Joanne Delk

School-level economic disadvantage and obesity in middle school children in central Texas, USA: a cross-sectional study

BackgroundAlthough children of lower socio-economic status (SES) in the United States have generally been found to be at greater risk for obesity, the SES-obesity association varies when stratified by racial/ethnic groups-with no consistent association found for African American and Hispanic children. Research on contextual and setting-related factors may provide further insights into ethnic and SES disparities in obesity. We examined whether obesity levels among central Texas 8th grade students (n=2682) vary by school-level economic disadvantage across individual-level family SES and racial/ethnicity groups. As a secondary aim, we compared the association of school-level economic disadvantage and obesity by language spoken with parents (English or Spanish) among Hispanic students.MethodsMultilevel regression models stratified by family SES and ethnicity were run using cross-sectional baseline data from five school districts participating in the Central Texas CATCH Middle School project. For family SES, independent multi-level logistic regression models were run for total sample and by gender for each family SES stratum (poor/near poor/just getting by, living comfortably, and very well off), adjusting for age, ethnicity, and gender. Similarly, multi-level regression models were run by race/ethnic group (African American, Hispanic, and White), adjusting for age, family SES, and gender.ResultsStudents attending highly economically disadvantaged (ED) schools were between 1.7 (95% CI: 1.1-2.6) and 2.4 (95% CI: 1.2-4.8) times more likely to be obese as students attending low ED schools across family SES groups (p<.05). African American (ORAdj =3.4, 95% CI: 1.1-11.4), Hispanic (ORAdj=1.8, 95% CI 1.1-3.0) and White (ORAdj=3.8, 95% CI: 1.6-8.9) students attending high ED schools were more likely to be obese as counterparts at low ED schools (p<.05). Gender-stratified findings were similar to findings for total sample, although fewer results reached significance. While no obesity differences across school ED categories were found for Hispanic Spanish-speaking students, Hispanic English-speaking students (HES) attending high ED schools were 2.4 times more likely to be obese as HES students at low ED schools (p=.003).ConclusionFindings support the need to prioritize economically disadvantaged schools for obesity prevention efforts and support further exploration of school SES context in shaping children’s physical activity and dietary behaviors.

Promoting Energy-Balance Behaviors Among Ethnically Diverse Adolescents: Overview and Baseline Findings of the Central Texas CATCH Middle School Project

The Central Texas Coordinated Approach To Child Health (CATCH) Middle School Project is a 3.5-year school-based project aimed at promoting physical activity (PA), healthy eating, and obesity prevention among public middle school students in Texas. This article describes the CATCH intervention model and presents baseline findings from spring 2009. CATCH comprises six core components: CATCH Team, CATCH PE, CATCH Classroom, CATCH Eat Smart Cafeteria, CATCH Family, and CATCH Social Marketing. A group randomized serial cross-sectional design is being employed to test the effect of three program support conditions (n = 10 schools each) on energy-balance behaviors: Basic (training and curriculum only), Basic Plus (training and curriculum plus CATCH facilitator support), and Basic Plus Social Marketing (all inputs plus social marketing component). The study sample is composed of a cross-sectional sample of eighth-grade students (primary outcome evaluation sample) and sixth- and seventh-grade students (PE process evaluation sample) who are selected and measured each year. At baseline, 37.9% of eight-grade students (n = 2,841; 13.9 years) were overweight/obese and 19.2% were obese. Eighth-grade students reported, on average, consuming sugar-sweetened beverages more than two times on the previous day and fruits and vegetables roughly three times on the previous day; only two of five school districts surpassed the recommended 50% cut-point for class time spent in moderate-and-vigorous PA as measured in classes of sixth- and seventh-grade students. Additional behavioral findings are reported. Body mass index and behaviors were comparable across conditions. Baseline findings underscore the need to promote student energy-balance behaviors.

