Biomedical subjects

Ruth P Saunders

Publications and source records attributed to Ruth P Saunders.

16 recordsLinked to original sources

PubMed2006

Goals and intentions mediate efficacy beliefs and declining physical activity in high school girls.

BACKGROUND: According to theory, girls who set goals about increasing their physical activity and who are dissatisfied with their current activity level are likely to form intentions to be active and to carry out those intentions, especially if they have high efficacy and control beliefs about being physically active. We tested those ideas while observing naturally occurring change during high school. METHODS: A cohort of 431 black and white girls was tested at the end of their 9th- and 12th-grade academic years. Confirmatory factor analysis established the structural invariance of the measures across the 3-year study period. Structural equation modeling and panel analysis were used to determine whether changes in goal setting and satisfaction would mediate relations of self-efficacy and perceived behavioral control with changes in intention and physical activity. Testing occurred between February and May in 1999 and 2004. Data were analyzed in 2006. RESULTS: Goal setting and intention mediated the indirect relation between self-efficacy and change in physical activity. Perceived behavioral control and physical activity change were related directly and also indirectly by a path mediated through satisfaction and intention. Black girls had lower self-efficacy, but changes in other variables were unrelated to race. CONCLUSIONS: These observations of longitudinal relations elaborate application of self-efficacy theory and the theory of planned behavior to physical activity by showing that goal setting and satisfaction mediate the relations of self-efficacy and perceived behavioral control with changes in intention and physical activity. The results encourage additional research to identify the sources and development of physical activity goals, and their attainment, among girls, and whether experimental manipulation of goals and intentions can mitigate the decline in girls' physical activity during high school.

Adolescent↗

PubMed2006

Perceptions of physical and social environment variables and self-efficacy as correlates of self-reported physical activity among adolescent girls.

OBJECTIVE: This cross-sectional study examined the direct and indirect effects of perceived equipment accessibility, neighborhood safety, and social support on self-reported physical activity among older adolescent girls. METHODS: Adolescent girls (n = 1,655) who were in the 12th grade completed a battery of questionnaires that included self-report measures of the perceived physical environment, social support, barriers self-efficacy, and physical activity. RESULTS: Perceived neighborhood safety did not exhibit direct or indirect effects on self-reported physical activity. Perceived equipment accessibility exhibited an indirect effect on self-reported physical activity that was accounted for by barriers self-efficacy. Perceived social support exhibited direct and indirect effects on self-reported physical activity; the indirect effect was accounted for by barriers self-efficacy. The relationships were independent of parental education and body mass index (BMI). CONCLUSIONS: Perceived physical environmental factors indirectly influenced self-reported physical activity, and perceived social environmental factors both directly and indirectly influenced self-reported physical activity in this sample of older adolescent girls.

Adolescent↗

PubMed2006

Community agency survey formative research results from the TAAG study.

School and community agency collaboration can potentially increase physical activity opportunities for youth. Few studies have examined the role of community agencies in promoting physical activity, much less in collaboration with schools. This article describes formative research data collection from community agencies to inform the development of the Trial of Activity for Adolescent Girls (TAAG) intervention to provide out-of-school physical activity programs for girls. The community agency survey is designed to assess agency capacity to provide physical activity programs for girls, including resources, programs, and partnerships. Most agency respondents (n = 138) report operations during after-school hours, adequate facilities, and program options for girls, although most are sport oriented. Agency resources and programming vary considerably across the six TAAG field sites. Many agencies report partnerships, some involving schools, although not necessarily related to physical activity. Implications for the TAAG intervention are presented.

Adolescent↗

PubMed2006

Data to action: using formative research to develop intervention programs to increase physical activity in adolescent girls.

Formative research is used to inform intervention development, but the processes of transmitting results to intervention planners and incorporating information into intervention designs are not well documented. The authors describe how formative research results from the Trial of Activity for Adolescent Girls (TAAG) were transferred to planners to guide intervention development. Methods included providing oral and written reports, prioritizing recommendations, and cross-checking recommendations with intervention objectives and implementation strategies. Formative work influenced the intervention in many ways. For example, results indicated that middle schools offered only coeducational physical education and health education classes, so the TAAG intervention was designed to be appropriate for both sexes, and intervention strategies were developed to directly address girls' stated preferences (e.g., enjoyable activities, opportunity to socialize) and barriers (e.g., lack of skills, fear of injury) for physical activity. The challenges of using formative research for intervention development are discussed.

