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K Resnicow

Publications and source records attributed to K Resnicow.

At least 55 records · Page 3Linked to original sources
PubMed1993

Evaluation of a school-site cardiovascular risk factor screening intervention.

BACKGROUND: Though several published reports have demonstrated the feasibility of conducting school-site cardiovascular risk factor screening programs as well as the ability of such programs to detect high-risk children and parents, less is known about their cognitive and behavioral impact. METHODS: Four Michigan elementary schools received a cardiovascular risk factor screening intervention twice between spring 1989 and spring 1990 and four other area schools served as comparison sites. All eight schools received the Michigan Model Comprehensive School Health Education Program. RESULTS: Among participating students (n = 1,166) and their parents (n = 514), significant favorable changes in relevant health knowledge as well as attitudes regarding nutrition and early detection of disease relative to comparison student (n = 480) and parents (n = 158), were observed. There was also a significant decrease in students' self-reported intake of high-fat foods and parents of children who participated were themselves significantly more likely to report having had their cholesterol and blood pressure tested. CONCLUSIONS: This quasi-experimental study suggests that school-based risk factor screening programs can positively influence the knowledge, attitude, and behavior of schoolchildren and their parents and may, therefore, represent a potentially effective adjunct to traditional curricular approaches to disease prevention and health education as well as an alternative means of early detection.

Blood Pressure↗
PubMed1993

Ten unanswered questions regarding comprehensive school health promotion.

The past two decades witnessed dramatic growth in support for comprehensive school health promotion. Yet, many questions about its effectiveness and feasibility remain unanswered. This article poses several research and policy questions, the answers to which may help to shape the future of school health programs in this country.

Adolescent↗
PubMed1993

Body mass index as a predictor of systolic blood pressure in a multiracial sample of US schoolchildren.

We examine the relationship between body mass index (weight divided by height squared) and systolic blood pressure and the implications of using obesity as a criterion for blood pressure screening in a multiracial sample of 11,370 schoolchildren. For the entire sample, the zero-order correlation between body mass index and systolic blood pressure was 0.39. Correlations were strongest among Hispanics (r = .51) and weakest among blacks (r = .29). Among white, black, Asian, and Hispanic boys with body mass index values in the upper decile, the odds of having elevated systolic blood pressure (above the 95th percentile) were significantly higher than among individuals in the bottom decile. Among girls with body mass index values in the top decile, higher odds of hypertension were observed only for whites and Hispanics. For the entire population, the sensitivity of screening only children with body mass index values in the top quartile was 52%. The sensitivity of this cutpoint was higher for Hispanics, although 36% of those with elevated systolic blood pressure would still be missed. These data confirm that overweight children are significantly more likely to have elevated systolic blood pressure and total blood cholesterol levels and that weight reduction may play an important role in the primary prevention of coronary heart disease among children of various ethnic backgrounds. Selective screening of overweight children, however, does not appear warranted.

Blood Pressure↗
PubMed1993

The Know Your Body program: a review of evaluation studies.

Know Your Body is a comprehensive school health promotion program for kindergarten through six grades, initially developed in the 1970s by the American Health Foundation. The impact of the KYB program has been evaluated in three field trials, the results of which have been reviewed in this article. Across the three studies, at 3-year follow-up, consistent positive intervention effects were reported for systolic blood pressure, diastolic blood pressure, smoking, HDL-cholesterol, and health knowledge. Results for total blood cholesterol, fitness score, heart-healthy snacks, fruit/vegetable intake, whole milk intake, and health attitudes were mixed. For body mass index, triceps skinfold, all remaining dietary variables, self-esteem/self-efficacy, and locus of control no significant effects were observed. Overall, significant treatment effects were reported for 19 of the 40 variables assessed at 3-year follow-up, an effects ratio of 48%. Consistent positive results at 5-year follow-up were reported for smoking and health knowledge. Mixed results were obtained for total blood cholesterol, diastolic blood pressure, and percent kilocalories from saturated fat. Consistent null results were reported for HDL-cholesterol, systolic blood pressure, body mass index, triceps skinfold, fitness score, percentage kilocalories from fat, cholesterol intake, and fiber intake. Overall, significant treatment effects were reported for 7 of 36 variables at 5-year follow-up, an effects ratio of 19%. Although reported program effects were largely mixed, they seem consistent with other health education evaluations. Null results may have been related to insufficient teacher implementation as well as weaknesses in design and assessment. Additional research is needed to determine the effect of the program on a broader range of outcomes, to what degree increasing the "dose" produces larger and more enduring treatment effects, and the relative impact of the various components that comprise the program.

