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Biomedical subjects

G S Parcel

Publications and source records attributed to G S Parcel.

At least 91 records · Page 5Linked to original sources
PubMed1979

Health education for kindergarten children.

A health education program for kindergarten children was jointly planned and conducted by health and education professionals. The program demonstrates an application of an approach based on skill development for health behavior. It is presented as an example of how a school district can take beginning steps in developing a foundation for teaching health skills. A unique activity of the program included medical students as a means of involving health care professionals as part of school health education.

Child, Preschool↗
PubMed1979

A comparison of absentee rates of elementary schoolchildren with asthma and nonasthmatic schoolmates.

Daily school attendance has been suggested as a health status measure for children. The present study compares school absence in children known to have asthma (N = 95) with a random sample of nonasthmatic elementary schoolchildren (N = 711). The differences in average percentage of days absent over one year were analyzed by comparing both groups' conditioning on ethnicity, sex, socioeconomic status, and grade. Children with asthma have a significantly higher absentee rate (absent 8.4% of days) than do nonasthmatic children (absent 5.9% of days) (P less than 9001). This significant difference holds true regardless of ethnicity of sex and for most socioeconomic groups. A comparison by grade level shows a similar trend for children with asthma and nonasthmatic children: absentee rates decrease as children get older; however, except for one grade level, children with asthma have a greater percentage of school days absent. Mean absentee rates for children with asthma were different when compared according to their mother's perception of severity of asthma--mild (6.9%), moderate (7.9%), and severe (13.9%).

Absenteeism↗
PubMed1978

Development of an instrument to measure children's health locus of control.

Studies were conducted with children ages 7 to 12 years to develop an instrument to measure children's health locus of control. Findings provide evidence that the Children's Health Locus of Control scale has acceptable levels of reliability, internal consistency, and construct validity. Item analysis and factor analysis were performed to determine item effectiveness and existence of significant subscales. Implications of this research for health education of children are disscussed. Links between the theoretical basis for the locus of control construct and a more comprehensive explanation of health behavior are outlined.

Attitude to Health↗
PubMed1977

Evaluation of a pilot school health education program for asthmatic children.

A pilot program was conducted and evaluated as a part of the development of a health education program designed to meet the needs of a specified target population. By focusing on a group of children with a common chronic health problem, it was possible to measure specific variables to evaluate the effectiveness of the program. Outcome evaluation together with subjective process information resulted in modification and changes in the program prior to implementation with a larger number of children and schools. The pilot phase conducted with a small number of children was demonstrated to be a critical part of the overall program development.

Asthma↗
PubMedDate not supplied

Operational design and quality control in the CATCH multicenter Trial.

BACKGROUND: The Child and Adolescent Trial for Cardiovascular Health (CATCH) was the first multicenter school-based research study to employ the fundamentals of clinical trials including the standardized protocol and Manuals of Operation, a steering committee for study governance, a distributed data system, an extensive quality control system, and a Data and Safety Monitoring Board. METHOD: CATCH tested the effectiveness of changes in school lunches, physical education, smoking policy, curricula, and family activities. Ninety-six elementary schools in four states were randomized to intervention or control conditions. The baseline cohort comprised 5, 106 ethnically diverse third graders followed through fifth grade. RESULTS: The percentages of calories from fat and saturated fat were reduced significantly more in the intervention school lunches than among the controls. Significant increases in moderate to vigorous activity levels in existing physical education classes were made as well. Changes in self-reported dietary, physical activity, and psychosocial measures were significant. There were no significant differences in the physiological measures. Measurement error was generally low for all physiologic measures except skinfolds, indicating a high level of reliability. Across all sites, the coefficients of variation for lipids, height, and weight were less than 3%, whereas for skinfolds, they were considerably higher, ranging from 6 to 8%. Intraclass correlations for lipid studies were also uniformly high at 0.99. Interobserver agreement scores for SOFIT were greater than 90% for 9 of the 11 activities observed. Data entry error rates were low with less than five errors per 1,000 fields for all forms. CONCLUSIONS: The CATCH results provided more scientific evidence on the importance of schools in the population approach to health promotion. Many of the strategies used in this complex multicenter trial in the areas of design and analysis, measurement, training, data management, and quality control protocols might be appropriate for adoption in other studies.

