Biomedical subjects

Mary Story

Publications and source records attributed to Mary Story.

At least 19 recordsLinked to original sources

PubMed2003

Associations of weight-based teasing and emotional well-being among adolescents.

BACKGROUND: Verbal harassment, such as bullying and hate speech, has received considerable attention recently, but less is known about weight-based teasing and its potential harmful effects on young people's psychosocial well-being. OBJECTIVE: To determine the associations of weight-based teasing and body satisfaction, self-esteem, depressive symptoms, and suicidal ideation and suicide attempts using a large sample of adolescents. DESIGN: Secondary analysis of survey and anthropometric data. SETTING: Ethnically and socioeconomically diverse communities in the urban and suburban school districts of the Minneapolis/St Paul metropolitan area. PARTICIPANTS: A school-based sample of 4746 adolescents in grades 7 to 12 at 31 public middle schools and high schools. MAIN OUTCOME MEASURES: Weight-based teasing from peers or family members, body satisfaction, self-esteem, depressive symptoms, and suicidal ideation and suicide attempts. RESULTS: Of the eligible students, 81.5% participated; 30.0% of adolescent girls and 24.7% of adolescent boys were teased by peers, and 28.7% of adolescent girls and 16.1% of adolescent boys were teased by family members. Approximately 14.6% of adolescent girls and 9.6% of adolescent boys reported teasing from both of these sources. Teasing about body weight was consistently associated with low body satisfaction, low self-esteem, high depressive symptoms, and thinking about and attempting suicide, even after controlling for actual body weight. These associations held for adolescent boys and girls, across racial, ethnic, and weight groups. Furthermore, teasing from 2 sources was associated with a higher prevalence of emotional health problems than either teasing from a single source or no teasing. CONCLUSIONS: Physicians and other health care providers should recognize the importance of weight-based teasing for young patients. Policy, programs, and education should focus on increasing awareness of what constitutes weight-based teasing, its potentially harmful effects on adolescents' emotional well-being, and reduction of this behavior.

Adolescent↗

PubMed2003

Factors associated with changes in physical activity: a cohort study of inactive adolescent girls.

OBJECTIVE: To identify factors associated with changes in physical activity in adolescent girls at risk for sedentary lifestyles and obesity. DESIGN: A cohort study was performed with 201 high school girls recruited to participate in an evaluation study of a school-based obesity prevention physical education program. Three assessments were performed during an 8-month period. MAIN OUTCOME MEASURES: Associations between physical activity and a range of personal factors (self-acceptance, self-worth, athletic competence, body image, depressive mood, perceived benefits, enjoyment of physical activity, self-efficacy, and body mass index), behavioral factors (watching television and time constraints), and socioenvironmental factors (social support and costs/resources) were assessed. RESULTS: The 2 strongest and most consistent factors associated with change in physical activity were time constraints and support for physical activity from peers, parents, and teachers. Measures assessing self-perceptions, global (ie, self-worth) and specific to physical activity (ie, self-efficacy to be physically active), were also associated with change in physical activity. For example, a decrease of 2.0 U for an adolescent's perceived time constraints (possible range, 3.0-12.0 U) would be expected to lead to an increase of 53 minutes of moderate to vigorous physical activity per week (95% confidence interval, 33-72 minutes). An increase of 2.0 U in perceived support for physical activity (possible range, 3.0-12.0 U) would be expected to lead to an increase of 35 minutes of moderate to vigorous physical activity per week (95% confidence interval, 13-56 minutes). An increase of 3.0 U on the self-worth scale (possible range, 5.0-20.0 U) might be expected to lead to an increase of 19 minutes of moderate to vigorous physical activity per week (95% confidence interval, 0-40 minutes). CONCLUSION: The effectiveness of interventions aimed at increasing physical activity among adolescent girls might be enhanced by engaging support from friends, family, and caring adults; addressing real and perceived time constraints; and helping adolescent girls feel more confident about themselves and their ability to engage in physical activity.

Adolescent↗

PubMed2003

New Moves: a school-based obesity prevention program for adolescent girls.