Adolescent↗

PubMed2005

Perceived physical environment and physical activity across one year among adolescent girls: self-efficacy as a possible mediator?

PURPOSE: This study involved an examination of the direct and mediated effects of perceived equipment accessibility and neighborhood safety on physical activity across a one-year period among adolescent girls. METHODS: Adolescent girls (N = 1,038) completed self-report measures of perceived environment, barriers self-efficacy, and physical activity in the Spring semesters of 1999 (baseline) and 2000 (follow-up) when students were in the 8th and 9th grades. RESULTS: An initial analysis demonstrated that neighborhood safety did not exhibit cross-sectional or longitudinal direct effects on physical activity, whereas equipment accessibility exhibited a statistically significant cross-sectional, but not longitudinal, direct effect on physical activity. The secondary analysis demonstrated that self-efficacy for overcoming barriers mediated the cross-sectional effect of equipment accessibility on physical activity. CONCLUSIONS: We conclude that the cross-sectional effect of perceived equipment accessibility on physical activity is mediated by self-efficacy for overcoming barriers among adolescent girls. This is consistent with the reciprocal relationships among the environment, person, and behavior described by social-cognitive theory.

Adolescent↗

PubMed2005

Comparison of barriers self-efficacy and perceived behavioral control for explaining physical activity across 1 year among adolescent girls.

The absence of longitudinal data about correlates of physical activity during adolescence has hindered the identification of key mediator variables that can be targeted by interventions. Building on the authors' previous report of a cross-sectional analysis, this study compared barriers self-efficacy and perceived behavioral control as predictors of change in 2 levels of physical activity across a 1-year period among a sample of Black and White adolescent girls (N=1,038). Self-efficacy did not predict change in either moderate or vigorous physical activity. In contrast, perceived behavioral control exhibited a longitudinal, independent relationship with change in vigorous physical activity. The authors concluded that perceived behavioral control is an independent predictor of change in vigorous physical activity levels across a 1-year period among a sample of Black and White adolescent girls and warrants study as a potential mediator variable in interventions designed to increase or maintain physical activity.

Adolescent↗

PubMed2005

Promoting physical activity in girls: a case study of one school's success.

This case study profiles one of 24 high schools that participated in a school-based, NIH-funded study to increase physical activity among high school girls. The case study school was one of 12 randomly assigned to the intervention group. The study intervention was based on the premise that a successful intervention is developed and tailored by teachers and staff to fit the context of their school. Intervention guidelines (Essential Elements) and the Coordinated School Health Program (CSHP) model were used to direct intervention activities for physical education, health education, school environment, school health services,faculty/staff health promotion, andfamily/community involvement. All girls at the case study school received the intervention. A team of school employees provided leadership to develop and implement the intervention in collaboration with a university project staff. Data collected over a two-year period were used to describe changes that occurred in each CSHP area. Key changes were made in the school environment, curricula, policies, and practices. Qualitative measures showed girls more involved in physical activity. Quantitative measures taken in eighth grade, and repeated with the same set of girls in ninth grade, showed increases in both moderate-to-vigorous physical activity (p = < .01) and vigorous physical activity (p = .04). Other schools can use this case to modify components of the CSHP model to increase physical activity among high school girls.

Adolescent↗

PubMed2005

Developing a process-evaluation plan for assessing health promotion program implementation: a how-to guide.

