Jason E. Maddock

Park-based physical activity in diverse communities of two U.S. cities. An observational study.

BACKGROUND Systematic study of human behavior in public parks and specific activity settings can inform policy to promote physical activity in diverse communities. METHODS Direct observation was used to assess physical activity in public parks in Tampa FL (n=10) and Chicago IL (n=18). Parks were selected from census tracts with high concentrations of white, African-American, and Hispanic populations. Representation from low- and high-income census tracts was also achieved. Physical activity was measured by a modified version of the System for Observing Play and Leisure Activity in Youth (SOPLAY). Activity codes from SOPLAY were transformed to energy expenditure per person (kcal/kg/min). RESULTS Seventy percent of Tampa and 51% of Chicago park users were observed engaged in sedentary behavior. In both cities, children were more likely than adults to be observed in walking or vigorous activity. In Tampa, parks located in neighborhoods with the highest concentration of Hispanic residents were associated with greatest levels of energy expenditure. In Chicago, parks in neighborhoods with the highest concentration of African Americans showed the highest energy expenditure per person. Gender was associated with physical activity only in Tampa parks. Energy expenditure also varied by activity areas. CONCLUSIONS More than one half of park users in both cities engaged in sedentary behavior. While differences in park-based physical activity by neighborhood income and racial/ethnic composition were observed, these differences can more likely be attributed to the types of designated activity areas that support physical activity. The study findings suggest that specific configurations of park environments can enhance physical activity in parks.

Multiple health risk behaviors in German first year university students

Multiple health risk behaviors have been identified as a problem in young adults which includes university students. The goals of this study included assessing the prevalence of major health risk behaviors in a cohort of German first year university students, analyzing the clustering of these behaviors and assessing readiness to change across multiple behaviors. A total of 1262 students from the schools of law, teaching and medicine at a German university participated in a voluntary and anonymous survey in 2005. The study assessed indicators and readiness for change regarding fruit and vegetable consumption, exercise, smoking and binge drinking as well as sociodemographic variables. Confirming the hypotheses, prevalences for risk behaviors were high; over 95% ate less than five servings of fruits and vegetables, 60% did not exercise sufficiently, 31% were current smokers and 62% reported binge drinking. Only 2% had none, 10.5% had one, 34.5% had two, 34.8% had three, and 18.2% showed all four risk behaviors. Readiness for behavior change was very low across multiple risk behavior combinations, especially for reducing binge drinking and increasing fruit and vegetable consumption. Medical students showed slightly more positive patterns than other students. The results indicate the need for addressing health behaviors in the student population of this university. If these findings can be replicated in other universities, programs that promote individual behavior change as well as changes in environmental conditions in the university environment are necessary to address this urgent problem.

Sun protection behaviors and stages of change for the primary prevention of skin cancers among beachgoers in Southeastern New England

Sun exposure is the most important avoidable cause of skin cancers. We report characteristics of a representative sample (N=2,324) of beachgoers in Southeastern New England during the summer of 1995. This sample was not employing adequate sun protection behaviors (83% did not often avoid the sun during midday and only 45% often used sunscreen). Important demographic and skin cancer risk factor differences in sun protective behaviors and stages of change for sun protection were found, especially differences based on age, gender, and degree of sun sensitivity. Consistent with previous research, increased age, female gender, and greater sun sensitivity were each independently associated with more sun protective behaviors. These findings underscore the need for interventions targeting high-risk populations, such as those receiving high-intensity sun exposures at the beach.

Transtheoretical Individualized Multimedia Expert Systems Targeting Adolescents' Health Behaviors

The transtheoretical model has advanced research and practice for many health behavior changes among adults, but few applications have been developed and applied among adolescents. This paper will describe an innovative and promising computer-based technology for standardized assessment and individualized theory-based intervention delivery called expert systems. Two different studies utilizing multimedia expert systems technology for assessing and intervening with adolescents targeting several health behaviors will be described. One study includes high school students and targets smoking cessation or prevention, sun protection, and dietary fat reduction. The other study includes urban adolescent female clients recruited in family planning clinics and targets condom adoption and either smoking cessation or prevention. The advantages and disadvantages of expert systems technology are reviewed. Multimedia expert system technology has the potential to enhance health promotion and adherence by integrating the strongest components from both clinical and public health models of intervention.