BACKGROUND: This study tests the feasibility of an innovative school-based program for obesity prevention among adolescent girls. New Moves was implemented as a multicomponent, girls-only, high-school physical education class. METHODS: Six schools were equally randomized into intervention and control conditions. Data were collected at baseline, postintervention, and 8-month follow-up to assess program impact on physical activity, eating patterns, self-perceptions, and body mass index (BMI) among 89 girls in the intervention and 112 girls in the control conditions. Program evaluation also included interviews with school staff, parent surveys, and participant interviews and process evaluation surveys. RESULTS: The feasibility of implementing New Moves was high, as indicated by strong satisfaction among participants, parents, and school staff, and by program sustainability. Participants perceived a positive program impact on their physical activity, eating patterns, and self-image. Girls in the intervention significantly progressed in their stage of behavioral change for physical activity from baseline to follow-up. However, for the majority of outcome variables, differences between intervention and control schools at postintervention and follow-up were not statistically significant. CONCLUSIONS: New Moves was well received and fills a needed niche within school physical education programs. An expanded intervention and evaluation is needed to enhance and assess long-term program effectiveness.

Adolescent↗

PubMed2003

Correlates of fruit and vegetable intake among adolescents. Findings from Project EAT.

BACKGROUND: This study aims to identify correlates of fruits and vegetables from within the domains of personal factors (taste preferences, health/nutrition attitudes, weight/body concerns, and self-efficacy), behavioral factors (meal frequency, fast food intake, and weight control behaviors), and socio-environmental factors (social support for healthy eating, family meal patterns, food security, socio-economic status, and home availability of fruits/vegetables). This study further aims to identify correlates of home availability and taste preferences for fruits/vegetables, and to explore patterns of interaction between availability and taste preferences. METHODS: The population included 3957 adolescents from 31 public middle and high schools in Minnesota. Structural equation modeling was used for model testing. RESULTS: The strongest correlates of fruit/vegetable intake were home availability of fruits/vegetables and taste preferences of fruits/vegetables. The final model explained 13% of the variance in fruit/vegetable intake, 45% of the variance in home availability, and 28% of the variance in taste preferences. Correlates of home availability included social support for healthy eating, family meal patterns, family food security, and socio-economic status. Correlates of taste preferences included health/nutrition attitudes and home availability of fruits/vegetables. A test of interaction effects indicated that when home availability of fruits/vegetables was low, intake patterns did not differ, regardless of taste preferences. In contrast, even when taste preferences for fruits/vegetables were low, if fruits/vegetables were available, intake increased. CONCLUSIONS: Interventions to increase fruit/vegetable intake in adolescents need to target socio-environmental factors such as greater availability of fruits/vegetables.

Adolescent↗

PubMed2003

Reading magazine articles about dieting and associated weight control behaviors among adolescents.

The purpose was to examine the sociodemographic characteristics of adolescents who read magazine articles about dieting/weight loss and the relationship between reading these types of magazine articles and psychosocial well-being and weight control behaviors. Dieting-related magazine exposure was associated with indicators of psychosocial distress and unhealthy dieting; interventions that address media consumption should reach out to all youth regardless of ethnic and social backgrounds

Adolescent↗

PubMed2003

Correlates of unhealthy weight-control behaviors among adolescents: implications for prevention programs.

This study aimed to identify correlates of unhealthy weight-control behaviors in adolescents to guide the development of programs aimed at the primary prevention of disordered eating. A model explaining unhealthy weight-control behaviors was tested among 4,746 adolescents using structural equation modeling. Models fit the data well and explained 76% of the variance in unhealthy weight-control behaviors among girls and 63% among boys. Weight-body concerns were a strong correlate of unhealthy weight-control behaviors in both girls and boys. Models also emphasized the importance of weight-specific social norms within the adolescent's proximal environment. Findings suggest the importance of addressing weight-body concerns within prevention programs and extending interventions beyond classroom settings to ensure changes in weight-related norms among peer groups and family members.

Adolescent↗

PubMed2003

Family meal patterns: associations with sociodemographic characteristics and improved dietary intake among adolescents.

