared to non-dieters. Changes in scores on five EDI subscales, eight self-esteem subscales, weight fluctuations, dietary intake, and physical activity patterns did not significantly differ over time by dieting status. CONCLUSION: Dieting may reflect a general pattern of unhealthy behaviors adopted in adolescence, rather than act as a causal factor in promoting psychologic distress.
Adolescent↗
Prospective analysis of personality and behavioral vulnerabilities and gender influences in the later development of disordered eating.
This article presents the 2-year findings of a prospective investigation of the precursors to the later development of an eating disorder in adolescents. The sample consisted of 852 girls and 815 boys who began to study in Grades 7-10 and participated for 3 consecutive years. For both genders, the strongest predictors of Year 3 risk status were Years 1 and 2 risk scores. When the effects of Year 1 and Year 2 risk were controlled, race (Caucasian) and poor interoceptive awareness at Year 2 were significant predictors of disordered eating at Year 3 for girls. Previous risk status was the only significant predictor of Year 3 risk for boys. Gender difference evaluations in the risk score components indicated that a significantly greater proportion of girls than boys endorsed behaviors that were similar to eating disorder diagnostic criteria. Poor interoceptive awareness may provide a vulnerability for eating disorders; possible pathways were discussed.
Child↗
Dieting behaviors and weight change history in female adolescents.
The prevalence of dieting, weight change history, and specific weight loss behaviors was examined in a population-based sample of 1,015 female 9th-12th graders. Healthy weight loss behaviors were reported much more frequently than unhealthy weight loss behaviors (e.g., healthy behaviors: exercise = 32.4%, decrease fat intake = 26.0%, reduce snacks = 25.0%, reduce kilocalorie intake = 22.4%; unhealthy behaviors: fasting = 8.1%, diet pills = 5.4%, vomiting = 4.4%). Obesity status and restrained eating scores were positively related to greater history of weight loss episodes, pounds lost, and weight fluctuations and to greater use of healthy weight loss methods and weight loss programs. Implications for public health recommendations regarding dieting and its associated behaviors in female adolescents are discussed.
Adolescent↗
Community-wide youth nutrition education: long-term outcomes of the Minnesota Heart Health Program.
The Class of 1989 was part of the Minnesota Heart Health Program, a research and demonstration project designed to reduce cardiovascular disease in three intervention communities. This paper describes the long-term outcomes of a school- and community-based intervention on healthy eating behaviors in one intervention and matched reference community. Beginning in the sixth grade (1983), seven annual waves of behavioral measurements were taken from both communities (baseline N = 2376). Self-reported data were collected at each time period including measures of knowledge and preferences for certain foods, and food salting behavior. Data were analyzed using an ANCOVA model adjusting for baseline dependent variable differences, with the school as the unit of analysis. Knowledge, healthy food choices and restraint in food salting behavior variables were significantly higher throughout most of the follow-up period in the intervention community for females. Males also indicated greater knowledge of healthier choices in the intervention community and greater restraint in salting behavior but results are less conclusive for healthy food choices. These results suggest that multiple intervention components such as behavioral education in schools coupled with community-wide health promotion strategies can produce modest but lasting improvement in adolescent knowledge and choices of heart healthy foods and less frequent food salting practices, and that this improvement is most notable among females.
Adolescent↗
Measurement of self-efficacy for diet-related behaviors among elementary school children.
Health promotion interventions intended to improve dietary behavior frequently incorporate self-efficacy as a construct to enhance behavior change. This paper presents results from a study to establish psychometric properties of a scale to measure children's self-efficacy for selecting healthful food. As part of a series of pilot studies to develop instrumentation for the Child and Adolescent Trial for Cardiovascular Health (CATCH), data were collected on third and fourth grade students (n = 1,127). Data analyses were conducted to estimate internal consistency, test-retest reliability, factorial validity, and criterion related validity. Results revealed acceptable estimates of internal consistency for the dietary self-efficacy scale (coefficient alpha = .84). Self-efficacy was strong associated with the children's usual food choices, accounting for about 34% of variance (Multiple R = .58). Findings support using such an instrument for evaluating intervention programs addressing nutrition behavior and for studies to determine the association of self-efficacy to dietary behavior or related constructs.
Child↗