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Background: School-based interventions are critical for enhancing the health of youth. The "Goals for Health (GFH)" school-based project was a goal-setting and life-skills intervention conducted in rural areas to increase self-efficacy, knowledge, and positive behaviors related to healthy eating. The intervention was peer-led with high school students teaching health and life skills to sixth-grade students. The purpose of this study was to examine the impact of the GFH school-based program on healthy eating outcomes related to self-efficacy, attitudes, knowledge, and behavior, and to examine the impact of quality of program implementation on the above outcomes. Methods: Twenty-three rural schools in Virginia (15) and New York (8) participated in the study. Twelve of the schools were intervention schools that received the 12-week GFH program. The remaining 11 were wait-list control schools. Sixth graders (n = 2120 baseline) from all schools were surveyed at 4 time points (preintervention, postintervention, 1 and 2 year follow-up). Results: Results included significant change patterns across the 4 assessment points in the predicted direction for healthy eating-related self-efficacy and fat and fiber knowledge. No significant change patterns were found at follow-up for fat, fiber, or fruit and vegetable intake. Results also indicated differences across gender and ethnicity and significant findings related to quality of implementation. Conclusions: Future interventions need to provide opportunities to practice healthy living skills over an extended period of time, include components that focus on contextual change in the school and the family, and monitor program implementation. (Contains 1 table and 3 figures.)

Goals for Health was a National Cancer Institute funded program designed to impact health behaviors of adolescents living in rural Virginia and New York. This study examined three specific objectives: (a) to examine participants' perceptions of the program components and the relationship between program components and overall program perception, (b) to examine whether subgroups of our participant population perceived the program differently, and (c) to examine whether having positive perceptions of the program predicted changes in program outcomes. Results indicated that program components were significantly related to program perceptions. Perceptions of the program did not differ by subgroup and program perceptions significantly predicted changes in tobacco attitudes and self-efficacy about eating behaviors. Given these findings, school consultants should become aware of how implementation of a program and perceptions of a program may impact program outcomes. (Contains 3 tables.)

Objective: To examine correlates of perceived access to cigarettes at home, school, and the store among youth. Methods: Virginia middle school youth were surveyed before beginning tobacco prevention programs. Multivariate analyses examined household smoking, peer smoking, and perceived community tobacco use for their relationship to perceived access at home, school, and the store. Results: Perceived access at home was associated with parent, sibling, and friend smoking. Perceived access at school and stores was associated with perceived peer and community smoking. Conclusions: Youth tobacco prevention programs should target the commercial and social sources of tobacco access to reduce experimentation, adoption, and addiction among youth.

Context: Increased fruit and vegetable intake can reduce cancer risk. Information from this study contributes to research exploring health disparities in high-risk dietary behavior. Purpose: Changes in fruit and vegetable behavior were evaluated to assess the effects of a low-intensity, physician-endorsed dietary intervention in a rural population. Methods: The study was a randomized trial of 754 patients from 3 physician practices in rural Virginia. Low-literacy nutrition education materials and personalized dietary feedback were administered by mail and telephone. Mixed model analysis of variance was used to determine the effect of the intervention on fruit and vegetable intake behavior, knowledge, intentions, and self-efficacy at 1, 6, and 12 months. Findings: The intervention effect was moderated by age, race, sex, and education. Intake at 1 and 6 months was increased for older and younger participants and those with some college, and further maintained at 12 months by those who did not complete high school. African Americans in the intervention group displayed significantly greater intentions to increase fruit/vegetable intake than whites/others. Knowledge of fruit/vegetable recommendations significantly increased in the intervention group at 12 months, particularly for men. Conclusions: For the rural population, a low-intensity physician-endorsed self-help dietary intervention was successful in initiating fruit and vegetable dietary changes at 1 and 6 months post-intervention, and increasing intentions to change in African Americans. The relationship of the moderating effects of age, race, sex and education need to be further explored in relation to dietary intervention and dietary behavior change for the rural population.

Objective: To examine mother-child dietary concordance that may contribute to healthy eating practices critical to cancer prevention in underserved rural families. Methods: A brief food frequency questionnaire was administered to 404 sixth-graders and their mothers in rural Virginia and New York. Results: Significant dietary fat concordance rates were indicated for mother-daughter dyads only. A 3-way interaction revealed that African American girls with mothers who report high fat intake are at highest risk for health-compromising dietary behaviors. Conclusion: Interventions may need to differentially motivate male and female adolescents and incorporate familial and cultural influences to promote healthy eating in rural youth.

Over a 2 1/2-year period (January 1981 to June 1983), 177 Escherichia coli isolates were obtained from 145 field-reared broiler flocks in the Delmarva peninsula, and 20 were obtained from clinically normal day-old hatchery chickens representing an additional 17 flocks in Delmarva. Ninety-one isolates obtained from the field-reared birds between 2 and 8 weeks of age were associated with complicated air-sac disease. Serotyping efforts demonstrated a predominance of O2, O35, and O78 serogroups and a large number of untypable isolates. More than 50% of the isolates in each of the three dominant serogroups were collected from broilers with colibacillosis, but they were never detected in the yolk-sac samples of clinically normal day-old hatchery chickens. In vitro biochemical characterization of the E. coli isolates revealed variable rates of carbohydrate fermentation and amino acid decarboxylation. No common characteristics appeared to be shared by the predominant serogroups isolated from clinically affected birds, although several serogroup-specific reactions were noted. The majority of the isolates were sensitive to chloramphenicol, gentamicin, nalidixic acid, ormethoprim-sulfadimethoxine, spectinomycin, neomycin, and ampicillin. About half of the isolates were sensitive to nitrofurantoin and the sulfa compounds. Less than 25% of the isolates were sensitive to streptomycin, erythromycin, tetracyclines, novobiocin, penicillin, bacitracin, and lincomycin.