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Background Waterpipe tobacco smoking (WTS or 'hookah') is common among adolescents and college students in the USA. However, there has not yet been a large-scale, nationally representative study independently examining WTS among young adults who are not in college. Objective This study sought to examine associations between attitudes, normative beliefs, certain socio-demographic factors and current WTS among young adults not in college and compare them to young adults in college. Methods A total of 3131 US adults ages 18-30 completed an online survey about WTS behaviour, attitudes, normative beliefs and relevant socio-demographic factors. Multivariable logistic regression was used to examine independent associations between these variables and current WTS stratified by student status. Results Ever WTS was reported by 29% of young adults not in college and by 35% of those in college, and current use rates were 3 and 7%, respectively. Multivariable models demonstrated that positive attitudes and perceived peer acceptability of WTS were significantly associated with increased current WTS for both young adults not in college [adjusted odds ratio (AOR) = 2.72; 95% CI: 2.00-3.71 and AOR = 2.02; 95% CI: 1.50-2.71, respectively] and young adults in college (AOR = 3.37; 95% CI: 2.48-4.58 and AOR = 2.05; 95% CI: 1.49-2.83, respectively). The magnitude of these associations was not significantly different when comparing individuals in college and not in college. Conclusions Among young adults, WTS is common in non-college-based populations as well as in college-based populations. Therefore, prevention programming should extend to all young adults, not only to those in college.

While active transportation has health, economic and environmental benefits, participation within the USA is low. The purpose of this study is to examine relationships of demographic and workplace factors with health-enhancing active transportation and commuting.Participants in the 2009 National Household Travel Survey reported demographics, workplace factors (time/distance to work, flextime availability, option to work from home and work start time) and active transportation (for any purpose) or commuting (to and from work, workers only) as walking or biking (≥10 min bouts only). Multiple logistic regression examined cross-sectional relationships between demographics and workplace factors with active transportation and commuting.Among 152 573 participants, active transportation was reported by 1.11% by biking and 11.74% by walking. Among 111 808 working participants, active commuting was reported by 0.80% by biking and 2.76% by walking. Increased odds (p0.05) of active commuting and transportation were associated with younger age, lower income, urban dwelling, and the highest and lowest education categories. Males had greater odds of commuting and transporting by bike but decreased odds of walk transporting. Inconsistent patterns were observed by race, but whites had greater odds of any biking (p0.05). Odds of active commuting were higher with a flexible schedule (p0.001), the option to work from home (p0.05), shorter time and distance to work (both p0.001), and work arrival time between 11:00 and 15:59 (walking only, p=0.001).Active transportation differed across demographic and workplace factors. These relationships could inform infrastructure policy decisions and workplace wellness programming targeting increased active transportation.

Purpose The purpose of this study was to use a match-mismatch paradigm to examine children's exercise discomfort during an aerobic shuttle run. Methods Thirty-four middle school females (n = 18) and males (n = 16) aged 11-14 yr participated. An Exercise Discomfort Index (EDI) was calculated as a rating of perceived exertion for the overall body (Children's OMNI Scale) x a rating of perceived muscle hurt (Children's OMNI Muscle Hurt Scale). Measurements were obtained immediately before (i.e., predicted) and after (i.e., actual) performance of the nationally standardized Progressive Aerobic Cardiovascular Endurance Run (PACER) shuttle test of aerobic fitness. Self-report physical activity and sport participation history were obtained before PACER performance. Results Two-way ANOVA (gender x assessment time point) showed a significant main effect for assessment time point: predicted EDI (means +/- SD = 25.9 +/- 20.1) was greater than actual EDI (means +/- SD = 19.4 +/- 17.8) for the total group (P = 0.021). However, neither the main effect of gender nor the gender x assessment time point interaction was significant. Idiographic analysis showed that overpredictors of discomfort reported less time (5.25 median h x wk(-1)) and engaged in less recreational activity than underpredictors (11.14 median h x wk(-1)). However, no significant relation (P = 0.508) was observed between PACER laps completed and exercise discomfort. Conclusions The sample of middle school children in this study predicted greater exercise discomfort than actually experienced when performing a PACER test. It is possible that a discomfort construct plays an important role in the initiation and maintenance of children's aerobic exercise, providing a basis for physical activity interventions.

