Search

Dietary and physical activity habits are developed early in life and are influenced by family environments. We describe and evaluate an intervention for low-income families to encourage healthy habits. The RD Parent Empowerment Program (http://www.eatright.org/programs/kidseatright/activities/content.aspx?id=6442477891) consists of four workshops centered on the 8 Habits of Healthy Children and Families (Academy of Nutrition and Dietetics Foundation). Registered dietitian nutritionists conduct the workshops in school and community settings using a structured leader guide and tailor the communication and interactive activities to the audience. Participants are parents of young children. Our goals were to use a phenomenologic approach to elicit participant feedback, determine whether participants in the RD Parent Empowerment Program made healthier choices for their families after attending the workshops, and identify which elements of the program participants believed contributed most to its success. The evaluation design used a pragmatic, mixed-methods approach utilizing postintervention focus groups and pre-post intervention scores on the Family Nutrition and Physical Activity (FNPA) survey. All workshop attendees aged 18 years or older were eligible to participate in the evaluation. One hundred twenty-three parents participated in the intervention across seven sites. Focus group results were analyzed using thematic analysis methods to match themes to the main intervention goals. t Tests were used to compare pre- and postintervention FNPA scores and demographic characteristics pooled across sites. FNPA scores significantly improved from pre- to postintervention by a mean of 4.3 FNPA points (6.5%; P0.01). Focus group participants reported behavior changes as a result of the program and identified the site leaders as integral to the program's success, triangulating the results. The RD Parent Empowerment Program generates meaningful self-reported behavior change in parents. Long-term sustainability of the changes must be investigated.

Scientific literacy reflects "a broad and functional understanding of science for general education purposes" (DeBoer, 2000, p. 594). Herein, we present the ongoing development of the Scientific Literacy Assessment (SLA), a work-in-progress measure to assess middle school students' (ages 11-14) scientific literacy. The SLA includes a selected response measure of students' demonstrated scientific literacy (SLA-D) and a motivation and beliefs scale based on existing measures of self-efficacy, subjective task value, and personal epistemology for science (SLA-MB). Our theoretical conceptualization of scientific literacy guided the development of our measure. We provide details from three studies: Pilot Study 1 (n = 124) and Pilot Study 2 (n = 220) describe the development of the SLA-D by conducting iterative item analyses of the student responses, think-aloud interviews with six students, and external expert feedback on the items in the SLA-D. Study 3 describes the testing of our prototype measure (n = 264). We present a validity argument including reliability evidence that supports the use of the current version of the SLA to provide evaluation of middle school students' scientific literacy. Our resulting SLA includes the SLA-D in two versions, each with 26 items and the SLA-MB with 25 items across three scales: value of science, scientific literacy self-efficacy, and personal

The article describes a task-centered, peer-mentoring (TCPM) group initiated by a group of female junior faculty to support one another toward tenure and work/life balance. It describes a qualitative study that investigated the peer-mentoring experiences of the participants and explored the implications and complications of peer-mentoring relationships for women in academia. The article begins by describing the group's formation in the context of literature that highlights challenges faced by untenured female faculty; next, it describes the task-centered group process and offers a theoretical framework based on feminist pedagogy. The results of the study and implications for further research and peer-mentoring practice in higher education are presented.

A decade ago, Lancaster and Roe described four critical gaps (i.e., communications, accessibility, credibility, and expectations) between research and practice in health education and health promotion that formed the framework for this department. Despite considerable attention and some progress, these gaps persist and are barriers to interaction and translation between health promotion and health education research and practice. Looking to the next several years as the new Associate Editors for this department, we renew the department’s commitment toward addressing these enduring gaps around which we frame new questions and invite continued dialogue.

The Center for Epidemiological Studies Depression scale (CES-D) was developed to assess the population prevalence of depression. The CES-D was developed and normed on an adult population. Since the CES-D's publication, various studies have both used and psychometrically assessed the scale for older adolescent populations. However, we found no report of the CES-D's psychometric properties for young adolescent populations. We conducted a confirmatory factor analysis of the CES-D with a large, young adolescent population that also included members of a number of different ethnic groups. We tested 12 models previously supported by factor analyses. Radloff's (1977) four-factor model (Depressed Affect, Positive Affect, Somatic Complaints, Interpersonal) was supported if the item "I felt that everything I did was an effort" is deleted, as this item has characteristics that are quite problematic in both the present data and in past data from adolescents. Second-order and hierarchical factor analyses fit the data well but suggested that Depressed Affect could not be distinguished from the General Depression factor. Given the high correlations among the four first-order factors, the standard scoring of the CES-D for one total score is justified.

