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Background: Many grief-based Health Education programs have not been theoretically examined to show how and why beneficial effects have been reported with their use and implementation. Purpose: We used a construct validity of the treatment approach to test the implicit theoretical structure of the theory of grief recovery (TOGR) and evaluate the extent of influence and estimated effect size that intervention exposure had on targeted variables of grief and grief recovery. Methods: Using a repeated measures design, the previously validated Grief Recovery Method® Instrument (GRM-I) was used to collect data from 3 observations where nonrandomized participants served as their own controls. Results: The repeated measures analysis of variance (ANOVA) showed significant increases in participants' scores on targeted variables between observations. Wilks' lambda showed an overall significant effect. Test-retest reliability of the GRM-I was acceptable. Discussion: A construct validity approach better equipped researchers to test theoretical assumptions of the TOGR-based intervention to produce desired changes in targeted variables. Translation to Health Education Practice: The importance of Health Education interventions to influence variables supportive of behavioral change are well documented. The present study showed that the theoretical structure of the TOGR-based intervention held and had the intended influence on variables of grief and grief recovery.

Background: Death education is focused on the lifestyle behavioral and emotional aspects of grief. Although several interventions exist that aim to influence grief, many have not been theoretically examined and have lacked valid and reliable instrumentation. Purpose: This study described a construct validity approach used to develop and validate the Grief Recovery Method® Instrument (GRM-I), a measure used to assess implicit theoretical variables of an intervention intended to influence grief and promote grief recovery. Methods: Content analysis of the program handbook, expert panel, and peer review were used to develop items. A pilot study and field and validity tests were used for validation purposes. Internal consistency was assessed using Cronbach's alpha. Results: Confirmatory analysis (n = 279) showed an overall adequate fit of the data to the hypothesized factorial structure (normed fit index = 0.97; relative fit index = 0.83; incremental fit index = 0.97; Tucker-Lewis index = 0.87; comparative fit index = 0.98; parsimony normed fit index = 0.19; parimony comparative fit index = 0.20; and root mean square error of approximation = 0.09). Cronbach's alpha for the full measure was 0.87. Discussion: This study established the GRM-I as a content valid and reliable measure. Translation to Health Education Practice: With future evaluative use of the GRM-I to test the implicit theoretical structure of the death education intervention, research will be able to show how and to what extent intervention components influenced variables of grief and grief recovery.

Background: In recent decades, the alignment of health and education has been at the forefront of school reform. Whereas the establishment of national in-school physical activity (ISPA) recommendations and state-level mandates demonstrates success, there has been less achievement in areas that address health disparities. The purpose of this investigation was to explore barriers and facilitators to implementing state-mandated ISPA policies in the Mississippi Delta. Methods: Focus groups or interviews were conducted with district administrators, school principals, teachers, and students. A total of 2 semistructured moderator guides were developed to focus on (1) student ISPA practices and preferences and (2) facilitators and barriers to implementing ISPA policies and practices. Results: A total of 6 themes were developed. In that, 2 themes addressed participant-described barriers ("primary challenges" and "interferences and excuses"). Three themes highlighted participant-described facilitators ("compromises," "things that work," and "being active at school"). Finally, 1 theme encompassed the participant-described need to address educating the whole child. Conclusions: There is a critical need for meaningful and relevant solutions to circumvent challenges to implementing ISPA policies and practices in the Mississippi Delta. The Whole School, Whole Community, Whole Child model offers a broad means of visualizing rural, low-income, racially concentrated schools to circumvent challenges and foster ISPA policies and practices.

Background: Mississippi (MS) Delta adults and youth report obesity rates far exceeding those of the state and nation. State law requires in-school physical activity and nutrition practices to address childhood obesity but does not require evaluation of outcomes, specifically the impact on weight-related outcomes. This paper offers 3 things: (1) describes the weight status of elementary school-age children in the MS Delta; (2) explains the importance of including waist-to-height ratio (WHtR) values when reporting body mass index (BMI); and (3) provides impetus for policy that requires weight-related health risk, as measured by WHtR, to be assessed regularly as a means to evaluate school health policy. Methods: We took anthropometric measures in a cross-sectional investigation of 1136 children from 11 public elementary schools in the MS Delta. Measures included BMI, waist circumference (WC) and WHtR. Results: The prevalence of overweight and obesity (BMI greater than or equal to 85th percentile) was 47.1% (18.3% overweight and 28.8% obese). In this sample, 59.9% and 42.0% were "at risk" for weight-related chronic disease based on WC (greater than or equal to 75th percentile) and WHtR (greater than 0.5), respectively. The differences in these proportions were statistically significant. The predominantly black districts reported higher on all of the weight-related measures. Conclusions: Investigators recommend the assessment of health policy include measures of health risk in addition to BMI, namely WHtR as it accounts for growth in both WC and height over age. Furthermore, WHtR is a more accurate indicator of fat distribution and health risk than WC alone. (Contains 3 tables.)

