Christine A. Brosnan

Overweight and Central Adiposity in School-Age Children and Links With Hypertension

The purpose of this study of school-age children was to estimate prevalence and interrelationships of overweight, central adiposity, and hypertension. It included 1,070 children in kindergarten through sixth grade (67% Hispanic, 26% African American, mean age = 8.9 years). Measures included body mass index (BMI), waist circumference (WC), systolic and/or diastolic hypertension identified by measurements on three separate occasions. Percentage overweight (BMI >or=95th percentile) was 28.7%, 17.9% were at risk of overweight, 28.8% had WC >or=90th percentile, and 9.4% had elevated (>or=90th percentile) systolic and/or diastolic blood pressure (BP). If we had screened only for BMI and examined those with BMI >or=85th percentile or underweight for hypertension, we would have missed 26% of the children with persistently elevated BP. WC explained variance in elevated BP not explained by BMI (p < .001). Measurement of WC is easily incorporated in a school-based screening protocol.

The cost of screening adolescents for overweight and hypertension using a community partnership model.

OBJECTIVES (1) Determine the prevalence of overweight and high blood pressure (BP) among middle and high school students over a 2-year period and, (2) measure the cost and initial outcomes of screening. DESIGN Cost and outcome description using a cross-sectional design sample. The target population was 12- to 19-year-old healthy students attending grades 7 through 12 at 3 proximal schools located in a large urban school district in Texas. RESULTS Of 2,338 students screened, 925 (39.6%) had a body mass index (BMI)>or=85th percentile and 504 (21.6%) had BMIs>or=95th percentile for age and gender. There were 346 students (14.8%) with BMIs>or=85th percentile and systolic blood pressure (SBP)>or=95th percentile for age, gender, and height. The cost of the 2-year screening program was

Features of the Built Environment Related to Physical Activity Friendliness and Children’s Obesity and Other Risk Factors

66,442, and the cost per student was

Effect of Newborn Screening for Congenital Adrenal Hyperplasia

28. The cost to identify a student with increased BMI or high SBP was

Type 2 diabetes in children and adolescents: An emerging disease

72 and

Characteristics of 98 Children and Adolescents Diagnosed With Type 2 Diabetes by Their Health Care Provider at Initial Presentation

107, respectively. CONCLUSIONS This study offered an objective framework to examine the cost and outcomes of screening children for overweight and increased BP. The study has implications for discussion and informed decision making about school-based screening for these conditions.

Student nurses participate in public health research and practice through a school-based screening program.

OBJECTIVES We investigated the relationships among environmental features of physical activity friendliness, socioeconomic indicators, and prevalence of obesity (BMI status), central adiposity (waist circumference, waist-height ratio), and hypertension. DESIGN AND SAMPLE The design was cross-sectional; the study was correlational. The sample was 911 kindergarteners through sixth graders from three schools in an urban school district residing in 13 designated neighborhoods. MEASURES Data from walking environmental community audits, census data for socioeconomic indicators, body mass index, waist circumference, waist-height ratio, and blood pressure were analyzed. A modified Alfonzos Hierarchy of Walking Needs model was the conceptual framework for environmental features (i.e., accessibility, safety, comfort, and pleasurability) related to physical activity. RESULTS Accessibility was significantly and negatively correlated with prevalence of obesity and with prevalence of a waist-height ratio >0.50. When neighborhood education was controlled, and when both neighborhood education and poverty were controlled with partial correlational analysis, comfort features of a walking environment were significantly and positively related to prevalence of obesity. When poverty was controlled with partial correlation, accessibility was significantly and negatively correlated with prevalence of waist-height ratio >0.50. CONCLUSIONS The built environment merits further research to promote physical activity and stem the obesity epidemic in children. Our approach can be a useful framework for future research.