Purpose To examine associations between the perceived smoking environment and smoking initiation among urban multi-ethnic adolescent girls in New York City. Methods Self-report surveys completed in grades 7, 8, and 9 assessed girls' (n = 858) smoking initiation, and perceived smoking environment (family smoking, friends' smoking, smoking norms, and cigarette availability). Carbon monoxide breath samples were collected from girls using a variation of the bogus pipeline procedure. Results Differences were found in smoking prevalence with white girls reporting the highest prevalence of smoking at baseline and greatest increase in smoking prevalence from seventh to eighth grade. Black girls reported an initial increase in smoking prevalence from seventh to eighth grade followed by a decrease from eighth to ninth grade. Family smoking, friends' smoking, smoking norms, and cigarette availability were all associated with smoking initiation at eighth grade but only friends' smoking was associated with smoking initiation at ninth grade. Few ethnic differences were found in risk factors at baseline and racial/ethnic group did not modify associations between risk and smoking initiation. Conclusions Urban adolescent girls of different racial/ethnic backgrounds had similar perceptions of the smoking environment. Despite the similarity of risk factors across racial/ethnic groups, urban white girls are at increased risk to initiate smoking. Preventive interventions that target girls' perceived smoking environment during early adolescence should be effective across ethnic groups.

Background Self-efficacy theory proposes that girls who have confidence in their capability to be physically active will perceive fewer barriers to physical activity or be less influenced by them, be more likely to pursue perceived benefits of being physically active, and be more likely to enjoy physical activity. Self-efficacy is theorized also to influence physical activity through self-management strategies (e.g., thoughts, goals, plans, and acts) that support physical activity, but this idea has not been empirically tested. Methods Confirmatory factor analysis was used to test the factorial validity of a measure of self-management strategies for physical activity. Next, the construct validity of the measure was tested by examining whether self-management strategies mediated the relationship between self-efficacy and self-reported physical activity, independently of several social-cognitive variables (i.e., perceived barriers, outcome expectancy value, and enjoyment), among cross-sectional samples of 6th grade ( n =309) and 8th grade ( n =296) girls tested between February 14 and March 17, 2002. Data were analyzed in 2004. Results Consistent with theory, self-efficacy had direct effects on the social-cognitive variables. The primary novel finding is that self-management strategies mediated the association of self-efficacy with physical activity in both samples. Conclusions The measure of self-management strategies for physical activity yields valid scores among adolescent girls and warrants experimental study as a mediator of the influence of efficacy beliefs on physical activity.

Physical activity declines in adolescent girls, and there is a need to understand factors that are associated with this phenomenon.1 Heaney and Israel suggest that in adults, social support together with social networks has an important causal effect on health, exposure to stress, and the relationship between stress and health.2 Almost every study that has examined the relationship between physical activity and social support has found a strong positive association using both cross-sectional and prospective study designs, and most have focused on adults.3–7 There is also evidence that social support may be more influential for women than for men5–7 and that social networks are the primary means by which individuals receive support. At the same time, the evidence for the relationship between peer support in adolescents is inconsistent. Most studies use overall measures of support with considerable variation in the measurement of physical activity.8 Most research on social networks or peer influence in adolescents has focused on health risk behaviors, such as the influence of peers on smoking behavior.9–14 Fewer studies have examined whether and how friends’ prosocial behaviors may affect the positive health behaviors of adolescents. For instance, prosocial groups are also thought to be protective against violent behavior in youth.14 Preliminary findings from the PACE (Patient-Centered Assessment and Counseling for Exercise) study showed the relationship between overall peer support and self-reported PA was stronger for girls compared to the boys. (unpublished analyses, J Prochaska & J Sallis, July, 2002). No published data currently exist on peer networks and physical activity among adolescent girls. To fill this gap in the literature, this paper provides preliminary data on the activity-related social networks of middle school girls. Social networks that include active girls or boys could positively influence girls’ physical activity by providing opportunities for social support, social influence, social engagement, and access to resources and personal contact to encourage physical activity.15,16 Understanding which social network features are related to physical activity and the ways by which they promote physical activity will allow interventions to target those factors. This study seeks to determine whether there is a relationship between a girl’s activity level and the activity level, context, and reciprocity (who initiates physical activity) of her close friends. The data for this manuscript were collected as part of a pilot study for the Trial of Activity in Adolescent Girls (TAAG) a multicenter intervention trial designed to test whether a school-based intervention will prevent the decline in physical activity in adolescent girls.

