Paul Branscum

A systematic analysis of childhood obesity prevention interventions targeting Hispanic children: lessons learned from the previous decade

Hispanic children suffer from the highest overall rates of prevalence for overweight and obesity in the US. In the last decade some interventions for prevention of childhood obesity have been developed and tailored to target this subgroup. The purpose of this review is to systematically analyze and summarize findings for health education and promotion interventions aimed at the prevention of childhood overweight and obesity among primarily Hispanic children. A systematic review of PubMed, CINAHL, and ERIC was done for the time period 2000 to May 2010. A posteriori effect size for the primary outcome of each intervention was calculated using G*Power. A total of nine interventions were located; five randomized controlled trials and four were either quasi‐experimental or pilot studies. Among these studies, only four had significant findings, and calculated effect sizes (Cohens f) ranged from small to medium with the highest f = 0.26. Interventions were more likely to be successful when participants were at higher risk for obesity, a parental component was included, the intervention contained theoretical underpinnings, the intervention was delivered by a dedicated staff, the intervention served older children and the intervention was longer in duration. More interventions need to be developed for Hispanic children. Future interventions should also develop and utilize culturally appropriate and sensitive materials and approaches.

After-School Based Obesity Prevention Interventions: A Comprehensive Review of the Literature

The purpose of this article was to review primary prevention interventions targeting childhood obesity implemented in the after school environment from 2006 and 2011. A total of 20 interventions were found from 25 studies. Children in the interventions ranged from kindergarten to middle schoolers, however a majority was in the 4th and 5th grades. Most of the interventions targeted both physical activity and dietary behaviors. Among those that focused on only one dimension, physical activity was targeted more than diet. The duration of the interventions greatly varied, but many were short-term or brief. Many interventions were also based on some behavioral theory, with social cognitive theory as the most widely used. Most of the interventions focused on short-term changes, and rarely did any perform a follow-up evaluation. A major limitation among after school interventions was an inadequate use of process evaluations. Overall, interventions resulted in modest changes in behaviors and behavioral antecedents, and results were mixed and generally unfavorable with regards to indicators of obesity. Recommendations for enhancing the effectiveness of after school based childhood obesity interventions are presented.

An Evaluation of the Validity and Reliability of a Food Behavior Checklist Modified for Children

OBJECTIVE The objective of this study was to report the construct validity and internal consistency reliability of the Food Behavior Checklist modified for children (FBC-MC), with low-income, Youth Expanded Food and Nutrition Education Program (EFNEP)-eligible children. METHODS Using a cross-sectional research design, construct validity was assessed using confirmatory factor analysis (weighted least squares method), and internal consistency reliability for 3 subscales was assessed using Cronbach alpha. RESULTS Ninety-seven children from low-income families completed the FBC-MC. Indicator tests suggest adequate model fit (comparative fit index = 0.962; root mean square error of approximation = 0.064) and item factor loadings were significant for all subscales (P < .05). The instrument appeared to have adequate reliability for 1 subscale (fruit and vegetable consumption, alpha = 0.67), but not for the other 2 (milk consumption, alpha = 0.43; healthful eating behaviors, alpha = 0.56). CONCLUSIONS AND IMPLICATIONS The FBC-MC may be a suitable instrument for evaluating dietary behaviors among Youth EFNEP-eligible children; however, more work is needed to establish internal reliability and criterion validity.

The Effect of a Recessionary Economy on Food Choice: Implications for Nutrition Education.

OBJECTIVE To determine the effect of an economic recession on food choice behaviors. DESIGN A qualitative study using semistructured, in-depth interviews followed by completion of a nutrition knowledge questionnaire and the Food Choice Questionnaire was conducted. SETTING AND PARTICIPANTS A convenience sample from a metropolitan city in the Midwest. Women with children younger than 18 years in the household who had experienced unemployment, underemployment, or loss of a house because of foreclosure in the previous year participated (n = 25). MAIN OUTCOME MEASURE Reported behaviors for food choices when grocery shopping and dining out and educational resources requested to inform nutrition education programs. ANALYSIS Interviews were coded with a matrix derived from participant statements. Common behaviors were grouped and broad themes were identified. RESULTS Numerous shopping strategies were recently used to save money (eg, buying only sale items, using coupons). Participants believed a healthful diet included a variety of foods with less sugar, salt, and fat. Recipes and menus that required little cost or preparation time and resources to track food expenditures were desired. CONCLUSIONS AND IMPLICATIONS Nutrition education should include money-saving shopping strategies, facilitate menu planning and cooking skills, and address food resource management to enable participants to acquire sufficient, acceptable, and nutritionally adequate food.

A true challenge for any superhero: an evaluation of a comic book obesity prevention program.

The purpose of this study was to pilot test the Comics for Health program, a theory-based nutrition and physical activity intervention for children. Twelve after-school programs were randomized to either a theory-based (n = 37) or a knowledge-based (n = 34 children) version of the intervention. Pretests, posttests, and 3-month follow-up tests were administered to evaluate the programmatic effects on body mass index percentile, obesity-related behaviors, and constructs of social cognitive theory. Both interventions found significant, yet modest effects for fruit and vegetable consumption (P < .005), physical activities (P < .004), and water and sugar-free beverage consumption (P < .001) and self-efficacy for fruit and vegetable consumption (P < .015) and physical activities (P < .009).

