American Journal of Health Promotion

To evaluate the psychometric characteristics of the Research on Urban Trail Environments (ROUTES) Trail Use Questionnaire.

Test-retest reliability was assessed by repeated measures (study 1); validity was assessed by comparing reported trail use to self-reported and objectively measured physical activity (PA) levels (study 2).

Study 1: a religious institution situated near a Los Angeles trail. Study 2: 1-mile buffer zones surrounding three urban trails (Chicago, Dallas, and Los Angeles).

Thirty-four adults between 40 and 60 years of age (10 men and 24 women) completed the ROUTES questionnaire twice (study 1). Study 2 participants were 490 adults (48% female and 73% white), mean age 48 years.

Trail use for recreation and transportation purposes, time and distance spent on trails, and characteristics of the trail and other trail users. PA was measured using the International Physical Activity Questionnaire and accelerometry.

Pearson correlation coefficients and κ statistics were used for test-retest reliability for continuous and categorical variables, respectively. Generalized linear models were used to evaluate hypotheses on PA comparing trail users and nonusers.

Test-retest statistics were acceptable (κ = .57, r 5 .66). Validity was supported by correlations between indices of trail use with self-reported PA and accelerometry, and significant group differences between trail users and nonusers in PA levels.

The ROUTES Trail Use Questionnaire demonstrated good reliability and validity.

Chronic diseases account for 70% of U.S. deaths. Health coaching may help patients adopt healthy lifestyle behaviors that prevent and control diseases. This integrative review analyzed health coaching studies for evidence of effectiveness and to identify key program features.

Multiple electronic databases were utilized, yielding a final sample of 15 documents.

The search was limited to peer-reviewed research articles published between 1999 and 2008. Studies were further analyzed if they (1) specifically cited coaching as a program intervention, and (2) applied the intervention to research.

Articles describing various quantitative and qualitative methodologies were critically analyzed using a systematic method.

Data were synthesized using a matrix format according to purpose, method, intervention, findings, critique, and quality rating.

All 15 studies utilized nonprobability sampling, 7 (47%) with randomized intervention and control groups. Significant improvements in one or more of the behaviors of nutrition, physical activity, weight management, or medication adherence were identified in six (40%) of the studies. Common features of effective programs were goal setting (73%), motivational interviewing (27%), and collaboration with health care providers (20%).

Health coaching studies with well-specified methodologies and more rigorous designs are needed to strengthen findings; however, this behavioral change intervention suggests promise.

Improve and expand an existing youth asset scale.

Consisted of seven steps: (1) review of poorer-performing items and constructs, (2) literature review for relevant new asset constructs/items, (3) review of revised instrument by panel of experts, (4) qualitative review through focus group research, (5) pilot-test of instrument, (6) evaluation of the performance of the instrument in a longitudinal study, and (7) conduct of test-retest analysis.

Youth (N = 1111) recruited through canvassing of randomly selected census tracts and blocks.

Youth Asset Survey (YAS).

Factor analysis was conducted on 50% of the baseline data and repeated on the second half of the baseline data. Correlations were computed for the test-retest analysis.

Following modifications to the YAS based upon qualitative research, the survey was administered to youth (mean age, 14.3years; 53% female; 39% white, 28% Hispanic, 23% African-American, 9% other). Cronbach α = .55–.92. A majority (27 of 34) of α ≥ .65. All items loaded on one construct at α ≥ .40. The final results yielded 17 constructs assessed via 61 items. Spearman correlations and intraclass correlations ranged from .60 to .82 and .58 to .87, respectively.

The results generally suggest that the expanded YAS is a reliable and valid measure of assets.

To examine the influence of a tobacco-free hospital campus (TFHC) policy on employee smoking behavior.

Questionnaires immediately prior to, 6 months after, and 1 year after implementation of a TFHC policy.

University-affiliated hospital system.

A cohort of smokers and recent quitters.

Smoking status, quit attempts, influence of TFHC policy.

Descriptive.

From 2024 employees who responded to an initial online survey prior to implementation of a TFHC policy, 307 respondents reported either current smoking or quitting smoking within the past 6 months. Of these, 210 (68%) agreed to follow-up surveys at 6 and 12 months post-policy implementation. At each of the three times, between 15% and 18.5% of the cohort reported not smoking, with at least 48% of those not smoking reporting 6 to 12 months continuous abstinence. Sixty percent or more of those who reported quit attempts or not smoking indicated that the TFHC policy was influential in their efforts.

