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Biomedical subjects

Mary Story

Publications and source records attributed to Mary Story.

At least 73 records · Page 4Linked to original sources
PubMed2004

Promotions to increase lower-fat food choices among students in secondary schools: description and outcomes of TACOS (Trying Alternative Cafeteria Options in Schools).

OBJECTIVES: (1) To describe promotional activities, particularly student-led, targeting lower-fat à la carte foods that were conducted in secondary schools; and (2) to describe the relationships between the number and duration of total promotional activities for lower-fat à la carte foods and cafeteria sales of such foods over two years. DESIGN: Promotional activities were implemented in schools that were randomised to the intervention condition of a larger, two-year, school-based, randomised, controlled nutrition intervention trial. SETTING: Ten Minnesota secondary schools. SUBJECTS: Students and school faculty, school food-service and research staff (measured at the school level). RESULTS: Over two years, 181 promotions were implemented (n=49 in Year 1 and n=132 in Year 2). In Year 1, the number of promotions conducted in schools was significantly associated with percentage lower-fat food sales. In Year 2, the duration of promotions was significantly associated with percentage lower-fat food sales. CONCLUSIONS: Collaborative efforts among students, school food-service staff and research staff can be successful in implementing a large number of nutrition-related, school-wide promotional activities. These efforts can increase the sales of lower-fat foods in à la carte areas of school cafeterias.

Adolescent↗
PubMed2004

Associations between body satisfaction and physical activity in adolescents: implications for programs aimed at preventing a broad spectrum of weight-related disorders.

This study examined associations among body satisfaction and physical and sedentary activities in 4,746 adolescents. Boys with lower body satisfaction reported significantly less physical activity and more TV viewing than boys with higher body satisfaction. In girls, trends were similar, but associations were not statistically significant. Associations were similar among overweight youth. In no instances, were lower levels of body satisfaction significantly associated with higher physical activity levels. These findings suggest that interventions that strive for increased physical activity in youth should avoid strategies that may lead to decreases in body satisfaction. Rather, programs should simultaneously strive to increase physical activity and improve body satisfaction. This type of approach may be effective in preventing obesity while avoiding increasing participants'risk for a low body satisfaction, unhealthy weight control practices, and eating disorders.

Journal Article↗
PubMed2004

A randomized school trial of environmental strategies to encourage fruit and vegetable consumption among children.

The Cafeteria Power Plus project examined whether a cafeteria-based intervention would increase the fruit and vegetable (FV) consumption of children. Twenty-six schools were randomly assigned to either an intervention or control condition. Baseline lunch observations of a sample (N = 1668) of first- and third-grade students occurred in the spring of 2000; follow-up was in the spring of 2002. The intervention took place during two consecutive school years beginning in the fall of 2000 and consisted of daily activities (increasing the availability, attractiveness, and encouragement for FV) and special events (kick-offs, samplings, challenge weeks, theater production, and finale meal). Training of food-service staff and cook managers was ongoing throughout the intervention phase. Students in the intervention schools significantly increased their total fruit intake. Process measures indicated that verbal encouragement by food-service staff was associated with outcomes. The outcomes suggest that multicomponent interventions are more powerful than cafeteria programs alone with this age group.

Child↗
PubMed2004

School-based approaches to affect adolescents' diets: results from the TEENS study.

This article reports on the outcomes of the Teens Eating for Energy and Nutrition at School (TEENS) study, a 2-year intervention study conducted in 16 middle schools with a goal of increasing students' intakes of fruits, vegetables, and lower fat foods. Despite positive interim results for students randomized to intervention schools, the positive effects of the intervention were not seen for the primary outcomes at the end of the 2nd year. Positive effects were seen only for a food choice score (suggesting that the students usually choose lower versus higher fat foods) and not for measures of food intake. Future studies may need to take a step back toward more controlled efficacy studies in working with this age-group. In addition, future work may consider the use of peer leaders, more intensive teacher training, ongoing formative assessment, and the testing of more powerful environmental change intervention strategies.