Child↗
PubMed1993

Are parents' self-reported total cholesterol levels useful in identifying children with hyperlipidemia? An examination of current guidelines.

OBJECTIVE: Recently, the American Academy of Pediatrics (AAP) Committee on Nutrition adopted the recommendation of the Expert Panel on Blood Cholesterol Levels in Children and Adolescents (NCEP) that children and adolescents with a family history of premature cardiovascular disease or parental hypercholesterolemia (> or = 240 mg/dL) be screened for hyperlipidemia. The rationale for using parental hypercholesterolemia as a screening trigger is based on sensitivity estimates using parents' actual lipid values. However, in clinical practice pediatricians may often have to rely on parents' self-reported cholesterol levels to determine a child's family risk history. This study examines the feasibility and utility of parental self-reported cholesterol levels as a means of identifying children with elevated total cholesterol levels. METHODS: As part of a school-based risk factor screening program that included total cholesterol measurement, conducted in nine elementary schools between 1989 and 1991, parents of participating children were asked if they had their cholesterol tested in the past year and if they had, to provide their total cholesterol values. RESULTS: If only the children who had one parent with a self-reported total cholesterol value > or = 240 mg/dL would have been screened, between 90% and 93% of children with elevated total cholesterol values, either > or = 170 mg/dL or > or = 200 mg/dL, would have been missed. CONCLUSIONS: These data suggest that parents' self-reported cholesterol values are an ineffective means of identifying children with elevated total cholesterol and modification of the current AAP, and NCEP guidelines for selective cholesterol screening in children may be warranted.

Adult↗
PubMed1992

A three-year evaluation of the know your body program in inner-city schoolchildren.

The impact of the Know Your Body (KYB) comprehensive school health education program was evaluated in a sample of first through sixth-grade students from New York City, using two analytic strategies: a longitudinal cohort and a "posttest only" cohort. In both cohorts, program impact was examined between condition (i.e., KYB vs. no-treatment comparison group) as well as within condition (i.e., low, moderate, and high student exposure). Students in the longitudinal cohort (n = 1,209) who were exposed to high implementation teachers had significantly (p < .05) lower total plasma cholesterol and systolic blood pressure at 3-year posttest than comparison students. Students in the posttest only cohort (n = 3,066) who had high implementation teachers showed significantly (p < .05) lower total plasma cholesterol, systolic blood pressure, self-reported intake of meat and desserts, as well as higher health knowledge and self-reported intake of "heart healthy" foods and vegetables than comparison students. In both cohorts, program effects for several outcome variables were linearly related to level of student exposure to the curriculum, suggesting a dose-response effect. While several methodologic limitations may have influenced study outcomes, these data nonetheless appear to confirm that the KYB program can have a significant positive impact on the knowledge, behavior, and selected risk factors of students in primary grades and that efforts to disseminate and evaluate school health education programs should include strategies to monitor and enhance teacher implementation.

Blood Pressure↗
PubMed1991

The relationship between breakfast habits and plasma cholesterol levels in schoolchildren.

The relationship between breakfast habits and plasma total cholesterol (TC) levels was examined in a sample of 530 US schoolchildren ages 9-19. Based on response to a 124-item food checklist, subjects' usual breakfast habits were classified into one of six discrete categories: 1) Skipper, 2) Ready-to-Eat (RTE) cereal with Fiber, 3) Traditional Breakfast, 4) Chips or Sweets, 5) Other RTE, or 6) Mixed Breakfasts. Breakfast skippers, controlling for age, gender, and body mass index, had significantly (p less than 0.05) higher TC levels, 172 mg/dl, than breakfast consumers, 160 mg/dl. Among breakfast eaters, the mean TC of the "Fiber RTE" group was significantly lower (p less than 0.01) than all other breakfast consumers. Usual skippers were less likely to believe in the importance and benefits of breakfast as well as the need to eat foods high in fiber. These findings suggest that encouraging chronic breakfast skippers to modify their dietary habits may improve their nutritional status and possibly reduce their risk for future heart disease.

