Delivering the Science and the Art of Health Promotion

Robert F. Allen
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Editor's Notes: A Billion and Change in Grants for Health Promotion

The U.S. Department of Health and Human Services announced $1.01 billion in funding opportunities for health promotion in fiscal year 2011 and selected winners for the first phase of these programs. These included $85 million over 5 years for 10 state Medicaid programs to develop incentive-based strategies, $900 million for 61 community-level programs through the community transformation grants, and nearly $10 million to help employers develop comprehensive workplace programs.

Call for Conference Proposals

Call for Manuscripts for Special Issue on Promoting Preconception Health—From Research to Practice

Interventions

Patricia A. McKee
Toben F. Nelson
Traci L. Toomey
Scott T. Shimotsu
Peter J. Hannan
Rhonda J. Jones-Webb

Adopting Local Alcohol Policies: A Case Study of Community Efforts to Regulate Malt Liquor Sales
In response to concerns about the impact of the sales of high-alcohol content beverages, such as malt liquor, on public nuisances and crime, many communities have considered passing legislation to limit the sales of such beverages. In a qualitative analysis of interviews with key informants and articles in local media outlets, this study examines the differences between cities that adopted such legislation and cities that considered but did not adopt legislation limiting sales of malt liquor. There were common barriers identified in both study groups, including: lack of enforcement tools, alcohol industry opposition, and a lack of public and political will for alcohol control. Cities that did adopt malt liquor sales restrictions appeared to have a stronger public mandate for a policy and were less influenced by alcohol industry opposition and lack of legislative authority for alcohol control. Local context emerged as a critical factor in the adoption of policies limiting the sale of malt liquor.

Genevieve Fridlund   Dunton
Keito Kawabata
Stephen Intille
Jennifer WolchMary Ann Pentz

Assessing the Social and Physical Contexts of Children’s Leisure-Time Physical Activity: An Ecological Momentary Assessment Study
This article reports on the use of real-time electronic surveys administered through mobile phones to describe where and with whom children engage in physical activity during leisure time. Results reveal that the most frequently reported contexts for children’s leisure time physical activity are outdoors and with family members and friends together.  Activities taking place at school such as recess and physical education and active transport to and from school were not included in the study.

Tina M. Kruger
Mark Swanson
Rian E. Davis
Sherry Wright
Katie Dollarhide
Nancy E. Schoenberg

Formative Research Conducted in Rural Appalachia to Inform a Community Physical Activity Intervention
Inadequate physical activity participation is a serious problem nationally in the United States, and particularly in the Appalachian region, in Eastern Kentucky.  To gather information that would be useful in designing a church-based intervention to promote increased physical activity in this region, investigators conducted a series of focus groups with residents and key informants in the region.  The qualitative review of the data revealed that whereas barriers to activity are similar to those reported in other studies, residents in this area are faced with region-specific obstacles related to the mountainous geography, low density of development, and weak economy.  Proposed solutions included working through the Cooperative Extension Service, offering programs that serve family members of different ages, and focusing on health, rather than appearance.

Susan B. Sisson
Sarah M. Camhi
Catrine Tudor-Locke
William D. Johnson
Peter T. Katzmarzyk

Characteristics of Step-Defined Physical Activity Categories in U.S. Adults
Epidemiological data from the National Health and Nutrition Examination Survey (NHANES) were examined to determine the patterns of physical activity within a nationally representative sample in terms of daily steps taken.  Accelerometry data were converted to steps-per-day using both a censored (removing very-low-intensity movement) and uncensored procedure.  Results confirmed existing self-report data indicating that the majority of adults in the United States are not engaging in recommended levels of activity (36.1% were sedentary, and 47.6% were low to somewhat active).  Characteristics associated with likelihood of being insufficiently active included being older, female, African-American, and of low socioeconomic status.  The findings strengthen the evidence for a targeted public health campaign to increase physical activity among adults in the United States.