OBJECTIVE: To examine family meal patterns and associations with sociodemographic characteristics and dietary intake in adolescents. DESIGN: A population-based cross-sectional study design was employed. Adolescents completed the Project EAT (Eating Among Teens) survey and the Youth and Adolescent Food Frequency Questionnaire within their schools. Subjects/setting The study population included 4,746 middle and high school students from Minneapolis/St. Paul public schools with diverse racial and socioeconomic backgrounds. Statistical analyses Associations were examined using cross tabulations, log-linear modeling, and linear regressions. RESULTS: There was a wide distribution in the frequency of family meals during the previous week: never (14.0%), 1 or 2 times (19.1%), 3 to 6 times (40.1%), and 7 or more times (24.8%). Sociodemographic characteristics associated with more frequent family meals included gender (boys), school level (middle school), race (Asian American), mother's employment status (not employed), and socioeconomic status (high). Frequency of family meals was positively associated with intake of fruits, vegetables, grains, and calcium-rich foods and negatively associated with soft drink consumption. Positive associations were also seen between frequency of family meals and energy; protein (percentage of total calories); calcium; iron; folate; fiber; and vitamins A, C, E, and B-6. CONCLUSIONS: Family meals appear to play an important role in promoting positive dietary intake among adolescents. Feasible ways to increase the frequency of family meals should be explored with adolescents and their families.

Adolescent↗

PubMed2003

Developing a school functioning index for middle schools.

Despite widespread recognition of schools' role in the healthy development of youth, surprisingly little research has examined the relationships between schools' overall functioning and the health-related behavior of students. School functioning could become an important predictor of students' health-related behavior and may be amenable to intervention. This paper describes the development and testing of the School Functioning Index (SFI) as a first step in investigating this question. The index was developed for use with middle schools and conceived as a predictor of students' violent behavior, with the potential for extending research applications to additional health and social behaviors. Using social cognitive theory, social ecological theory, and social disorganization theory as guides, three domains were identified to operationalize school functioning and identify candidate SFI items: 1) resources available to the school and students; 2) stability of the school population; and 3) the schools' performance as a socializing agent for students. Data for candidate SFI items were collected from public archives and directly from 16 middle schools participating in a school-based dietary intervention study. Data collection from schools, particularly concerning student aggressive behavior and disciplinary actions, presented challenges. The final SFI comprised nine items and demonstrated good internal consistency and variability. The SFI was modestly correlated in expected directions with violence and other health behaviors. This work supports the feasibility of combining multiple school-level indicators to create a measure of overall school functioning. Further investigation of validity and more acceptable data collection methods are warranted.

Adolescent↗

PubMed2003

Overeating among adolescents: prevalence and associations with weight-related characteristics and psychological health.

OBJECTIVE: To assess the prevalence of overeating among adolescents and to examine associations between overeating and sociodemographic characteristics, weight status, dieting behaviors, body satisfaction, depressive mood, self-esteem, and suicide. METHOD: A school-based sample of 4746 boys and girls in public middle and high schools in Minnesota completed the Project EAT (Eating Among Teens) survey and anthropometric measurements of height and weight. RESULTS: Overall, 17.3% of girls and 7.8% of boys reported objective overeating in the past year. Youths who engaged in overeating were more likely to be overweight or obese, to have dieted in the past year, to be trying to lose weight currently, and to report that weight and shape are very important to their overall feelings about self. Youths who met criteria for binge eating syndrome (high frequency of objective overeating with loss of control and distress regarding the binge eating) scored significantly lower on measures of body satisfaction and self-esteem and higher on a measure of depressive mood than those who reported either subclinical or no binge eating. Overeating was associated with suicide risk; more than one fourth of girls (28.6%) and boys (27.8%) who met criteria for binge eating syndrome reported that they had attempted suicide. CONCLUSIONS: Overeating among adolescents is associated with a number of adverse behaviors and negative psychological experiences. As the current study is cross-sectional, it is not possible to ascertain cause and effect. Future research should seek to identify whether objective overeating is an early warning sign of additional psychological distress or is a potential consequence of compromised psychological health. Clinical implications are discussed.

