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Biomedical subjects

J F Sallis

Publications and source records attributed to J F Sallis.

At least 19 recordsLinked to original sources

Reliability of moderate-intensity and vigorous physical activity stage of change measures for young adults.

BACKGROUND: The purpose of this study was to examine the reliability of stage of change (SOC) measures for moderate-intensity and vigorous physical activity in two separate samples of young adults. Staging measures have focused on vigorous exercise, but current public health guidelines emphasize moderate-intensity activity. METHOD: For college students in the USA (n=105) and in Australia (n=123), SOC was assessed separately on two occasions for moderate-intensity activity and for vigorous activity. Test-retest repeatability was determined, using Cohen's kappa coefficient. RESULTS: In both samples, the reliability scores for the moderate-intensity physical activity staging measure were lower than the scores for the vigorous exercise staging measure. Weighted kappa values for the moderate-intensity staging measure were in the "fair to good" range for both studies (0.50 and 0.45); for the vigorous staging measure kappa values were "excellent" and "fair to good" (0.76 and 0.72). CONCLUSIONS: There is a need to standardize and improve methods for staging moderate-intensity activity, given that such measures are used in public health interventions targeting HEPA (health-enhancing physical activity).

Adult↗

A physical activity screening measure for use with adolescents in primary care.

OBJECTIVE: To develop a reliable and valid physical activity screening measure for use with adolescents in primary care settings. STUDY DESIGN: We conducted 2 studies to evaluate the test-retest reliability and concurrent validity of 6 single-item and 3 composite measures of physical activity. Modifications were based on the findings of the 2 studies, and a best measure was evaluated in study 3. Accelerometer data served as the criterion standard for tests of validity. RESULTS: In study 1 (N = 250; mean age, 15 years; 56% female; 36% white), reports on the composite measures were most reliable. In study 2 (N = 57; mean age, 14 years; 65% female; 37% white), 6 of the 9 screening measures correlated significantly with accelerometer data. Subjects, however, had great difficulty reporting bouts of activity and distinguishing between intensity levels. Instead, we developed a single measure assessing accumulation of 60 minutes of moderate to vigorous physical activity. Evaluated in study 3 (N = 148; mean age, 12 years; 65% female; 27% white), the measure was reliable (intraclass correlation, 0.77) and correlated significantly (r = 0.40, P<.001) with accelerometer data. Correct classification (63%), sensitivity (71%), and false-positive rates (40%) were reasonable. CONCLUSION: The "moderate to vigorous physical activity" screening measure is recommended for clinical practice with adolescents.

Adolescent↗

A multicomponent program for nutrition and physical activity change in primary care: PACE+ for adolescents.

BACKGROUND: Most adolescents do not meet national recommendations for nutrition and physical activity. However, no studies of physical activity and nutrition interventions for adolescents conducted in health care settings have been published. The present study was an initial evaluation of the PACE+ (Patient-centered Assessment and Counseling for Exercise plus Nutrition) program, delivered in primary care settings. PARTICIPANTS: Adolescents aged 11 to 18 years (N = 117) were recruited from 4 pediatric and adolescent medicine outpatient clinics. Participants' mean (SD) age was 14.1 (2.0) years, 37% were girls, and 43% were ethnic minorities. INTERVENTION: Behavioral targets were moderate physical activity, vigorous physical activity, fat intake, and fruit and vegetable intake. All patients completed a computerized assessment, created tailored action plans to change behavior, and discussed the plans with their health care provider. Patients were then randomly assigned to receive no further contact or 1 of 3 extended interventions: mail only, infrequent telephone and mail, or frequent telephone and mail. MEASURES: Brief, validated, self-report measures of target behaviors were collected at baseline and 4 months later. RESULTS: All outcomes except vigorous physical activity improved over time, but adolescents who received the extended interventions did not have better 4-month outcomes than those who received only the computer and provider counseling components. Adolescents who targeted a behavior tended to improve more than those who did not target the behavior, except for those who targeted vigorous physical activity. CONCLUSIONS: A primary care-based interactive health communication intervention to improve physical activity and dietary behaviors among adolescents is feasible. Controlled experimental research is needed to determine whether this intervention is efficacious in changing behaviors in the short- and long-term.

Adolescent↗

Screening measure for assessing dietary fat intake among adolescents.

