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Objectives. We explored the effect of disseminating evidence-based guidelines that promote physical activity on US health department organizational practices in the United States. Methods. We implemented a quasi-experimental design to examine changes in the dissemination of suggested guidelines to promote physical activity (The Guide to Community Preventive Services) in 8 study states; the remaining states and the Virgin Islands served as the comparison group. Guidelines were disseminated through workshops, ongoing technical assistance, and the distribution of an instructional CD-ROM. The main evaluation tool was a pre- and post-dissemination survey administered to state and local health department staffs (baseline n = 154; follow-up n = 124). Results. After guidelines were disseminated through workshops, knowledge of and skill in 11 intervention-related characteristics increased from baseline to follow-up. Awareness-related characteristics tended to increase more among local respondents than among state participants. Intervention adoption and implementation showed a pattern of increase among state practitioners but findings were mixed among local respondents. Conclusions. Our exploratory study provides several dissemination approaches that should be considered by practitioners as they seek to promote physical activity in the populations they serve. (Am J Public Health, 2007;97:1900-1907. doi: 10.2105/AJPH.2006.090399)

Objective The purpose of this study was to identify whether or not there are associations between frequency of eating homegrown produce among rural parents and their preschool children and overall intake. Study design A cross-sectional study, including parents (n= 1,658) and their preschool children (aged 2 to 5 years) enrolled in a parent education program, in eight rural Southeast Missouri counties was conducted. Main outcome measures Parents completed a telephone interview answering questions for themselves and their preschool child about their fruit and vegetable intake during the past 7 days using a 29-item food frequency questionnaire (82% response rate). Statistical analysis performed Frequency of eating homegrown fruits and vegetables was examined and categorized as almost always/always (n=226), sometimes (n=871), and rarely/never (n=546). Odds ratios with 95% confidence intervals, independent sample t tests (two-sided) analyses, and analysis of covariance (with post hoc tests) were conducted. Results Significant differences were found in the overall fruit and vegetable diets and nutrient quality between all three groups for both parents and their preschool children. Furthermore, frequency of eating homegrown fruits and vegetables promoted a positive home environment with increased availability of produce (rarely/never=4.3 items, sometimes=4.7 items, almost always/always=5.2 items), preschooler's preference for them (rarely/never=3.5 favorites, sometimes=3.7 favorites, almost always/always=4.8 favorites) and parental role modeling (rarely/ never=5.3 fruit and vegetable eating observations, sometimes=6.2 fruit and vegetable eating observations, almost always/always=6.3 fruit and vegetable eating observations). Interactions within the larger community food environment were not significantly affected as measured by weekly food dollars spent (rarely/never=$136, sometimes=$117, almost always/always=$137) or eating out the previous month (rarely/never=7.7 times, sometimes=7.2 times, almost always/always=7.0 times). Conclusions Our findings suggest that educational programs promoting awareness of local produce sources and facilitating the development of gardening programs may be a worthwhile investment. J Am Diet Assoc. 2007;107:577-584.

Objective: Examine the role of food spending behaviors and perceptions on fruit and vegetable intake among preadolescent children and their parents. Design: Cross-sectional study. Setting: Metropolitan city. Participants: Five hundred fifty-five parent/child dyads participating in the PARADE study. More than 50% of participants were African American and nearly 40% of households were low income. Variables Measured: Body mass index calculated from child anthropometric data and parents' self-reported height and weight. Adult and child fruit and vegetable intake, annual household income, and food purchase behavior and perceptions obtained from parent questionnaire. Analysis: Analysis of variance used to identify differences in means at P Results: No statistically significant differences in fruit and vegetable intake by income status were observed. Children in households spending the least per week on groceries consumed fewer daily fruits and vegetables. Perceptions of cost of fruits and vegetables were also found to be significantly associated with fruit and vegetable intake among children and parents. Conclusions and Implications: Public health efforts to raise awareness of the relatively low cost of fruits and vegetables should be continued. These efforts may be complemented with policy strategies that make fruits and vegetables more viable options for low-income households. Key Words: Fruit and vegetable intake, food purchase, grocery spending (J Nutr Educ Behav. 2007;39:26-30)