Adolescent↗

PubMed2003

Food environment in secondary schools: a la carte, vending machines, and food policies and practices.

OBJECTIVES: This study described the food environment in 20 Minnesota secondary schools. METHODS: Data were collected on school food policies and the availability and nutritional content of foods in school à la carte (ALC) areas and vending machines (VMs). RESULTS: Approximately 36% and 35% of foods in ALC areas and in VMs, respectively, met the lower-fat criterion (< or = 5.5 fat grams/serving). The chips/crackers category constituted the largest share of ALC foods (11.5%). The median number of VMs per school was 12 (4 soft drink, 2 snack, 5 other). Few school food policies were reported. CONCLUSIONS: The availability of healthful foods and beverages in schools as well as school food policies that foster healthful food choices among students needs greater attention.

Adolescent↗

PubMed2003

The association of the school food environment with dietary behaviors of young adolescents.

OBJECTIVES: We examined the association between young adolescents' dietary behaviors and school vending machines, à la carte programs, and fried potatoes' being served at school lunch. METHODS: Using a cross-sectional study design, we measured à la carte availability and the number of school stores, vending machines, and amounts of fried potatoes served to students at school lunch in 16 schools. Grade 7 students (n = 598) completed 24-hour dietary recall interviews. RESULTS: A la carte availability was inversely associated with fruit and fruit/vegetable consumption and positively associated with total and saturated fat intake. Snack vending machines were negatively correlated with fruit consumption. Fried potatoes' being served at school lunch was positively associated with vegetable and fruit/vegetable intake. CONCLUSIONS: School-based programs that aim to promote healthy eating among youths should target school-level environmental factors.

Adolescent↗

PubMed2003

Common design elements of the Girls health Enrichment Multi-site Studies (GEMS).

The Girls health Enrichment Multi-site Studies (GEMS) was a multi-center research program created for the purpose of testing interventions designed to prevent excess weight gain by African-American girls, as they enter and proceed through puberty. However, GEMS was not a "multi-center clinical trial" in the usual sense. Although these studies applied similar eligibility criteria, observed a similar follow-up schedule, and followed a similar measurement protocol, important differences existed, as well. Each field center developed its own intervention(s) and corresponding control, and tailored its study to the specific hypothesis being tested. Therefore, the study populations were somewhat different, with recruitment strategies that varied accordingly, and supplemental evaluations appropriate to the specific interventions were conducted on a site-specific basis. The purpose of this paper is to describe the common design elements of the GEMS Phase 1 pilot studies. This report presents the basic study design, a brief overview of the interventions, the measurements taken and their rationale, and procedures both for compiling the collaborative database, and performing site-specific analyses.

Adolescent↗

PubMed2003

Collaborative planning for formative assessment and cultural appropriateness in the Girls health Enrichment Multi-site Studies (GEMS): a retrospection.

OBJECTIVE: The Girls health Enrichment Multi-site Studies (GEMS), Phase 1, developed and pilot-tested interventions to prevent obesity in African-American preadolescent girls. This article describes the collaborative planning process undertaken to take full advantage of formative assessment activities for improving contextual relevance and cultural appropriateness. DESIGN: Working group activities were designed to stimulate awareness and reflection among group members and, through them, among other field center investigators and staff about developmental, cultural, and contextual issues for formative assessment. SETTING: Telephone, Internet, and face-to-face interactions across GEMS field centers in Houston, Texas; Memphis, Tennessee; Minneapolis, Minnesota; and Palo Alto, California. PARTICIPANTS: Investigators and staff involved in intervention development. MAIN OUTCOME MEASURES: The utility of the process was judged from feedback by participants and field center principal investigators about the contribution of the collaborative effort to improving the perceived relevance and cultural appropriateness of formative assessment data collection and interpretation. RESULTS: A working bibliography was compiled. A detailed matrix of programmatic, child, family, and contextual issues related to ethnicity, socioeconomic status, general health and lifestyle, food, physical activity, and body image/weight control was completed. Additional guidance was derived from a workshop that involved scholars with expertise in aspects of African-American culture, child development, and family processes. CONCLUSIONS: This process improved the breadth and depth of GEMS formative assessment activities by increasing the appreciation of the complex structural, contextual, and personal forces at play. A similar process may be useful to other investigators when attempting to develop culturally appropriate interventions.