This study tested the longitudinal factorial invariance of a theoretically consistent, higher-order model for Center for Epidemiologic Studies-Depression (CES-D) scores among adolescent girls and boys in middle school. Data were collected from 2,416 adolescents who completed a survey containing the CES-D in the fall of 1998, spring of 1999, and spring of 2000. The invariance analyses were conducted using LISREL 8.50 with maximum likelihood estimation and the Satorra-Bentler scaled chi-square statistic and standard errors. The higher-order model demonstrated longitudinal, as well as gender, invariance of the overall factor structure and first- and second-order structure coefficients, first-order factor variances, second-order factor variances and covariances, and item uniquenesses. The results demonstrate that meaningful comparisons of composite CES-D scores can be made across time among girls and boys in middle school.

Objective We examined the relationship between naturally occurring changes in physical activity and depressive symptoms across a 2-year period among adolescent boys and girls. Methods Participants (N = 4594) reported their frequency of physical activity outside of school and completed the Center for Epidemiological Studies Depression scale in the Fall of 1998 (beginning of 7th grade; baseline data), Spring of 1999 (end of 7th grade; interim data), and Spring of 2000 (end of 8th grade; follow-up data). Results Latent growth modeling indicated that a 1 SD unit change in the frequency of leisure-time physical activity was inversely related to a.25 SD unit change in depressive symptoms. This relationship was attenuated but remained statistically significant when simultaneously controlling for the confounding variables of sex, socioeconomic status, smoking, alcohol consumption, and the value participants placed on their health, appearance, and achievement. Conclusions Naturally occurring changes in physical activity were negatively related with changes in depressive symptoms. The results encourage randomized controlled trials to experimentally determine whether an increase in physical activity reduces depression risk among adolescent boys and girls.

This article compares four mixed-model analyses valid for group-randomized trials (GRTs) involving a nested cohort design with a single pretest and a single posttest, the most common design used in GRTs. This study makes estimates of intraclass correlations (ICCs) available to investigators planning GRTs with alcohol, tobacco, and other drug measures as the outcomes of interest. It also provides formulae demonstrating the potential benefits to the standard error of the intervention effect of both adjustments for fixed and time-varying covariates, as well as correlations over time. These estimates will allow other researchers using these variables to plan their studies by performing a priori power analyses for any of four common analytic options.

Despite widespread recognition of schools' role in the healthy development of youth, surprisingly little research has examined the relationships between schools' overall functioning and the health-related behavior of students. School functioning could become an important predictor of students' health-related behavior and may be amenable to intervention. This paper describes the development and testing of the School Functioning Index (SFI) as a first step in investigating this question. The index was developed for use with middle schools and conceived as a predictor of students' violent behavior, with the potential for extending research applications to additional health and social behaviors. Using social cognitive theory, social ecological theory, and social disorganization theory as guides, three domains were identified to operationalize school functioning and identify candidate SFI items: 1) resources available to the school and students; 2) stability of the school population; and 3) the schools' performance as a socializing agent for students. Data for candidate SFI items were collected from public archives and directly from 16 middle schools participating in a school-based dietary intervention study. Data collection from schools, particularly concerning student aggressive behavior and disciplinary actions, presented challenges. The final SFI comprised nine items and demonstrated good internal consistency and variability. The SFI was modestly correlated in expected directions with violence and other health behaviors. This work supports the feasibility of combining multiple school-level indicators to create a measure of overall school functioning. Further investigation of validity and more acceptable data collection methods are warranted.

Objective To explore potential predictors of adolescents'fruit and vegetable intake by expanding on current theory and drawing from other adolescent research. Design This research reports on baseline and interim data from a school-based intervention study. Data were collected through surveys administered to students at the beginning and end of their 7th grade year. Setting The students attended 16 public schools in Minnesota. Participants Data were collected on 3878 students; approximately half were female and 67% were white. All students in the 7th grade cohort were invited to participate in the surveys and over 94% completed both surveys. Variables Measured Our dependent variable, fruit and vegetable intake, was assessed by a validated fruit and vegetable food frequency scale. Predictive factors assessed included parenting style, spirituality/religiosity, depressive symptoms, and other commonly assessed predictors. Analysis Generalized linear mixed model regression. Omnibus test of association using P Results Subjective norms, barriers, knowledge, usual food choice, parenting style, spirituality /religiosity, and depressive symptoms were statistically significant predictors of intake. The model explained about 31% of the variance in fruit and vegetable consumption. Conclusions and Implications To better understand adolescents' fruit and vegetable intake, we must explore novel predictors. Our results need to be replicated, and more exploratory research in this field is needed.

