Health Education Journal

The purpose of this longitudinal study was to examine changes in physical activity behavior, psychological factors and interpersonal influences associated with exercise behavior during the transition from secondary school to high school in Sanandaj, Iran.

Data were collected from students in 2006 (N = 1,073), of whom 844 provided follow-up data in 2009.

The students were in high school in 2009 (51% male) with a mean age of 16.42 ± 1.73 years.

Physical activity-related cognitions, interpersonal influences, and physical activity behavior were measured using self-report questionnaires. To assess the effects of time and sex on psychosocial factors, analysis of variances (ANOVAs) were conducted. The relative stability of physical activity psychosocial correlates from wave 1 through wave 2 was assessed using Pearson product-moment correlations.

There were significant differences according to sex across time for physical activity, psychological variables and interpersonal influences associated with exercise activities. The girls were less active than boys at both time points. Girls reported lower self-efficacy and perceived more barriers and fewer perceived benefits for physical activity over time. Interpersonal influences on activity were more stable for girls than boys.

The results offer evidence for decreasing physical activity in boys and girls and sex differences in cognitive variables and interpersonal influences. This is important for understanding how to address the problem of physical inactivity among Iranian youth.

Approximately 1.4 million or 13% of all children who die each year could be prevented with widely-available vaccines.

We examined if women’s empowerment improved child immunization using data on 1,056 mothers with young children from Nepal.

The study utilized the 2006 Nepal Demographic and Health Survey, a nationally-representative sample of 10,793 women from 8,707 households across Nepal. We selected all mothers with first child between the ages of 12 and 23 months at the time of interview. This resulted in a sample of 1,056 mothers.

Among the measures of women’s empowerment, mothers’ education was significantly associated with child immunization. The odds of being fully immunized for children of mothers with secondary education were 5.91 times the odds for children of mothers without any formal education. Other measures of women’s empowerment – women’s age at birth of first child, gap in age between spouses, women’s knowledge about sexually-transmitted diseases, their role in intra-household financial, health and mobility decisions, and their perceptions toward wife beating – were not associated with child immunization. Among control variables, mothers who received antenatal care were 3.31 times as likely to immunize their children as mothers who did not receive any antenatal care. Other such barriers to health service use such as cost of care, distance to health services, and quality of health services were not significant.

To improve child immunization, Nepal should strengthen its antenatal care services. Additionally, over 56% of mothers in Nepal had no formal education; to improve child health in the long run, the country should focus on education of women and girls.

To determine differences in sun-protection behaviours, and incidence of sunburn, between Australian adolescent female fake tan users and non-users.

Cross sectional survey.

398 adolescent females aged 12 to 18 years participated in a survey at public venues, schools, and online. The main outcome measures were self-reported fake tan usage in the past 12 months, frequency of sunburns and habitual sun-protection behaviours.

Surveys were completed in New South Wales, Australia.

The prevalence of self-reported use of fake tanning products in the past 12 months among Australian adolescent females was 34.5%. Female fake tan users were significantly less likely to report wearing a hat, wearing a shirt with sleeves or wearing pants covering to the knees. There was no difference between fake tan users and non-users in use of sunscreen, seeking shade, wearing sunglasses or avoidance of peak ultraviolet (UV) hours. Logistic regression modelling, when accounting for age, desire for a tan and skin type, revealed fake tan users were more likely to experience frequent sunburns and less likely to wear protective clothing.

Our findings show that fake tan use among Australian female adolescents is associated with decreased sun protection, specifically reduced use of both upper and lower body protective clothing. Fake tan users were significantly more likely to experience repeated sunburns, after controlling for skin type. These findings provide impetus for the development of health education programmes targeting a new sub-group of adolescents with distinct tanning behaviours.

To explore the diagnosis, treatment and referral patterns of chronic oro-facial pain patients by generalist primary care dentists (GDPs) in the UK.

A cross-sectional survey was conducted using a non-stratified random sample of 500 GDPs who were selected from the General Dental Council register. A self-complete postal questionnaire with four hypothetical clinical case scenarios describing sub-types of chronic oro-facial pain (COFP) was used to investigate diagnosis, treatment and referral options of GDPs.

Two hundred and twenty (44%) GDPs responded. The majority correctly diagnosed temporomandibular disorder (TMD; 88%) and burning mouth syndrome (BMS; 92%). There was more variation in the diagnosis of the other cases related to persistent oro-facial pain. For TMD there was a clear preference for treatment with occlusal splint therapy, and referral to a temporomandibular joint (TMJ) specialist. The BMS scenario showed drug therapy and referral to an oral medicine specialist to be most popular. The chronic oro-facial pain cases had greater variation in management and choice of psychotherapy was related to duration of pain symptoms.

