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Background: Given sparse knowledge on dissemination, this study sought to explore key benefits, barriers and contextual factors that are perceived to be important to the adoption and implementation of the 'Community Guide's' evidence-based physical activity recommendations., Design: We conducted case studies in two states where extensive adoption and implementation of the Guide's recommendations have occurred and in two states where widespread dissemination has lagged. Interviews (n = 76) were semi-structured and included both quantitative and qualitative methods. Participant perceptions from the following areas were examined: (i) priority of physical activity, (ii) awareness of and ability to define the term 'evidence-based approaches' and (iii) awareness, adoption, facilitators, benefits, challenges and barriers to Guide adoption., Results: Key enabling factors among high capacity states included: funds and direction from the Centers for Disease Control and Prevention; leadership support; capable staff; and successful partnerships and collaborations. Restraining forces among low capacity states included: the Guide recommendations being too new; participants being too new to current job; lack of time and training on how to use the Guide recommendations; limited funds and other resources and lack of leadership., Conclusion: To be effective, we must gain an understanding of contextual factors when designing for dissemination.

Background: Competency-based education allows public health departments to better develop a workforce aimed at conducting evidence-based control cancer., Methods: A 2-phased competency development process was conducted that systematically obtained input from practitioners in health departments and trainers in academe and community agencies (n = 60)., Results: Among the 26 competencies developed, 10 were rated at the beginner level, 12 were intermediate, and 4 were advanced. Community-level input competencies were seen as beginner level, whereas policy-related competencies were rated as advanced., Conclusion: Although adaptation to various audiences is needed, these competencies provide a foundation on which to build practitioner-focused training programs.

Objective: The High 5 for Preschool Kids (H5-KIDS) program tested the effectiveness of a home based intervention to teach parents how to ensure a positive fruit-vegetable (FV) environment for their preschool child, and to examine whether changes in parent behavior were associated with improvements in child intake., Methods: A group randomized nested cohort design was conducted (2001 to 2006) in rural, southeast Missouri with 1306 parents and their children participating in Parents As Teachers, a national parent education program., Results: When compared to control parents, H5-KIDS parents reported an increase in FV servings (MN=0.20, p=0.05), knowledge and availability of FV within the home (p=0.01), and decreased their use of noncoercive feeding practices (p=0.02). Among preschoolers, FV servings increased in normal weight (MN=0.35, p=0.02) but not overweight children (MN=-0.10, p=0.48), relative to controls. The parent's change in FV servings was a significant predictor of child's change in FV in the H5-KIDS group (p=0.001)., Conclusion: H5-KIDS suggests the need for, and promise of, early home intervention for childhood obesity prevention. It demonstrates the importance of participatory approaches in developing externally valid interventions, with the potential for dissemination across national parent education programs as a means for improving the intake of parents and young children.

Background: The evidence of health benefits associated with the consumption of a variety fruits and vegetables (FV) is well known. The "5 A Day Color Way" campaign is a national effort to translate the science with a message of increased colorful FV consumption for the public. The extent of the translation and adherence to these recommendations among families in a community setting is an important public health question., Methods: Parents enrolled in 8 rural Missouri county parent education programs answered surveys for their preschool children (n = 1658) about FV consumption and barriers to purchasing them by color., Results: Of parents, 40% (n = 668) and 26% (n = 425) of children ate from all 5 colors some time the previous week. However, no parents and only 1 child attained perfect adherence to the guidelines (all 5 colors most days of the week). Disliking the taste and not in the habit of purchasing colorful FV were significant predictors for not meeting recommendations for red, yellow/orange, and green FV., Conclusions: Interventions targeting young children and their families (ie, child care settings, elementary schools) that establish preference for color specific FV may be ideal in rural communities to encourage movement toward adherence to the campaign.

Introduction: Because of the public's growing awareness of the childhood obesity epidemic, health policies that address obesogenic environments by encouraging healthy eating and increased physical activity are gaining more attention. However, there has been little systematic examination of state policy efforts. This study identified and described state-level childhood obesity prevention legislation introduced and adopted from 2003 through 2005 and attempted to identify regional geographic patterns of introduced legislation., Methods: A scan of legislation from all 50 states identified 717 bills and 134 resolutions that met study inclusion criteria. Analyses examined patterns in the introduction and adoption of legislation by time, topic area, and geography., Results: Overall, 17% of bills and 53% of resolutions were adopted. The amount of legislation introduced and adopted increased from 2003 through 2005. The topic areas with the most introduced legislation were school nutrition standards and vending machines (n = 238); physical education and physical activity (n = 191); and studies, councils, or task forces (n = 110). Community-related topic areas of walking and biking paths (37%), farmers' markets (36%), and statewide initiatives (30%) had the highest proportion of bills adopted, followed by model school policies (29%) and safe routes to school (28%). Some regional geographic patterns in the introduction of legislation were observed. There was no statistical association between state-level adult obesity prevalence and introduction of legislation., Conclusion: Public health and health policy practitioners can use this information to improve advocacy efforts and strengthen the political climate for establishing childhood obesity prevention legislation within state governments. Expanded surveillance (including standardized identification and cataloging) of introduced and adopted legislation will enhance the ability to assess progress and identify effective approaches. Future policy research should examine determinants, implementation, and effectiveness of legislation to prevent childhood obesity.

Diabetes among African American women is a pressing health concern, yet there are few evaluated culturally relevant prevention programs for this population. This article describes a case study of the Eat Well Live Well Nutrition Program, a community-based, culturally specific diabetes prevention nutrition program for African American women. The stages of change theory and principles from community organization guided the development of the program. Health education strategies, including participatory development and program delivery by peer educators, were applied to promote cultural relevance. Results indicated that overall participants (90%) believed the program to be culturally relevant and were very satisfied with the program (82%). Cultural relevancy was significantly associated with greater program satisfaction and changes in dietary patterns when controlling for the number of sessions attended. Conclusions suggest that participatory strategies can be effective in designing culturally specific prevention programs for African American women.

Although the relationship of psychosocial factors to physical activity has been explored, there is increased interest in how perceptions of the community environment influence behavior. However, few methodological studies have incorporated perceptions of the social and community environment (protective social factors) or addressed key measurement issues. Computer-assisted telephone interviews were administered to a national sample of 1,818 U.S. adults. Unadjusted and multivariate-adjusted odds ratios were calculated to compare active and inactive participants by Protective Social Factors (PSF) scores and selected sociodemographics. Confirmatory factor analysis and reliability analysis suggested strong PSF scale psychometric properties (alpha = .92). After adjustment for potential confounders, a 10-point rise in the PSF score resulted in a 12% increased likelihood of meeting Centers for Disease Control and Prevention/American College of Sports Medicine recommendations. Additional analyses indicated that greater perceived PSFs were associated with meeting these recommendations among Whites but not among African Americans.