Multicomponent interventions are recommended for health behavior change among adolescents. However, it is difficult to disentangle the effects of multiple intervention components. This article reports outcomes associated with varying levels of exposure to a school-based nutrition intervention, Teens Eating for Energy and Nutrition at School (TEENS). Four incremental exposureswere possible: (1) control group, (2) school environment interventions only, (3) classroom plus environment interventions, and (4) peer leaders plus classroom plus environment interventions. Patterns suggesting dose response were observed, with peer leaders reporting the largest increases in fruit, vegetable, and lower fat food consumption. Students exposed to classroom plus environment interventions also improved, whereas students exposed only to school environment interventions showed trends toward choosing lower fat foods and declining fruit intake and no change in vegetable intake. Control students’ choices remained stable. Future studies may investigate mechanisms for peer leaders’ changes, maximizing curriculum effectiveness, and improving environmental interventions.

OBJECTIVE To describe the development and psychometric testing of a survey to assess multiple influences on young adolescents' eating behaviors. METHODS A 204-item survey was piloted with middle-school students. We incorporated a broad view of determinants of eating behavior in an effort to expand the current field of predictors. RESULTS The survey was reduced to 147 items and administered to 3,878 students. Internal consistencies were generally >0.70. Test-retest reliabilities were 0.30-0.98, mostly >0.60. CONCLUSIONS We estimated psychometric properties for a range of measures in a diverse sample. This is important as the increasing demand for outcomes-based research expands the need for psychometrically sound survey measures.

The family mealtime environment has great potential to affect the eating behaviors of youth in the family. It is difficult to determine the important elements of a healthy mealtime environment because a valid assessment of the family environment is so difficult to obtain. The objective of this study is to examine the level of agreement between adult and adolescent perceptions of the family mealtime environment and adolescent mealtime behavior. A telephone survey was used to query adult and adolescent family members about how they perceive the family mealtime environment and the adolescent's mealtime behavior. A convenience sample of 282 adult/adolescent pairs from four schools in the Minneapolis/St. Paul area completed the telephone surveys. Frequencies of responses and the associations between the adult and adolescent responses are presented. Pearson correlations and regression were used to examine the level of association between adult and adolescent responses. Mixed-model regression was used for the continuous variables, and mixed-model logistic regression was used for the dichotomous variables. This study showed very little concordance between adolescent and adult responses. Only one question regarding arguments about eating during mealtime showed concordance. Adults and adolescents living in the same household seem to have different perceptions of the family mealtime environment and adolescent eating patterns. Researchers need to be aware of and concerned with the validity of the use of self-report for descriptions of family mealtime. They also need to be aware of the difference in adult and adolescent perceptions and consider these differences when designing messages for the family.

This paper describes a step in exploring the context of health messages within other issues important to families with teenage children. A telephone survey of parents was conducted as part of the formative evaluation for a school and family‐based nutrition intervention with young adolescents. Parents were asked to indicate the frequency with which they talked to their teenage children about a variety of issues, including school and home management issues, wellness issues and health risks. Our results suggest that school and home management issues are more frequently discussed than are health messages. In addition, we saw differences by socioeconomic status (SES) of families. Lower SES families gave more messages overall and gave more priority to messages about health risks as compared to higher SES families. Increasing our understanding regarding family communication with teenagers may help us improve our effectiveness in working with families to reduce health risk factors in youth.

We examined the association between perceived neighborhood characteristics and transport and 2-year changes in accelerometer-determined nonschool MET-weighted moderate to vigorous physical activity (MW-MVPA) and sedentary behavior of adolescent girls. Reporting that children do not play outdoors in their neighborhood, that their neighborhood was well lit, and that there were trails in their neighborhood were each associated with significant decreases in nonschool MW-MVPA. None of the neighborhood or transportation measures was associated with changes in nonschool sedentary behavior. Further work is needed to understand the determinants of the decline in physical activity and the increase in sedentary behavior among adolescent girls.

