Danae M. Dinkel

How accurate are the wrist-based heart rate monitors during walking and running activities? Are they accurate enough?

Background Heart rate (HR) monitors are valuable devices for fitness-orientated individuals. There has been a vast influx of optical sensing blood flow monitors claiming to provide accurate HR during physical activities. These monitors are worn on the arm and wrist to detect HR with photoplethysmography (PPG) techniques. Little is known about the validity of these wearable activity trackers. Aim Validate the Scosche Rhythm (SR), Mio Alpha (MA), Fitbit Charge HR (FH), Basis Peak (BP), Microsoft Band (MB), and TomTom Runner Cardio (TT) wireless HR monitors. Methods 50 volunteers (males: n=32, age 19–43 years; females: n=18, age 19–38 years) participated. All monitors were worn simultaneously in a randomised configuration. The Polar RS400 HR chest strap was the criterion measure. A treadmill protocol of one 30 min bout of continuous walking and running at 3.2, 4.8, 6.4, 8.0, and 9.6 km/h (5 min at each protocol speed) with HR manually recorded every minute was completed. Results For group comparisons, the mean absolute percentage error values were: 3.3%, 3.6%, 4.0%, 4.6%, 4.8% and 6.2% for TT, BP, RH, MA, MB and FH, respectively. Pearson product-moment correlation coefficient (r) was observed: r=0.959 (TT), r=0.956 (MB), r=0.954 (BP), r=0.933 (FH), r=0.930 (RH) and r=0.929 (MA). Results from 95% equivalency testing showed monitors were found to be equivalent to those of the criterion HR (±10% equivalence zone: 98.15–119.96). Conclusions The results demonstrate that the wearable activity trackers provide an accurate measurement of HR during walking and running activities.

Physical activity barriers and facilitators among working mothers and fathers

BackgroundThe transition to parenthood is consistently associated with declines in physical activity. In particular, working parents are at risk for inactivity, but research exploring physical activity barriers and facilitators in this population has been scarce. The purpose of this study was to qualitatively examine perceptions of physical activity among working parents.MethodsWorking mothers (n = 13) and fathers (n = 12) were recruited to participate in one of four focus group sessions and discuss physical activity barriers and facilitators. Data were analyzed using immersion/crystallization in NVivo 10.ResultsMajor themes for barriers included family responsibilities, guilt, lack of support, scheduling constraints, and work. Major themes for facilitators included being active with children or during children’s activities, being a role model for children, making time/prioritizing, benefits to health and family, and having support available. Several gender differences emerged within each theme, but overall both mothers and fathers reported their priorities had shifted to focus on family after becoming parents, and those who were fitting in physical activity had developed strategies that allowed them to balance their household and occupational responsibilities.ConclusionsThe results of this study suggest working mothers and fathers report similar physical activity barriers and facilitators and would benefit from interventions that teach strategies for overcoming barriers and prioritizing physical activity amidst the demands of parenthood. Future interventions might consider targeting mothers and fathers in tandem to create an optimally supportive environment in the home.

Evaluation of GoGirlGo!; A practitioner based program to improve physical activity

BackgroundGoGirlGo! (GGG) is designed to increase girls’ physical activity (PA) using a health behavior and PA-based curriculum and is widely available for free to afterschool programs across the nation. However, GGG has not been formally evaluated. The purpose of this pilot study was to evaluate the effectiveness of the GGG curricula to improve PA, and self-efficacy for and enjoyment of PA in elementary aged girls (i.e., 5-13 years).MethodsNine afterschool programs were recruited to participate in the pilot (within subjects repeated measures design). GGG is a 12-week program, with a once a week, one-hour lesson with 30 minutes of education and 30 minutes of PA). Data collection occurred at baseline, mid (twice), post, and at follow-up (3-months after the intervention ended). PA was assessed via accelerometry at each time point. Self-efficacy for and enjoyment of PA was measured using the Self-Efficacy Scale and the Short-PA enjoyment scale and was assessed at baseline, post, and follow-up. Fidelity was assessed at midpoint.ResultsAcross all age groups there was a statistically significant increase in PA. Overall, on days GGG was offered girls accumulated an average of 11 minutes of moderate-to-vigorous PA compared to 8 minutes during non-GGG days. There was a statistically significant difference in girls’ self-efficacy for PA reported between baseline and post, which was maintained at follow-up. An improvement in enjoyment of PA for girls was found between baseline and follow-up. According to fidelity assessment, 89% of the activities within the curriculum were completed each lesson. Girls appeared to respond well to the curriculum but girls 5-7 years had difficulties paying attention and understanding discussion questions.ConclusionsEven though there were statistically significant differences in self-efficacy for PA and enjoyment of PA, minimal increases in girls’ PA were observed. GGG curricula improvements are warranted. Future GGG programming should explore offering GGG every day, modifying activities so that they are moderate-to-vigorous in intensity, and providing additional trainings that allow staff to better implement PA and improve behavior management techniques. With modifications, GGG could provide a promising no-cost curriculum that afterschool programs may implement to help girls achieve recommendations for PA.

