Erin R. Hager

Design, synthesis, and evaluation of novel boronic-chalcone derivatives as antitumor agents.

A series of boronic-chalcone derivatives were synthesized and tested for antitumor activity against human breast cancer cell lines. The results show the boronic-chalcones are more toxic to breast cancer cells compared to normal breast cells than other known chalcones.

Challenge! Health Promotion/Obesity Prevention Mentorship Model Among Urban, Black Adolescents

OBJECTIVES: The objective of this study was to evaluate a 12-session home/community-based health promotion/obesity prevention program (Challenge!) on changes in BMI status, body composition, physical activity, and diet. METHODS: A total of 235 black adolescents (aged 11–16 years; 38% overweight/obese) were recruited from low-income urban communities. Baseline measures included weight, height, body composition, physical activity (PA), and diet. PA was measured by 7-day play-equivalent physical activity (≥1800 activity counts per minute). Participants were randomly assigned to health promotion/obesity prevention that is anchored in social cognitive theory and motivational interviewing and was delivered by college-aged black mentors or to control. Postintervention (11 months) and delayed follow-up (24 months) evaluations were conducted. Longitudinal analyses used multilevel models with random intercepts and generalized estimating equations, controlling for baseline age/gender. Stratified analyses examined baseline BMI category. RESULTS: Retention was 76% over 2 years; overweight/obese status declined 5% among intervention adolescents and increased 11% among control adolescents. Among overweight/obese youth, the intervention reduced total percentage of body fat and fat mass and increased fat-free mass at delayed follow-up and increased play-equivalent physical activity at postintervention but not at delayed follow-up. Intervention adolescents declined significantly more in snack/dessert consumption than control adolescents at both follow-up evaluations. CONCLUSIONS: At postintervention, there were intervention effects on diet and PA but not BMI category or body composition. At delayed follow-up, dietary changes were sustained and the intervention prevented an increase in BMI category. Body composition was improved for overweight/obese youth. Changes in body composition follow changes in diet and PA and may not be detected immediately after intervention.

Implementation of Local Wellness Policies in Schools: Role of School Systems, School Health Councils, and Health Disparities

BACKGROUND Written local wellness policies (LWPs) are mandated in school systems to enhance opportunities for healthy eating/activity. LWP effectiveness relies on school-level implementation. We examined factors associated with school-level LWP implementation. Hypothesized associations included system support for school-level implementation and having a school-level wellness team/school health council (SHC), with stronger associations among schools without disparity enrollment (majority African-American/Hispanic or low-income students). METHODS Online surveys were administered: 24 systems (support), 1349 schools (LWP implementation, perceived system support, SHC). The state provided school demographics. Analyses included multilevel multinomial logistic regression. RESULTS Response rates were 100% (systems)/55.2% (schools). Among schools, 44.0% had SHCs, 22.6% majority (≥75%) African-American/Hispanic students, and 25.5% majority (≥75%) low-income (receiving free/reduced-price meals). LWP implementation (17-items) categorized as none = 36.3%, low (1-5 items) = 36.3%, high (6+ items) = 27.4%. In adjusted models, greater likelihood of LWP implementation was observed among schools with perceived system support (high versus none relative risk ratio, RRR = 1.63, CI: 1.49, 1.78; low versus none RRR = 1.26, CI: 1.18, 1.36) and SHCs (high versus none RRR = 6.8, CI: 4.07, 11.37; low versus none RRR = 2.24, CI: 1.48, 3.39). Disparity enrollment did not moderate associations (p > .05). CONCLUSIONS Schools with perceived system support and SHCs had greater likelihood of LWP implementation, with no moderating effect of disparity enrollment. SHCs/support may overcome LWP implementation obstacles related to disparities.

Nighttime Sleep Duration and Sleep Behaviors among Toddlers from Low-Income Families: Associations with Obesogenic Behaviors and Obesity and the Role of Parenting

BACKGROUND Shortened sleep duration is associated with poor health and obesity among young children. Little is known about relationships among nighttime sleep duration, sleep behaviors, and obesogenic behaviors/obesity among toddlers. This study characterizes sleep behaviors/duration and examines relationships with obesogenic behaviors/obesity among toddlers from low-income families. METHODS Mothers of toddlers (age 12-32 months) were recruited from urban/suburban sites serving low-income families. Mothers provided demographic information and completed the Brief Infant Sleep Questionnaire (BISQ); a 6-item Toddler Sleep Behavior Scale was derived (TSBS-BISQ, higher score reflects more recommended behaviors). Toddler weight/length were measured; obesity defined as ≥95th percentile weight-for-length. Measures of obesogenic behaviors: physical activity [accelerometry, minutes/day in Moderate-to-Vigorous Physical Activity (MVPA)] and diet quality [24-hour recall, Healthy Eating Index 2005 (HEI-2005)]. Bivariate and adjusted multivariable models examined associations between nighttime sleep behaviors/duration and obesogenic behaviors/obesity. RESULTS Sample included 240 toddlers (mean age = 20.2 months), 55% male, 69% black, 59% urban. Toddlers spent 55.4 minutes/day in MVPA, mean HEI-2005 score was 55.4, 13% were obese. Mean sleep duration was 9.1 hours, with 35% endorsing 5-6 recommended sleep behaviors (TSBS-BISQ). In multivariable models, MVPA was positively related to sleep duration; obese toddlers had a shorter nighttime sleep duration than healthy weight toddlers [odds ratio = 0.69, p = 0.014]. Nighttime sleep duration was associated with high TSBS-BISQ scores, F = 6.1, p = 0.003. CONCLUSIONS Toddlers with a shorter nighttime sleep duration are at higher risk for obesity and inactivity. Interventions to promote healthy sleep behaviors among toddlers from low-income families may improve nighttime sleep duration and reduce obesogenic behaviors/obesity.