Research has begun to show associations between adolescents' mealtime practices and their engagement in problem behaviors. Few studies have addressed this longitudinally and/or examined lunchtime practices during the school day. This study tests for associations between urban multiethnic middle school students' ( N = 1498) lunchtime practices in the sixth grade and their engagement in problem behaviors by eighth grade. Positive associations were found between not eating lunch at school in the sixth grade and increased drug use and delinquency by eighth grade. Eating lunch outside of school was found to be significantly associated with smoking and marijuana use only. Gender differences in associations between lunchtime practices and problem behaviors were suggested. Implications for school policy and prevention efforts are discussed.

To describe the development of an original scale that measures perceived school climate for active travel in fourth- and fifth-grade girls and boys.The data were analyzed using confirmatory factor analysis (CFA) to provide evidence of factorial validity, factorial invariance, and construct validity.The CFA supported the fit of a 3-factor (encouragement, praise, and importance) correlated model for the school climate for active travel measure. This hierarchical model was invariant between sex and across a 7-month time period, and initial evidence for construct validity was provided.School climate for active travel is a measurable construct, and preliminary evidence suggests relationships with more support for active travel from friends and family.

Background Preliminary evidence suggests that the physical environment and transportation are associated with youth physical activity levels. Only a few studies have examined the association of physical environmental factors on walking and bicycling to school. Therefore, the purpose of this study was (1) to examine the test-retest reliability of a survey designed for youth to assess perceptions of physical environmental factors (e.g. safety, aesthetics, facilities near the home) and transportation, and (2) to describe the associations of these perceptions with both physical activity and active transport to school. Methods Test and retest surveys, administered a median of 12 days later, were conducted with 480 sixth- and eighth-grade girls in or near six U.S. communities. The instrument consisted of 24 questions on safety and aesthetics of the perceived environment and transportation and related facilities. Additionally, girls were asked if they were aware of 14 different recreational facilities offering structured and unstructured activities, and if so, whether they would visit these facilities and the ease with which they could access them. Test-retest reliability was determined using kappa coefficients, overall and separately by grade. Associations with physical activity and active transport to school were examined using mixed model logistic regression (n = 610), adjusting for grade, race/ethnicity, and site. Results Item-specific reliabilities for questions assessing perceived safety and aesthetics of the neighborhood ranged from 0.31 to 0.52. Reliabilities of items assessing awareness of and interest in going to the 14 recreational facilities ranged from 0.47 to 0.64. Reliabilities of items assessing transportation ranged from 0.34 to 0.58. Some items on girls' perceptions of perceived safety, aesthetics of the environment, facilities, and transportation were important correlates of physical activity and, in some cases, active transport to school. Conclusion This study provides some psychometric support for the use of the questionnaire on physical environmental factors and transportation for studying physical activity and active transport to school among adolescent girls. Further work can continue to improve reliability of these self-report items and examine their association of these factors with objectively measured physical activity.

Social competence is increasingly multidimensional during adolescence as young people encounter a variety of new social situations and can respond with a broad range of appropriate behaviors. However, research on social competence has focused more on children than adolescents. The present study examined the relationships between components of social competence (e.g., assertiveness and social confidence) and adolescent problem behaviors including alcohol use and antisocial behaviors (e.g., aggression and delinquency). A survey was administered to 6th grade students (N=2411) entering 20 New York City public and parochial middle schools and again a year later in the 7th grade. Findings indicated that verbal aggression was reported most frequently among students (93%), followed by physical aggression (69%), delinquent behaviors (53%), and alcohol use (16%). Structural equation modeling indicated that while assertiveness was protective in terms of adolescent problem behaviors, social confidence--the level of confidence that students had in initiating social interactions including dating--was associated with greater alcohol use and antisocial behavior both cross-sectionally and longitudinally. Additional analyses revealed that social confidence related to the initiation of dating (e.g., asking someone out for a date or having a conversation with a member of the opposite sex) was most strongly correlated with each problem behavior outcome. These findings suggest that social confidence, particularly as it relates to precocious dating behavior during early adolescence, is a risk factor for the early initiation of alcohol use and antisocial behavior. Language: en

The Trial of Activity for Adolescent Girls (TAAG) combines social ecological and social marketing approaches to promote girls’ participation in physical activity programs implemented at 18 middle schools throughout the United States. Key to the TAAG approach is targeting materials to a variety of audience segments. TAAG segments are individuals who share one or more common characteristic that is expected to correlate with physical activity. Thirteen focus groups with seventh and eighth grade girls were conducted to identify and characterize segments. Potential messages and channels of communication were discussed for each segment. Based on participant responses, six primary segments were identified: athletic, preppy, quiet, rebel, smart, and tough. The focus group information was used to develop targeted promotional tools to appeal to a diversity of girls. Using audience segmentation for targeting persuasive communication is potentially useful for intervention programs but may be sensitive; therefore, ethical issues must be critically examined.