Black or African American↗

PubMed2003

An after-school obesity prevention program for African-American girls: the Minnesota GEMS pilot study.

OBJECTIVE: This paper describes the development of an after-school obesity-prevention program for African-American girls, and presents findings from a 12-week pilot trial conducted by the University of Minnesota. This study was part of the GEMS project, created to test interventions designed to reduce excess weight gain in African-American girls. DESIGN: Two-arm parallel group, randomized controlled trial. Measures were taken at baseline and at 12 weeks follow up. SETTING: An after-school community program. PARTICIPANTS: Fifty-four African-American girls, 8- to 10-years of age, and their parents/caregivers. INTERVENTION: The after-school intervention was conducted twice a week for 12 weeks, and focused on increasing physical activity and healthy eating. A family component was also included. Girls in the control group received a program over 12 weeks unrelated to nutrition and physical activity. OUTCOMES: Measures included height and weight (body mass index), percent body fat (DEXA), physical activity, assessed using a CSA accelerometer and self-report, two 24-hour dietary recalls, and psycho-social and demographic variables. Parental data included demographic and psycho-social characteristics, and dietary measures. Additionally, process evaluation data on the intervention were collected. RESULTS: Recruitment goals were met. After adjustment for baseline level, follow-up BMI did not differ between the treatment groups, an expected finding, given that this was a pilot study. At 12 weeks follow up, differences between the intervention and control groups were in the hypothesized direction of change for most variables, among both the girls and their parents. Process evaluation results demonstrated that the program was well attended, and well received, by girls and parents. CONCLUSIONS: An after-school obesity prevention program for low-income African-American girls is a promising model for future efforts.

Adult↗

PubMed2003

Recruitment of African-American pre-adolescent girls into an obesity prevention trial: the GEMS pilot studies.

OBJECTIVE: The objective of this report is to describe the methods used to recruit 8- to 10-year-old African-American girls into four 12-week randomized controlled pilot studies on obesity prevention. DESIGN: The Girls health Enrichment Multi-site Study (GEMS) involved 4 field centers which independently developed and tested interventions designed to prevent excess weight gain in African-American girls. Each field center developed its own recruitment plan, but used a standardized recruitment reporting form. The goal was to recruit 40-60 girls, depending on the center. MEASURES: Recruitment yields were computed at each site. Socio-demographic data and weight status were collected for 210 African-American girls who were randomized into the study, as well as for their parents/caregivers. Data were collected on the sources from which participants heard about the study, and the reasons for their interest in the project. RESULTS: The 4 field centers used multiple, but different, recruitment strategies. The most commonly used approaches were mailings, flyers, radio announcements, and group presentations. Caregivers were most likely to hear about the program from the radio (29%), a flyer from the school (23%), or from their child (18%). Among caregivers, the most common reasons for participating were: interest in health (56%), interest in diet/health (51%), and believing the program would be fun for their child (46%). The most frequent reason given by girls was that the program sounded like fun (70%). Three of the 4 field centers met their recruitment target goals. CONCLUSIONS: The GEMS experience demonstrates the feasibility of recruiting and enrolling African-American girls in short-term intervention studies of behavior change. The multiple recruitment strategies, which included developing trusting relationships in the respective communities, were considered critical to the success of recruitment.

Advertising↗

PubMed2003

Body image perceptions and dieting among African-American pre-adolescent girls and parents/caregivers.