Adolescent↗
PubMed1991

Diet and serum lipids in vegan vegetarians: a model for risk reduction.

The lipid levels and dietary habits of 31 Seventh-Day Adventist vegan vegetarians (aged 5 to 46 years) who consume no animal products were assessed. Mean serum total cholesterol (3.4 mmol/L), low-density-lipoprotein cholesterol (1.8 mmol/L), and triglyceride (0.8 mmol/L) levels were lower than expected values derived from the Lipid Research Clinics Population Studies prevalence data. Mean high-density-lipoprotein cholesterol (1.3 mmol/L) was comparable to expected values. Analysis of quantitative food frequency data showed that vegans had a significantly lower daily intake of total energy, percentage of energy from fat (31% vs 38%), total fat, saturated fat, monounsaturated fatty acids, cholesterol, and protein and a significantly higher intake of fiber than a sample of matched omnivore controls. Vegans' food intake was also compared with expected values, matched for sex and age, derived from the second National Health and Nutrition Examination Survey and Continuing Survey of Food Intakes by Individuals 24-hour recall data. The vegan diet was characterized by increased consumption of almonds, cashews, and their nut butters; dried fruits; citrus fruits; soy milk; and greens. We conclude from the present study that a strict vegan diet, which is typically very low in saturated fat and dietary cholesterol and high in fiber, can help children and adults maintain or achieve desirable blood lipid levels.

Adolescent↗
PubMed1990

The relation between body mass index and plasma total cholesterol in a multiracial sample of US schoolchildren.

The relation between body mass index expressed as weight in kilograms divided by height in meters cubed (weight (kg)/height (m3)) and plasma total cholesterol was assessed in a sample of 11,389 US schoolchildren, aged 5-18 years, between 1984 and 1989. Among whites and Hispanics, a statistically significant nonlinear relation was found between weight (kg)/height (m3) and plasma total cholesterol. Mean cholesterol values increased exponentially above the 50th percentile of body mass index. Additionally, mean cholesterol levels as well as the odds of hypercholesterolemia (total cholesterol value greater than 180 mg/dl) were highest among children with weight (kg)/height (m3) values above the 95th percentile. Among black children, weight (kg)/height (m3) did not appear to be related to plasma total cholesterol. Possible explanations as well as public health implications of these findings are discussed.

Adolescent↗
PubMed1989

Implementation of a pilot school-site cholesterol reduction intervention.

A school-based cholesterol reduction intervention was offered to primary grade students in two New York City public schools. Subjects were participating in the "Know Your Body" school health program which includes an annual cholesterol screening for all students. Students with total serum cholesterol values greater than 170 mg/dl were eligible for a workshop designed to teach students to identify the amount and type of fat and fiber in various foods and to recognize the negative health consequences of eating a diet high in cholesterol and saturated fat as well as the benefits of eating a diet high in complex carbohydrate and fiber. Thirty-four students completed the five-session behavioral group intervention. Following the workshop, mean total cholesterol for the 34 intervention participants fell 9.0% from baseline (196.9 mg/dl to 179.1 mg/dl). Cholesterol levels decreased 6.6% for a matched sample of comparison subjects (n = 118) participating only in the "Know Your Body" program. While several methodological limitations existed in this pilot study, the results suggest school-site cholesterol reduction interventions for high-risk individuals are feasible, cost-effective, and potentially efficacious.

Child↗
PubMed1989

Plasma cholesterol levels of 6585 children in the United States: results of the know your body screening in five states.

Medical and public health recommendations regarding detection and treatment of hyperlipidemia in children have generally been based on two principal epidemiologic studies: the Lipids Research Clinics Population Study (1972 to 1976) and the Bogalusa Heart Study (1973 to 1974). The present study was initiated to further describe the distribution of plasma cholesterol levels in a multiracial sample of American children. Between 1984 and 1988, the total cholesterol levels of 6585 children from 22 schools were measured as part of the Know Your Body School Health Program. For the entire population, ages 5 to 18 years, the mean total cholesterol concentration was 166.4 mg/dL. Total cholesterol was significantly greater in girls (168 mg/dL) than in boys (165 mg/dL), although sex differences were inconsistent across race/ethnicity. The mean value for blacks, 173 mg/dL, and Hispanics, 168 mg/dL, was higher than for Asians, 165 mg/dL, and whites, 163 mg/dL. Across race/ethnicity, values tended to peak between ages 8 and 10 years for girls and approximately 10 years of age for boys. These values are slightly higher than those reported in the Lipids Research Clinics and Bogalusa studies. Public health implications of these findings are discussed.

