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Biomedical subjects

T Baranowski

Publications and source records attributed to T Baranowski.

At least 37 records · Page 2Linked to original sources
PubMed2000

GO GIRLS!: results from a nutrition and physical activity program for low-income, overweight African American adolescent females.

This article describes the development, implementation, and results of an intervention designed for inner-city, overweight African American adolescent women. Fifty-seven participants were recruited from four public housing developments. Participants were administered physiologic, dietary, and cognitive assessments at baseline and immediately postintervention. Each session comprised three elements: (1) an educational/behavioral activity, (2) 30 to 60 minutes of physical activity, and (3) preparation and tasting of low-fat meals. In the absence of a control group, results were compared for high and low attenders, the former defined as attending at least 50% of the sessions. High attenders (n = 26) showed more favorable 6-month posttest values for most outcomes compared with low attenders (n = 31). These effects achieved statistical significance for nutrition knowledge, low-fat practices, perceived changes in low-fat practices, and social support.

Adolescent↗
PubMed1999

Factors related to adiposity among children aged 3 to 7 years.

OBJECTIVE: To compare diet and physical activity between a group of children aged 4 to 7 years who had increased their sum of 7 skinfolds by 1.5 standard deviations or more since the previous year and those who had not. SUBJECTS/DESIGN: A longitudinal design was used wherein children had their body composition assessed at 4 annual intervals. Fifteen study subjects were identified from a larger study on the development of cardiovascular risk factors in children. Three matched control subjects were identified for all but 4 study subjects. Children were included if they were 3 or 4 years old at the time of the first of 4 annual clinics to collect data. Children were volunteers from a mid-sized city. MEASURES: Seven skinfold sites were assessed, each 3 times. An average was taken of the mean at each site. Diet and physical activity were assessed using observational methods for up to 4 days for each of 3 years between the 4 annual clinics (held in the summers of 1986, 1987, 1988, and 1989). RESULTS: Children consumed significantly (P = .02) more fat grams and suggestively higher percentages of energy from fat (P = .06), total energy (P = .08), and percentage energy from protein (P = .10). No differences were detected for percent energy from carbohydrate, physical activity, or height. CONCLUSIONS: Programs to prevent childhood obesity might have success by targeting dietary fat consumption among children as young as 4 years old, but further research is needed.

Adipose Tissue↗
PubMed1999

Gender differences in chronic disease risk behaviors through the transition out of high school.

BACKGROUND: Major life transitions (e.g., graduation from high school) are times when many changes occur in a person's social and physical environment. Men and women likely experience aspects of these changes differently. As a result, health-related behaviors likely change at these times with possible differences in these changes by gender. METHODS: Gender differences in the performance of chronic disease risk-related behaviors (fruit, juice, and vegetable intake; physical activity; tobacco and alcohol use; and sexual practices) through the transition out of high school (HS) were assessed in a secondary analysis of a nationally representative sample from the 1992 National Health Interview Survey-Youth Risk Behavior Survey. The survey was completed by 5881 young people aged 14 to 21 years. Regression discontinuity analysis with piecewise regression was performed. RESULTS: Statistically significant gender by transition effects were obtained for exercise/physical activity (decreases at the transition point for males), snuff use (decrease for females in HS), binge drinking and number of days drinking alcohol (increases for males at the transition point), and use of alcohol or drugs before sexual intercourse (decrease for females post HS). Fruit intake decreased for males and females and daily and heavy cigarette smoking increased during the HS years. Effect sizes were small but promising, given that the data set was not designed to test this hypothesis. CONCLUSION: These data offer evidence of differences by gender in chronic disease risk behaviors through the HS transition. Longitudinal studies are needed to assess the true nature of these differences, the tracking of these risk behaviors and their personal, social, and environmental determinants, including gender-specific determinants, that may explain these changes and inform future intervention development.

Adolescent↗
PubMed1999

Patterns in child and adolescent consumption of fruit and vegetables: effects of gender and ethnicity across four sites.