Tobacco use using a waterpipe is an emerging trend among college students. Although cigarette smoking is low among college athletes, waterpipe tobacco smoking may appeal to this population. The purpose of this study was to compare cigarette and waterpipe tobacco smoking in terms of their associations with organized sport participation.In the spring of 2008, we conducted an online survey of 8,745 college students at eight institutions as part of the revised National College Health Assessment. We used multivariable regression models to assess the associations between tobacco use (cigarette and waterpipe) and organized sports participation.Participants reported participation in varsity (5.2%), club (11.9%), and intramural (24.9%) athletics. Varsity athletes and individuals who were not varsity athletes had similar rates of waterpipe tobacco smoking (27.6% vs. 29.5%, p=.41). However, other types of athletes were more likely than their counterparts to have smoked waterpipe tobacco (35.1% vs. 28.7%, p.001 for club sports and 34.8% vs. 27.7%, p.001 for intramural sports). In fully-adjusted multivariable models, sports participants of any type had lower odds of having smoked cigarettes, whereas participants who played intramural sports (odds ratio=1.15, 95% confidence interval=1.03, 1.29) or club sports (odds ratio=1.15, 95% confidence interval=1.001, 1.33) had significantly higher odds of having smoked waterpipe tobacco.College athletes are susceptible to waterpipe tobacco use. In fact, compared with their nonathletic counterparts, club sports participants and intramural sports participants generally had higher odds of waterpipe tobacco smoking. Allure for waterpipe tobacco smoking may exist even for individuals who are traditionally considered at low risk for tobacco use.

The Public Health Training Center (PHTC) national program was first established at accredited schools of public health in 2000. The PHTC program used the US Health Resources and Services Administration's grants to build workforce development programs, attracting schools as training providers and the workforce as training clients. This article is a reflection on the experience of two schools, whose partnership supported one of the PHTCs, for the purpose of opening a conversation about the future of continuing education throughout schools and degree programs of public health. This partnership, the Pennsylvania & Ohio Public Health Training Center (POPHTC), concentrated its funding on more intensive training of public healthcare workers through a relatively narrow inventory of courses that were delivered typically in-person rather than by distance-learning technologies. This approach responded to the assessed needs and preferences of the POPHTC's workforce population. POPHTC's experience may not be typical among the PHTCs nationally, but the collective experience of all PHTCs is instructive to schools of public health as they work to meet an increasing demand for continuing education from the public health workforce.

Research findings indicate a relationship between weight perception and depression in adolescents. This study explored the relationship between weight perception, gender, and depressive symptoms in rural adolescents. Among 623 rural adolescents who completed a health inventory and a depression scale, 75 participants (n = 62 females; n = 13 males) had depressive symptoms and were used in data analysis. A two-way ANOVA model was used to evaluate the effects of weight perception and gender on depressive symptoms in rural adolescents. Although the 2-way ANOVA was not significant, there was a statistical significant finding for females who reported perceived weight problems and depression. The interaction between gender and weight perception was of marginal statistical significance (p = 0.07). Females who perceived a problem with their weight had higher depressive scores compared to females who did not perceive a problem with their weight (p = 0.0002), however no difference was observed for males. Implications are for rural nurses to screen adolescents for depressive symptoms and their weight perception during health care visits, with emphasis on females.

It is essential to train health care providers to deliver care sensitive to the needs of diverse individuals with varying degrees of health literacy. We aimed to evaluate an innovative, theory-based, educational intervention involving social marketing and health literacy.In 2006 at a large medical school, all first-year students were exposed to the intervention. They completed pre- and post-test anonymous surveys including demographic data, covariates, and key outcome variables. Paired t-tests and multiple linear regression were used to evaluate the intervention and to determine independent associations among the key outcome variables.Post-intervention scores were significantly higher than pre-intervention scores for social marketing (3.31 versus 1.90, p0.001), health literacy (3.41 versus 2.98, p0.001), and comfort in brochure development (3.11 versus 2.52, p0.001) (N=83). After controlling for demographic and covariate data, health literacy and comfort in brochure development were independent predictors of comfort interacting with diverse populations.A brief intervention involving social marketing and health literacy can improve skills that improve medical students' comfort with patients of diverse backgrounds.Health care providers can be taught educational principles and skills involved in developing effective patient education materials. These skills may improve providers' comfort with direct patient interaction.