This study describes body image and weight concern attitudes of pre-adolescent African-American (AA) girls and their parent/caregivers. Cross-sectional survey data were collected from 189 low-income 8- to 10-year-old AA girls and 179 parents/caregivers of AA girls from 2 urban areas, Memphis and Minneapolis/St. Paul. Results demonstrated that most AA girls were either happy with their weight, or did not think about it at all. However, 20% of girls would like to be larger than their current size, and 50% would like to be smaller. Girls in Minneapolis/St. Paul were more likely than Memphis girls to report weight dissatisfaction. One third of parents reported concerns that their daughters were too heavy. Seventy-two percent of parents reported that they were trying to lose weight. Discussions include possible regional differences in weight concern among AA girls, and implications for obesity prevention programs.

Black or African American↗

PubMed2002

Weight-related concerns and behaviors among overweight and nonoverweight adolescents: implications for preventing weight-related disorders.

OBJECTIVES: To assess weight-related concerns and behaviors in a population-based sample of adolescents and to compare these concerns and behaviors across sex and weight status. DESIGN: The study population included 4746 adolescents from St Paul or Minneapolis, Minn, public schools who completed surveys and anthropometric measurements as part of Project EAT (Eating Among Teens), a population-based study focusing on eating patterns and weight concerns among teenagers. MAIN OUTCOME MEASURES: Measured weight status, weight-related concerns (perceived weight status, weight disparity, body satisfaction, and care about controlling weight), and weight-related behaviors (general and specific weight control behaviors and binge eating). RESULTS: Weight-related concerns and behaviors were prevalent among the study population. Although adolescents were most likely to report healthy weight control behaviors (adolescent girls, 85%; and adolescent boys, 70%), also prevalent were weight control behaviors considered to be unhealthy (adolescent girls, 57%; and adolescent boys, 33%) or extreme (adolescent girls, 12%; and adolescent boys, 5%). Most overweight youth perceived themselves as overweight and reported the use of healthy weight control behaviors during the past year. However, the use of unhealthy and extreme weight control behaviors and binge eating were alarmingly high among overweight youth, particularly adolescent girls. Extreme weight control practices (taking diet pills, laxatives, or diuretics or vomiting) were reported by 18% of very overweight adolescent girls, compared with 6% of very overweight adolescent boys (body mass index, > OR = 95th percentile). CONCLUSION: Prevention interventions that address the broad spectrum of weight-related disorders, enhance skill development for behavioral change, and provide support for dealing with potentially harmful social norms are warranted in light of the high prevalence and co-occurrence of obesity and unhealthy weight-related behaviors.

Adolescent↗

PubMed2002

Adolescent vegetarians: how well do their dietary patterns meet the healthy people 2010 objectives?

OBJECTIVES: To examine whether adolescent vegetarians were more likely than nonvegetarian peers to meet the dietary recommendations of the Healthy People 2010 objectives and to examine differences in other nutrients between these 2 groups. DESIGN: A total of 4746 adolescents from 31 middle and high schools in the Twin Cities area of Minnesota. Data were collected via self-report surveys, with a student response rate of 81.5%. SETTING: Urban secondary schools. PARTICIPANTS: Participants were equally divided by sex. The mean age was 14.9 years; 34.3% were in junior high school and 65.7% in high school. The racial/ethnic distribution was 48.5% white, 19.0% African American, 19.2% Asian American, 5.8% Hispanic, 3.5% American Indian, and 3.9% mixed or other. MAIN OUTCOME MEASURES: Questions on vegetarian status and whether particular foods (eggs, dairy foods, chicken, fish) were excluded. Dietary intake was assessed using the Youth and Adolescent Food Frequency Questionnaire. RESULTS: Vegetarian adolescents were significantly more likely than nonvegetarian adolescents to meet the Healthy People 2010 objectives. This was particularly noteworthy for total fat (70% vs 48%), saturated fat (65% vs 39%), daily servings of vegetables (26% vs 14%), and 5 or more servings of fruits and vegetables (39% vs 28%). Vegetarians were also less likely to eat fast food or drink regular soda and fruit drinks. Vegetarians consumed less vitamin B(12), more diet soda, more caffeine, and more iron. CONCLUSION: Adolescent vegetarians have a dietary pattern that is more likely than nonvegetarians to meet the Healthy People 2010 objectives.

Adolescent↗