Adolescent↗
PubMedDate not supplied

Analysis of a multicomponent smoking cessation project: what worked and why.

BACKGROUND: Health promotion interventions often contain several, conceptually diverse elements. As a result, it is often difficult to determine why interventions succeed or fail as well as which components should be retained or eliminated. One method to examine the effectiveness of individual intervention elements is process analysis. METHODS: Kick It! is a multicomponent smoking cessation intervention developed for lower socioeconomic African Americans. The intervention includes several components, including a 24-page printed cessation manual, a staged-cessation video, a quit contract, two "Quit and Win" contests, and a single telephone booster call. Using data from a randomized intervention trial designed to test the efficacy of the Kick It! intervention, this article examines the use, impact, and interaction of the intervention's subcomponents as well as possible mediating variables related to successful quitting among intervention participants (n = 650). RESULTS: In univariate as well as multivariate analyses adjusting for age and stage of change, two of the five elements, watching the video and entering a Quit and Win contest, were significantly associated with 6-month point prevalence abstinence. Submitting a quit contract and receiving the booster call were significantly associated with quitting in univariate analyses, while reading the Kick It! guide was not significantly associated with quitting in either analysis. CONCLUSIONS: Despite the positive effects observed for individual elements, quitting was not significantly greater among intervention relative to comparison subjects. The primary reason for this appears to be the overall lack of intervention use. Additional research examining strategies to increase use of the Kick It! intervention components as well as the optimal sequencing and combination of components may be warranted.

Adult↗
PubMedDate not supplied

Correlates of occasional cigarette and marijuana use: are teens harm reducing?

This paper examines characteristics that distinguish heavy and occasional cigarette and marijuana use among U.S. high school seniors. High school seniors who completed the 1994 Monitoring the Future survey (N = 15,929) were classified as nonusers, occasional users, and heavy users of cigarettes and marijuana. Level of use was examined with regard to degree of perceived risk of regular use, perceived risk of occasional use as well as several psychosocial factors previously shown to be associated with use (e.g., peer use, close friends' approval of use, and self-esteem). Involvement with other drugs and high-risk behaviors across levels of use was also examined. Heavy users of cigarettes or marijuana reported significantly lower perceived risk of regular use of each substance compared to occasional users. Heavy and occasional users did not generally differ with regard to perceived risk of occasional use. Compared to heavy users, occasional cigarette or marijuana users reported significantly lower rates of illicit drug use, heavy alcohol use, and high-risk driving behaviors as well as fewer problem behaviors and higher grades. Some adolescents may moderate their cigarette and marijuana use to minimize harmful effects they associate with heavier use (i.e., they may be practicing harm reduction). Additional research is needed to better understand controlled substance use, and incorporate this information into prevention and cessation programs.

Adolescent↗
PubMedDate not supplied

Evaluation of the American Cancer Society's Research Promotion Guide.

The American Cancer Society has supported cancer research for more than 50 years and has devoted more than $2.2 billion to cancer research. This article describes an evaluation of the Research Promotion Guide of the American Cancer Society, a reference tool developed by the National Home Office for regional division staff and volunteers whose work involved public relations and fundraising. The purposes of this study were the following: 1) to determine the level and type of use of the guide; and 2) to assess factors that may influence the level and type of use. Fifty-five participants were interviewed by telephone. Overall, 78% of them were aware of the guide. Three factors significantly and positively associated with level of use were: compatibility (the perception that the guide is relevant to one's job); attending a training session; and years employed at the American Cancer Society. This study, a pilot project for the Collaborative Evaluation Fellows Project (CEFP), demonstrated that collaboration between nonprofit and academic institutions is feasible and can serve the needs of the students and organizations. The lessons learned can be applied to evaluations in general and to future CEFP projects.

Humans↗