Objective: To assess the accuracy of parents as reporters of both their own and their 2- to 5-year-old children's fruit and vegetable intake. Design: Observational study with a 1-meal intake assessment by an independent observer, followed by a telephone survey to determine the previous day's consumption using a 29-item fruit,juice, and vegetable food frequency questionnaire. Setting: Two separate meal assessments in communitybased settings. Participants: A convenience sample of 61 parent-child dyads from Eastern Missouri was recruited from a school health fair and the Parents as Teachers program. The mean age of the parents was 31.1 years, and 91% were female.The mean age for children was 39.0 months, and 60% were female. Variables Measured: Parent and child fruit and vegetable intake. Analysis: Interobserver agreement using a kappa statistic. Results: Parents accurately reported their children's intake on most fruits and vegetables (kappa = 0.59-0.61). Parents were the least accurate in recalling the consumption of raisins from oatmeal cookies (kappa = 0.05) and 100% juice (kappa = 0.17). Conclusions and Implications: Parents can serve as accurate proxies to report fruit and vegetable consumption by their preschoolers on a food frequency questionnaire used to determine intake for the previous day. This can be a helpful evaluation method for research involving young children. KEY WORDS: parent proxy, dietary assessment, preschool children

Objective: This exploratory study examined how estimates of one's fruit and vegetable intake in childhood are related to 3 current dietary behaviors among African American women: intake of fruits and vegetables, exposure to and preference for fruits and vegetables, and preference for trying new foods. Design: Baseline data from a randomized dietary intervention trial. Setting: Ten urban public health centers in St. Louis, Missouri. Participants: 1227 African American women. Variables Measured: A 33-item fruit and vegetable food frequency questionnaire, items measuring estimates of childhood fruit and vegetable intake, adult fruit and vegetable intake, exposure to and preference for fruit and vegetable, and preference for trying new foods. Analysis: Linear regression evaluated the association between predictors and continuous measures; logistic regression determined the association between predictors and categorical measures. Results: Estimates of one's vegetable intake as a child were significantly related to exposure and preference for both fruits and vegetables, trying of new foods, and intake of both fruits and vegetables in adulthood. Estimates of eating fruit as a child were not significantly associated with these adult dietary behaviors. Conclusions and Implications: Developmental influences on adult dietary patterns may be stronger for vegetables than fruits among African American women. Additional emphasis is needed regarding exposure to and preference for vegetable intake in childhood. KEY WORDS: African American women, fruit and vegetable consumption, food exposure and preference

The purpose of this study was to better understand the number and types of social needs experienced by Medicaid beneficiaries with type 2 diabetes, and how their social needs are associated with key health indicators. Also examined were factors that influence patients' interest in navigation services for health and social needs to inform future interventions and service delivery. The study expands upon prior research, much of which has focused on only one social need (e.g., food insecurity) or one health outcome. The hypothesis was that among individuals with type 2 diabetes, those with a greater number of social needs would report more health‐related problems and be more interested in receiving social needs navigation services. Participants completed a cross‐sectional survey by phone (n = 95) or online (n = 14). Most (85%) reported having at least one social need (M = 2.5, SD = 2.2), most commonly not having enough money for unexpected expenses (68%) or necessities like food, shelter and clothing (31%), medical costs (24%), and utilities (23%). Results supported our comprehensive conceptual model. Having more social needs was associated with greater perceived stress, diabetes distress, problems with sleep and executive and cognitive functioning, less frequent diabetes self‐care activities, more days of poor mental health and activity limitations, worse self‐reported health and more hospitalisations. Number of social needs also was positively associated with interest in having a social needs navigator. Social needs were not associated with days of poor physical health, BMI, self‐reported A1C or smoking status. Social needs were associated with a wide range of indicators of poor health and well‐being. Participants with the greatest social need burden were most open to intervention. [ABSTRACT FROM AUTHOR]

This study addresses the following research questions: (a) What are the various types of family structures that exist in urban African American households? and (b) to what extent do differences in family structure influence social, psychological, and economic well-being as reported by urban African American women? The authors present findings from 301 African American women who participated in a community-based nutrition prevention program in a large Midwestern urban center. This study's results indicate that family structure has more influence on African American women's economic well-being than do social and psychological factors. Implications of these findings for intervention are presented.

The authors outline the short-term effects of a health promotion program on low-income minority women. The theory and methodology behind the Eat Well, Live Well Nutrition Program is described, and the results of the program are analyzed.

We examined patient knowledge as a moderator of psychological reactions to illness among patients with insulin-dependent diabetes mellitus. We reasoned that knowledgeable patients would have the most severe reactions to their illness because the causal implications of good or poor metabolic control would be most apparent. Accordingly, we expected that more knowledgeable patients would react more negatively than less knowledgeable patients to poor metabolic control but would react more positively to good metabolic control. Results from a sample of 46 patients with insulin-dependent diabetes mellitus supported this hypothesis. These findings suggest that increased patient knowledge may not produce uniformly positive results. Patient education programs must consider the psychological implications of patient knowledge in addition to the physiological consequences.