Process evaluation is used to monitor and document program implementation and can aid in understanding the relationship between specific program elements and program outcomes. The scope and implementation of process evaluation has grown in complexity as its importance and utility have become more widely recognized. Several practical frameworks and models are available to practitioners to guide the development of a comprehensive evaluation plan, including process evaluation for collaborative community initiatives. However, frameworks for developing a comprehensive process-evaluation plan for targeted programs are less common. Building from previous frameworks, the authors present a comprehensive and systematic approach for developing a process-evaluation plan to assess the implementation of a targeted health promotion intervention. Suggested elements for process-evaluation plans include fidelity, dose (delivered and received), reach, recruitment, and context. The purpose of this article is to describe and illustrate the steps involved in developing a process evaluation plan for any health promotion program.

Adolescent↗

PubMed2005

The impact of states' small group health insurance reforms on uninsurance rates.

The impact of states' small group market reforms on uninsurance rates was examined. Reform status was quantified on five reform dimensions: Access Improvement, Premium Reduction, Premium Differential Reduction, Continuity of Coverage, and Enhancing Valued Plan Features. These reform indices were calculated based on actuarial judgment of the market impact potential of each regulation. Regression analysis showed no association between uninsurance rates and the depth of reforms on any dimension, while controlling for income, foreign-born population, black population, and employment in the smallest businesses. Possible reasons for the lack of impact are discussed.

Government Regulation↗

PubMed2005

Promotion of physical activity among high-school girls: a randomized controlled trial.

OBJECTIVES: Many adolescent girls fail to meet national guidelines for physical activity, and the prevalence of obesity is increasing among this group. Our study examined the effects of a comprehensive school-based intervention on physical activity among high-school girls. METHODS: A group-randomized controlled field trial was conducted at 24 high schools. A school-based sample of 2744 girls (48.7% African American, 46.7% White) participated in a measurement protocol when they were in eighth and then ninth grade. A comprehensive physical activity intervention was designed to change the instructional program and the school environment to increase support for physical activity among girls. RESULTS: At follow-up, 45% of girls in the intervention schools and 36% of girls in the control schools reported vigorous physical activity during an average of 1 or more 30-minute time blocks per day over a 3-day period. CONCLUSIONS: A comprehensive school-based intervention can increase regular participation in vigorous physical activity among high-school girls.

Adolescent↗

PubMed2004

Small group health insurance: ranking the states on the depth of reform, 1999.

States are ranked based on the potential of their small group health insurance reforms to enhance health insurance uptake. Reforms were quantified based on their market impact potential. Five dimensions of reforms were identified, Access Improvement, Premium Reduction, Premium Differential Reduction, Continuity of Coverage, and Enhancing Valued Plan Features. The reform indices representing these dimensions were developed based on document review of state statutes, combined with actuarial judgment to identify and assign scores to market-relevant regulations in line with their impact potential. The distribution of the states' reform scores and rankings show wide variation in the depth and focus of their reforms. Only seven of the top ten states on the Total Reform index had consistently higher scores on two or more reform dimensions. The conceptual linkages between specific regulations and the documented small group market problems lead to normative expectations of an association between the depth of state reforms and the prevalence of uninsurance.

Health Care Reform↗

PubMed2003

Correlates of recreational and transportation physical activity among adults in a New England community.

BACKGROUND: Promotion of transportation-related physical activity is consistent with current national recommendations. However, few studies have simultaneously examined correlates of recreational and transportation physical activity. METHODS: Surveys were mailed to 1002 adults residing in a Massachusetts suburb. The survey included measures of self-reported recreational and transportation-related physical activity and demographic, cognitive, interpersonal, and environmental variables potentially correlated with activity. Multiple linear regression was used to examine the associations between environmental variables and the two outcomes. RESULTS: Respondents (n = 413) who averaged 51.2 +/- 16.8 years of age reported 132.3 +/- 140.5 min/week recreational physical activity and 142.1 +/- 180.9 min/week transportation activity. Sidewalks (P = 0.02) and traffic (P = 0.01) were each associated with higher levels of recreational physical activity in unadjusted analyses, but in models that controlled for age, self-efficacy for physical activity and family social support for physical activity, these environmental variables were nonsignificant. Three perceived environmental variables (enjoyable scenery, sidewalks, traffic) and one objective environmental variable (distance from home to a community rail-trail) each showed associations (P </= 0.05) with transportation-related physical activity in models that controlled for age and self-efficacy. CONCLUSIONS: Neighborhood physical environmental variables were associated with transportation physical activity, but not with recreational physical activity. Further research is needed to identify shared and unique correlates of recreational and transportation physical activity in urban, suburban, and rural settings.

