Molly M. Scott

Children’s Mental Health Care following Hurricane Katrina: A Field Trial of Trauma-Focused Psychotherapies

New Orleans school children participated in an assessment and field trial of two interventions 15 months after Hurricane Katrina. Children (N = 195) reported on hurricane exposure, lifetime trauma exposure, peer and parent support, posttraumatic stress disorder (PTSD), and depressive symptoms. Teachers reported on behavior. At baseline, 60.5% screened positive for PTSD symptoms and were offered a group intervention at school or individual treatment at a mental health clinic. Uptake of the mental health care was uneven across intervention groups, with 98% beginning the school intervention, compared to 37% beginning at the clinic. Both treatments led to significant symptom reduction of PTSD symptoms, but many still had elevated PTSD symptoms at posttreatment. Implications for future postdisaster mental health work are discussed.

Comparing Perceived and Objectively Measured Access to Recreational Facilities as Predictors of Physical Activity in Adolescent Girls

A number of studies in recent years have identified both self-report and objectively measured accessibility of recreational facilities as important predictors of physical activity in youth. Yet, few studies have: (1) examined the relationship between the number and proximity of objectively measured neighborhood physical activity facilities and respondents’ perceptions and (2) compared objective and self-report measures as predictors of physical activity. This study uses data on 1,367 6th-grade girls who participated in the Trial of Activity for Adolescent Girls (TAAG) to explore these issues. Girls reported whether nine different types of recreational facilities were easily accessible. These facilities included basketball courts, golf courses, martial arts studios, playing fields, tracks, skating rinks, swimming pools, tennis courts, and dance/gymnastic clubs. Next, geographic information systems (GIS) were used to identify all the parks, schools, and commercial sites for physical activity located within a mile of each girl’s home. These sites were then visited to inventory the types of facilities available. Girls wore accelerometers to measure their weekly minutes of non-school metabolic equivalent weighted moderate-to-vigorous physical activity (MW-MVPA). The number of facilities within a half-mile of girls’ homes strongly predicted the perception of easy access to seven out of nine facility types. Both individual facility perceptions and the total number of facilities perceived were associated with increased physical activity. For each additional facility perceived, girls clocked 3% more metabolic equivalent weighted moderate-to-vigorous physical activity (p < 0.001). Although girls tended to record 3% more of this kind of physical activity (p < 0.05) per basketball court within a mile of their homes, objective facility measures were otherwise unrelated to physical activity. The results from this study suggest that raising the profile of existing facilities may help increase physical activity among adolescent girls.

Girls' perception of neighborhood factors on physical activity, sedentary behavior, and BMI

Objective: The purpose of this study was to examine the association of perceived physical neighborhood factors with physical activity, sedentary behavior, and BMI among adolescent girls.

Not enough fruit and vegetables or too many cookies, candies, salty snacks, and soft drinks?

Objectives. There are many contributors to obesity, including excess consumption of “discretionary calories” (foods high in sugar and fat and low in essential nutrients), lack of fruit/vegetable consumption, and insufficient physical activity. This study contrasted physical activity, fruit/vegetable consumption, and discretionary calorie consumption from selected foods relative to the 2005 dietary guidelines. Methods. We conducted a cross-sectional survey in 228 urban census tracts in Los Angeles County (LAC) and Southern Louisiana (SL) and estimated calories in the past 24 hours from fruit, vegetables, cookies, candy, salty snacks, sweetened soda, and alcohol among 2,767 participants. Results. The population-weighted mean daily intake of calories from candy, cookies, salty snacks, soda, and alcohol was 438 in LAC and 617 in SL. Alcohol comprised a small portion of the calories consumed. Reported discretionary calorie consumption from a small set of items exceeded guidelines by more than 60% in LAC and 120% in SL. In contrast, the mean consumption of fruit and vegetables fell 10% short in LAC and 20% in SL. There was significant heterogeneity in consumption of cookies, candy, salty snacks, and soda across income, gender, and race. Conclusions. The overconsumption of discretionary calories was much greater than the underconsumption of fruit and vegetables. This finding suggests that unless the excessive consumption of salty snacks, cookies, candy, and sugar-sweetened beverages is curtailed, other interventions focusing on increasing physical activity and fruit and vegetable consumption will have a limited impact on obesity control. It may be politically more expedient to promote an increase in consumption of healthy items rather than a decrease in consumption of unhealthy items, but it may be far less effective.

Proximity to School and Physical Activity Among Middle School Girls: The Trial of Activity for Adolescent Girls Study

BACKGROUND Proximity to routine destinations is an important correlate of physical activity. We examined the association between distance from school and physical activity in adolescent girls. METHODS We mapped the addresses of 1554 sixth-grade girls who participated in the Trial of Activity for Adolescent Girls (TAAG) Study and calculated the shortest distance from home to school along the street network. Using a hierarchical design we examined the association between MET-weighted moderate to vigorous physical activity (MW- MVPA) and distance to school, while controlling for potential confounders. RESULTS Distance to school was inversely associated with weekday MW- MVPA for middle school girls. For every mile the girls lived from their schools, they engaged in an average of 13 fewer MET-weighted minutes per week. CONCLUSIONS Distance to school is inversely associated with MW-MVPA. The most adversely affected girls lived more than 5 miles from school. Time spent commuting could explain reduced time for physical activity.

Trauma Exposure and Mental Health Problems Among School Children 15 Months Post-Hurricane Katrina

The purpose of this study was to examine prevalence, correlates and predictors of mental health in children in New Orleans 15 months post-Hurricane Katrina. Analyses were conducted on 195 children who completed self-reports of hurricane and lifetime trauma exposure, social support, post-traumatic stress disorder (PTSD) symptoms, and depression. Teachers completed the Strengths and Difficulties Questionnaire. Children reported high incidence of PTSD symptoms: 36.9% moderate to severe and 23.6% mild. In multiple regression analyses, gender, social support, and lifetime trauma exposure, but not hurricane exposure, significantly predicted PTSD. Age, social support, and lifetime trauma exposure, but not hurricane exposure, significantly predicted child depressive symptoms. Teachers reported lower levels of problems and no significant predictors of teacher reports other than age and school. PTSD and depression were significant problems for children 15 months post-Hurricane Katrina. Lifetime trauma exposure was the strongest predictor of both PTSD and depression. Effective and accessible treatment is needed for such children.