BACKGROUND: Clinical preventive guidelines recommend that health care providers counsel adolescents on nutrition. Brief, accurate, and reproducible dietary assessments are needed. The purpose of the current pair of studies was to develop a dietary fat screening measure for use with adolescents. METHODS: Two measures were developed-a 21-item and a 4-category measure. The measures differed in the level at which fat consumption was assessed (food item vs food group). Study 1 (N = 231, age M = 15 years, 57% female, 41% Euro-American) evaluated reliability. Study 2 (N = 59, age M = 14 years, 63% female, 37% Euro-American) evaluated construct validity and correct classification rates. RESULTS: Internal consistencies (alpha > 0.70) and test-retest reliabilities (ICC > 0.60) were adequate for both measures. Neither measure correlated with total fat assessed by a 3-day food record (P > 0.05). The 21-item measure correlated significantly with percentage of calories from fat (r = 0.36, P <.01). Correct classification rate (71%) and sensitivity (81%) of the 21-item measure were good. Specificity (47%) was lower, indicating some subjects with a low-fat diet were misclassified by the screening measure. CONCLUSIONS: The 21-item measure is quick to complete and score, is inexpensive to reproduce, and has demonstrated reliability and validity. The measure could be clinically useful, but further improvements should be attempted to improve specificity.

Adolescent↗

Parental provision of transportation for adolescent physical activity.

BACKGROUND: Physical activity (PA) is important to adolescents' health. Parent transportation to activity locations is a practical strategy for increasing youth PA that has rarely been examined. DESIGN: Cross-sectional surveys of students and parents. SETTING/PARTICIPANTS: Ethnically diverse students (N=1678; 712 boys, 966 girls; M age=13.0 years) from 24 middle schools (grades six to eight) and their parents completed surveys (response rate=72%). MAIN OUTCOME MEASURES: Frequency of parents transporting adolescents to PA locations was studied in relation to adolescents' reported participation in PA during the previous week and their involvement in sports and activity lessons during the past year. RESULTS: Parents transported adolescents to PA locations 2.13 times per week, with boys being transported more often than girls (p=0.03). Ethnic/racial differences in frequency of transport were evidenced (p=0.002). Parent transportation for PA significantly contributed to girls' total PA (p=0.001) and their participation in sports/activity lessons (p=0.001). Transportation contributed marginally (p=0.06) to boys' total PA, but significantly to their participation in sports/activity lessons (p=0.001). CONCLUSIONS: Parent provision of transportation to activity locations is associated with out-of-school PA in a diverse adolescent population. This variable should be targeted for intervention.

Adolescent↗

Compliance with federal and state legislation by indoor tanning facilities in San Diego.

BACKGROUND: The prevalence rates of both skin cancers and indoor tanning among the US population are high and have increased substantially in recent years. Low compliance by indoor tanning facilities with safety regulations may place consumers at greater risk of skin and ocular damage. OBJECTIVE: This study quantified the level of compliance by indoor tanning facilities with selected federal and state regulations and recommendations. METHODS: Tanning facilities (N = 54) in San Diego County, California, were visited by a confederate posing as a prospective customer. Compliance with 13 regulations/recommendations were assessed by either direct query or observation of the presence/absence of signs and warning labels. Operators' responses to 5 risk-based questions also were noted. RESULTS: No facility complied with all 13 regulations/recommendations. Compliance with 3 protective eyewear regulations was high (89%-100%). In contrast, compliance with maximum tanning frequency recommendations (approximately 6%) and parental consent regulations (approximately 43%) was disturbingly low. CONCLUSION: The investigators recommend instituting mandatory, comprehensive training for operators, as well as systematic compliance monitoring with enforcement of penalties for noncompliance.

Beauty Culture↗

Six-month patient outcomes in a preventive cardiology center.

More effective ways to improve lifestyle behaviors need to be developed. Two hundred forty adult patients at a preventive cardiology clinic were randomly assigned to receive either one or five sessions of behavioral instruction to improve cardiovascular risk behaviors. Results for 102 patients from 6-month follow-up data revealed few significant differences between the two groups. However, in the two groups combined, there were significant reductions in total calories, percent of calories from total fat, percent of calories from saturated and monounsaturated fat, and dietary cholesterol. Reductions were also found in systolic blood pressure, triglycerides, body mass index, and weight. In multiple regression analyses, changes in physiologic variables were primarily associated with baseline and demographic characteristics. Changes in total calories, percent of calories from polyunsaturated fat, and walking were predicted by changes in social support or knowledge. Although most patients improved, the intensity of behavior change instruction was not related to the amount of change in cardiovascular risk factors. (c) 2001 by CHF, Inc.

Journal Article↗

Effects of a physical activity intervention on body image in university seniors: project GRAD.