The authors assessed a cohort of 2,335 students from the Minneapolis, Minnesota, area to identify predictors of violent behavior and to determine whether the predictors varied by gender. The sample was 76% White; boys and girls were equally represented. The majority lived with two parents. A measure of violent behavior collected at the end of the eighth-grade year (2000) was entered into Poisson regression against baseline data collected at the beginning of the seventh-grade year (1998). Predictors of violent behavior influencing both boys and girls included depressive symptoms, perceived invulnerability to negative future events, paternal nonauthoritative behavior, and drinking alcohol. Additional predictors of violent behavior specific to girls included both risk and protective factors.

Despite considerable evidence that physical activity confers substantial health benefits, many adolescents do not engage in sufficient activity to meet minimum recommended levels.1,2 Physical activity (PA) declines during the transition from childhood to adolescence in both girls and boys.3–6 Boys generally engage in more PA at each age,6 and there is a sharp decline among teenage girls.7,8 Understanding the gender discrepancy can inform interventions promoting PA among girls. One of the few large-scale physical activity intervention studies in middle schools underscores this concern: investigators found that boys were more active than girls both during physical education (PE) classes9 and on school grounds during non-PE times.10 After 2 years of intervention, significant increases in PA were detected among boys but not girls.11 Because adolescents spend a substantial amount of time at school, this environment is of interest for understanding and modifying PA behaviors.12,13 The extent to which the school climate supports girls’ being physically active may be important. School climate has been described as the quality of the overall school environment, comprising 4 domains: physical environment, social system, culture, and aggregated characteristics of members of the school community.14,15 Each of these domains could potentially affect girls’ participation in PA, for example, through adequate PA facilities (physical environment), interpersonal relationships that are respectful of gender differences and social and pubertal development (social system), values and norms that support a physically active lifestyle for all (culture), and the prevalence of PA-related behaviors of other girls and female staff members in the school (aggregated characteristics). There is some evidence to support the hypothesis that general school climate or functioning affects students’ health behaviors such as use of tobacco, alcohol, or violence.16–18 Research also suggests that school-level norms specifically concerning alcohol or tobacco use are related to individual students’ substance use.19,20 To date, there has been less research into the effects of school climate on physical activity. School-level measures such as the recent School Health Index 21 will help facilitate investigations into the effects of school policies and physical environments on physical activity and other health behaviors. However, the School Health Index does not have an explicit gender focus, nor does it explicitly evaluate students’ perceptions of the culture regarding PA. A computerized literature search yielded no school climate survey measures specific to girls’ or to general PA. Qualitative research, however, supports the idea that girls perceive school climate regarding PA to be relevant to their PA participation both in PE classes22–24 and overall.25 The purpose of this study was to establish the factorial validity, factorial invariance, and construct validity of an original scale assessing perceived school climate for girls’ physical activity in a sample of sixth- and eighth-grade girls. The measure was developed as part of the Trial of Activity for Adolescent Girls (TAAG), a multicenter intervention study to promote PA in middle school girls. The candidate items for the school climate measure were developed through a review of qualitative research with adolescent girls including formative assessment conducted as part of the developmental phase of TAAG, as well as resources designed for school-level assessments, such as the CDC’s School Health Index21 and the National Association of School Physical Educators’ PE Program Improvement and Self-Study Guide for middle schools.26 After developing the scale items, we used standard confirmatory factor analytic procedures27,28 to establish the factorial validity and the multigroup and longitudinal factorial invariance of the school climate measure in samples of sixth- and eighth-grade girls. After the factorial validity and invariance of the measure were established, structural equation modeling was used to assess construct validity of the school climate measure by testing its relationship with physical activity, as well as the equivalence of that relationship between the 2 groups of girls (sixth and eighth graders), using standard procedures.29

In this longitudinal study, we examined the relationship between changes in time spent watching television and playing video games with frequency of leisure-time physical activity across a 2-year period among adolescent boys and girls (N=4594). Latent growth modelling indicated that a decrease in time spent watching television was associated with an increase in frequency of leisure-time physical activity. That relationship was strong in magnitude and independent of sex, socioeconomic status, smoking, and the value participants placed on health, appearance, and achievement. Our results encourage the design of interventions that reduce television watching as a possible means of increasing adolescent physical activity.