OBJECTIVES: Few studies have examined the association of gender and ethnicity with fruit and vegetable consumption. We examined these associations using baseline data from four school-based sites funded under the National Cancer Institute's 5 A Day for Better Health Program. METHODS: Diet was measured using 24-hour recalls at three sites and seven-day food records at one site. Demographics were obtained via self-report or school records. Regression analyses for clustered data were employed with fruit and vegetables combined and fruit and vegetables separately. RESULTS: Girls ate more fruit, more vegetables and more fruit and vegetables combined than boys at the Georgia site. Ethnicity was significant in two sites: In Georgia, African-Americans ate more fruit and more fruit and vegetables combined than European-Americans; in Minnesota, Asian-American/Pacific Islanders and African-Americans ate more fruit than European-Americans, and European-Americans and African-Americans ate more vegetables than Asian-Americans. No significant effects were found at the Alabama or Louisiana sites. CONCLUSIONS: Ethnicity was related to fruit and vegetable consumption in Georgia and Minnesota. Consistent with prior studies, gender was related to fruit and vegetable consumption, with girls consuming more servings than boys; however, this was observed at one site only, Georgia. Consumption levels were similar to national estimates for children and varied by region. Further studies are needed using a single methodology to facilitate regional comparisons.

Adolescent↗
PubMed1999

Pilot study of the validity and reliability of brief fruit, juice and vegetable screeners among inner city African-American boys and 17 to 20 year old adults.

OBJECTIVE: Compare the validity and reliability of a one-week fruit, juice and vegetable (FJV) food frequency questionnaire (FFQ) that does not require averaging in response categories and one-week food recognition form (FRF) against three to four 24-hour dietary recalls (24hdr) among mostly African-American boys and 17 to 20 year-old adults for possible use in subsequent intervention studies. DESIGN: In Study One, the FFQ was administered to 40 boys in four Boy Scout (BS) troops on two occasions separated by two weeks. The FRF was administered to 36 boys in four other BS troops after school on six school days, covering seven consecutive days. All these boys completed four 24hdr, including one Sunday. In Study Two, 56 17 to 20 year-old adults completed the FFQ during telephone interviews on two occasions two weeks apart. In between, they completed three 24hdr by telephone interview on one weekend and two weekdays. SUBJECTS/SETTING: Participants in Study One were members of eight urban BS troops, and in Study Two were high school (HS) seniors and recent HS graduates. BS data were collected at times scheduled for troop meetings or immediately after school. The young adult group completed telephone interviews in the evenings and on weekends. MAIN MEASURES: This research compared a FJV FFQ and a FJV FRF (incorporating the same 24 foods) against three to four 24hdr conducted using NDS software from the University of Minnesota. STATISTICAL ANALYSES PERFORMED: Descriptive statistics, intraclass correlations, Spearman correlations, corrections for attenuation. RESULTS: The first FFQ provided substantially higher mean consumption estimates for both groups. The FFQ had moderate reliability across assessments and moderate validity coefficients for fruit and total FJV combined for the BS sample. The FRF had higher validity coefficients for juice. The FFQ had moderate reliability and poor validity among the young adult group. Correction for measurement error in the 24hdr substantially increased validity coefficients to high levels for BS fruit and total FJV and to moderate levels for the HS groups, with some exceptions. APPLICATIONS/CONCLUSIONS: FFQ more validly assessed fruit and combined FJV consumption for the nine to 14 year-old BS but overestimated mean values. FRF means were closer to those of the 24hdr and were more valid for assessing juice consumption. The FFQ had moderate validity among the young adult group but overestimated consumption. Further research is needed on simpler methods of reporting diet in these age groups.

Adolescent↗
PubMed1999

Intraindividual variability and reliability in a 7-day exercise record.

PURPOSE: High levels of day-to-day or intraindividual variability implies unreliability of a measure of physical activity. Unreliability in a measure leads to attenuation of correlations with other variables. As intraindividual variability increases, the number of days necessary to assess physical activity to achieve the desired level of reliability increases. The use of an intraclass correlation to assess day-to-day reliability in a measure assumes compound symmetry. METHODS: This study reports on these issues in a sample of 165 elementary school teachers who maintained a 7-d record of physical activity each year for 3 yr. Analyses were conduced with physical activity measured as minutes, MET minutes, and kcal. Analyses were conducted with PROC MIXED in SAS controlling for the clustering effect by school. RESULTS: Compound symmetry could not be supported across 7 d of the record. The weekdays tended to intercorrelate, Saturday correlated at very low levels, and Sunday correlated with Monday only. Compound symmetry was supported across the three weeks. CONCLUSIONS: To achieve a reliability of 0.8 using a 7-d activity record requires 2 wk of assessment. The reliability of measures of physical activity require more careful attention, and likely require more points of assessment to achieve desired levels.