Qualitative evaluation of GoGirlGo! Insights from staff on using a curriculum within after-school programs to improve physical activity.

Background. After-school programs (ASPs) are a promising opportunity for increasing girls’ physical activity (PA). Few curricula are targeted specifically for the needs of girls, and the effectiveness of most of these curricula is unknown. One curriculum that is specifically designed to facilitate PA in girls in the ASP setting but has not been formally evaluated is GoGirlGo! (GGG). The purpose of the qualitative assessment was to explore staff’s overall satisfaction with GGG and to identify best practices for implementation. Method. A qualitative case study consisting of semistructured interviews with staff (n = 21) was conducted. Data were analyzed using the process of immersion/crystallization. Results. A majority of participants reported being satisfied with GGG. Best practices for implementation included having site directors schedule time and space for GGG and adapting GGG to fit the needs of the girls. Suggested improvements included increasing the intensity of the PA offered, adding visuals (e.g., videos), and providing interactive staff training. Discussion. This qualitative exploration of GGG provided several suggested modifications for GGG. These modifications may strengthen GGG and other girl-focused ASP programs to improve girls’ ability to obtain recommended levels of PA in ASPs.

Postural control strategies differ in normal weight and overweight infants

BACKGROUND Evidence suggests obesity can have a negative influence on a childs motor development and postural control behavior. Little research has examined the impact of infant weight on gross motor behavior, particularly postural control at the onset of sitting. OBJECTIVE The purpose of this study was to determine whether normal weight and overweight infants differed in their postural control strategies at the onset of sitting and one-month post onset of sitting. METHODS 29 infants (n=19 normal weight, n=10 overweight) were recruited to participate in this study. Infants length and weight were measured at 3 months of age (visit 1). Infants center of pressure (COP) was measured on an AMTI force platform at the onset of sitting (visit 2) and one-month post onset (visit 3). Data were analyzed using linear measures (range and RMS for the anterior/posterior (AP) and medial/lateral (ML) directions, sway path) and nonlinear measures (Sample Entropy in AP and ML directions). RESULTS Overweight infants had significantly greater RMS values in the ML direction at visit 2 and reduced Sway Path values in comparison to normal weight infants at visits 2 and 3. Further, there was a significant difference in Sample Entropy as overweight infants increased Sample Entropy from visit 2 to 3 while normal weight infants decreased Sample Entropy values during this time period. CONCLUSIONS These findings suggest that overweight infants adopt a different postural control strategy. This altered strategy may limit exploration early in development. More research is needed to determine if longitudinal differences continue to emerge.

Mother knows breast: A content analysis of breastfeeding in television network news

ABSTRACT Major health organizations worldwide have touted the benefits of breastfeeding and engaged in campaigns to increase rates of practice. This study content analyzes network television news transcripts (N = 475) to investigate the coverage of breastfeeding over a 15-year time period (1999–2013) across three networks (ABC, NBC, CBS). Results revealed that although television news reports on breastfeeding have steadily increased, topics have become more trivial. Reports were also found to heavily rely on episodic frames and primarily appear in morning news programs. Such coverage may have the ability to diminish the importance breastfeeding has on society and to deter policy advancement. Theoretical and practical implications for campaign development and promotion are discussed.