Shirley Y. Huang
Jeannette Hogg
Stephanie Zandieh
Susan B. Bostwick

A Ballroom Dance Classroom Program Promotes Moderate to Vigorous Physical Activity in Elementary School Children
This study investigates whether an existing ballroom dance program can engage fourth and fifth graders in moderate to vigorous physical activity (MVPA) at nationally recommended levels with an associated impact on body mass index (BMI). The System for Observing Fitness Instruction Time (SOFIT) and direct health rate monitoring were used to determine subjects’ MVPA levels. BMI was calculated from measured height and weight. Data from the SOFIT observations showed that a mean of 50% and 67% of class time in the first and second halves of the program were spent in MVPA. Data from the heart rate monitor revealed 71% of students with MVPA for ≥50% of class time. Improvements in BMI percentiles were documented. This study demonstrates that ballroom dance can provide MVPA in elementary school children with a positive impact on BMI.

Melanie A. Wakefield
Emily Brennan
Sarah J. Durkin
Kim McLeod
Katherine C. Smith

Making News: The Appearance of Tobacco Control Organizations in Newspaper Coverage of Tobacco Control Issues
Tobacco-related newspaper articles appearing in Australian daily newspapers from 2004-2007 were analyzed to determine the presence of advocacy groups in coverage about tobacco issues.  Each article examined was coded for mentions of any of 16 tobacco control advocacy groups, article type, prominence, topic, tone of the event, and author's opinion.  Twenty-two percent (22%) of the 4,387 articles examined met the inclusion criteria of including content regarding advocacy groups.  It was found that Australian tobacco control advocacy groups have a reasonable presence within the news on tobacco control issues and are likely to influence the discussion regarding evolving and controversial issues.

Brian G. Moss
William H. Yeaton
 

U.S. Children’s Preschool Weight Status Trajectories: Patterns From 9-Month, 2-Year, and 4-Year Early Childhood Longitudinal Study–Birth Cohort Data
Using data from the Early Childhood Longitudinal Study–Birth cohort, this study examined patterns of change in U.S. children’s early weight status (normal, at-risk, or obese) from infancy through preschool. The nationally representative sample included U.S. preschool children surveyed at 9 months (n = 8900), with a follow-up at 2 years (n = 7500) and preschool (n = 7000). Individual children’s weight status was determined from Centers for Disease Control and Prevention growth charts. Layered, categorical data analysis of changes in weight status showed that young children whose early weight status was normal tended to retain a normal weight status and not to develop an unfavorable status (at-risk or obese). In contrast, children who were obese at an early age were more likely to be in an at-risk or obese weight category at a later age. The results suggest that early weight status can provide important information relevant for early entry point prevention and treatment of childhood obesity.

Sato Ashida
Anna V. Wilkinson
Laura M. Koehly
 

Social Influence and Motivation to Change Health Behaviors Among Mexican-Origin Adults: Implications for Diet and Physical Activity
Using a survey of 475 adults from 161 Mexican-origin families, this study examined the association of motivation to change diet and physical activity behaviors with encouragement from members of the social network. Participating families were recruited from an ongoing study, and may have received one of several permutations of a print-based intervention. Motivations to change diet and/or physical activity and receipt of encouragement from members of the social network were self-reported via a telephone interview 3 months after participants joined the study. Hierarchical linear modeling showed that having at least one social network member who encouraged participants to eat more fruits and vegetables or to engage in regular physical activity were both associated with participants’ motivation to engage in the relevant behavior. The findings affirm the potentially influential role played by members of the social network in motivating lifestyle behavior change.

Examining Physical Activity Levels and Alcohol Consumption: Are People Who Drink More Active?
This review summarizes the scientific literature focused on the relationships between alcohol consumption and levels of physical activity. Data extraction was accomplished using terms or phases such as alcohol, alcohol consumption, drinking, physical activity, exercise, and physically active. Data synthesis includes use of the Matrix Method and PRISMA guidelines. Seventeen (n = 17) studies were identified and analyzed. It was found that alcohol consumers were more physically active than non-drinking peers. In addition, several studies suggested that as drinking increased so did the physical activity level. The studies pointed to a positive association between alcohol consumption and physical activity.