A TFHC policy may lead to increased employee smoking quit attempts and successful cessation. Health care facilities should broaden smoking restrictions to include the entire workplace campus, not only to reduce exposure to environmental tobacco smoke, but also to increase tobacco cessation.

To study informal skill transfer via staff networks as a complement to formal training among afterschool childcare providers implementing a health promotion program.

Cross-sectional, sociometric network analysis.

Boston Young Men's Christian Association (YMCA) afterschool programs implementing the iPLAY program.

All 91 staff members at 20 sites were eligible; 80 completed the survey (88% response rate).

At the network level, network density measured system-level connectedness. At the staff level, the independent variable was out degree, the number of individuals to whom respondents noted a program-related connection. The dependent variable was skill gains, the number of key implementation skills gained from the network.

We mapped the staff program-related social network. We utilized multiple linear regression to estimate the relationship between out degree and skill gains, and we adjusted for clustering of staff in sites.

Most staff (77%) reported gaining at least one skill from the network, but only 2% of potential network connections were established. The regression model showed that out degree (i.e., number of program-related contacts) was significantly associated with skill gains (β = .48, p < .01) independent of other variables.

Informal skill transfer in staff networks may be a useful complement to formal training for implementation of health promotion programs, but informal skill transfer was likely underutilized in this network. Future research employing longitudinal and/or multisite data should examine these findings in greater detail.

This study employed qualitative research to describe the relationship between spirituality and overall health among a sample of Latino women. A framework is presented for understanding this complex relationship.

Findings are presented from a qualitative analysis of six 1.5-hour focus group sessions.

The research was conducted among Latino women living in Chicago, Illinois, and Northeastern New York communities. We employed a community-based participatory research approach in which community members were active participants throughout the research process.

Subjects were 47 Latino women 31 to 81 years, all of whom were Christian and the majority (43%) of whom had less than a high school education. Twenty-seven percent reported having high school diplomas, and the same percentage reported at least some college. Of the women who answered the questions, one did not have health insurance, 69% had public health insurance, and 29% had private health insurance.

Grounded theory using selective coding was employed to understand the relationship between spirituality and health and to develop the conceptual framework.

Spirituality was expressed as a vital component of health, and the belief in a need for balance of physical, mental, and spiritual health was described. An active and a passive relationship between spirituality and health emerged, with active being most common. Asking God for help or faith as a coping strategy were subdomains of the active relationship, and God responsible for health fell under the passive domain. These relationship types influenced beliefs about participation in one's own health.

The findings that emerged contribute to an understanding of how spirituality plays a role in health beliefs among Latino women, which has implications for health promotion research and program development for addressing health disparities.

Assess whether a convenient care clinic (CCC) medical weight-loss program can promote weight loss.

Prospective cohort study with follow-up at 10 weeks.

A CCC (Lindora Health Clinic) weight-loss program (Lean for Life) based in a retail pharmacy (Rite Aid Pharmacy) in Costa Mesa, California.

The first 100 people to purchase the weight-loss program.

A 10-week, $465 medical weight-loss program with individual counseling sessions; a hypocaloric diet of 900 to 1200 kcal/day (25%–30% carbohydrates, 40% protein, 25% fat); and adjunctive pharmacologic treatment, if necessary.

We collected data on age, height, weight, visits per week, medication use, comorbid conditions, and weight change.

Data were analyzed based on length of enrollment and mean percent weight loss. Statistical tests used were t-test and Spearman rank correlation test.

Eighty-six subjects had valid data entries for weight change over the 10-week period. Average age was 51.6 years; mean starting body mass index was 30.3. Thirty patients participated for 0 to 4 weeks, 30 for 4 to 9 weeks, and 26 for 10 weeks. Mean percent weight changes for the 0 to 4, 5 to 9, and 10-week groups were −1.6, −6.0, and −8.1, respectively. Forty-five (45%) of the patients achieved medically significant weight loss (≥ 5%).

The study shows that a medical weight-loss program offered at a CCC in a retail pharmacy can produce medically significant weight loss of ≥5%. Further research of collaborations between the retail and medical weight-loss industries is warranted. Study design limitations included selection bias and confounding variables other than the weight-loss program.

