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Biomedical subjects

Steven H Kelder

Publications and source records attributed to Steven H Kelder.

29 records · Page 2Linked to original sources
PubMed2003

School climate and the institutionalization of the CATCH program.

School climate refers to various physical and psychosocial structures that shape schools' social and physical environments. The Child and Adolescent Trial for Cardiovascular Health (CATCH) study provided an opportunity to study how aspects of school climate are associated with continued implementation of the CATCH program. Nutrient analysis of menus, observations of physical education (PE) classes, and teacher and staff self-reports were used to measure CATCH program components. Results of this study indicate that aspects of school climate were associated with continued implementation of the CATCH classroom component but not the CATCH food service or PE components. These findings have implications for how we plan for the progression of innovative school health promotion programs from the initial trial stage to institutionalization. Measures of school climate may be useful in determining a school's readiness to adopt and implement an innovative health promotion curriculum.

Adolescent↗
PubMed2003

Teaching testicular self-examination: education and practices in pediatric residents.

OBJECTIVE: Although testicular cancer is the most common cancer among 15- to 35-year-old male individuals, physicians seldom conduct testicular self-examination (TSE) education, thus potentially missing opportunities for early detection. Pediatric residents should be learning TSE skills training and be encouraged to incorporate them into routine practice. There are no published studies addressing the medical education and practices of pediatric residents regarding testicular cancer and TSE. The purpose of this study was to determine the prevalence of pediatric residents who teach TSE to their adolescent patients, and significant factors related to teaching TSE. METHODS: A cross-sectional study was conducted of all pediatric residents at 2 pediatric residency programs during the 2000 to 2001 academic year. A self-administered, 37-item Internet-based questionnaire was developed, pilot-tested, and then used. Statistical analyses included frequency distributions, univariate analysis, correlation coefficient, and logistic regression. RESULTS: A total of 129 (61%) of the eligible pediatric residents participated. Fourteen (29%) of the male residents reported performing TSE on themselves at least once a month, and 30 (61%) reported performing TSE at least every 3 months. The most frequent reason cited for not performing TSE monthly was "know how, but forget to do it" (97%). Forty (40%) of all residents reported teaching TSE to their 12- to 21-year-old male patients during a routine annual physical examination. The 2 most common reasons for not teaching TSE were "never thought about including it" (36%) and "lack of time" (29%). The senior-level residents reported teaching TSE to their male patients during a routine annual physical examination more often (51%) than the first-year pediatric residents (21%; odds ratio [OR]: 3.99; 95% confidence interval [CI]: 1.5-10.5). There was no difference in teaching TSE between the male residents who report performing TSE (43%) and those who do not perform TSE (37%; OR: 1.27; 95% CI: 0.36-4.5) and between male and female residents (OR: 0.9; 95% CI: 0.44-1.9). There was no association between knowledge of TSE and testicular cancer with teaching TSE or practicing TSE. In a logistic regression model, confidence in testicular examination (OR: 3.1; 95% CI: 1.2-7.9), confidence teaching TSE (OR: 3.6; 95% CI: 1.2-10.9), and knowing someone with testicular cancer (OR: 2.4; 95% CI: 1.0-5.8) were associated with residents' teaching TSE to their patients. CONCLUSION: Fewer than half of the pediatric residents teach TSE to their adolescent patients. Confidence in performing a testicular examination, confidence in teaching TSE, and knowing someone with testicular cancer were the most important factors related to teaching TSE. This information could be used to design an educational intervention to increase physician promotion of TSE and ultimately increase young males' TSE practices. Additional studies are recommended to determine the generalizability of these results.

Adolescent↗
PubMed2003

Beliefs and social norms about codeine and promethazine hydrochloride cough syrup (CPHCS) onset and perceived addiction among urban Houstonian adolescents: an addiction trend in the city of lean.

In the current study, we used a qualitative approach to investigate relevant beliefs and norms associated with codeine and promethazine hydrochloride cough syrup (CPHCS) consumption, initiation, and perceived addiction among 48 alternative school students who identified themselves as current CPHCS users. In general, both boys and girls believed that CPHCS addiction started during an individual's initial consumption. A majority of both groups reported that their second CPHCS event was initiated during the same or next day after their first event. Our findings suggest that friends and an innovative form of hip-hop music called "screw" are strong reinforcers of CPHCS use.

