Melinda J. Ickes

A Systematic Review of Physical Activity Interventions in Hispanic Adults

Healthy People 2020 aims to achieve health equity, eliminate disparities, and improve the health of all groups. Regular physical activity (PA) improves overall health and fitness and has the capability to reduce risk for chronic diseases. Identifying barriers which relate to the Hispanic population is important when designing PA interventions. Therefore, the purpose was to review existing PA interventions targeting Hispanic adults published between 1988 and 2011. This paper was limited to interventions which included more than 35% Hispanic adults (n = 20). Most of the interventions were community based (n = 16), although clinical, family-based, and faith-based settings were also represented. Interventions incorporated theory (n = 16), with social cognitive theory and transtheoretical model being used most frequently. Social support was integral, building on the assumption that it is a strong motivator of PA. Each of the interventions reported success related to PA, social support, and/or BMI. Lessons learned should be incorporated into future interventions.

The role and impact of nurses in American elementary schools: a systematic review of the research.

School nurses are tasked with the critical job of keeping students safe and well. Due to competing demands for resources in schools, the impact of school nurses must be demonstrated to secure their jobs. A systematic review of the literature from 1937 to 2013 was conducted to show the efficacy of school nursing activities in American elementary schools. While some studies of immunization compliance, attendance rates, body mass index screening, vision screening, and follow-up are promising, results are mixed and additional evidence is needed. The impact of school nurses on educational and health outcomes must continue to be evaluated and more rigorous evaluation methods should be explored. Suggestions for future research and collaborations are discussed.

Global School-Based Childhood Obesity Interventions: A Review

Background: The issue of childhood overweight and obesity has become a global public health crisis. School-based interventions have been developed and implemented to combat this growing concern. The purpose of this review is to compare and contrast U.S. and international school-based obesity prevention interventions and highlight efficacious strategies. Methods: A systematic literature review was conducted utilizing five relevant databases. Inclusion criteria were: (1) primary research; (2) overweight or obesity prevention interventions; (3) school-based; (4) studies published between 1 January 2002 through 31 December 2013; (5) published in the English language; (6) child-based interventions, which could include parents; and (7) studies that reported outcome data. Results: A total of 20 interventions met the inclusion criteria. Ten interventions each were implemented in the U.S. and internationally. International interventions only targeted elementary-aged students, were less likely to target low-income populations, and were less likely to be implemented for two or more years in duration. However, they were more likely to integrate an environmental component when compared to U.S. interventions. Discussion: Interventions implemented in the U.S. and internationally resulted in successful outcomes, including positive changes in student BMI. Yet, varying approaches were used to achieve success, reinforcing the fact that a one-size-fits-all approach is not necessary to impact childhood obesity. However, building on successful interventions, future school-based obesity prevention interventions should integrate culturally specific intervention strategies, aim to incorporate an environmental component, and include parents whenever possible. Consideration should be given to the potential impact of long-term, frequent dosage interventions, and subsequent follow-up should be given attention to determine long-term efficacy.

Impact of recess interventions on children's physical activity - a meta-analysis.

Objective. The purpose of this paper was to explore the effect of recess interventions on childrens physical activity (PA) levels and to examine which specific interventions/characteristics have more influence on childrens PA Data Source. Academic Search Premier, CINAHL, ERIC, MEDLINE, ProQuest, SPORT Discus Study Inclusion and Exclusion Criteria. Papers published between 1986 and 2012, published in the English language, and evaluating any recess intervention with PA as an outcome Data Extraction. Study outcomes were distilled into seven domains related to PA: age, gender, intervention type, intervention duration, duration of PA per intervention session, outcome measures, and study region Data Synthesis. Effect sizes were pooled within and across studies for each domain separately. Moderator analyses were performed using gender, age, and total length of intervention. Twenty-three independent samples were provided from 13 studies. Results. The estimated overall effect size for time in PA was 56 (SE .07), suggesting a positive and significant mean difference between pretest and posttest PA time after implementing a recess intervention. Differences in PA levels were moderated by age, duration and type of intervention, and type of outcome measures. Conclusion. The limited evidence suggests recess interventions can improve youth PA levels. Implications reinforce the importance of schools in advocating for recess during the school day. Strategies shown to increase student PA during recess should be implemented.

Polytobacco Use Among College Students

INTRODUCTION Use of more than one tobacco product among college students is increasing in popularity, leading to nicotine addiction and additional health risks. The study (1) examined polytobacco use patterns among college students who had ever used tobacco; and (2) assessed the sociodemographic and personal factors associated with current polytobacco use, compared to current single product use and former tobacco use among college students. METHODS Of 10,000 randomly selected college students from a large public university in the Southeast, a sample of 1593 students age 18 or older completed an online survey assessing tobacco use and attitudes. Ever tobacco users were included in this study (n = 662, or 41.6% of survey completers). RESULTS About 15% of ever users reported current polytobacco use, and more than 70% of polytobacco users smoked cigars, little cigars, or clove cigarettes in combination with one or more products. Cigarettes were the most commonly-used product among single users, followed by hookah. Males, underclassmen, and students with greater acceptance of cigarette use were more likely to be polytobacco users. Race/ethnicity was marginally related to polyuse status, with white/non-Hispanics 28% less likely to be polytobacco users versus single product users. CONCLUSIONS Polytobacco users were more likely than single users to consume emerging tobacco products, (ie, hookah and electronic cigarettes). Males, underclassmen, and racial/ethnic minorities were more at risk for polytobacco use. As young people are particularly prone to nicotine addiction, there is a need to further investigate polytobacco use among college students.