Integrating health education and health promotion into practice is routinely done by nurses. According to a national survey, the need for mental health services has increased in over two thirds of school districts. This article describes the screening of 193 adolescents in Rural Western Pennsylvania’s 9th, 10th, and 11th graders for depressive symptoms. Ten percent (N=19) of students had depressive symptoms, the majority of which were female. These students were interviewed by the research team. The outcome themes and referrals are reported as well as the discussion of implications for nurses in screening for depression and health promotion.

In the Fall of 2004, the SOPHE Publications Committee surveyed SOPHE members to solicit feedback on the three SOPHE publications: Health Promotion Practice, Health Education & Behavior, and News & Views. For each publication, members were asked to provide insight as to how they use the publication, to evaluate its content and application, and to make recommendations for changes or improvements to make the publication a more valuable resource. The SOPHE publication readership is, on the whole, a highly educated group with careful reading habits, thoughtful informed opinion of the publications, and a high level of experience in the health education field. The publications meet their readership’s needs, are respected as a valuable reference tool, and are a source and a forum for new ideas in the health education field. Recommendations for action are made to the publication editors and editorial boards and the SOPHE staff, board, and general membership.

Self-efficacy and enjoyment were examined among 34 middle school children ( M age = 12.5 yr.) performing the Progressive Aerobic Cardiovascular Endurance Run (PACER). Exercise self-efficacy (running) and physical activity enjoyment were measured after viewing a video illustrating the PACER, and subsequently following a PACER test. Significantly greater pre- than post-exercise self-efficacy was reported; enjoyment scores did not differ. Ratings of self-efficacy were higher before exercise than after, but enjoyment scores were not significantly different. A significant correlation was found between post-exercise self-efficacy and enjoyment, but not between pre-exercise self-efficacy and enjoyment. Although positive correlations were found between PACER laps and pre-/post-exercise self-efficacy, correlations with ratings of enjoyment were not significant. Exercise self-efficacy was associated with children's beliefs about the task-specific PACER aerobic exercise; however, exercise enjoyment was stable. Children's self-efficacy and enjoyment beliefs should be considered when developing interventional strategies to promote aerobic exercise participation.

The Healthy People 2010 Objectives and the Taskforce on Public Health Workforce Development both have recognized the important roles of state and local agencies in the education and training of their employees. This article describes an initial step in the development of a tool to assess agencies' training readiness using five factors derived from learning organization theory. These factors (resources, policies, learning culture, programs, and leadership) offer a useful framework for further development of a tool to assess training program readiness.

Character education in schools involves formal instruction in honesty, trust, cooperation, respect, responsibility, hope, determination, and loyalty; it also lays the foundation for positive leadership development. The values mentioned are important to leaders regardless of their race, religion, economic status, or other defining characteristics, to promote a livable and workable society. For adolescents, positive leadership behavior is character education in action.

A well-constructed student health survey can provide administrators with the in formation they need to develop policy and curriculum materials and to refine existing services.

The authors explore the differences between adolescents who have a sense of belonging in their families and adolescents who do not using six variables: self-esteem, locus of control, sense of belonging in school, sense of belonging in the community, time spent with family, and level of involvement in school and community activities. The two groups were found to be significantly different with respect to all six variables. The importance of this research for clinicians working with adolescents and families is discussed.