Activities of Daily Living↗
PubMed1999

Influence of school organizational characteristics on the outcomes of a school health promotion program.

Researchers assessed the possible moderating effects of school organizational characteristics (school climate, school health, and job satisfaction) on outcomes of a teacher health behavior change program. Thirty-two public schools were matched and randomly assigned either to treatment or control conditions. Organizational, dietary, and physiologic data were collected from third to fifth grade teachers over three years. Treatment schools received a teacher wellness program for two years. Psychometrics of most organizational scales achieved acceptable levels of reliability. Mixed model analyses were conducted to test for moderating effects. Treatment schools with high organizational climate and health scores reported higher fruit and juice and vegetable consumption at Year 2 compared with intervention schools with low scores. Treatment schools with high job satisfaction scores reported higher fruit and juice and lower-fat food consumption at Year 3 compared with intervention schools with low scores. These measures may be used as a tool to assess the environment in which school health promotion programs are presented. Future interventions may need to be tailored to the organizational characteristics of schools.

Education↗
PubMed1999

Psychosocial correlates of dietary intake: advancing dietary intervention.

Psychosocial variables that predict dietary behavior become important targets for change in nutrition education programs. Psychosocial variables in models with higher predictability provide more effective levers to promote healthy dietary change. A review of the literature on models with psychosocial variables predicting dietary fat and fruit and vegetable consumption revealed generally low predictiveness, R2 < 0.3 (where R2 is the squared multiple correlation of the statistical model). No single theory provided models that regularly out-predicted others. When models predicted narrower categories of behavior (e.g. milk or salad consumption), predictiveness tended to be higher. Substantial problems were revealed in the psychometrics of both the independent and dependent variables. Little theory-based research has been conducted with adolescents, and the few studies done with children had low predictiveness. In order to increase the predictiveness of models, future research should combine variables from several theories, attend to the psychometrics of all variables, and incorporate variables that moderate the relationship of psychosocial to dietary behavior (e.g. genetics of taste, stage in the life course). Refinements on current research would include longitudinal designs and use of non-self-report methods of dietary behavior to supplement the self-report methods. Improved understanding of dietary behavior should lead to more effective dietary behavior change interventions.

Adolescent↗
PubMed1999

Cultural sensitivity in public health: defined and demystified.

There is consensus that health promotion programs should be culturally sensitive (CS). Yet, despite the ubiquitous nature of CS within public health research and practice, there has been surprisingly little attention given to defining CS or delineating a framework for developing culturally sensitive programs and practitioners. This paper describes a model for understanding CS from a public health perspective; describes a process for applying this model in the development of health promotion and disease prevention interventions; and highlights research priorities. Cultural sensitivity is defined by two dimensions: surface and deep structures. Surface structure involves matching intervention materials and messages to observable, "superficial" characteristics of a target population. This may involve using people, places, language, music, food, locations, and clothing familiar to, and preferred by, the target audience. Surface structure refers to how well interventions fit within a specific culture. Deep structure involves incorporating the cultural, social, historical, environmental and psychological forces that influence the target health behavior in the proposed target population. Whereas surface structure generally increases the "receptivity" or "acceptance" of messages, deep structure conveys salience. Techniques, borrowed from social marketing and health communication theory, for developing culturally sensitive interventions are described. Research is needed to determine the effectiveness of culturally sensitive programs.

Black or African American↗
PubMed1999

Ethnic differences in cancer risk behaviors through the transition out of high school.