Objective: The purpose of the study was to determine whether students consume alcohol in greater quantities when drinking in celebration of an event or holiday versus typical drinking use. Celebratory occasions include tailgating during football games, holidays, and the beginning and ending of academic semesters. Participants: Traditional undergraduates, ages 18 to 24, who attended the university full time in the Fall 2007 and the Spring 2008. Methods: Eight hundred participants were randomly selected to participate in the study. A stratified random sample was drawn according to class rank and sex. A total of 287 survey responses were collected. Results: Alcohol consumption was greatest during typical weekend drinking, followed by celebration drinking and then by typical weekday drinking. Conclusions: Celebration drinking was expected to be greater than typical drinking; however, typical weekend drinking episodes were greater than celebratory drinking. Intervention efforts should focus on reducing weekend alcohol consumption. (Contains 3 tables.)

The purpose of this study was to develop a valid and reliable instrument to measure the Social Cognitive Theory (SCT) constructs of smoking refusal skill-efficacy, positive smoking refusal outcome expectations & importance and negative smoking refusal outcome expectations & importance. This article details the rigorous instrument development procedure in which the instrument (1) reflects the learning objectives of a psychosocial smoking prevention program (2) reflects the SCT which the program was based on and (3) had adequate sensitivity to capture variation in student responses. A two-stage panel review established face validity. Instrument stability using test retest methods (Pearson r: P less than 0.002) and internal consistency (Cronbach's alpha: 0.74-0.97) were established. Construct validity was tested with confirmatory factor analysis, 57 of the 62 instrument items loaded as hypothesized.

Many work-site physical activity interventions use theoretical variables in the design of their programs. Yet, these interventions do not document the degree of change in theoretical variables produced by the intervention. This study examined the construct validity of an intervention designed to affect social cognitive theory variables linked to exercise behavior. Construct validation methods were used to evaluate an instructional intervention composed of four 60-minute sessions delivered across 2 weeks. Increases were found in self-regulation skills, outcome-expectancy values, and self-efficacy for the treatment group. No significant increases were detected for the comparison group on any study variables. Sixty-seven percent of the treatment group was able to maintain exercise behavior across 12 months, whereas the comparison group declined in exercise participation from 68% to 25% across 12 months. The study revealed the intervention effective in producing the intended changes in social cognitive theory constructs. The analysis shows self-regulation-mediated exercise behavior. (Contains 4 figures.)

Tested the construct validity of an effective psychosocial smoking-prevention curriculum on mediating variables considered responsible for decreasing adolescent smoking initiation, examining Social Cognitive Theory constructs hypothesized as essential for program effectiveness. Results of data from 6th graders in treatment and comparison groups indicated that the program affected two constructs: refusal self-efficacy and total positive refusal expectations and importance. (SM)

The purpose of this research was to develop a baseline understanding of the knowledge and perceptions that certified personal trainers have of both prescription and nonprescription weight loss drugs. A 16-item qualitative survey instrument was used to interview certified personal trainers. Interviews were conducted via telephone to assess trainers' current level of knowledge and perceptions of weight loss drugs. Questions about both prescription medications and over-the-counter (OTC) medications were included in the survey instrument. All trainers (n = 43) held current National Association of Personal Trainers (NAPT) certifications or certification from the American College of Sports Medicine (ACSM). Criteria for inclusion were dependent on having knowledge about prescription weight loss medications (n = 24). Almost half of the sample had no knowledge of weight loss medications. Of the 43 trainers surveyed, 580/0 were able to list one currently or previously available medication, 42% were able to list two medications, and no certified personal trainer was able to provide names of more than two medications. Personal trainers did not support the use of either prescription or OTC weight loss medications. In fact, these interventions were rated the lowest on a 7-point scale among options assessed concerning their importance to a weight loss program: diet (6.67), exercise (7.00), and medication use (1.96). The results suggest a lack of awareness of weight loss medications and a potential bias against prescription weight loss medication use. This finding illustrates the need for further studies of fitness professionals' perceptions of and attitudes toward antiobesity medications as a form of weight loss intervention. KEY WORDS weight loss medication, prescription, over-thecounter, personal trainers