Texas Adolescent Tobacco and Marketing Surveillance System's Design

Objectives To provide a full methodological description of the design of the wave I and II (6-month follow-up) surveys of the Texas Adolescent Tobacco and Marketing Surveillance System (TATAMS), a longitudinal surveillance study of 6th, 8th, and 10th grade students who attended schools in Bexar, Dallas, Tarrant, Harris, or Travis counties, where the 4 largest cities in Texas (San Antonio, Dallas, Fort Worth, Houston, and Austin, respectively) are located. Methods TATAMS used a complex probability design, yielding representative estimates of these students in these counties during the 2014-2015 academic year. Weighted prevalence of the use of tobacco products, drugs and alcohol in wave I, and the percent of: (i) bias, (ii) relative bias, and (iii) relative bias ratio, between waves I and II are estimated. Results The wave I sample included 79 schools and 3,907 students. The prevalence of current cigarette, e-cigarette and hookah use at wave I was 3.5%, 7.4%, and 2.5%, respectively. Small biases, mostly less than 3.5%, were observed for nonrespondents in wave II. Conclusions Even with adaptions to the sampling methodology, the resulting sample adequately represents the target population. Results from TATAMS will have important implications for future tobacco policy in Texas and federal regulation.

Implementation of a Computerized Tablet-Survey in an Adolescent Large-Scale, School-Based Study

BACKGROUND Computerized surveys present many advantages over paper surveys. However, school-based adolescent research questionnaires still mainly rely on paper-and-pencil surveys as access to computers in schools is often not practical. Tablet-assisted self-interviews (TASI) present a possible solution, but their use is largely untested. This paper presents a method for and our experiences with implementing a TASI in a school setting. METHODS A TASI was administered to 3907 middle and high school students from 79 schools. The survey assessed use of tobacco products and exposure to tobacco marketing. To assess in-depth tobacco use behaviors, the TASI employed extensive skip patterns to reduce the number of not-applicable questions that nontobacco users received. Pictures were added to help respondents identify the tobacco products they were being queried about. RESULTS Students were receptive to the tablets and required no instructions in their use. None were lost, stolen, or broken. Item nonresponse, unanswered questions, was a pre-administration concern; however, 92% of participants answered 96% or more of the questions. CONCLUSIONS This method was feasible and successful among a diverse population of students and schools. It generated a unique dataset of in-depth tobacco use behaviors that would not have been possible through a paper-and-pencil survey.

Weight Status and Cigarette and Electronic Cigarette Use in Adolescents

INTRODUCTION Research shows that adolescents who are overweight or obese may be at greater risk of cigarette smoking, and that this relationship may vary by gender. However, this relationship is understudied for electronic cigarettes (e-cigarettes). Given the high rate of adolescent obesity and the rise in e-cigarette use in adolescents, this relationship should be investigated. METHODS Data are from the third wave (collected October 2015-January 2016) of the Texas Adolescent Tobacco and Marketing Surveillance system. Students were in the seventh, ninth, and 11th grades (n=2,733) from five counties surrounding four major Texas metropolitan areas (Houston, Austin, San Antonio, Dallas). Weighted logistic regression was used to determine if weight status (healthy weight, overweight, or obese) was correlated with ever and past 30-day cigarette or e-cigarette use, controlling for sociodemographics. Models were stratified by gender. Data analyses were conducted in March 2017. RESULTS Compared with healthy-weight boys, obese boys had higher odds of past 30-day e-cigarette use (AOR=3.45, 95% CI=1.34, 8.33) and cigarette smoking (AOR=4.52, 95% CI=1.32, 15.51). There was no significant relationship between weight status and cigarette or e-cigarette use in girls. CONCLUSIONS This study supports that there is a positive relationship between weight status and past 30-day cigarette and e-cigarette use for boys, but that there is no association for girls.