Adolescent↗
PubMedDate not supplied

Changes in the nutrient content of school lunches: results from the CATCH Eat Smart Food service Intervention.

BACKGROUND: The Child and Adolescent Trial for Cardiovascular Health (CATCH) tested the effectiveness of a multilevel intervention aimed at promoting a healthful school environment and positive eating and physical activity behaviors in children. The CATCH Eat Smart Program targeted the school food service staff and aimed to lower the total fat, saturated fat, and sodium content of school meals. METHODS: The Eat Smart intervention was conducted in 56 intervention schools over a 2(1/2)-year period.+Five consecutive days of school menu, recipe, and vendor product information were collected from intervention and control schools at three intervals, Fall 1991, Spring 1993, and Spring 1994, to assess the nutrient content of school menus as offered. RESULTS: There was a significantly greater mean reduction in the percentage of calories from total fat (adjusted mean difference -4.1%; P < 0.0001) and saturated fat (adjusted mean difference -1.3%; P = 0.003) in intervention compared with control schools from baseline to follow-up. Although the sodium content of school lunches increased in both conditions, the mean increase was significantly lower in intervention schools (adjusted mean difference -89 mg; P = 0.034). There were no statistically significant differences for total amounts of cholesterol, carbohydrate, protein, dietary fiber, total sugars, calcium, iron, vitamin A value, and vitamin C. Average total calories decreased significantly; however, the mean total calories (683 kcal) for intervention schools remained above one-third of the Recommended Dietary Allowances for this age group. CONCLUSIONS: The CATCH Eat Smart intervention successfully lowered the total fat and saturated fat content of school lunches as offered, while maintaining recommended amounts of calories and essential nutrients.

Adolescent↗
PubMedDate not supplied

Improving school breakfasts: effects of the CATCH Eat Smart Program on the nutrient content of school breakfasts.

BACKGROUND: This paper describes the impact of the Eat Smart School Nutrition Program, the food service component of the Child and Adolescent Trial for Cardiovascular Health (CATCH), on the percentage of calories from total fat and saturated fat and the sodium content of school breakfasts. METHODS: Fifty-nine of the 96 CATCH schools offered breakfast. We collected 5 consecutive days of school breakfast menu, recipe, and vendor product information at three periods to assess the nutrient content of the school menus as offered. RESULTS: At baseline (Fall 1991), intervention school breakfasts provided 28% of calories from total fat and control schools 30%. Decreases occurred over time in both groups, but no significant differences were attributable to the intervention (adjusted mean difference = -0.4; P = 0.77). Saturated fat exceeded the Eat Smart goal at baseline in all schools and by follow-up (Spring 1994), the reduction in mean percentage of calories from saturated fat was greater in intervention than in control schools (adjusted mean difference = -1.6%; P = 0.052). Sodium goals were not achieved. Mean calorie levels were maintained at or above Eat Smart goals throughout the study in both groups. Differences over time in other dietary variables (percentage of calories from protein and carbohydrate and mean levels of protein, carbohydrate, calcium, iron, vitamin A value, vitamin C, total sugars, and dietary fiber) were not statistically significant between groups. No significant reductions in student participation in the School Breakfast Program (SBP) occurred. CONCLUSIONS: The Eat Smart food service intervention improved school breakfast composition, but not significantly more so than in control schools. Fat and saturated fat in school breakfasts were lowered while maintaining calories, other essential nutrient levels, and student participation in the SBP. Secular trends and also the possibility that control schools were affected by the Eat Smart intervention may account for these findings.

Adolescent↗
PubMedDate not supplied

The effects of the Child and Adolescent Trial for Cardiovascular Health upon psychosocial determinants of diet and physical activity behavior.