Investigate the extent to which risk of weight gain is affected by emotional health. Also, determine the influence of age, baseline weight, physical activity (PA), energy intake, and changes in PA and energy intake on the relationship between emotional health and weight gain.

Prospective cohort.

Two metropolitan areas in the Mountain West.

Total of 256 middle-aged, apparently healthy women.

Emotional health was assessed using the General Well-Being Schedule. PA was measured using Actigraph accelerometers. Energy intake was measured using 7-day weighed food records. All assessments were taken at baseline and again at the follow-up approximately 2 years later.

Relative risk (RR) was calculated using incidence data.

With no variables controlled, women with less than positive (LTP) emotional health had 59% greater risk of weight gain (≥ 2 kg) than women with positive emotional health (RR, 1.59; 95% confidence intervals [CI], 1.04–2.44). After adjustments for each potential confounder individually, risk of weight gain did not change significantly. However, adjusting for all of the potential confounders simultaneously weakened the risk of weight gain (RR, 1.43; 95% CI, .93–2.21). Risk of weight gain (≥ 2 kg) was no greater in depressed women compared with their counterparts.

Middle-aged women with LTP emotional health are at significantly increased risk of weight gain over time compared with women with positive emotional health.

Determine if recruitment methods are differentially related to the reach of a physical activity program in metro/urban vs. rural settings.

Cross-sectional survey.

Kansas counties.

Ninety-four Cooperative Extension agents responsible for 102 counties.

Promotional score, task force activity, and years of program delivery were assessed using a self-report survey. Reach was assessed for each county by dividing the number of participants by intended population using census data.

Rural/urban comparisons on reach were completed using a Mann-Whitney test. Multiple linear regression models were used to determine the relationship between independent variables and participation rate by setting type.

Metro/urban counties had lower mean participation rates than rural counties (z = −4.5; p < .001). In metro/urban counties, the regression on participation rate was significant (R² = .19; F = 4.09; p = .011), but only promotional score significantly contributed to the model (p = .003). In rural counties, the regression was also significant (R² = .34; F = 6.64; p = .001), with task force activity and years of delivery making significant contributions (p = .001 and p = .017, respectively).

Interpersonal methods may be more effective in recruiting physical activity program participants in rural settings, whereas using a greater variety of promotional methods may be more effective in metro/urban settings.

To provide evidence about the types of transportation infrastructure that support bicycling.

Population-based survey with pictures to depict 16 route types.

Metro Vancouver, Canada.

1402 adult current and potential cyclists, i.e., the “near market” for cycling (representing 31% of the population).

Preference scores for each infrastructure type (scale from − 1, very unlikely to use, to +1, very likely to use); current frequency of use of each infrastructure type (mean number of times/y).

Descriptive statistics across demographic segments; multiple linear regression.

Most respondents were likely or very likely to choose to cycle on the following broad route categories: off-street paths (71%–85% of respondents); physically separated routes next to major roads (71%); and residential routes (48%–65%). Rural roads (21%–49%) and routes on major streets (16%–52%) were least likely to be chosen. Within the broad categories, routes with traffic calming, bike lanes, paved surfaces, and no on-street parking were preferred, resulting in increases in likelihood of choosing the route from 12% to 37%. Findings indicate a marked disparity between preferred cycling infrastructure and the route types that were currently available and commonly used.

This study provides evidence for urban planners about bicycling infrastructure designs that could lead to an increase in active transportation.

The purpose of this study was to develop a self-report instrument to measure perceived physical and social environmental factors in the worksite setting that are shown to influence physical activity.

Initial items were generated from a review of the literature and were sent out for peer and expert panel review. A revised questionnaire was sent to 1250 participants to determine and test the emerging factor structure.

The instrument was tested at two worksites in the mid-South.

Participants consisted of a random sample of regular full-time employees at the two worksites.

Principal axis factoring with a varimax rotation was used to explore the data in the first group of participants. Confirmatory factor analysis was used to test the fit of the final model in the second group of participants. Measures used included the comparative fit index, parsimony goodness of fit index, root mean square error of approximation, and the root mean square residual.

The final analysis showed an adequate fit of the data to the hypothesized factor structure (n = 683). The instrument showed good internal consistency, temporal stability, construct reliability, and discriminant validity.

The Worksite Supportive Environments for Active Living Survey is a reliable and valid tool for investigating perception of the worksite environment related to physical activity.