American Journal of Health Promotion

To determine whether certain patterns of objectively measured physical activity (PA) are associated with the risk factors for or the diagnosis of the metabolic syndrome (MS).

Latent class analysis, including assessment of the associations between latent PA classes and risk factors for the MS.

Random sample from throughout the United States using data from the 2003–2004 National Health and Nutrition Examination Survey.

A total of 3458 civilian adult noninstitutionalized U.S. citizens.

Daily minutes of moderate-to-vigorous PA across a 7-day week based on accelerometer measurements, as well as high blood pressure, blood glucose levels, triglyceride levels, and body mass index, along with low levels of high density lipoproteins, using clinical cut points.

Membership in the more active PA classes was consistently associated with lower odds of all risk factors for the MS. However, when participants were categorized into quartiles of the coefficients of variation of PA across 7 days, few differences were seen in any of the risk factors.

Accumulating the total weekly recommended amount of PA is consistently associated with positive health profiles, and more PA than the recommended amounts may be even better. However, the manner in which this activity is accumulated, either spread over most days of the week or compressed into just a couple of days, may have similar associations with the risk factors for the MS.

Sexually transmitted disease (STD) rates have continued to increase among men who have sex with men (MSM). The present study used qualitative methods to assess sources of human immunodeficiency virus (HIV)/STD information and responses to HIV/STD prevention messages among MSM. This was done to understand how to design more effective media campaigns on HIV/STD prevention and testing for this population.

One-on-one semistructured, qualitative interviews and a brief demographic written survey were conducted.

A Massachusetts community-based organization specializing in HIV/AIDS healthcare.

A novel, modified, respondent-driven sampling method was used to recruit a diverse sample of 50 Massachusetts MSM between January and April 2005; qualitative interviews were conducted until redundancy in responses was achieved.

Qualitative data were analyzed using content analysis. NVIVO software was used to organize transcripts, identify themes, and report frequency of responses.

Respondents reported having derived information on sexual health from multiple media sources. Direct outreach, gay- and HIV-centered organizations, print and broadcast media, public transportation ads, and the Internet held the greatest potential for dissemination. Primary care providers were also frequently seen as trusted sources of HIV/STD prevention information. Ideas for content often included having “people just like you” in ads.

Health messages that focus on getting tested for HIV and STDs, practicing safe sex, and incorporating straightforward and accurate information on prevention may be the most acceptable to MSM. Providers should be proactive in disseminating information about HIV/STD prevention.

Exploratory factor analysis is used to identify latent factors for public health interventions. The most popular factor retention criterion, the eigenvalue greater than one (EVG1) rule, leads to the retention of more factors than warranted. The use of parallel analysis (PA) as a factor retention criterion is recommended.

Environmental factors that are likely to affect the propensity of individuals to walk are identified. Results from PA are compared with those obtained by using the EVG1 rule.

Telephone survey data were collected from three communities (spanning 12 counties) in the Appalachian region.

The sample was composed of adults between the ages of 40 and 65 years. There were 1019 completed surveys.

The data on 14 variables, including measures of neighborhood safety, beauty, and access to walking facilities were collected.

A principal components analysis was performed. The factors retained after using the EVG1 rule were compared with the factors retained after using PA. Varimax rotation was used to aid factor interpretation.

The EVG1 rule led to the retention of nearly twice the number of latent factors as did the PA criterion.

The use of the EVG1 rule in research may mislead policy makers to focus on trivial interventions. They are urged to use PA to obtain more parsimonious and externally valid interventions.

Assess whether family environmental factors affected changes in fruit and snack consumption among 12- to 14-year-old adolescents participating in a Dutch healthy diet promotion program.

Data were derived from pretest and posttest questionnaires completed by adolescents in 10 schools in the intervention arm of the program trial and questionnaires completed by their parents during program implementation.

Lower vocational schools in the southern and central parts of The Netherlands.

Questionnaire answers of 502 parents were matched with those of their children.

Eight school lessons using various theory-based materials and strategies.

Dietary intake, ethnicity, education level, employment status, parenting style, food purchase considerations, family food rules, and food availability and accessibility at home.

Regression analyses.

No significant family environmental predictors of program-induced changes in either fruit or snack intake were found.

A limitation of the study was that all data were self-reported. No evidence was found that there were subgroups of adolescents who profited less from the program because of family environmental factors.

To test whether implementing a staff wellness program affects the nutrition and physical activity environment at child care centers.

Quasi-experimental controlled trial.

Child care centers in low income neighborhoods in California.

Eighty-two staff members at 13 centers completed the study.

Intervention and control groups received training and education about nutrition and physical activity. The intervention group also participated in a worksite wellness program.

Staff members' personal health habits, self-efficacy in working with families on nutrition and physical activity, and changes in children's food and physical activity environments were assessed.

Statistical software was used to analyze change scores for pre-post measures and to test differences for end point—only measures.

Although significant differences in staff members' personal health behaviors were not observed, staff from intervention sites exhibited more positive changes in their comfort level in talking to parents about nutrition and physical activity. Intervention sites reported providing more fresh fruits (p = .004) and vegetables (p = .03) to children as part of regular meals and snacks and serving more fresh fruits (p = .05) at children's celebrations. Control sites reported greater increases in sweetened foods (p = .02) and sweetened beverages (p = .05) at children's celebrations.