An overview of assessment methodology for obesity-related variables in infants at risk

Background: The first 2 years of a child’s life are a particularly critical time period for obesity prevention. Aim: An increasing amount of research across the world is aimed at understanding factors that impact early childhood obesity and developing interventions that target these factors effectively. With this growing interest, new and interdisciplinary research teams are developing to meet this research need. Due to rapid growth velocity during this phase of the lifespan, typical assessments used in older populations may not be valid or applicable in infants, and investigators need to be aware of the pros and cons of specific methodological strategies. Methods: This paper provides an overview of methodology available to assess obesity-related factors in the areas of anthropometry and body composition, nutrient intake, and energy expenditure in infants aged 0–2 years. Results: Gold standard measures for body composition, such as dual-energy X-ray absorptiometry (DXA) or other imaging techniques, are costly, require highly trained personnel, and are limited for research application. Nutrient intake methodology primarily includes surveys and questionnaires completed via parent proxy report. In terms of energy expenditure, methods of calorimetry are expensive and may not differentiate between different activities. Questionnaires or physical activity sensors offer another way of energy expenditure assessment. However, questionnaires have a certain recall bias, while the sensors require further validation. Conclusions: Overall, in addition to understanding the pros and cons of each assessment tool, researchers should take into consideration the experience of the interdisciplinary team of investigators, as well as the cost and availability of measures at their institution.

Nurse and physician reflections on the application of a quality standards training program to reduce maternal mortality.

OBJECTIVE High rates of maternal mortality persist in Low and Middle Income countries, despite increasing rates of facility-based births, suggesting a need to focus on quality of maternity care. The purpose of the current study was to evaluate provider perspectives on the implementation of material taught during an evidence-based medical education session aimed at reducing common causes of maternal death in government hospitals in India. DESIGN Several months after the training, labor room nurses and physicians from twenty-two hospitals participated in semi-structured focus group discussions. SETTING Training sessions were held in an off-site location in each of fourteen districts across Kerala, India. PARTICIPANTS Nurses and physicians working in labor and delivery wards within government hospitals. INTERVENTION Participants were trained on evidence-based practices to treat and prevent common causes of maternal death. Training was a combination of lecture and hands-on practice, conducted over a single working day in a classroom setting. MEASUREMENTS AND FINDINGS Main items of discussion were challenges to implementing material taught in the training session and identification of successful strategies to adopt the recommended standards of care. Primary barriers to implementation of quality standards were provider unwillingness to apply new techniques, inadequate infrastructure, challenges with staffing capacity and lack of required materials and equipment. Facilitators to implementing standards of care included staff motivation, supportive leadership and co-training of nurses and doctors. KEY CONCLUSIONS In international settings, clinical uptake of evidence-based material taught in a classroom format may differ by physician attitude and may be moderated by external factors such as infrastructure quality and equipment availability. In some circumstances, highly motivated staff may overcome external barriers through effort and persistence. IMPLICATIONS FOR PRACTICE Continuing medical education aimed to improve utilization of evidence-based maternity care in low- and middle-income countries may have limited effect without complementary support from hospital administration and provision of adequate infrastructure, equipment and materials to support evidence-based practice.

Health Promotion Needs in Faith-Based Organizations: Perceptions of Religious Leaders in Bamako

The purpose of this study was to explore imams’ and pastors’ perspectives of the health promotion needs of congregants in Bamako, Mali and to examine the physical environment for health promotion in faith-based organizations’ (FBOs). In-depth one-on-one interviews were conducted with imams (n = 10) and pastors (n = 2) as well as observations of the physical environment in FBOs in Bamako, Mali. Data were analyzed using a content analysis approach guided by the social ecological model. Leaders frequently mentioned poverty and affordability as challenges perceived by congregants but congregants support each other with financial contributions. The main challenge mentioned was a lack of knowledge among leaders (primarily imams) about health and health programs.

Awareness and Attitudes of Nigerian Men Living in Abuja on Prostate Cancer and Screening

Prostate cancer (PCa) is the most commonly diagnosed cancer among Nigerian men. The prevalence of PCa varies within Nigeria, with the highest prevalence of 1046 per 100,000 in men over the age of 40 reported in Lagos. Unfortunately, 40% of these men are diagnosed with locally advanced disease and 35% with metastatic disease. Given the ability to screen for PCa among high-risk individuals, late stage diagnosis of PCa could be potentially reduced through education of men so that they seek screening. Along these lines, it is important to assess a population’s knowledge and awareness on PCa and screening. Our study addresses this issue by evaluating awareness and attitudes of Nigerian men in Abuja on PCa and screening. Our results revealed gaps in awareness and perception of susceptibility to PCa and low levels of PCa screening. Factors such as age, education level, and income affected PCa awareness. In conclusion, our study points to the need to educate younger men of lower education and socioeconomic status in Nigeria with the aim to increase screening and earlier detection of PCa.