BACKGROUND: The Child and Adolescent Trial for Cardiovascular Health is a multisite study of a school-based intervention to reduce or prevent the development of risk factors for cardiovascular disease. The purpose of this paper is to present the evaluation results of the 3-year intervention, focusing upon the psychosocial variables conceptualized as determinants of dietary and physical activity behaviors. METHODS: A total of 96 schools across four study sites (California, Louisiana, Minnesota, and Texas) were randomized to two treatment conditions: intervention and control. Pre- and postmeasurements on the health behavior questionnaire were collected from over 6,000 students. The data analyses utilized a nested design approach in which schools served as the primary unit of analysis. Repeated-measures multivariate analyses were applied to investigate effect sizes for each determinant and to explore theoretical relationships among the determinants over time. RESULTS: The findings indicated sustained significant effects in improved knowledge, intentions, self-efficacy, usual behavior, and perceived social reinforcement for healthy food choices (P < 0.0001 for these five variables) after 3 years. Intermittent effects were observed for perceived support and self-efficacy for physical activity. No gender by determinant interaction effects were observed, and girls reported significantly greater perceived reinforcement for healthy eating than did boys. CONCLUSION: The CATCH program was effective in changing the psychosocial variables likely to influence a reduction in behavior for cardiovascular disease. The study is significant in that it demonstrates the viability and effectiveness of a sustained multifaceted intervention in a preadolescent population. The results point to a need for greater understanding of adolescent developmental issues and the role of community environment (particularly social support) in creating effective curricula.

Adolescent↗
PubMedDate not supplied

Tobacco use measurement, prediction, and intervention in elementary schools in four states: the CATCH Study.

BACKGROUND: The Child and Adolescent Trial for Cardiovascular Health (CATCH) is a multistate field trial examining the effects of school environment, classroom curricula, and family intervention components in promoting the cardiovascular health of elementary school students. The purpose of this paper is to describe the CATCH tobacco use intervention and measurement, including the adoption of tobacco-free school policies. METHODS: In this study, changes in school tobacco use policies and smoking experimentation among students were assessed. Smoking experimentation was measured in all CATCH schools when the students were in their fifth-grade year. A total of 6,527 subjects in 96 schools in California, Louisiana, Minnesota, and Texas answered questions about behaviors and potential correlates of smoking as part of the CATCH health behavior questionnaire in Spring 1994. School tobacco use policy, an important complement to classroom- and home-based prevention efforts, was promoted as part of the CATCH intervention. The degree to which such policy was implemented was measured using surveys of school officials. RESULTS: At the end of fifth grade, only 4.8% of the subjects indicated that they had experimented with tobacco. School intervention condition was not a factor in the prediction of experimentation. Those whose best friend or sibling smoked, or who had ready access to cigarettes in the home, were more likely to have experimented with smoking. In the 3 years of the study, the percentages of tobacco-free schools went up from 49.7 to 76.8%. Though differences in the rate of policy adoption could not be directly attributed to the CATCH intervention, the implementation of the tobacco-free schools' policies did vary substantially from state to state. Minnesota and Texas, with stronger state laws supporting local policy, had nearly completely smoke-free schools. In spite of a statewide tobacco control initiative, California was slower to implement school policies. Louisiana, which allows local decision making regarding smoking policy, had the most difficulty establishing a policy for all districts. CONCLUSION: Future studies should examine the impact of parallel policy interventions that are ongoing at both school and state levels. Tobacco-free policies appear to be a crucial part of school-based interventions and must be tailored to political and regional factors affecting a given school district.

Adolescent↗
PubMedDate not supplied

Impact of a computer-assisted education program on factors related to asthma self-management behavior.

OBJECTIVE: To evaluate Watch, Discover, Think and Act (WDTA), a theory-based application of CD-ROM educational technology for pediatric asthma self-management education. DESIGN: A prospective pretest posttest randomized intervention trial was used to assess the motivational appeal of the computer-assisted instructional program and evaluate the impact of the program in eliciting change in knowledge, self-efficacy, and attributions of children with asthma. Subjects were recruited from large urban asthma clinics, community clinics, and schools. Seventy-six children 9 to 13 years old were recruited for the evaluation. RESULTS: Repeated-measures analysis of covariance showed that knowledge scores increased significantly for both groups, but no between-group differences were found (P: = 0.55); children using the program scored significantly higher (P: < 0.01) on questions about steps of self-regulation, prevention strategies, and treatment strategies. These children also demonstrated greater self-efficacy (P: < 0.05) and more efficacy building attribution classification of asthma self-management behaviors (P: < 0.05) than those children who did not use the program. CONCLUSION: The WDTA is an intrinsically motivating educational program that has the ability to effect determinants of asthma self-management behavior in 9- to 13-year-old children with asthma. This, coupled with its reported effectiveness in enhancing patient outcomes in clinical settings, indicates that this program has application in pediatric asthma education.

Adolescent↗