Kari-Lyn Sakuma

Executive cognitive function and food intake in children.

OBJECTIVE The current study investigated relations among neurocognitive skills important for behavioral regulation, and the intake of fruit, vegetables, and snack food in children. DESIGN Participants completed surveys at a single time point. SETTING Assessments took place during school. PARTICIPANTS Participants were 107 fourth-grade children from a large US city. Ninety-one percent were Latino, and 4% were African-American, which represented school ethnic distribution. MAIN OUTCOME MEASURE(S) Independent variable included was self-reported executive cognitive function (ECF). Dependent variables included self-reported fruit, vegetable, and snack food intake. ANALYSES Primary analyses general linear regression models covarying for appropriate demographic variables. RESULTS Analyses demonstrated that ECF proficiency was negatively related to snack food intake, but was not significantly related to fruit and vegetable intake. CONCLUSIONS AND IMPLICATIONS Since ECF is correlated with snack food intake, future studies may consider assessing the potential of enhancing ECF in health promotion interventions.

Preventing Risk for Obesity by Promoting Self-Regulation and Decision-Making Skills: Pilot Results from the PATHWAYS to Health Program (PATHWAYS).

The overall aim of the two school-based pilot studies was to evaluate whether an approach to prevention that focused on changing child impulse control, decision making, and social competence can be effective in changing attitudes toward food intake and physical activity as risk factors for obesity. The strategy used was to translate specific components of one evidence-based program for violence prevention (Promoting Alternative Thinking Strategies: PATHS) into an elementary school curriculum program for obesity prevention. Both studies demonstrated significant changes in positive attitudes toward self-regulation of appetitive behavior. In addition, Study 2 demonstrated positive changes in actual food choices and television viewing patterns. Implications are that comprehensive efforts to prevent youth risk for obesity should include as one component school-based curricula that target self-regulation and decision-making skills.

Siblings Are Special: Initial test of a New Approach for Preventing Youth Behavior Problems

PURPOSE A growing body of research documents the significance of siblings and sibling relationships for development, mental health, and behavioral risk across childhood and adolescence. Nonetheless, few well-designed efforts have been undertaken to promote positive and reduce negative youth outcomes by enhancing sibling relationships. METHODS Based on a theoretical model of sibling influences, we conducted a randomized trial of Siblings Are Special (SIBS), a group-format afterschool program for fifth graders with a younger sibling in second through fourth grades, which entailed 12 weekly afterschool sessions and three Family Nights. We tested program efficacy with a pre- and post-test design with 174 families randomly assigned to condition. In home visits at both time points, we collected data via parent questionnaires, child interviews, and observer-rated videotaped interactions and teachers rated childrens behavior at school. RESULTS The program enhanced positive sibling relationships, appropriate strategies for parenting siblings, and child self-control, social competence, and academic performance; program exposure was also associated with reduced maternal depression and child internalizing problems. Results were robust across the sample, not qualified by sibling gender, age, family demographics, or baseline risk. No effects were found for sibling conflict, collusion, or child externalizing problems; we will examine follow-up data to determine if short-term impacts lead to reduced negative behaviors over time. CONCLUSIONS The breadth of the SIBS programs impact is consistent with research suggesting that siblings are an important influence on development and adjustment and supports our argument that a sibling focus should be incorporated into youth and family-oriented prevention programs.

Translating evidence based violence and drug use prevention to obesity prevention: development and construction of the Pathways program

Effective school-based obesity prevention programs are needed to prevent and reduce the growing obesity risk among youth. Utilizing the evidence-rich areas of violence and substance use prevention, translation science may provide an efficient means for developing curricula across multiple health behaviors. This paper introduces Pathways to Health, a school-based obesity prevention program that was developed by translating from evidence-based violence and drug use prevention programs, Promoting Alternative THinking Strategies and the Midwestern Prevention Project STAR (STAR). We illustrate how a hypothesized underlying behavior change mechanism in two domains of risk behavior, violence and substance use, can be applied to obesity prevention. A 4-step translational process is provided and may be relevant for use in developing other curricula to address multiple health risk behaviors. Practical application and decision points are also provided.

Evaluating Depressive Symptom Interactions on Adolescent Smoking Prevention Program Mediators: A Mediated Moderation Analysis

INTRODUCTION Smoking prevention interventions have been shown to be effective in reducing smoking prevalence in the United States. Further work is needed to address smoking in China, where over one third of the worlds current smokers reside. China, with more than 60% of the male population being smokers, also presents a unique opportunity to test cognitive processes involved in depression, social influences, and smoking. Adolescents at-risk for developing depression may process social information differently from low-risk counterparts. METHODS The Wuhan Smoking Prevention Trial was a school-based longitudinal randomized controlled trial aimed at preventing initiation and escalation of adolescent smoking behaviors. Thousand three hundred and ninety-one male seventh-grade students were assessed with a 200-item paper-and-pencil baseline survey, and it was readministered 1 year later following program implementation. RESULTS Friend prevalence estimates were significantly higher among 30-day smokers and among those at highest risk for depression symptoms. The program appeared to be successful in changing the perception of friend smoking prevalence only among adolescents with a comorbidity of high scores of depression symptoms and who have experimented previously with smoking. This Program x Comorbidity interaction on perceived friend smoking prevalence was significant in predicting 30-day smoking 1 year after program implementation. CONCLUSIONS This study provides evidence that those adolescents with high levels of depressive symptoms may be more sensitive to social influences associated with smoking prevalence. Individual Disposition x Social Environmental Influences may be important when developing future effective prevention programming.

A Qualitative Exploration of Youth in the “New” China Perspectives on Tobacco Use From Adolescents in Southwest China

School-based prevention programs are not common in China and the attempts to modify successful Western prevention programs have largely shown little effect. Distinct cultural and social systems differences could explain why modified programs have been unsuccessful. Smoking behavior is examined from the perspective of Chinese adolescents as part of the development of a large intervention trial. A total of 16 focus groups with 128 participants were conducted in Chengdu in Sichuan province of China. Impressions of adolescent smokers were mixed, most seeing the behavior as common among boys. Smokers were seen as being overwhelmed and stressed. Girls’ smoking was mostly seen as universally “bad” and reflecting poorly on a girl’s character. However, a small portion of focus group participants suggested that female smoking was fashionable and trendy. With social norms changing rapidly in the “new” China, understanding what the new generation of Chinese youth thinks about smoking is critical in determining how to address and tailor prevention efforts.

Adapting Smoking Cessation Programming to the Bulgarian Context

Tobacco control efforts are among Bulgarias leading health priorities, although enforcement of policies translated from other regions is challenging due to the high national smoking prevalence, especially among health professionals and school personnel. This article reviews the sociocultural and economic background relevant to health policy change and smoking cessation initiatives. Recommendations are made for effective Bulgarian tobacco control.