Activities of Daily Living↗

PubMed2002

Examining social-cognitive determinants of intention and physical activity among black and white adolescent girls using structural equation modeling.

Structural equation modeling was used to evaluate components within the theories of reasoned action (TRA), planned behavior (TPB), and self-efficacy (SET) for understanding moderate and vigorous physical activity among 1,797 Black and White adolescent girls. Modest to strong support was provided for components of TPB and SET; weak support was provided for components of TRA. Perceived behavioral control was related to vigorous physical activity. Self-efficacy was related to moderate and vigorous physical activity, and it accounted for the effect of intention on physical activity. The observed relationships were similar between Black and White girls. Self-efficacy and perceived behavioral control are independent influences on physical activity among Black and White adolescent girls and warrant study as potential mediators in physical activity interventions.

Adolescent↗

PubMedDate not supplied

Evaluation of a community-based intervention to promote physical activity in youth: lessons from Active Winners.

PURPOSE: To test the effects of a community-based physical activity intervention designed to increase physical activity and to conduct an extensive process evaluation of the intervention. DESIGN: Quasi-experimental. SETTING: Two rural communities in South Carolina. One community received the intervention, and the other served as the comparison. SUBJECTS: Public school students who were in fifth grade at the start of the study (558 at baseline) were eligible to participate. A total of 436 students participated over the course of the study. INTERVENTION: The intervention included after-school and summer physical activity programs and home, school, and community components designed to increase physical activity in youth. The intervention took place over an 18-month period. MEASURES: Students reported after-school physical activity at three data collection points (prior to, during, and following the intervention) using the Previous Day Physical Activity Recall (PDPAR). They also completed a questionnaire designed to measure hypothesized psychosocial and environmental determinants of physical activity behavior. The process evaluation used meeting records, documentation of program activities, interviews, focus groups, and heart rate monitoring to evaluate the planning and implementation of the intervention. RESULTS: There were no significant differences in the physical activity variables and few significant differences in the psychosocial variables between the intervention and comparison groups. The process evaluation indicated that the after-school and summer physical activity component of the intervention was implemented as planned, but because of resource and time limitations, the home, school, and community components were not implemented as planned. CONCLUSIONS: The intervention did not have a significant effect on physical activity in the target population of children in the intervention community. This outcome is similar to that reported in other studies of community-based physical activity intervention.

Child↗

PubMedDate not supplied

Physician-patient interaction and hysterectomy decision making: the ENDOW study. Ethnicity, Needs, and Decisions of Women.

OBJECTIVE: To investigate physician-patient communication in the context of hysterectomy decision making. METHODS: A series of 17 focus groups with African American and white women (n=82) between the ages of 30 and 65 were run. Personal interviews with physicians (n=7) also were conducted. Transcripts were analyzed using NUD*IST software and note-based techniques. RESULTS: For both patients and physicians, the optimal physician-patient interaction would be for the physician to provide plain, usable information to the patient allowing the patient to make the hysterectomy decision. CONCLUSIONS: The current state of physician-patient interaction represents collaboration but not a shared approach approximating the deliberative model.

Adult↗

PubMedDate not supplied

Comparison of social variables for understanding physical activity in adolescent girls.

OBJECTIVE: To evaluate social support and theory of planned behavior (TPB) constructs in explaining physical activity in adolescent girls. METHODS: One thousand seven hundred ninety-seven 8th-grade girls completed a survey measuring social provisions, family support, TPB constructs, moderate-to-vigorous physical activity (MVPA), and team sport involvement (TSI). RESULTS: Structural equation modeling (SEM) indicated statistically significant direct effects from TPB constructs and social provisions to intention; social provisions, family support, and intention to MVPA; and social provisions and family support to TSI. CONCLUSIONS: Social variables play a greater role in explaining TSI than in explaining MVPA in this sample.

Adolescent↗