The greater variation in responses to scenarios based on patients with chronic oro-facial pain may reflect the difficulty clinicians face in diagnosing and treating this condition. Management appears to follow a biomedical model and most clinicians chose to refer patients for treatment. There are few specialist services to cater for such referrals, indicating a need to train primary care practitioners in management of chronic COFP, along with the establishment of evidence-based guidelines.

To explore attitudes to and beliefs about childhood overweight and obesity among Bangladeshi mothers and to check maternal perceptions of their children’s weight status.

Mixed methods cross-sectional study.

A general practice in East London, UK.

Qualitative interviews with 14 mothers; weighing and measuring 22 children.

Mothers were generally aware of broad health promotion messages about diet and exercise, but many tended to under-estimate their children’s weight status. Differences in view did not reflect in any simple way English language skills, and the range of views reflected those in the majority population.

Health promotion initiatives should assess individual needs; membership of a Bangladeshi community does not necessarily predict knowledge, beliefs or behaviour, and assumptions that this community is different from others are misleading.

American Indian children and adolescents are at risk for obesity, type 2 diabetes, hypertension, elevated cholesterol, and smoking, all of which are risk factors for cardiovascular disease.

To address these health issues, we developed, implemented, and evaluated a culturally appropriate cardiovascular disease curriculum called ‘In Our Voice’ for American Indian students in grades 7 through 12. The curriculum consisted of 16 modules lasting 50 minutes each, and it was implemented as a pilot test at five sites in two western states.

We faced many challenges to success, including competing demands for instructional time and classrooms, which prevented two schools from completing the curriculum. Two notable findings emerged: students preferred a multicultural focus over a culturally tailored focus, and they desired more interactive educational materials.

Recommendations for successfully implementing an innovative curriculum include ensuring the ongoing presence of researchers at school sites, funding an internal curriculum champion at every site, and maintaining student advisory boards to communicate student feedback to researchers.

This project collected data on cancer risk factors among urban Native American youth in the northeast to inform development of a prevention initiative.

Face to face interviews were conducted.

Interviews were conducted in homes, at a social service agency, and in a private space at a Native American cultural event in Buffalo and Niagara Falls, New York.

Forty-one youth (ages 9–13) and 17 caregivers were interviewed about their health behaviours.

Poor dietary choices and a sedentary lifestyle places these youth at risk for developing cancer later in life. Many of these youth’s family members and some of their peers smoke, thus exposing them to the temptation to initiate smoking and the effects of second hand smoke.

This data informed development of a curriculum designed to reduce the cancer risk factors of poor diet, recreational tobacco use, and limited physical activity.

Sexually-transmitted disease (STD) is a facilitating cofactor that contributes to human immunodeficiency virus (HIV) transmission. Previous studies indicated a high prevalence of STDs among men who have sex with men (MSM) in China. To date, limited data are available for correlates of STD infection among young migrant MSM in China. The current study intends to examine the association between demographic and behavioral factors and STD infection.

Data were collected from a sample of 307 migrant MSM aged 18–29 years in Beijing in 2009. Multivariate logistic regression analysis was employed to examine the factors associated with a history of STDs.

Results showed that about 13% of MSM reported a history of STDs. The average number of lifetime sexual partners was 15.0. About 56.7% of MSM did not use a condom at the first sexual encounter. The percentage of MSM who used a condom consistently was 47.4%. Multivariate logistic regression results showed that STD history was positively associated with education, income, the number of lifetime male sexual partners, and negatively associated with the frequency of properly using a condom.

STD history was associated with socioeconomic status and sexual risk behaviors. The results suggested that HIV prevention intervention programs need to educate MSM to reduce the number of sexual partners and to use a condom properly. Furthermore, HIV prevention intervention programs among MSM need to be tailored to meet the needs of different socioeconomic groups of MSM.

Adolescents and young adults have been shown to be the age group most at risk of music-induced hearing loss (MIHL), which is already evident and increasing among this group.

The purpose of this review is to provide further insight into the effectiveness of education programmes on attitude and behaviour towards loud music exposure in adolescents and young adults, and to suggest positive and influential ways of delivering hearing health education.

Literature searches were conducted using various databases, including PubMed, Google Scholar and Cumulative Index to Nursing and Allied Health Literature (CINAHL). Authors went through the abstracts of these articles to identify those which were potentially relevant; subsequently the full articles were retrieved.