The home environment and toddler physical activity: an ecological momentary assessment study

Physical activity (PA) promotion/obesity prevention in toddlerhood should include home environments.

College Mentors A View From the Inside of an Intervention to Promote Health Behaviors and Prevent Obesity Among Low-Income, Urban, African American Adolescents

This article examined the views of college mentors who administered Challenge!—a home- and community-based health promotion/overweight prevention intervention that effectively reduced the progression to overweight among African American adolescents. In-depth qualitative interviews among 17 mentors (81%) conducted 1 year following the intervention yielded four primary findings: (a) the importance of a strong mentor–mentee relationship often extending beyond the issues of diet and physical activity, (b) concern at the adversities the adolescents faced (e.g., poverty and household instability); (c) the personal impact of the mentoring process on the mentors’ own dietary and physical activity behavior and career choices; and (d) recommendations regarding subsequent mentoring programs. In summary, college students are a valuable resource as mentors for low-income, African American adolescents and provide insights into the success of health promotion/overweight prevention interventions.

The Active Living Research 2014 Conference: "niche to norm".

Comments on the 2014 Active Living Research Conference theme(written by Keshia Pollack)WhenIthinkofthewordniche,phrasessuchasa“specializedplace”or a “distinct segment” come to mind. When it was time to identify thetheme for the 2014 Active Living Research (ALR) Conference, wethought about how some people consider the field of active living aniche area. Because of this, it is not entirely surprisingly that aroundthe world, communities still lack sidewalks, pedestrians and bicyclistsare injured or killed by speeding traffic, and physical inactivity remainsa global pandemic (Kohl et al., 2012). In selecting the theme “niche tonorm,”weaimedtorecognizetheimportanceofadvancingactivelivingfrom an emerging research field with limited impact to well-acceptedfindings that guide every day decision-making across various sectorsto create more active communities. We wanted to encourage dialoguearound how to take evidence-based interventions that promote physi-cal activity mainstream, and we did just that.The Conference included workshops, oral and poster presentations,and keynote addresses documenting how environmental and policychanges that increase physical activity are increasingly more common.We heard presenters discuss complete street ordinances, which havebeen adopted in hundredsof communities. We learnedhow thousandsof schools are implementing evidence-based policies and programs toincrease youth activity and combat the childhood obesity epidemic.Tools such as Walk Score were described as a way to help millions ofhome buyers and renters find walkable neighborhoods. My own workto develop and disseminate Promoting Safety is helping ensure that ef-fortstocreateenvironmentsthatfacilitateopportunitiesforphysicalac-tivityconsiderthefactthattransportation-relatedinjuriesareoneoftheleading causes of death for Americans ( U.S. Centers for Disease Controland Prevention, 2014). By partnering with architects, planners, trans-portation engineers, and colleagues from parks and recreation, weshowed how injury prevention and public health professionals canhelpensurethatnewandrenovatedspacesmaximizebothactivelivingand safety (Pollack et al., 2014–in this issue). These examples are just afewthatillustratehowworkingacrosssilosandengagingvariousstake-holders can help move active living from niche to norm.To build on the momentum from the 2014 ALR Annual Conference,there are many other exciting initiatives that those of us in the field ofactive living can leverage to continue to take physical activity interven-tions mainstream. For instance, physical activity environments and re-lated policies are controlled by non-health sectors, including urbanplanning, transportation, parks and recreation, education, architecture,and corporations, among others, so active living and public health ex-perts need to have inputinto decision-makingthateffects our environ-ments (Sallis et al., 1998, 2006). There is emerging evidence regardingthe benefits of using tools such as Health Impact Assessments (HIA) tointegrate health considerations and evidence into non-health sectors(Dannenberg et al., 2013). Across the United States, HIAs have opti-mizedhealthoutcomesandminimizedadverseimpacts,andidentified,for example, ways to promote opportunities for physical activity whenupdating comprehensive plans or zoning policies (Health ImpactProject, 2014). HIAs provide opportunities to deepen relationshipswith non-health sectors responsible for making decisions about envi-ronments and policies that affect physical activity, and evidence isemerging as to their roles in supporting health-promoting decisionsand changing the way communities are designed (Health ImpactProject, 2014).Wecansuccessfullytakeactivelivingfromtheperipherytothecore,from niche to norm, by continuing to strengthen and foster interdisci-plinary collaborations, and by reaching out to individuals in sectorswhereactivelivingisnottheircentralfocus.Thereisaneedtoestablishlong-term and collaborativeapproachestotranslate what worksandtodisseminateit widely.Manyof us in the fieldhavebeguntodothis,andas we showed at the 2014 ALR Conference, we have a great foundationupon which to build and implement policies and environments thatpromote population-wide increases in physical activity.The 2014 Active Living Research Conference (written by JamesF. Sallis)Each ALR Conference attempts to perceptibly advance research andits translation to practice and policy. Our goal is to use research tomake meaningful contributions to improving environments and poli-cies that support active living, healthy weights, and a culture of health.In 2014 there was clear movement in taking active living from “nicheto norm” in public health and advocacy organizations, among govern-ment officials, and to a global stage.Research was the major focus of the Conference, with 98 researchpresentations and posters. ALR attracts significant and innovative re-search, and some of the best studies are published in this supplementto Preventive Medicine. The 2014 Conference was the second in whichpracticeandpolicysubmissionswereinvited,and44suchpresentationswereintermixedwithresearchpresentations.Thegoalofthedualfocusistofacilitatecommunication of researchtothosewhocanuseitandtoinform researchers about needs of practitioners and policymakers tostimulate future research.The public health presence at ALR2014 was strong, with keynotepresentation from Jonathan Fielding, Director and Health Officer forthe Los Angeles County Department of Public Health, and an overviewof the Institute of Medicines report, “Evaluating Obesity Prevention Ef-forts,” from Lawrence Green of the University of California, San