The wellness intervention shows promise in improving the children's food environment in a child care setting.

We describe the perceived usefulness of a learning collaborative for translating obesity prevention science into practice at YMCA after-school programs.

We conducted mixed-methods research to identify beneficial aspects of the collaborative and to assess perceived effect of the collaborative on ability to meet goals.

Sixty-one YMCA after-school programs serving roughly 2500 children in 21 states.

After-school program staff attending learning sessions for the collaborative.

YMCA learning collaboratives comprise a structured organizational change process delivered during 9 to 12 months that aim to empower staff to find local methods for achieving specific program outcomes related to diet and physical activity.

Eight focus groups conducted during the collaboratives assessed their usefulness. A post hoc Web-based follow-up survey (39 respondents; response rate, 40.6%) assessed final perceived effect.

Qualitative and quantitative data were highly positive about the usefulness of the collaborative. The collaboratives' duration, peer learning, multilevel staff involvement, focus on creating a supportive organization, and regular coaching support enabled many respondents to make program and policy changes consistent with project goals. There was consensus that executive-level commitment to the work was critical.

Learning collaboratives are a promising tool for embedding health promotion practices in existing after-school programs through a structured organizational change process.

Examine the association between the levels of participation in an incentive-based health promotion program (Vitality) and inpatient medical claims among members of a major health insurer.

A 1-year, cross-sectional, correlational analyses of engagement with a health promotion program and hospital claims experience (admissions costs, days in hospital, and admission rate) of members of a national private health insurer.

Adult members of South Africa's largest national private health insurer, Discovery Health. Insured members were also eligible for voluntary membership in an insurance-linked incentivized health promotion program, Vitality.

The study sample included 948,974 adult members of the Discovery Health plan for the year 2006. Of these, 591,134 (62.3%) were also members of the Vitality health promotion program.

The study sample was grouped based on registration and the level of engagement with the Vitality health promotion program into the following: not registered (37.5%), registered but not engaged with any health promotion activity (21.9%), low engagement (30.9%), and high engagement (9.5%). High engagement was defined a priori by the accumulation of an arbitrary number of points on the Vitality program, allocated against specific activities (knowledge, fitness-related activities, assessment and screening, and healthy choices). Hospital admission costs, the number of days in hospital, and hospital admission rates were compared among highly engaged members and those members who were not enrolled in the program, nonengaged, and lowly engaged. Data were normalized for age, gender, plan type, and chronic disease status.

Highly engaged members had lower costs per patient, shorter stays in hospital, and fewer admissions compared with other groups (p < .001). Low or no engagement was not associated with lower hospital costs. Admission rates were also 7.4% lower for cardiovascular disease, 13.2% lower for cancers, and 20.7% lower for endocrine and metabolic diseases in the highly engaged group compared with any of the other groups (p < .01).

Engagement in an incentive-based wellness program, offered by a health insurer, was associated with lower health care costs.

Depressed employees are vulnerable to adverse work outcomes. We hypothesized that work performance is impaired by depression and is worsened by exposure to psychosocial work stressors.

Longitudinal cohort study with surveys administered at baseline, 6, 12, and 18 months.

Recruitment in primary care offices.

A total of 14,268 were screened; 286 depressed, employed adults (18–62 years) and 193 controls were enrolled.

At-work limitations (presenteeism) and absenteeism were measured with the Work Limitations Questionnaire (WLQ) and WLQ Work Absence Module, respectively. Work stressors were assessed using a modified version of the Job Content Questionnaire.

Univariate and multivariate tests assessed the degree to which at-work limitations were related to depression and/or stressful work.

Presenteeism and absenteeism were significantly worse for the depression group at each time point (p ≤ .001). In cross-sectional models, presenteeism was associated with more severe depression symptoms, poorer general physical health, psychologically demanding work, the interaction of psychologically demanding work with depression, and less job control (r² range = .33–.54). Absences were explained by depression symptom severity and poorer general physical health but not work stressors (r² = .19). Because of minimal change in the work stressors, their longitudinal effects on outcomes were mostly nonsignificant.

This study found that depression symptoms are related to work absences and impaired work performance, and results partly confirmed that work stressors add to this impact. Results suggest that workers with depression may benefit from care involving medical and vocational interventions.

To examine the impact of body mass index (BMI) on the effectiveness of a disease management—health promotion intervention among community-dwelling Medicare beneficiaries with disabilities.

Secondary data analyses of a randomized controlled trial.

Nineteen counties in upstate New York and on the West Virginia—Ohio border.

Four hundred fifty-two Medicare beneficiaries who participated in the Medicare Primary and Consumer-Directed Care Demonstration between August 1998 and June 2002 and completed the 22-month follow-up.

Multicomponent disease management—health promotion intervention involving patient education, individualized health promotion coaching, medication management, and physician care management.

Body mass index and dependence in Activies of Daily Living (ADLs).

Multivariate linear regression.

The intervention resulted in significantly less worsening in ADLs dependence among normal-weight participants (coefficient, − .42; p = .04). However, the intervention did not have a significant effect for underweight participants (F test p = .33 vs. underweight participants in the control group) or overweight or obese participants (F test p = .78 vs. overweight or obese participants in the control group).

A positive effect of the intervention on disability was found among normal-weight participants but not among underweight or overweight or obese participants. Future health promotion interventions should take into consideration the influence of BMI categories on treatment effects.