Diana Silver
Beth C. Weitzman
Tod Mijanovich
Martha Holleman

How Residential Mobility and School Choice Challenge Assumptions of Neighborhood Place–Based Interventions
In order to determine how mobility matters for place-based health interventions, this study examined (1) the assumption that children will remain in a neighborhood long enough to absorb the cumulative benefits of neighborhood health interventions, (2) whether neighborhood interventions serve the majority of children living within the community and (3) the degree to which adolescents are attending schools outside the neighborhoods in which they live.  An analysis of cross-sectional household survey data on childhood mobility and school enrollment in Baltimore, Detroit, Philadelphia, and Richmond was undertaken.  The measures included number of years parents lived in the neighborhood, location of school child attends, marital status, race, family income, child’s age and sex.   Chi-square and logistic regression were used to analyze data.  Most teens reported living in the city they were born and residential mobility was more pronounced among black than white children.  Comprehensive interventions that are directed at multiple low income neighborhoods within a single city may prove more beneficial than interventions focusing on a single neighborhood.  

Research Methods

Emily Haisley
Kevin G. Volpp
Thomas Pellathy
George Loewenstein

The Impact of Alternative Incentive Schemes on Completion of Health Risk Assessments
The study of 1299 employees in a healthcare management and information technology company tested the impact of different configurations of incentives on HRA completion rates. Assignment to the treatment versus non-treatment condition was determined by management Assignment to arms within the treatment groups was randomized by office location. All employees (n=1299) in all conditions, including 629 in the comparison condition, were offered a $25 gift certificate for completing the health risk assessment. Those (n=184) in the direct payment condition were offered a grocery certificate worth $25.  Those in the lottery condition were assigned to teams of 4-8 people and offered the chance to win a prize with an expected value of $25, but an actual value of $100, and a bonus value of an additional $25 if 80% of team members participated. Participation rates were 40% in the comparison condition, 44% in the grocery gift certificate condition and 64% in the lottery condition.

Ding Ding
Nicole L. Bracy
James F. Sallis
Brian E. Saelens
Gregory J. Norman
Sion Kim Harris
Nefertiti Durant
Dori Rosenberg
Jacqueline Kerr

Is Fear of Strangers Related to Physical Activity Among Youth?
This study assesses reliability of a newly developed Fear of Stranger Danger (FSD) scale, and uses this scale to examine measurement invariance and identify demographic variation in FSD. The study uses data from neighborhoods with various socioeconomic characteristics and walkability in San Diego, Boston, and Cincinnati. Data are gathered from 171 parent-adolescent pairs and 116 parents of children. Test-retest reliability and internal consistency for FSD are presented along with tests of differential item functioning for measurement invariance, t-test for associations between FSD and demographic variables, and partial correlation for associations of FSD with physical activity, screen time, and body mass index (BMI) z-score. The new FSD scale had moderate to substantial test-retest reliability and excellent internal consistency. Measurement invariance was established across gender, race/ethnicity, and income. FSD was positively associated with restrictive parental rules for playing outside and negatively associated with children’s outdoor physical activity in the neighborhood  It was not associated with other measures of physical activity, screen time, or BMI z score, and thus there were inconsistent associations of fears of stranger danger with youth physical activity.

The Art of Health Promotion

Colleen Seifert
Larry S. Chapman
Joseph K. Hart
Paul Perez

Enhancing Intrinsic Motivation in Health Promotion and Wellness
Motivation for healthier behavior is a central tenet of Health Promotion and Wellness. Worksite wellness programs utilize incentives as a “best practice” approach to programming.  Significant incentive rewards can attract 90%+ of eligible employees.  However without intentional efforts to capitalize on the extrinsic motivation associated with the incentive by enhancing the level of intrinsic motivation they are not likely to lead to long term behavior change.  There are a variety of programming strategies that have been documented in the behavioral science literature as enhancing the level of intrinsic motivation for health behavior change. 

American Journal of Health Promotion |  248-682-0707