OBJECTIVES: A training needs assessment project tested the use of "universal" competencies for establishing a model training agenda for the public health workforce. METHODS: Agency supervisors selected competencies for training priorities. Regional and national public health leaders used these selections to design the model training agenda. RESULTS: The competencies given high priority by supervisors varied among state and local agencies and included some not within the universal set. The model training agenda reflected supervisors' priorities as well as leaders' perspectives. CONCLUSIONS: The universal competencies provide a useful starting point, but not necessarily an exclusive framework, for assessing and meeting the training needs of the public health workforce.

The purpose of this study was to investigate the psychometric properties of a child self efficacy scale for learning, peer interactions, and resisting pressure to use drugs, to use in an elementary school drug prevention education program based on social cognitive theory. A diverse cohort of 392 4th and 5th grade students completed the 20-item self efficacy scale and social support and social skills instruments. The results provide evidence for a valid and reliable 3-factor self efficacy scale. Subscale internal consistency reliability was good to excellent (Cronbach's alpha = 0.75, 0.83, 0.91). Construct validity was supported by correlations between each subscale and social skills, social support, and demographic data. The scale has potential as a tool to measure self efficacy in children related to learning, peer interactions, and resisting peer pressure to use drugs and to help shape drug education programs.

Integrating health education and health promotion into practice is routinely done by nurses. According to a national survey, the need for mental health services has increased in over two thirds of school districts.This article describes the screening of 193 adolescents in Rural Western Pennsylvania's 9th, 10th, and 11th graders for depressive symptoms. Ten percent (N=19) of students had depressive symptoms, the majority of which were female. These students were interviewed by the research team. The outcome themes and referrals are reported as well as the discussion of implications for nurses in screening for depression and health promotion.

Meeting the health needs of individuals in rural communities involves addressing the challenges of complex multifaceted health problems, limited local health resources and services, isolation, and distance. Interdisciplinary collaboration can create solutions to health care problems that transcend conventional, discipline-specific methods, procedures, and techniques. This paper reports on the four-pronged approach of the Western Maryland Area Health Education Center used to prepare allied health students to be interdisciplinary team members in rural areas. It describes the development of four interdisciplinary instructional team member training venues (in-class instruction, Web-based modules, service-learning programs, and faculty development workshops) that integrate opportunities to develop and practice interdisciplinary health promotion skills in rural communities. Challenges to implementing the model are described, including developing faculty and student training participation, integrating training venues into existing programs at participating institutions, and designing a unified program evaluation.

Each of the certified health education specialist responsibilities and competencies for health educators has a leadership element. Health educators demonstrate leadership in a variety of roles with individuals, organizations, and programs. In this article, transformational and transactional leadership qualities are presented as reflection points on leadership for health educators.

Evaluating workforce development for public health is a high priority for federal funders, public health agencies, trainees, trainers, and academic researchers. But each of these stakeholders has a different set of interests. Thus, the evolving science of training evaluation in the public health sector is being pulled simultaneously in a number of different directions, each emphasizing different methods, indicators, data-collection instruments, and reporting priorities. We pilot-tested the evaluation of a 30-hour, competency-based training course in a large urban health department. The evaluation processes included strategic, baseline assessment of organizational capacity by the agency; demographic data on trainees as required by the funder; a pre- and posttraining inventory of beliefs and attitudes followed by a posttraining trainee satisfaction survey as required by the trainers and the agency; and a 9-month posttraining follow-up survey and discussion of learning usefulness and organizational impact as desired by the academic researchers and the trainers. Routinely requiring all of these processes in training programs would be overly burdensome, time-consuming, and expensive. This pilot experience offers some important practical lessons for training evaluations in the future.

OBJECTIVE To examine the use of a school-based mental health program that works to prevent drug and alcohol problems and promote student mental health. METHODS Students' presenting concerns, services used, service format and people to whom students were referred for services were investigated. Student use among schools was compared using chi-square analyses. RESULTS The program was highly used, with a range of concerns differentiated by school type. Student concerns, service format, and student referral and follow-up varied significantly. CONCLUSION Student use is a product of student need, school structure, and mental health educator.

Schools can take the initiative in dealing with community agencies, says this writer, who offers some suggestions on how schools can help such agencies develop programs to meet student needs.