Adolescent↗
PubMed2004

Well-child visits in the video age: pediatricians and the American Academy of Pediatrics' guidelines for children's media use.

OBJECTIVES: The goal of this study was to evaluate awareness of, agreement with, and implementation of the American Academy of Pediatrics (AAP) media use guidelines among pediatricians. Pediatricians' beliefs about several media effects were also measured, as was their own media use. Pediatricians were also asked about how often they make media recommendations as part of anticipatory guidance during well-child visits, as well as the perceived efficacy of and barriers to making such recommendations. DESIGN: A cross-sectional survey mailed to all members of the Minnesota chapter of the AAP. PARTICIPANTS: A total of 365 pediatricians completed the survey. MEASURES: The 58-item survey assessed familiarity with, agreement with, and implementation of each of 3 AAP recommendations, to limit children's media time, to discourage television (TV) viewing among children <2 years of age, and to encourage alternative entertainment for children. Pediatricians were also asked about the perceived effectiveness of and barriers to guideline implementation. In addition, pediatricians were asked to report their own TV viewing habits and their opinions about how much media affect children's health and behavior. RESULTS: Most pediatricians were familiar with and also agreed with the 3 AAP recommendations. Their agreement may stem from the fact that pediatricians almost universally believe that children's media use negatively affects children in many different areas, including children's aggressive behavior, eating habits, physical activity levels, risk for obesity, high-risk behaviors, and school performance. Pediatricians were most likely to have encouraged alternative entertainment and were least likely to have discouraged TV viewing for children <2 years of age. The majority of pediatricians provided all 3 recommendations to parents at least sometimes. Most pediatricians reported that their recommendations were at least a little effective when they did make them. The most frequent barrier pediatricians reported facing was a lack of parental motivation or support for the recommendations, with approximately one-third of pediatricians also citing a lack of time and a sense of futility in affecting patients' media habits as barriers. Finally, pediatricians who watched the greatest amounts of TV were significantly more likely than those who watched less to think that the AAP recommendation to limit children's total media time to no more than 1 to 2 hours per day is unrealistic, whereas those who watched less were more likely to agree with the recommendation. CONCLUSIONS: Results suggest that the efforts of the AAP in reaching pediatricians have been largely successful, with the majority of pediatricians in Minnesota being aware of and agreeing with the 3 major recommendations suggested by the AAP policy statement on children, adolescents, and television. However, implementation of the recommendations could be improved, especially because pediatricians usually think that the recommendations are at least a little effective when made. Strategies for overcoming barriers to making recommendations need to be addressed, including the sense of futility in affecting media use that some pediatricians may feel.

Adolescent↗
PubMed2004

An environmental intervention to promote lower-fat food choices in secondary schools: outcomes of the TACOS Study.

OBJECTIVES: We evaluated an environmental intervention intended to increase sales of lower-fat foods in secondary school cafeterias. METHODS: Twenty secondary schools were randomly assigned to either an environmental intervention or a control group for a 2-year period. The intervention increased the availability of lower-fat foods and implemented student-based promotions. RESULTS: A steeper rate of increase in sales of lower-fat foods in year 1 (10% intervention vs -2.8% control, P =.002) and a higher percentage of sales of lower-fat foods in year 2 (33.6% intervention vs 22.1% control, P =.04) were observed. There were no significant changes in student self-reported food choices. CONCLUSIONS: School-based environmental interventions to increase availability and promotion of lower-fat foods can increase purchase of these foods among adolescents.

Adolescent↗
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

Development and implementation of a visual card-sorting technique for assessing food and activity preferences and patterns in African American girls.