The College Alcohol Problems Scale

A short, reliable two-factor instrument measuring drinking-related negative consequences was developed from a previous measure using two samples of college students. In Study I, data on alcohol use and problems associated with alcohol use were collected on 382 introductory psychology students. The original College Alcohol Problems Scale (CAPS) was tested and found to fit the data poorly. Sequential methods were used to develop a revised instrument. Principal components analyses (PCA) on half of the sample were conducted on 20 items written to measure negative consequences related to college student drinking. Results indicated a two-factor solution measuring social and emotional problems. Confirmatory factor analyses (CFA) on the other half of the sample confirmed the two-factor structure. Further refinement of the instrument resulted in the revised CAPS (CAPS-r), an eight-item two-factor scale. In Study II, the response format was altered to coincide with the Young Adult Problem Screening Test. A total of 726 students completed the instrument as part of a university-wide random sample. CFA showed that the hypothesized model fit well across all measures of model fit and the factor structure was invariant across gender. Additional analyses revealed that the scale was internally consistent and externally valid. A short reliable and valid measure of alcohol-related problems is needed to enable low-cost data collection on college campuses across the nation, as well as to facilitate program evaluation and routine epidemiological surveillance and monitoring.

Statistical power of articles published in three health psychology-related journals.

Power was calculated for 8,266 statistical tests in 187 journal articles published in the 1997 volumes of Health Psychology (HP), Addictive Behaviors (AB), and the Journal of Studies on Alcohol (JSA). Power to detect small, medium, and large effects was .34. .74. and .92 for HP; .34, .75, and .90 for AB; and .41, .81. and .92 for JSA. Mean power estimates are .36, .77, and .91, giving a good estimation for the field of health psychology. J. Cohen (1988) recommended that power to detect effects should be approximately .80. Using this criterion, the articles in these journals have adequate power to detect medium and large effects. Intervention studies have much less power to detect effects than nonintervention studies do. Results are encouraging for this field, although studies examining small effects are still very much underpowered. This issue is important, because most intervention effects in health psychology are small.

Baseline results from Hawaii's Nā Mikimiki Project: a physical activity intervention tailored to multiethnic postpartum women.

During the postpartum period, ethnic minority women have higher rates of inactivity/under-activity than white women. The Nā Mikimiki (“the active ones”) Project is designed to increase moderate-to-vigorous physical activity over 18 months among multiethnic women with infants 2–12 months old. The study was designed to test, via a randomized controlled trial, the effectiveness of a tailored telephone counseling of moderate-to-vigorous physical activity intervention compared to a print/website materials-only condition. Healthy, underactive women (mean age = 32 ± 5.6 years) with a baby (mean age = 5.7 ± 2.8 months) were enrolled from 2008–2009 (N = 278). Of the total sample, 84% were ethnic minority women, predominantly Asian–American and Native Hawaiian. Mean self-reported baseline level of moderate-to-vigorous physical activity was 40 minutes/week with no significant differences by study condition, ethnicity, infants age, maternal body mass index, or maternal employment. Women had high scores on perceived benefits, self-efficacy, and environmental support for exercise but low scores on social support for exercise. This multiethnic samples demographic and psychosocial characteristics and their perceived barriers to exercise were comparable to previous physical activity studies conducted largely with white postpartum women. The Nā Mikimiki Projects innovative tailored technology-based intervention and unique population are significant contributions to the literature on moderate-to-vigorous physical activity in postpartum women.

Liability concerns and shared use of school recreational facilities in underserved communities

BACKGROUND In underserved communities, schools can provide the physical structure and facilities for informal and formal recreation as well as after-school, weekend, and summer programming. The importance of community access to schools is acknowledged by authoritative groups; however, fear of liability is believed to be a key barrier to community access. PURPOSE The purpose of this study was to investigate perceptions of liability risk and associated issues among school administrators in underserved communities. METHODS A national survey of school administrators in underserved communities (n=360, response rate of 21%) was conducted in 2009 and analyzed in 2010. Liability perceptions in the context of community access were assessed through descriptive statistics. RESULTS The majority of respondents (82.2%) indicated concern for liability should someone be injured on school property after hours while participating in a recreational activity. Among those that did not allow community access, 91% were somewhat to very concerned about liability and 86% believed that stronger legislation was needed to better protect schools from liability for after-hours recreational use. Among those who claimed familiarity with a state law that offered them limited liability protection, nearly three fourths were nevertheless concerned about liability. CONCLUSIONS Liability concerns are prevalent among this group of school administrators, particularly if they had been involved in prior litigation, and even if they indicated they were aware of laws that provide liability protection where use occurs after hours. Reducing these concerns will be important if schools are to become locations for recreational programs that promote physical activity outside of regular school hours.

Short form of a situational temptation scale for heavy, episodic drinking.

PURPOSE A short form for situational temptations to drink scale was developed from an original 21-item inventory by Migneault. METHODS The form measured four hypothesized subscales of temptations on a sample of 348 college drinkers (66% female). Peer pressure, social anxiety, negative affect, and positive/social situations subscales were replicated and reduced. RESULTS Strong empirical support was found for a hierarchical model, indicating that the four subscales can be summed to provide a global measure of situational temptations. Confirmatory factor results, internal and external validity, and high correlations with the original measures indicate that the short form was as psychometrically valid as the original measure. IMPLICATIONS Measures of external validity demonstrated the applicability of this measure to heavy drinking prevention programs.