Social influences on use of cigarettes, e-cigarettes, and hookah by college students

ABSTRACT Objectives: (1) Compare social norms and perceived peer use between college student cigarette, e-cigarette, and/or hookah users and nonusers; and (2) determine variables associated with social influences. Participants: Undergraduate students attending a large university in the Southeast United States (N = 511). Methods: An April 2013 online survey assessed use of 3 types of tobacco, social norms, perception of peer use, number of smokers in life, exposure to secondhand smoke, and demographic characteristics. Results: Participants indicated greater acceptance of emerging tobacco products than for cigarettes and consistently overestimated the percent of peers who use various tobacco products. Males and current users had higher social norm scores for all 3 forms of tobacco. Conclusion: To counter marketing of alternative tobacco products, education about the dangers of their use needs to be implemented across college campuses as part of a comprehensive tobacco control strategy that also includes tobacco-free campus policies.

A Tobacco-Free Campus Ambassador Program and Policy Compliance

Abstract Objective: Assess impact and feasibility of a Tobacco-Free Ambassador Program on campus policy compliance. Participants: Trained Ambassadors made 253 visits to campus sites over 15 months to observe and/or approach violators. Methods: Policy violators were observed at 23 locations during Wave 1 (April–June 2012) and/or Wave 2 (April–June 2013). For locations with at least 5 visits, average violators per visit were compared between the 2 waves using a paired t test. Attributes of violators were summarized. Cigarette butts were collected over 3-day periods in 4 campus hotspots during each wave. Personnel time and cost to implement the program were determined. Results: There were declines in observed violators per Ambassador visit and number of cigarette butts over time. Rate of violators per visit declined from 5.47 to 1.93, a 65% decrease. Personnel time was equal to 1.5 full-time equivalents annually. Conclusions: The Ambassador Program was a feasible and potentially effective strategy to increase policy compliance.

Prevalence of human immunodeficiency virus testing and associated risk factors in college students.

Abstract Objective: This study documents the prevalence of human immunodeficiency virus (HIV) testing in a sample of college students and examines associated demographic and behavioral characteristics. Participants: College students aged 18 or older were randomly selected to participate in a health behavior survey at a southeastern university in September 2011. Methods: Only sexually active students were included (N = 905). Relationships between demographic and sexual behavior characteristics were explored using logistic regression and classification regression tree (p ≤.05). Results: Only 36.2% reported having been tested for HIV. Age was the most significant factor associated with testing. Factors associated with those least likely to be tested were race and anal sexual activity. Unsafe sexual behaviors were also associated with lower rates of HIV testing. Conclusions: Findings support the need for targeted HIV interventions on college campuses. Such interventions need to be tailored for at-risk students and take into consideration factors likely to contribute to HIV testing.

Does Behavioral Intention Predict Nutrition Behaviors Related to Adolescent Obesity

The theory of planned behavior (TPB) proposes that the single best predictor of a persons behavior is intention to perform that behavior. Successful application of the TPB supports that attitudes, subjective norms, and perceived behavioral control are predictive factors of behavioral intention (BI). The purpose of this study was to examine the extent to which BI pre- dicted nutrition behaviors linked to adolescent obesity. A cross-sectional design obtained a convenience sample of 318 middle school students who completed a 129-item validated instrument. Multiple regression was used to establish predictors for fruit and vegetable (FV) consumption and sweetened beverages (SBs) versus water consumption. The mean BI scores were as follows: FV consumption, M = 12.18, standard deviation (SD) = 5.74, and SB versus water consumption, M = 12.42, SD = 6.07. This denotes a moderate intent to participate in the behavior. Regression showed that BI was predictive for consumption of FV among over- weight and obese students and con- sumption of water versus SB in normal weight students (P < .05). BI was linked to nutrition behaviors related to obesity prevention in adolescents. Differences among those students who were considered normal weight and overweight/obese existed and should be considered when working with these populations and designing future interventions.

e-Cigarette Use and Perceived Harm Among Women of Childbearing Age Who Reported Tobacco Use During the Past Year

BackgroundThe prevalence of electronic cigarette use grows. Amid increased e-cigarette use nationwide, this paper attempts to identify underlying risk factors for the most vulnerable populations. ObjectiveThe purpose of the study was to assess predictors of e-cigarette use among female current and former tobacco users of childbearing age—specifically to determine whether demographic factors, pregnancy status, conventional cigarette smoking, and perceived e-cigarette harm are associated with e-cigarette use. Reasons for using e-cigarettes were also measured. MethodsA cross-sectional, correlational design was used; 194 current and former female tobacco users, 18–45 years of age, from two university-affiliated prenatal clinics and one women’s health clinic in Kentucky took part. Slightly more than half were pregnant. Age, race/ethnicity, education, pregnancy status, use history for cigarettes and e-cigarettes, and perception of health hazard from e-cigarettes were measured, and associations with e-cigarette use were made with Mann–Whitney U-tests or Spearman’s rank correlations. Predictors of e-cigarette use were determined using proportional odds modeling. ResultsMost current e-cigarette users were also current cigarette smokers (88%). Nearly half of current and former e-cigarette users were pregnant. Most women perceived e-cigarettes as a minor (38%) or moderate (31%) health hazard. In the proportional odds model, younger women were at greater risk for e-cigarette use, whereas minority women and those who were pregnant were less likely to be e-cigarette users. DiscussionPregnant women were less likely to be more recent e-cigarette users, compared with nonpregnant women. However, nearly all current e-cigarette users were dual tobacco users, including pregnant women. It is both imperative and timely to determine the impact of e-cigarette use on maternal and infant health, thus improving healthcare provider confidence to discuss the health implications of e-cigarette use with their patients.