Adolescent↗
PubMed2003

School-year employment among high school students: effects on academic, social, and physical functioning.

This study describes the effects of different weekly work intensity levels on adolescent functioning in a sample of 3,083 high school students in rural South Texas, where economically disadvantaged and Hispanic youth are heavily represented. Anonymous surveys were conducted in 10th- and 12th-grade students' classrooms in 1995. The following effects were associated with long hours of weekly employment during the school year: (1) decreased performance/engagement in school and satisfaction with amount of leisure time, and (2) increased health risk behaviors and psychological stress. The effects of school-year work on academic factors and health behaviors differed by grade, but not by race/ethnicity, parent education, or race/ethnicity and parent education considered together. It was concluded that parents and professionals should continue to monitor the number of weekly hours that students work during the school year.

Adolescent↗
PubMed2002

Tracking of physical and physiological risk variables among ethnic subgroups from third to eighth grade: the Child and Adolescent Trial for Cardiovascular Health cohort study.

BACKGROUND: The Child and Adolescent Trial for Cardiovascular Health (CATCH), a multisite field trial, tested the effectiveness of multiple interventions for cardiovascular disease risk behaviors in children in third through fifth grades. This paper reports the tracking of physiologic variables through eighth grade. METHODS: The cohort began with 5,106 third grade students from diverse ethnic backgrounds: 69% Caucasian, 14% Hispanic, 13% African American, and 4% other. Seventy-two percent of students were remeasured. Measures described are serum lipids, blood pressure, and body anthropometrics. Tracking was examined across three time points (third, fifth, and eighth grades) with a scaled Kendall concordance coefficient and percentage retention within quintiles across time. RESULTS: For the overall sample, tacking was strongest for body mass index (BMI) (Kendall coefficient = 0.86) and weight (0.86), followed by skinfold thicknesses (0.72-0.78), serum lipids (0.67-0.72), and blood pressure (0.45-0.51). For BMI, 96% of students stayed within +/-1 quintile from third to fifth grades; 90% stayed within this range from third to eighth grades. CONCLUSIONS: There were small but noticeable gender and ethnic differences: tracking was stronger among boys and African American students. These results demonstrate that the children's relative level of cardiovascular risk remained stable over a 6-year period.

Adolescent↗
PubMed2002

Designing effective nutrition interventions for adolescents.

By altering dietary behaviors, nutrition interventions during adolescence have the potential of affecting children at that time and later in life. The majority of interventions implemented in the teen years have occurred in schools, but other intervention sites have included after-school programs, summer camps, community centers, libraries, and grocery stores. Programs with successful outcomes have tended to be behaviorally based, using theories for the developmental framework; included an environmental component; delivered an adequate number of lessons; and emphasized developmentally appropriate strategies. One planning method that can be used in the development of nutrition interventions is Intervention Mapping. The steps of Intervention Mapping include conducting a needs assessment, developing proximal program objectives, mapping appropriate strategies and methods to address the objectives, planning the program design, planning program adoption and implementation, and evaluation. The use of intervention-planning techniques, coordination of nutrition and physical education interventions, using technological advances such as CD-ROMs, incorporation of policy changes into intervention efforts, and dissemination of effective programs are all trends that will influence the future development of effective nutrition programs for adolescents.

Adolescent↗
PubMed2002

Type A behavior and daily living activity among older minority women.

INTRODUCTION: The association between type A behavior pattern (TABP) and physical activity is unclear, with studies reporting both positive and negative results and some reporting no association. Because previous studies have looked primarily at the relationship between TABP and exercise, the purpose of this study was to assess the association between TABP and (1) total activity, (2) activity at work, (3) exercise, (4) household chores, (5) leisure activity, and (6) inactivity. METHODS: Two hundred twenty-seven women (111 African American, 116 Hispanic) from a larger study (Women on the Move) were used in the analysis for this study. The mean age was 49.3 years (SD 7 years), mean weight 77 kg (SD 17.6 kg), and mean body mass index (BMI) 30 (SD 6.5). As part of the Women on the Move Study, participants completed a 7-day diary and a 10-item Activity Temperament Scale. Multiple regression analysis was conducted to test the relationship between TABP and daily activity. Significant findings were observed for total activity and leisure activity with the Activity Temperament Scale summary score. Both had positive associations, indicating that those who had a higher score on the Activity Temperament Scale also had higher total activity kilocalories (kcal) and leisure activity kilocalories. Significant positive findings were also observed for total activity, leisure activity, and exercise with individual items on the Activity Temperament Scale. Household chores, work, and inactivity had significant negative associations with one or more of the individual items on the Activity Temperament Scale. CONCLUSIONS: Although previous studies have reported on TABP and physical activity (primarily exercise), these findings provide new information specific to daily living activity by dimension in an older minority population. Results suggest a positive association between TABP and daily living activity with a general pattern of higher scores associated with higher activity and lower scores associated with higher inactivity. However, even though some significant findings were observed, the overall models did not reveal meaningful associations.