School wellness team best practices to promote wellness policy implementation

Schools with wellness teams are more likely to implement federally mandated Local Wellness Policies (LWPs, Local Education Agency-level policies for healthy eating/physical activity). Best practices have been developed for wellness teams based on minimal empirical evidence. The purpose of this study is to determine, among schools with wellness teams, associations between LWP implementation and six wellness team best practices (individually and as a sum score). An online survey targeting Maryland school wellness leaders/administrators (52.4% response rate, 2012-2013 school year) was administered that included LWP implementation (17-item scale: categorized as no, low, and high implementation) and six wellness team best practices. Analyses included multi-level multinomial logistic regression. Wellness teams were present in 311/707 (44.0%) schools, with no (19.6%), low (36.0%), and high (44.4%) LWP implementation. A sum score representing active wellness teams (mean=2.6) included: setting healthy eating/physical activity goals (66.9%), informing the public of LWP activities (71.4%), meeting ≥4times/year (45.8%), and having school staff (46.9%), parent (25.4%), or student (14.8%) representation. In adjusted models, goal setting, meeting ≥4times/year, and student representation were associated with high LWP implementation. For every one-unit increase in active wellness team sum score, schools were 41% more likely to be in high versus no implementation (Likelihood Ratio=1.41, 95% C.I.=1.13, 1.76). In conclusion, wellness teams meeting best practices are more likely to implement LWPs. Interventions should focus on the formation of wellness teams with recommended composition/activities. Study findings provide support for wellness team recommendations stemming from the 2016 Healthy, Hunger-Free Kids Act final rule.

Successes of the Healthy Hunger-Free Kids Act

health in many years and, in part, led to tremendous changes to the school food environment. Because of the HHFKA, foods served as part of the National School Lunch Program were dramatically changed in 2012. This represented the first major change to school meals in 15 years. The lunch meal pattern changes, which align with the Dietary Guidelines of 2010, included grade-specific calorie/portion size specifications (including calorie maximums, not just minimums), increased amounts of fruits and vegetables served, only whole-grain–rich grains, no whole milk, and reductions in sodium. Three years after the implementation of these meal pattern changes, research examining the impact is accumulating, with the article by Johnson and colleagues 2 in this issue of JAMA Pediatrics adding to

Using the CDC’s Worksite Health ScoreCard as a Framework to Examine Worksite Health Promotion and Physical Activity

Introduction Worksite health promotion programs are emerging as an effective approach for addressing the adult obesity epidemic and improving the overall health of employees. Methods We conducted a scoping review to identify articles that described a physical activity component (eg, promoted increased physical or reduced sitting time) of a worksite health promotion intervention. Our search specified full-length articles published in English from January 2000 through July 2015. We used the Centers for Disease Control and Prevention’s Worksite Health ScoreCard, a validated tool, as a framework to summarize information on organizational supports strategies (18 questions) and physical activity strategies (9 questions) implemented by worksite health promotion programs. We also determined whether or not the included studies reported significant (P < .05) improvements in physical activity. Results We identified 18 worksite health promotion programs; 11 produced significant improvements in physical activity. Incentives, health risk assessments, health promotion committees, leadership support, marketing, and subsidies or discounts for use of exercise facilities were the most effective organizational supports strategies cited, and physical activity seminars, classes, and workshops were the most effective physical activity strategies cited. Conclusion The use of the Health ScoreCard allowed for a practical interpretation of our findings, which can inform next steps for the field. Future research should explore the relationships between components of worksite health promotion programs and their outcomes to further develop best practices that can improve worker health and promote physical activity.