Jennie L. Hill

Comparison of the Computerized ACTIVITYGRAM Instrument and the Previous Day Physical Activity Recall for Assessing Physical Activity in Children

Abstract This study compared the validity of childrens physical activity recall through a computerized assessment (ACTIVITTYGRAM) and through a popular paper and pencil assessment (Previous Day Physical Activity Recall; PDPAR). A total of 147 sixth-grade children from two schools completed the two recall instruments. Data from both self-report instruments were obtained over the same 3 days, and these data were matched by time with data from a subsample of children who wore an accelerometry-based activity monitor (n = 28). To confirm previous validity research with the PDPAR, a larger sample (n = 128) with matched data on the PDPAR and the accelerometer were also used. Activity levels recorded from all three instruments were computed for three periods (afternoon: 3–6 pm, evening: 6–11 p.m. and afternoon/evening: 3–11 p.m.). Descriptive and correlational analyses were conducted across days and for the separate time periods to evaluate the two self-report instruments. There were no differences in mean activity bouts reported on the ACTIVTTYGRAM and the PDPAR (p>.05). Ccrrelations with the activity monitor were above. 50 for both the PDPAR and the ACTIVITYGRAM, and the relationships were consistent across days and periods for both measures. The magnitude of the correlations varied widely in the two schools for the ACTIVITYGRAM comparisons (r = .80 vs. r = .20) but not for the PDPAR, suggesting differential administration or understanding of the ACTIVIYGRAM instrument. Direct correlations between the ACTIVITYGRAM and the PDPAR measures were high (r =. 72), and classification agreement exceeded 80% for the school that provided adequate assistance and training on the ACTIVITYGRAM. Results were weaker in the school with less staff support. This study provides convergent and criterion evidence to support the validity of the computerized ACTIVITYGRAM assessment and suggests similar information as the paper and pencil PDPAR assessment in young children. The study also revealed no differences in PDPAR values or associations, when a simpler scoring procedure was used instead of the traditional more complex metabolic equivalent-based approach.

Cohesion as shared beliefs in exercise classes

The purpose of the study was to determine if perceptions of cohesion in exercise classes demonstrated sufficiently high consensus and between-group variance to support a conclusion that exercise classes are groups. Participants (N = 1,700) in 130classes were tested on either the Group Environment Questionnaire (GEQ) or the Physical Activity Group Environment Questionnaire (PAGEQ). Results showed that exercise classes satisfied the statistical criteria necessary to support a conclusion that they are true groups; that is, they exhibited acceptable levels of consensus about cohesion within classes and acceptable differences in cohesion between classes. In addition, index-of-agreement values were significantly greater for participants completing the PAGEQ than for participants completing the GEQ. Finally, consensus was greatest when participants evaluated how the exercise class satisfied their own personal task needs (i.e., individual attractions to the group-task), and second greatest when participants evaluated the collective unity around the task objectives (i.e., group integration-task).

Does availability of physical activity and food outlets differ by race and income? Findings from an enumeration study in a health disparate region

BackgroundLow-income, ethnic/racial minorities and rural populations are at increased risk for obesity and related chronic health conditions when compared to white, urban and higher-socio-economic status (SES) peers. Recent systematic reviews highlight the influence of the built environment on obesity, yet very few of these studies consider rural areas or populations. Utilizing a CBPR process, this study advances community-driven causal models to address obesity by exploring the difference in resources for physical activity and food outlets by block group race and income in a small regional city that anchors a rural health disparate region. To guide this inquiry we hypothesized that lower income and racially diverse block groups would have fewer food outlets, including fewer grocery stores and fewer physical activity outlets. We further hypothesized that walkability, as defined by a computed walkability index, would be lower in the lower income block groups.MethodsUsing census data and GIS, base maps of the region were created and block groups categorized by income and race. All food outlets and physical activity resources were enumerated and geocoded and a walkability index computed. Analyses included one-way MANOVA and spatial autocorrelation.ResultsIn total, 49 stores, 160 restaurants and 79 physical activity outlets were enumerated. There were no differences in the number of outlets by block group income or race. Further, spatial analyses suggest that the distribution of outlets is dispersed across all block groups.ConclusionsUnder the larger CPBR process, this enumeration study advances the causal models set forth by the community members to address obesity by providing an overview of the food and physical activity environment in this region. This data reflects the food and physical activity resources available to residents in the region and will aid many of the community-academic partners as they pursue intervention strategies targeting obesity.

Randomized controlled trial targeting obesity-related behaviors: Better Together Healthy Caswell County.