Positive Outcome Expectations and Tobacco Product Use Behaviors in Youth

ABSTRACT Background: Outcome expectations are an important determinant of health behavior, according to Social Cognitive Theory; yet recent literature has not examined the relationship between outcome expectations and tobacco product use (e.g., use of cigarettes, cigars, hookah, e-cigarettes, or smokeless tobacco). Objectives: This study examines if outcome expectations at baseline, among an adolescent cohort of never users of tobacco products, predicts tobacco product use (i.e., cigarettes, hookah, e-cigarette, cigar, or smokeless tobacco) or susceptibility to use at 6-month follow-up. Methods: Data are from the first two waves of a Texas cohort study of urban middle school and high school students, which were collected in 2014–2015. Logistic regression analyses were used; these adjusted for socio-demographic variables. Analyses were limited to never users of any tobacco product at baseline (n = 1999, N = 357,035). Results: Outcome expectations related to stress relief predicted ever use of (AOR: 4.21, 95% CI 1.84–9.60) and susceptibility (AOR: 2.97, 95% CI 1.01–8.70) to tobacco products. Additional outcome expectations (e.g., relaxation, concentration, slimness, etc.) were not associated with ever use or susceptibility. Conclusions/Importance: This study extends the literature regarding outcome expectations among adolescents regarding tobacco products. It is important that interventions offer alternative solutions to stress relief that do not include tobacco products.

The Role of Schools in Food and Beverage Marketing: Significance, Challenges, Next Steps

The potential detrimental effects of food and beverage advertising through television and print have been documented (e.g., Institute of Medicine [IOM], 2006; Holt, Ippolito, Desrochers, & Kelley, 2007; see also Chap. 8), however less research has examined this type of advertising in schools. It is necessary to further the literature in this area, because children spend a great deal of time in schools (Frumkin, 2006) and begin to form life-long habits during these age periods (Birch, 1999). In order to further our understanding of the influence of in-school food and beverage marketing and promotion, the current chapter aims to do the following (1) present a brief review of the current literature on in-school food and beverage promotion; (2) describe the development of a tool to assess in-school food and beverage promotion (as defined as advertising and product promotion); (3) present data from a pilot study that used the new in-school observation tool; and (4) highlight challenges and future goals in this area of research.Printed eBook exclusively available to patrons whose library offers Springer’s eBook Collection.*** ▶ € |

Promoting Teacher Adoption of Physical Activity Breaks in the Classroom: Findings of the Central Texas CATCH Middle School Project

24.95 ▶ springer.com/mycopy J.D. Williams, Rutgers Business School, Newark and New Brunswick, Newark, NJ, USA; K.E. Pasch, University of Texas, Austin, TX, USA; C.A. Collins, John Hopkins University School of Medicine, Baltimore, MD, USA (Eds.) Advances in Communication Research to Reduce Childhood ObesityChildhood obesity is a major public health problem in the USA, with youth at all stages of development at increasing risk (Health, 2008). Between 1976 and 2004, increases in overweight prevalence ranged from 5.0 % to 12.4 % for 2-to-5-year olds, 6.5 % to 17 % for 6-to-11-year olds, and 5.0 % to 17.6 % for 12- to– 19-year olds (Ogden, Carroll, &, Flegal, 2008; Ogden et al., 2006; Ogden & Carroll, 2010). These statistics are particularly alarming as overweight youth disproportionately suffer from chronic conditions such as hypertension and diabetes, thus resulting in reduced quality of life at an early age (Anderson & Butcher, 2006). Overweight children are also at high risk for becoming overweight adults with the attendant comorbid conditions, including osteoarthritis and certain forms of cancer (Freedman, Dietz, Srinivasan, & Berenson, 1999; Dietz, 1998; Khaodhiar, McCowen, & Blackburn, 1999). As a consequence, a sense of urgency exists to disentangle the complex, multifactorial interactions between individual and environmental factors that lead to child weight imbalance and obesity (Johnson-Taylor & Everhart, 2006; Papas et al., 2007; Sallis & Glanz, 2006; Wang & Beydoun, 2007).