Activities of Daily Living↗
PubMed2002

Diary days needed to estimate activity among older African-American and Hispanic women.

PURPOSE: The purpose of this study was to estimate variation in energy expenditure among older African-American and Hispanic female workers and nonworkers, and identify the number of days of diary self-report necessary to reliably estimate activity. METHODS: 227 women (111 African-American, 116 Hispanic) from the Women On The Move study completed a 7-d diary and were used in the analysis for this study (mean age 49.3 yr, SD = 7.0; mean weight 77.0 kg, SD = 17.6 kg; mean BMI 30, SD = 6.5). Kcal per day for total activity and specific types of activity were calculated for each subject and used in generalizability analyses. RESULTS: Results indicated that 11 d of activity are needed to reliably estimate total activity for African-American nonworkers and 8 d for Hispanic nonworkers. For workers, 12 d of activity are needed to reliably estimate total activity for African-Americans and 14 d are required for Hispanics. Days of diary self-report required by activity type for African-Americans range from 6 to 48 for nonworkers and from 6 to 30 for workers. For Hispanics, days of diary self-report required by activity type range from 8 to 111 for nonworkers and 7 to 42 for workers. CONCLUSIONS: The results of this study indicate the need for more than 7 d of diary self-report to achieve reliable estimates of total activity in older African-American and Hispanic women. The study also found that certain types of activity could be reliably estimated in less than 7 d. However, when there is less variability in the measure/behavior, the reliability is expected to be less and more measurement days are needed to achieve a desired level of reliability.

Adult↗
PubMedDate not supplied

Predicting initiation of smoking in adolescents: evidence for integrating the stages of change and susceptibility to smoking constructs.

We examined the concurrent and predictive validity of stages of change and susceptibility to smoking with respect to smoking onset among adolescents. We also sought to determine whether concurrent use of the two constructs, in the form of an integrated stage/susceptibility index, would predict adolescent smoking acquisition better than eithe r construct alone. Data were examinedfrom two study populations: a prospective study of 1,124 elementary-school through senior-high-school students and a cross-sectional study of 5,624 high-school students. Both constructs demonstrated good concurrent and predictive validity. A measure integrating the stages of smoking acquisition and susceptibility to smoking constructs was created by dividing the precontemplation group as a function of susceptibility. This new classification system yielded better concurrent and predictive validity than did either stage of smoking acquisition or susceptibility to smoking alone.

Adolescent↗
PubMedDate not supplied

The relationship between perceived exposure to promotional smoking messages and smoking status among high school students.

Data on self-reported perceived exposure to pro-smoking messages were collected from 1,608 high school students surveyed through the ASPIRE (A Smoking Prevention Interactive Experience) Program in Houston, Texas, in 2003. Results indicated that high school smoking quitters had approximately twice the odds of perceived exposure to pro-smoking messages as nonsmokers through billboard advertisements (Adjusted Odds Ratio [AOR] = 2.04, 95% CI: 1.09, 3.81), newspapers & magazines (AOR: 1.97, 95% CI: 1.09, 3.56), and movies (AOR: 1.94, 95% CI: 1.03, 3.65). Smoking experimenters marginally perceived more exposure to pro-smoking radio messages (AOR = 1.31, 95% CI: 1.04, 1.67) and billboard advertisements (AOR = 1.28, 95% CI: 1.02, 1.61) compared to nonsmokers. Lastly, current smokers were 1.82 times as likely to report exposure to pro-smoking poster advertisements as nonsmokers (95% CI: 1.19, 2.79, p < or = .05). These findings suggest that experimenters and quitters may pay more attention to smoking advertisements than nonsmokers and current smokers.

Adolescent↗