This review highlights the dangers of significant exposure to music on hearing mechanics in adolescents and young adults, and shows that this danger continues to increase with modern music culture. Because the consequences are not immediate, it is difficult for the young to perceive the seriousness of a problem that may not present itself for many years. Conventional education may go a little way in helping to raise awareness but a raised awareness of consequences does not, in itself, change behaviour. There is a significant gap in literature regarding effective methods of education that will inspire attitude change, and have a bearing on actions.

This review has concluded that there is a lack of understanding of how to best influence and educate adolescents and young adults in a way that will motivate and encourage a change in listening habits. It is of vital importance that these groups are made aware of the immediate and future dangers, and how changes in listening behaviour do not necessarily lower their enjoyment.

To assess quantity and quality of nutrition and food safety information in science textbooks prescribed by the Central Board of Secondary Education (CBSE), India for grades I through X.

Content analysis.

A coding scheme was developed for quantitative and qualitative analyses. Two investigators independently coded the data and inter-coder reliability was assessed using Cohen’s Kappa. The inferences were then reviewed by an expert group.

There was high agreement (Kappa = 0.89) between coders. Nutrition topics got > 10% pages in textbooks of grades I to VII, while they were omitted in subsequent grades. Food safety got a mere 1% of page allocation only in grades I to III books. Over 25% of biology illustrations related to nutrition in grades I, II and IV but not in others. Nutrition topics in textbooks beyond grade IV were repetitive and inconsistent. Some illustrations depicted uncommon foods and had urban bias.

Nutrition and food safety content in science textbooks is low. Important topics such as nutritional needs during adolescence, obesity, unhealthy foods and food labelling are not covered. These findings provide direction for strengthening textbook content to promote nutrition education in schools.

Internationally, it is well established that the behaviour, performance, and achievement of schoolchildren is directly linked to the nutritional status of overall diet – including the contents of their school lunch-boxes. In a previous survey study by the lead authors, primary school children’s food consumption behaviour was investigated. Results indicated that most children’s lunch-boxes contained an over-representation of ‘undesirable’ food groups and an under-representation of fruit and vegetables. This follow-up study examined children’s awareness of healthy food choices and investigated what food groups children would choose if given free choice when constructing a lunch-box.

The data was obtained by surveying 1,184 primary school children from eight different urban primary schools in the Manawatu Region of New Zealand. Food items included in this survey represented the 40 most common foods from the previous study. A series of accompanying food charts were used in combination with the checklists. From these lists the children were asked to construct a hypothetical ideal ‘dream’ lunch-box and a ‘healthy’ lunch-box.

Results indicated a significant difference between the fruit and vegetable content between lunch-boxes, demonstrating that children understood fruit and vegetables are healthy – but that they did not necessarily translate this knowledge into action.

The influences on children’s choices in fruit and vegetables are as complex as the barriers to them eating. This study offers unique insight into the knowledge and behaviours of schoolchildren when selecting and consuming fruit and vegetables – especially given a degree of autonomy and choice.

The present study investigated stakeholders’ reactions to the introduction of a traffic light food classification system in primary and secondary school canteens.

Interviews and focus groups were conducted with stakeholders approximately 18 months after the introduction of the traffic light system, followed by telephone and web-based surveys.

The context of the study was Western Australia, where a comprehensive healthy food policy was recently introduced in government schools.

Stakeholder groups included parents, principals, teachers, canteen managers, and representatives of parents and citizens committees.

Participants reported high levels of acceptance of the traffic light system and supported its extension to nutrition education programmes targeting children and parents.

The results suggest that there is likely to be considerable support for an extension of the traffic light policy to the health curriculum in schools and into other food provision contexts.

To ascertain paraprofessionals’ perceptions regarding a self-directed computer-supported nutrition educational intervention to disadvantaged mothers of infants.

Qualitative focus group study.

Three county extension programs in a Midwestern state, which serve disadvantaged families.

Sixteen paraprofessional nutrition educators, affiliated with Extended Food and Nutrition Programs (EFNEP), took part in three focus groups led by a facilitator following a semi-structured questioning route.

Three themes emerged: (1) paraprofessionals’ perceptions of personal connections with learners; (2) paraprofessionals’ perceptions of lesson plans; and (3) paraprofessionals’ perceptions of self-directed lessons.

Data provided exemplars of paraprofessional teaching strategies used with the disadvantaged populations they service, a recommendation to develop a blended curriculum, and insight regarding technology. A preventive nutrition education program, focusing on the reduction of childhood obesity though informed infant feeding practices, can be delivered using a combination of direct contact paraprofessional education and self-directed computer-supported lessons.