Differences were assessed by ethnic group in the performance of cancer risk related lifestyle behaviors through the transition out of high school. Data were obtained from a nationally representative probability sample survey, the 1992 National Health Interview Survey-Youth Risk Behavior Survey. A cross-sectional sub-sample included adolescents with an age range from high school freshmen to young adults within four years after high school. Self reported indicators of diet, physical activity, cigarette smoking, smokeless tobacco use, alcohol use, and sexual practices were the primary dependent measures. Cancer risk increased at the transition out of high school through changes in cancer related behaviors. Hispanic-American males experienced somewhat higher risks after the transition for chewing tobacco and snuff. African Americans experienced somewhat higher risks after the transition for physical activity, chewing tobacco, and number of sexual partners. Further research needs to verify these findings with longitudinal designs, assessment of tracking of behaviors through the transition, and of the ecological, social and psychosocial correlates that may explain why these changes occurred.

Adolescent↗
PubMed1998

2-year tracking of children's fruit and vegetable intake.

OBJECTIVE: To evaluate the tracking of children's fruit and vegetable intake over 2 years. DESIGN: Children in the control group from the Gimme 5 nutrition education intervention trial completed three 7-day food diaries once a year in 1994, 1995, and 1996, beginning when they were in third grade. SUBJECTS: Five hundred sixty-one students from public elementary schools. STATISTICAL ANALYSES PERFORMED: Tracking was examined through correlation of fruit and vegetable servings over the 2 years as well as the percent of subjects remaining in the same or adjacent quintiles of fruit and vegetable intake, using the kappa statistic. RESULTS: Tracking of fruit and vegetable intake was fair to moderate over the 2 years. One-year correlations for total fruit and vegetable servings were .37 for boys and .46 for girls; 2-year correlations were .48 for boys and .40 for girls. kappa values for remaining in the same quintile generally exceeded chance rates only for the top and bottom quintiles. No values exceeded .50. APPLICATION/CONCLUSION: The drift in ranking may have been a result of true changes in fruit and vegetable intake or measurement error (i.e., inability to accurately assess actual intake). If this drift reflects true change, it may be difficult for nutrition education programs targeting this age group to demonstrate long-term behavioral effects on fruit and vegetable intake. If the drift is the result of measurement limitations, improved dietary assessment may yield stronger tracking.

Child↗
PubMed1998

Mediating variable framework in physical activity interventions. How are we doing? How might we do better?

INTRODUCTION: Behavioral science provides the foundation for physical activity interventions. The mediating variable framework is used to assess the status of physical activity interventions and the roles that are, or could be played, by behavioral theory. METHODS: Twenty-five physical activity intervention studies and 45 physical activity correlational studies were found in the literature, tabulated, and included in the analysis. RESULTS: Behavioral interventions for promoting physical activity have worked primarily when participants were motivated enough to volunteer or when a school-based physical education program changed. In most cases, behavioral or psychosocial theory accounted for 30% or less of the variability in physical activity behaviors. Most intervention studies do not measure mediating variables, and when they do, they do not systematically effect changes in all the mediating variables on which they are predicated. DISCUSSION: To increase the effectiveness of physical activity interventions, more physical activity research should focus on a better understanding of the predictors of physical activity and toward interventions demonstrated to effect change in these predictors of physical activity. CONCLUSION: Changing the focus to basic behavioral and social science and mediator change research should provide a more systematic and cost-effective approach to increasing the effectiveness of physical activity interventions.

Adult↗
PubMed1998

Physical activity interventions in low-income, ethnic minority, and populations with disability.

BACKGROUND: Low-income, racial and ethnic minority, and populations with disabilities are more likely to be sedentary than the general population. Increasing physical activity in these groups is an important public health challenge. This report summarizes interventions that have targeted populations at risk for inactivity. METHODS: Computer and manual searches were performed to identify manuscripts published from 1983 to 1997. Interventions conducted in these populations in which physical activity was part of the intervention, and activity or cardiorespiratory fitness were outcome measures, were included in the review. RESULTS: Fourteen studies were identified. Most studies used pre-post or quasi-experimental designs. Common intervention features for the ten studies that included ethnic minority groups were community advisory panels, community needs assessments, and community members delivering the intervention. Eight studies reported a theoretical framework that guided the intervention. Increased physical activity was documented in two studies. Post-intervention follow-up was conducted in two studies; both reported no significant findings. Only four studies for people with disabilities were found; all four reported post-intervention physical activity change. CONCLUSION: Much work remains to develop effective interventions for these populations. Research that involves the community at all steps in the design and implementation of the intervention shows greatest promise for promoting behavior change. Future intervention studies should include: (1) rigorous experimental designs; (2) theoretically based interventions; and (3) validated assessment instruments to detect physical activity change.