This article compares four mixed-model analyses valid for group-randomized trials (GRTs) involving a nested cohort design with a single pretest and posttest. This study makes estimates of intraclass correlations (ICCs) available to investigators planning GRTs addressing dietary outcomes. It also provides formulae demonstrating the potential benefits to the standard error of the intervention effect (σΔ) from adjustments for both fixed and time-varying covariates and correlations over time. These estimates will allow other researchers using these variables to plan their studies by estimating a priori detectable differences and sample size requirements for any of the four analytic options. These methods are demonstrated using data from the Teens Eating for Energy and Nutrition at School study. Mixed-model analyses of covariance proved to be the most powerful analysis in that data set. The formulae may be applied to any dependent variable in any GRT given corresponding information for those variables on the parameters that define the formulae.

Synopsis This paper provides a first step in addressing special considerations for youth in a relatively new area of physical activity research. After reviewing the urgent need for novel approaches to increasing physical activity, the growing interest in the effects of community design are discussed. Although most discussion on this topic has focused on adults, there are important differences between youth and adults that warrant a special focus on youth and need to be accounted for. This article presents a schematic that accounts for how and where youth spend their time, decomposing the day into time spent in travel and time spent at destinations, and identifying portions of those times that are spent engaged in physical activity. By focusing on both spatial and behavioral dimensions of youth time, the schematic may help organize and advance scientific inquiry into the relationships between community design and physical activity specifically for youth.(Am J Health Promot 2004;0[0]:000‐000.)

This article reports on the outcomes of the Teens Eating for Energy and Nutrition at School (TEENS) study, a 2-year intervention study conducted in 16 middle schools with a goal of increasing students’ intakes of fruits, vegetables, and lower fat foods. Despite positive interim results for students randomized to intervention schools, the positive effects of the intervention were not seen for the primary outcomes at the end of the 2nd year. Positive effects were seen only for a food choice score (suggesting that the students usually choose lower versus higher fat foods) and not for measures of food intake. Future studies may need to take a step back toward more controlled efficacy studies in working with this age-group. In addition, future work may consider the use of peer leaders, more intensive teacher training, ongoing formative assessment, and the testing of more powerful environmental change intervention strategies.

In the past students requesting contraceptives from SBCs [school-based clinics] had been given vouchers to pick up the contraceptives at community clinics at no cost. Because many vouchers went unfilled a new policy involving direct on-site distribution of contraceptives was instituted in May 1998. (Appointments were necessary for requesting contraceptives.) In the present study we sought to evaluate the effects of the change in distribution systems on students’ receipt of requested contraceptives and demand for contraceptives from SBCs. (excerpt)

OBJECTIVES To assess prevalence of elevated depressive symptoms in young adolescents and examine associations between symptoms and sociodemographic and behavioral factors. METHODS Cross-sectional survey data from 3621 seventh grade students from 16 middle schools were analyzed. RESULTS Elevated depressive symptoms were reported by 40% of girls and 30% of boys. Socioeconomic status, race/ethnicity, and age group were independently associated with depressive symptomatology. For girls, monthly alcohol use, monthly smoking, heavy drinking, and inhalant use were significant correlates. For boys, monthly alcohol use and inhalant use were significant. CONCLUSIONS Elevated depressive symptomatology was a prevalent problem. Substance use was often associated with depressive symptoms, especially among girls.

Objective To describe the family mealtime environment and assess associations with adult fruit, vegetable, and fat intake. Design Telephone survey. Participants A convenience sample of 277 adults in the Minneapolis/St. Paul area were recruited through 4 schools. The sample was 85% female and 70% married. The mean number of children in the household was 2.6 (range 1 to 9). Variables Measured Adult fruit and vegetable intake, fat intake, and perceptions of the mealtime environment. Analysis Descriptive and mixed-model linear regression. Results Participants reported that the television was frequently on during dinner meals and almost one third felt that their family was too busy to eat dinner together. A higher frequency of television viewing during dinner was associated with lower fruit and vegetable consumption and higher fat consumption. Planning meals in advance was associated with higher fruit and vegetable consumption; however, 46% of the adults did not plan meals in advance. Arguments concerning eating behavior during dinner were associated with higher fat consumption. Conclusion and Implications The family meal environment is associated with adult eating patterns and should be considered when designing nutrition messages for families.