OBJECTIVE: Card-sorting tasks for assessing food and activity preferences and patterns among African American girls were developed. Associations among food preference and intake frequency, activity preference and frequency, and body mass index were examined. DESIGN: Participants completed newly developed card-sorting tasks assessing food and activity preferences and patterns. Height and weight were measured. SUBJECTS/SETTING: Ninety-six 8- to 10-year-old African American girls from schools and community centers in Minneapolis-St. Paul. MAIN OUTCOME MEASURES: Preference and frequency data for 64 foods/beverages and 34 activities. STATISTICAL ANALYSES: Frequencies for food and activity preference and frequency categories were computed. Pearson correlations among food and activity preference, frequency, and body mass index were computed. RESULTS: High-sugar (eg, fruit drinks, soda) and/or high-fat (eg, ice cream, cookies) foods were among the most popular and frequently consumed. Ninety-six percent of girls liked fruit drinks, with 35% consuming them "almost every day." Less-structured activities such as biking, games, jump rope, and dance were most popular. Biking was preferred by 85% of girls, with 48% biking "almost every day." Food preference and frequency categories were moderately correlated (r=0.30 to 0.58), as were activity preference and frequency (r=0.37 to 0.49). APPLICATIONS: The card-sorting tasks are useful tools for assessing food and activity preferences and patterns in girls. Obesity prevention programs for African American girls should include preferred activities such as dance, jump rope, and active play. Programs may also benefit from a focus on replacing high fat/high sugar snacks and sweetened beverages with low-fat, lower-calorie snacks and beverages (eg, fruit, vegetables, water).

Black or African American↗
PubMed2003

Obesity in American-Indian children: prevalence, consequences, and prevention.

BACKGROUND: American Indians of all ages and both sexes have a high prevalence of obesity. The health risks associated with obesity are numerous and include Type 2 diabetes mellitus, hypertension, dyslipidemia, and respiratory problems. Obesity has become a major health problem in American Indians only in the past few generations and it is believed to be associated with the relative abundance of high-fat, high-calorie foods and the rapid change from active to sedentary lifestyles. METHODS: The authors reviewed selected literature on prevalence of obesity in American-Indian children, and health consequences of obesity. RESULTS: Obesity is now one of the most serious public health problems facing American-Indian children, and it has grave implications for the immediate and long-term health of American-Indian youth. Unless this pattern is reversed, American-Indian populations will be burdened by an increased incidence of chronic diseases. Intervention studies are urgently needed in American-Indian communities to develop and test effective strategies for obesity prevention and treatment. CONCLUSIONS: To be effective, educational and environmental interventions must be developed with full participation of the American-Indian communities.

Adult↗
PubMed2003

Changes in the nutrient content of school lunches: results from the Pathways study.

BACKGROUND: Pathways, a randomized trial, evaluated the effectiveness of a school-based multicomponent intervention to reduce fatness in American-Indian schoolchildren. The goal of the Pathways food service intervention component was to reduce the fat in school lunches to no more than 30% of energy from fat while maintaining recommended levels of calories and key nutrients. METHODS: The intervention was implemented by school food service staff in intervention schools over a 3-year period. Five consecutive days of school lunch menu items were collected from 20 control and 21 intervention schools at four time periods, and nutrient content was analyzed. RESULTS: There was a significantly greater mean reduction in percent energy from fat and saturated fat in the intervention schools compared to the control schools. Mean percentages of energy from fat decreased from 33.1% at baseline to 28.3% at the end of the study in intervention schools compared to 33.2% at baseline and 32.2% at follow-up in the control schools (P<0.003). There were no statistically significant differences for calories or nutrients between intervention and control schools. CONCLUSIONS: The Pathways school food lunch intervention documented the feasibility of successfully lowering the percent of energy from fat, as part of a coordinated obesity prevention program for American-Indian children.

Child↗
PubMed2003

School climate and implementation of the Pathways study.