A review of motivational interviewing-based interventions targeting problematic drinking among college students

This article reviews motivational interviewing (MI) -based interventions targeting heavy drinking college students published between 2003 and 2008. A total of 11 MI-based interventions were included in this study. Students receiving the interventions were generally heavy drinkers or adjudicated students. Based on this review MI-based interventions appear to be consistently effective at reducing alcohol use and drinking problems. Most of the interventions focused on enhancing motivation for decreasing alcohol consumption. Many studies did not explicitly identify a behavioral theory, and antecedents of behaviors were rarely reported. Very few studies utilized randomized controlled design. Recommendations for future interventions are presented.

Comparing the Utility of the Theory of Planned Behavior Between Boys and Girls for Predicting Snack Food Consumption Implications for Practice

The purpose of this study was to use the theory of planned behavior to explain two types of snack food consumption among boys and girls (girls n = 98; boys n = 69), which may have implications for future theory-based health promotion interventions. Between genders, there was a significant difference for calorie-dense/nutrient-poor snacks (p = .002), but no difference for fruit and vegetable snacks. Using stepwise multiple regression, attitudes, perceived behavioral control, and subjective norms accounted for a large amount of the variance of intentions (girls = 43.3%; boys = 55.9%); however, for girls, subjective norms accounted for the most variance, whereas for boys, attitudes accounted for the most variance. Calories from calorie-dense/nutrient-poor snacks and fruit and vegetable snacks were also predicted by intentions. For boys, intentions predicted 6.4% of the variance for fruit and vegetable snacks (p = .03) but was not significant for calorie-dense/nutrient-poor snacks, whereas for girls, intentions predicted 6.0% of the variance for fruit and vegetable snacks (p = .007), and 7.2% of the variance for calorie-dense/nutrient-poor snacks (p = .004). Results suggest that the theory of planned behavior is a useful framework for predicting snack foods among children; however, there are important differences between genders that should be considered in future health promotion interventions.

A review of physical activity interventions on determinants of mental health in children and adolescents

The purpose of this article was to review the effects of physical activity (PA) lifestyle intervention on determinants of mental health among children and adolescents. A search was performed using the databases Academic Search Premier, CINHAL, EBSCOHost, PsycARTICLES and PsycINFO. Inclusion criteria were studies that utilized PA interventions designed to impact a determinant of mental health in a target population of 6–18 years. From this search, 537 results were identified and eight met the inclusion criteria. All studies reported an inverse relationship between PA and depression. Seven found a significant (p < 0.05) reduction in depression when various aerobic and/or resistance training exercises were introduced. Only one study found a negative correlation between very light intensity activity and determinants of psychological health (e.g. depression and anxiety); however, these results were not statistically significant. In conclusion, promoting PA appears to improve determinants of mental health, such as depression, global self-worth and self-efficacy. Recommendations for enhancing future interventions are presented.

The use of the internet for prevention of binge drinking among the college population: a systematic review of evidence

AIMS There are many consequences of binge drinking compared with light or moderate drinking behaviors. The prevalence rate and intensity of binge drinking is highest among the college-aged population. Given the popularity and high use of the Internet among college students, a novel approach for programming is through Internet-based interventions. The purpose of this study was to conduct a systematic review of Internet-based interventions targeting binge drinking among the college population. METHODS Eligibility criteria included peer-reviewed articles evaluating Internet-based interventions for binge drinking prevention among college students published between 2000 and 2014. Only English language articles were included. Review articles and articles only explaining intervention pedagogies were not included. After a systematic screening process, a total of 14 articles were included for the final review. Each article was read thoroughly in order to extract the following variables: study design and sample size, average age of participants, underpinning theoretical framework, and intervention description and duration. This review also synthesized a methodological assessment with variables such as outcome measures, sample size justification, number of measurements and use of process evaluations. RESULTS All studies but one reported a significant reduction in the frequency and quantity of alcohol consumption and problems related with heavy drinking. Furthermore, Internet-based interventions appeared to be more effective than traditional print-based interventions; however, face-to-face interventions were typically more effective. CONCLUSIONS This review supports using the Internet as a brief intervention approach that can effectively support efforts to reduce binge drinking among college students.

How College Students Search the Internet for Weight Control and Weight Management Information: An Observational Study.

Background: Few studies have attempted to examine how young adults search for health information on the Internet, especially information related to weight control and weight management. Purpose: The purpose of this study was to determine search strategies that college students used for finding information related to weight control and weight management on the Internet. Methods: A sample of undergraduate students (n = 30) were given 11 scenarios related to weight control and weight management and used the Internet to find solutions. Observations were recorded using video and audio software (Camtasia). Results: Participants used search engines for 97% of searches, and all participants but one used Google. Success rates varied from 96.4% to 57.1%. Transcripts from the audio recordings taken during the search revealed 4 themes: (1) Google is efficient; (2) perceptions about common sense information; (3) determinants of website credibility; and (4) difficulties finding and interpreting information. Discussion: Google was oftentimes exclusively accessed and relied upon to help users craft relevant search terms and correct misspellings. Users are also oftentimes confused about what dictates “credible” information. Translation to Health Education Practice: Health educators can use information from this study to develop interventions targeting health and computer literacy.