Peer education has become a popular strategy for health promotion interventions with adolescents. but it has not been used widely in school-based nutrition educntion This paper describes and reports on the feasibility of the peer leader component of a school-based nutrition intervention for young adolescents designed to increase fruit and vegetable intakes and lower fat foods. Abour 1,ooO seventh-grade students in eight schools received the nutrition intervention. Ofthese, 272 were trained as peer leaders 10 assist the teacher in implementing the activities. Resultsfrom a multicomponent process evaluation based on peer leader and classroom student feedback, direct classroom observation, and teacher ratings and interviews are presented Results show that peer-led nutrition education approaches in schools are feasible and have high acceptability among peer leoders, classroom students, and teachers. (J Sch Health. 2002;72(3):121-127) espite the importance of healthy eating during adoles- D cence on both immediate and long-term health, studies consistently show that adolescents as a group have poor dietary habits that do not meet current dietary recommenda- tions.I4 Nutrition-related concerns include low intake of fruits, vegetables, fiber and calcium-rich foods; high intake of foods high in fat and sugar; unhealthful dieting; and erratic eating behaviors, such as meal skipping.ub Recent national data show that only 1% of adolescent males and females met national recommendations for all the Food Pyramid groups, and 18% of females and 7% of the males did not meet any of the recommendations.' Evidence also suggests that dietary quality declines from childhood to adolescence. Lytle et al' followed a cohort of students from third grade to eighth grade and found that intake of fruits, vegetables, milk, and fruit juices decreased and soft drink consumption increased during this time. The shift in eating patterns as children move into adolescence likely occurs due to lifestyle, and to developmental, social and, environ- mental changes. Growing independence and eating away from home, concern with appearance and weight, need for peer acceptance, and full schedules, all affect on eating patterns and food ch0ices.8-~ Nutrition education can help young people attain the knowledge and skills they need to make healthful food choices and develop lifelong healthy eating patterns. Schools are ideal settings for nutrition education because they reach most youth, and nutrition fits into several subject areas including health, science, and consumer science. Schools also provide opportunities to practice healthy eating since more than one-half of youth in the United States eats one of their three major meals in school. Since eating is a socially learned behavior influenced by social pressures, school-based programs also can harness the power of peer influences to support and reinforce healthy eating.' Given the research documenting the poor dietary quality of adolescents' diets and the importance of nutrition educa- tion, sqrisingly few nutrition education studies have been

Background. Low levels of physical activity (PA) and highly sedentary leisure habits (SLH) in youth may establish behavioral patterns that will predispose youth to increased chronic disease risk in adulthood. The purpose of this paper was to examine associations of demographic and psychosocial factors with self-reported PA and SLH in young adolescents. Methods. A general linear mixed model predicted self-reported PA and SLH in the spring from demographic and psychosocial variables measured the previous fall in 3798 seventh grade students. Results. PA and SLH differed by race, with Caucasian students reporting among the highest PA and lowest SLH. Perceptions of higher academic rank or expectations predicted higher PA and lower SLH. Depressive symptomatology predicted higher SLH scores but not PA. Higher self-reported value of health, appearance, and achievement predicted higher PA and lower SLH in girls. Girls who reported that their mothers had an authoritative parenting style also reported higher PA and lower SLH. Conclusions. Determinants of PA and SLH appear to differ from each other, particularly in boys. Development of effective programs to increase PA and/or decrease SLH in young adolescents should be based on a clear understanding of the determinants of these behaviors.

This article presents the first estimates of school-level intraclass correlation for dietary measures based on data from the Teens Eating for Energy and Nutrition at School study. This study involves 3,878 seventh graders from 16 middle schools from Minneapolis–St. Paul, Minnesota. The sample was 66.8% White, 11.2% Black, and 7.0% Asian; 48.8% of the sample was female. Typical fruit and vegetable intake was assessed with a modified version of the Behavior Risk Factor Surveillance System questionnaire. Twenty-four-hour dietary recalls were conducted by nutritionists using the Minnesota Nutrition Data System. Mixed-model regression methods were used to estimate variance components for school and residual error, both before and after adjustment for demographic factors. School-level intraclass correlations were large enough, if ignored, to substantially inflate the Type I error rate in an analysis of treatment effects. The authors show how to use the estimates to determine sample size requirements for future studies.