BACKGROUND: Pathways was a multisite school-based study to prevent obesity in American Indian school children by encouraging healthy eating and physical activity. METHODS: Over the 3-year study, a total of 290 in-depth interviews were conducted with school administrators, food service managers, classroom teachers, and physical education instructors in all 21 intervention schools to examine support and barriers for Pathways. Analysis included qualitative assessment of key themes using NUD*IST and quantitative modeling of the impact of a school climate score on implementation of intervention components. RESULTS: Overall, teachers, food service managers, and physical education instructors were supportive of the Pathways interventions. School administration and lack of family participation were perceived barriers at some schools. Attitudes toward the program ranged from neutral to positive during the first year, with about two-thirds giving positive ratings, with greater variation in successive years. Overall, the mean score was 3.5 on a 5-point scale (1=very negative, 5=very positive). School climate score was positively associated with classroom curriculum and student exposure indices, but not with family attendance, food service, or physical activity implementation indices. The latter two indices were associated with site. CONCLUSIONS: An assessment of school climate through interviews is useful in understanding successes and failures in a school-based health intervention and can predict implementation success for some programs.

Child↗
PubMed2003

The impact of the Pathways intervention on psychosocial variables related to diet and physical activity in American Indian schoolchildren.

BACKGROUND: The purpose of this study was to examine the impact of the Pathways intervention on pychosocial variables related to physical activity and diet in American Indian children. METHODS: Schools serving American Indian children were randomized to a multicomponent intervention or control condition. At baseline (fall of third grade) and in the spring semester of third, fourth, and fifth grades 755 boys and 692 girls completed a classroom-administered questionnaire. The questionnaire assessed self-efficacy, knowledge, and behavioral intentions related to diet and physical activity, as well as weight loss behaviors and body image. RESULTS: Knowledge of nutrition and physical activity messages increased in both boys and girls in the intervention group compared to controls; however, knowledge of which foods contained more fat did not increase consistently. Compared to controls, self-efficacy to be physically active increased among girls in intervention schools, but not among boys, whereas self-efficacy to make more healthy food choices did not increase more than in controls in either gender. In the intervention group, compared to controls, healthy food intentions and participation in physically active behaviors increased in both boys and girls. Perception of healthy body size and weight loss attempts did not differ in the intervention and control groups. CONCLUSION: The Pathways intervention program had a positive impact on several aspects of obesity-related knowledge, attitudes, and behaviors.

Child↗
PubMed2003

Couch potatoes or french fries: are sedentary behaviors associated with body mass index, physical activity, and dietary behaviors among adolescents?

OBJECTIVE: To describe the demographic characteristics of adolescent boys and girls who engage in three sedentary behaviors (television/video use, computer use, and reading/homework), and to explore how each sedentary activity is associated with body mass index (BMI), dietary behaviors, and leisure time physical activity. DESIGN: This study draws on data collected from Project EAT (Eating Among Teens), a school-based survey examining personal, behavioral, and socioenvironmental factors that are associated with nutritional intake among adolescents. SUBJECTS: The study sample consists of 4746 middle and high school students from 31 public schools in a metropolitan area of the upper Midwest. All students were invited to participate. The overall response rate for Project EAT was 81.5%. Data collection was completed during the 1998-1999 school year. STATISTICAL ANALYSIS: Multivariate linear regression was used for examining associations between independent and dependent variables, controlling for age, race/ethnicity, and socioeconomic status. All differences were considered statistically significant at P<.05. RESULTS: Among boys, television/video use and time spent reading/doing homework were positively associated with BMI (P<.05), whereas for girls television/video and computer use were positively associated with BMI (P<.05). High television/video use among boys and girls was associated with more unhealthful dietary behaviors (eg, increased consumption of soft drinks, fried foods, and snacks) (P<.05). In contrast, time spent reading/doing homework was associated with more healthful dietary behaviors (eg, increased consumption of fruits and vegetables) (P<.05). Leisure time physical activity was not associated with television/video use among boys or girls, but was positively associated with computer use and time spent reading/doing homework (P<.05). Applications/Conclusions Messages and advice aimed at reducing time spent in sedentary activities should be targeted at television/video use instead of time spent reading, doing homework, or using a computer. Nutrition education should incorporate messages about the influence of the media and advertising on dietary behaviors.

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↗