Adolescent↗
PubMed1998

"5 A Day" achievement badge for urban boy scouts: formative evaluation results.

BACKGROUND: Certain cancers are more common among African Americans (AA). Fruit and vegetables (F&V) reduce cancer risk, but Americans, and African Americans in particular, do not meet the "5 A Day" goal. Scouting organizations, particularly urban Boy Scout groups that target inner-city youth, provide promising channels for nutritional behavioral change programs. METHODS: Focus groups were conducted with urban Boy Scouts and their parents to identify factors influencing F&V consumption and evaluate potential intervention activities. Twenty-four-hour dietary recalls were collected from 85 area Boy Scouts. A national data set was used to obtain values for F&V consumption by African American and European American (boys age 0-16). RESULTS: Vegetable preferences were low and a negative peer influence for vegetables was reported. The group has limited food-preparation skills, but both parents and scouts reported that F&V were available in their homes. Use of goal setting and use of problem-solving techniques were limited. The local scouts' mean F&V intake was 3.2 servings per day. Ethnic differences in F&V consumption were identified in the national data. CONCLUSIONS: Based on these results and previous interventions in schools, an overall structure for the intervention was developed to include eight weekly troop sessions and two camping sessions, parent newsletters, seven weekly home badge assignments, and ten comic books.

Adolescent↗
PubMed1998

How best to measure implementation of school health curricula: a comparison of three measures.

The impact of school health education programs is often attenuated by inadequate teacher implementation. Using data from a school-based nutrition education program delivered in a sample of fifth graders, this study examines the discriminant and predictive validity of three measures of curriculum implementation: class-room observation of fidelity, and two measures of completeness, teacher self-report questionnaire and post-implementation interview. A fourth measure, obtained during teacher observations, that assessed student and teacher interaction and student receptivity to the curriculum (labeled Rapport) was also obtained. Predictive validity was determined by examining the association of implementation measures with three study outcomes; health knowledge, asking behaviors related to fruit and vegetables, and fruit and vegetable intake, assessed by 7-day diary. Of the 37 teachers observed, 21 were observed for two sessions and 16 were observed once. Implementation measures were moderately correlated, an indication of discriminant validity. Predictive validity analyses indicated that the observed fidelity, Rapport and interview measures were significantly correlated with post-test student knowledge. The association between health knowledge and observed fidelity (based on dual observation only), Rapport and interview measures remained significant after adjustment for pre-test knowledge values. None of the implementation variables were significantly associated with student fruit and vegetable intake or asking behaviors controlling for pre-test values. These results indicate that the teacher self-report questionnaire was not a valid measure of implementation completeness in this study. Post-implementation completeness interviews and dual observations of fidelity and Rapport appear to be more valid, and largely independent methods of implementation assessment.

Child↗
PubMed1998

Results of the TeachWell worksite wellness program.

OBJECTIVE: This study examined whether providing a school-based teacher wellness program enhances the impact of a health curriculum on student outcomes and improves cognitive, behavioral, and physiological outcomes among participating teachers. METHODS: Thirty-two elementary schools were randomly assigned to experimental or comparison conditions. Comparison group schools received the Gimme-5 program, a curriculum designed to increase fourth and fifty graders' consumption of fruits and vegetables. Experimental schools received Gimme-5 and the teacher wellness program, which included 54 workshops over 2 years, along with several schoolwide health activities. Physiological, behavioral, and cognitive outcomes were assessed in teachers and students. RESULTS: There was no evidence that the intervention favorably modified any student or teacher end points; nor did intervention teachers deliver the Gimme-5 program with greater fidelity than comparison teachers. CONCLUSION: Confidence in the null results is bolstered by the randomized design, baseline sample equivalence, appropriate mixed-model analyses, and lack of selective or differential attrition. Insufficient participation in the wellness program appears a likely explanation for the lack of teacher and student effects. Factors specific to the school setting and intervention may have diminished participation and, thus, intervention effects.

Adult↗