Background: Evidence supports the role of physical and social environments in active living, including perception of environment. However, measurement of perceived environments in rural settings is lacking. This study describes the development of the Rural Active Living Perceived Environmental Support Scale (RALPESS). Methods: Premised on social ecological and cognitive perspectives, 85 initial items were generated through a literature review and a mixed-methods investigation of "activity-friendly" environments. Items were organized by resource areas--town center, indoor and outdoor physical activity areas, schools, churches, and areas around the home/neighborhood--and submitted for expert panel review. In 2009, a revised questionnaire was disseminated to adolescents, parents, public school staff, and older adults in 2 rural southeastern United States counties. Principal component analysis with varimax rotation was used to explore factor structure (n = 542). Results: The final analysis yielded 33 items with 7 factors: 1) church facilities, 2) town center connectivity, 3) indoor areas, 4) around the home/neighborhood, 5) town center physical activity resources, 6) school grounds, and 7) outdoor areas. Conclusions: The RALPESS is a valid, internally consistent, and practically useful instrument to measure perceptions of rural environments in the context of physical activity across the lifespan. Confirmatory factor analysis is recommended to validate factor structure. [ABSTRACT FROM AUTHOR]

Exercise is consistently related to physical and psychological health benefits in older adults. Bandura's social-cognitive theory (SCT) is one theoretical perspective on understanding and predicting exercise behavior. Thus, the authors examined whether three SCT variables--self-efficacy, self-regulation, and outcome-expectancy value--predicted older adults' (N = 98) exercise behavior. Bivariate analyses revealed that regular exercise was associated with being male, White, and married; having higher income, education, and self-efficacy; using self-regulation skills; and having favorable outcome-expectancy values (p < . 05). In a simultaneous multivariate model, however, self-regulation (p = . 0097) was the only variable independently associated with regular exercise. Thus, exercise interventions targeting older adults should include components aimed at increasing the use of self-regulation strategies. [ABSTRACT FROM AUTHOR]

Examines the effect of vertical ground-reaction forces (VGRF) on lower-extremity joint cryotherapy during landing in the United States. Measurement of VGRF on landing after cryotherapy treatments; Effect of cryotherapy on motor activity of active individuals; Negative indication in VGRF from cryotherapy.

Social support may mitigate stress related to the refugee experience, including during resettlement. For refugee women, social support can play an important role during pregnancy. In-depth interviews were conducted within a sample of 45 Bhutanese refugee women. Perceived social support was measured using the Norbeck Social Support Questionnaire. Averaged social support scores are reported to account for personal network size. Participants were identified as "low support" and "high support" based on their reported score. The mean social support score reported was 18.9. Participants experiencing a secondary resettlement within the U.S. were 4.52 (95% CI 1.19–17.15) times as likely to report a "high support" network compared to participants who resettled directly from Nepal. Personal social networks are an important source of support for resettled refugee women during pregnancy in the U.S.. Refugee women who experience secondary resettlement may perceive stronger support from their personal connections. [ABSTRACT FROM AUTHOR]

Objective: In this study, we investigated associations between physical education (PE) classroom motivational strategies and leisure-time physical activity (PA) for children in predominantlyblack urban school environments. Methods: We used cross-sectional data consisting of observations of PE classes and a survey of children on their attitudes and PA behavior. We assessed 740 students and 48 PE classes across 4 schools and applied multilevel statistical analysis. Results: Classroom-level variables explain 73% variance in leisure-time PA. Classroom use of extrinsic motivation, intrinsic motivation, and PA promotion motivational strategies are associated with leisure-time PA. Conclusion: Classroom motivational strategies hold the potential to foster leisure-time PA among children. PE curriculum, training, and classroom strategies can be useful tools for encouraging PA and addressing childhood obesity. Further research is encouraged. [ABSTRACT FROM AUTHOR]

Effective exercise interventions are needed to improve quality of life and decrease the impact of chronic disease. Researchers suggest males have been underrepresented in exercise intervention studies, resulting in less understanding of their exercise practices. Findings from preference survey methods suggest reasonable association between preference and behavior. The purpose of the research described in this article was to use factorial survey, a preference method, to identify the characteristics of exercise interventions most likely to appeal to male participants, so preferences might be incorporated into future intervention research. The research was guided by the framework of Bandura’s social cognitive theory, such that variations in individual, environmental, and behavioral factors were incorporated into vignettes. Participants included 53 adult male nonadministrative staff and contract employees at a public university in the Southeastern United States, who each scored 8 vignettes resulting in 423 observations. Multilevel models were used to assess the influence of the factors. Participants scored vignettes that included exercising with a single partner, playing basketball, and exercising in the evening higher than vignettes with other options. Qualitative analysis of an open response item identified additional alternatives in group size, participant desire for coaching support, and interest in programs that incorporate a range of activity alternatives. Findings from this research were consistent with elements of social cognitive theory as applied to health promotion. Factorial surveys potentially provide a resource effective means of identifying participants’ preferences for use when planning interventions. The addition of a single qualitative item helped clarify and expand findings from statistical analysis. [ABSTRACT FROM AUTHOR]