Introduction Collaborative and multilevel interventions to effectively address obesity-related behaviors among rural communities with health disparities can be challenging, and traditional research approaches may be unsuitable. The primary objective of our 15-week randomized controlled pilot study, which was guided by community-based participatory research (CBPR) principles, was to determine the effectiveness of providing twice-weekly access to group fitness classes, with and without weekly nutrition and physical activity education sessions, in Caswell County, North Carolina, a rural region devoid of medical and physical activity resources. Methods Participants were randomly divided into 2 groups: group 1 was offered fitness sessions and education in healthful eating and physical activity; group 2 was offered fitness sessions only. Outcome measures were assessed at baseline and immediately after the intervention. Standardized assessment procedures, validated measures, and tests for analysis of variance were used. Results Of 91 enrolled participants, most were African American (62%) or female (91%). Groups were not significantly different at baseline. Group 1 experienced significantly greater improvements in body mass index (F = 15.0, P < .001) and waist circumference (F = 7.0, P = .01), compared with group 2. Both groups significantly increased weekly minutes of moderate physical activity (F = 9.4, P < .003). Participants in group 1 also had significantly greater weight loss with higher attendance at the education (F = 14.7, P < .001) and fitness sessions (F = 18.5, P < .001). Conclusion This study offers effective programmatic strategies that can reduce weight and increase physical activity and demonstrates feasibility for a larger scale CBPR obesity trial targeting underserved residents affected by health disparities. This study also signifies successful collaboration among community and academic partners engaged in a CBPR coalition.

One-Year Mixed-Methods Case Study of a Community–Academic Advisory Board Addressing Childhood Obesity:

Objective: Using a community-based participatory research and systems-based approach, the purpose of this community case study is to describe the planning process and first-year experiences of community–academic advisory board (CAB) partners involved with the development of an evidence-based childhood obesity treatment program in a medically underserved region. Method: Regional community partners (n = 9; Pittsylvania/Danville Health District, Children’s Healthcare Center, Danville Parks & Recreation, and Danville Boys & Girls Club) and academic partners (n = 9) met monthly to select and adapt an evidence-based childhood obesity program, develop evaluation and recruitment protocols, and plan for program implementation. In the first 3 months, members developed a mixed-methods capacity evaluation, administered at 3 and 11 months following the first CAB meeting. Results: Most capacity dimensions were rated highly and demonstrated no significant change over time. However, perceptions of trust approached a significant increase (p = .055), the ability to resolve conflicts significantly increased (p = .018), and participation and influ-ence perceptions significantly decreased (p = .001). Qualitative analysis elucidated members’ experiences and key facilitator and barrier themes emerged. Conclusions: Similarities and differences between community and academic members’ experiences allowed synthesis of best practices and lessons learned. The methodological framework and best practices can inform the capacity development for new community–academic collaborations.

The Influence of Parental Health Literacy Status on Reach, Attendance, Retention, and Outcomes in a Family-Based Childhood Obesity Treatment Program, Virginia, 2013-2015

Introduction Few interventions have evaluated the influence of parent health literacy (HL) status on weight-related child outcomes. This study explores how parent HL affects the reach, attendance, and retention of and outcomes in a 3-month multicomponent family-based program to treat childhood obesity (iChoose). Methods This pre–post, quasiexperimental trial occurred in the Dan River Region, a federally designated medically underserved area. iChoose research protocol and intervention strategies were designed using an HL universal precautions approach. We used validated measures, standardized data collection techniques, and generalized linear mixed-effect parametric models to determine the moderation effect of parent HL on outcomes. Results No significant difference in HL scores were found between parents who enrolled their child in the study and those who did not. Of 94 enrolled parents, 34% were low HL, 49% had an annual household income of less than

Do the Features, Amenities, and Quality of Physical Activity Resources Differ Between City and County Areas of a Large Rural Region?

25,000, and 39% had a high school education or less. Of 101 enrolled children, 60% were black, and the mean age was 9.8 (standard deviation, 1.3) years. Children of parents with both low and high HL attended and were retained at similar rates. Likewise, parent HL status did not significantly influence improvements in effectiveness outcomes (eg, child body mass index [BMI] z scores, parent BMI, diet and physical activity behaviors, quality of life), with the exception of child video game/computer screen time; low HL decreased and high HL increased screen time (coefficient = 0.52, standard error, 0.11, P < .001). Conclusion By incorporating design features that attended to the HL needs of parents, children of parents with low HL engaged in and benefited from a family-based childhood obesity treatment program similar to children of parents with high HL.

Leadership in Physical Activity Groups for Older Adults: A Qualitative Analysis

The goal of this work was to provide a community-academic partnership with actionable information for physical activity (PA) for a rural health-disparate region. Identified PA outlets were audited and combined with survey data for 813 residents in the region. Less than a third of sampled residents (28%) met PA recommendations, with low perceptions of safety for PA. PA resource outlets in rural areas had higher numbers of incivilities. On the basis of our findings, 4 actionable strategies are recommended: shared-use agreements, reducing incivilities, addressing issues related to safety from traffic, and increasing the number of PA resources in rural areas.