Project GRAD (Graduate Ready for Activity Daily) was a randomized controlled study to teach university seniors behavioral skills necessary for increasing and/or maintaining physical activity habits in preparation for the transition to working adult roles after graduation. This study examines the secondary effects of this intervention on body image concerns among college-aged men and women. Three hundred thirty-eight undergraduates (54%female, Mage = 24years, SD = 1.95; MBody Mass Index = 24.26, SD = 4.0) were studied. The sample was 61/% Anglo, 16% Latino, 16% Asian/Pacific Islander, 4% African American, and 3% Native American/Other Body image concerns were assessed at pre- and posttreatment using 2 subscales of the Eating Disorder Inventory: Drive for Thinness and Body Dissatisfaction. Because the latter concentrates on body parts typically associated with female concerns (e.g., thighs, hips, buttocks), a parallel scale was developed to target body parts that may be of more concern to men (e.g., legs, shoulders, arms, stomach). Results indicated that compared to the control group, women in the intervention showed a significant increase in drive for thinness without any changes in body dissatisfaction. For men, there were no significant changes in drive for thinness or body dissatisfaction. These results suggest that physical activity interventions may have some negative consequences of increasing concerns about thinness in women. This negative effect occurred despite intervention content designed to prevent concern over eating, dieting, and the importance of weight. Health promotion studies should include assessments of potential negative side effects.

Adult↗

A prospective analysis of the relationship between walking and mood in sedentary ethnic minority women.

Walking for exercise is becoming widely recognized for bestowing health benefits. This study examined the association of walking for exercise and mood in sedentary, ethnic minority women over a five-month period. Ethnic minority women (N = 102) participated in a randomized, controlled trial of a 7-week behaviorally based telephone and mail intervention that promoted the adoption of walking for exercise compared to a non-behavioral minimal intervention. At 2-month post-test and 5-month follow-up, participants reported significant decreases in depressive mood and increases in vigor. Increase in walking over the course of the study was associated with change in vigor. Limited evidence was found to support a relationship between walking for exercise and mood improvement in ethnic-minority women.

Adult↗

Changes and tracking of physical activity across seven years in Mexican-American and European-American mothers.

Longitudinal changes in physical activity among 129 Mexican-American (mean age 30.8; SD = 5.6) and 97 European-American (mean age 31.2; SD = 5.4) women were studied. Two physical activity recall interviews were administered at baseline and 7 years later. At baseline, European-American women reported more vigorous leisure activity (p < .005) than Mexican-Americans, and Mexican-Americans reported more moderate work activity (p < .02) than European-Americans. Virtually all components of physical activity increased significantly over the 7 years. Pearson tracking correlations for total energy expenditure were about r = 0.30. The finding that both groups increased physical activity overtime was unexpected and was unrelated to a reduction in the number of preschool children in the homes over time.

Adult↗

The association of school environments with youth physical activity.

OBJECTIVES: This study assessed the association of school environmental characteristics with student physical activity on campus. METHODS: Physical activity areas (n = 137) at 24 public middle schools were assessed for area type, size, and improvements (e.g., basketball courts). Student physical activity and the presence of equipment and supervision were directly observed before school, after lunch, and after school. RESULTS: Environmental characteristics explained 42% of the variance in the proportion of girls who were physically active and 59% of the variance for boys. CONCLUSIONS: School environments with high levels of supervision and improvements stimulated girls and boys to be more physically active.

Adolescent↗

Behavioral science research in diabetes: lifestyle changes related to obesity, eating behavior, and physical activity.

Lifestyle factors related to obesity, eating behavior, and physical activity play a major role in the prevention and treatment of type 2 diabetes. In recent years, there has been progress in the development of behavioral strategies to modify these lifestyle behaviors. Further research, however, is clearly needed, because the rates of obesity in our country are escalating, and changing behavior for the long term has proven to be very difficult. This review article, which grew out of a National Institute of Diabetes and Digestive and Kidney Diseases conference on behavioral science research in diabetes, identifies four key topics related to obesity and physical activity that should be given high priority in future research efforts: 1) environmental factors related to obesity, eating, and physical activity; 2) adoption and maintenance of healthful eating, physical activity, and weight; 3) etiology of eating and physical activity; and 4) multiple behavior changes. This review article discusses the significance of each of these four topics, briefly reviews prior research in each area, identifies barriers to progress, and makes specific research recommendations.

Behavior Therapy↗

Leisure-time physical activity in school environments: an observational study using SOPLAY.

BACKGROUND: Schools provide settings for physical activity (PA), but objective tools for measuring PA are lacking. We assessed an instrument to directly observe group PA and measured the leisure-time PA of adolescents throughout the school day. METHODS: Leisure-time PA was studied by direct observation in 24 middle schools in Southern California using SOPLAY (System for Observing Play and Leisure Activity in Youth). SOPLAY uses momentary time sampling to record the activity of each individual as sedentary, walking, or very active. RESULTS: The largest proportion of students visited activity areas at lunch time (19.5%), followed by before (4. 1%) and after school (2.1%). More boys than girls visited activity areas before school (33.4 vs 7.7) and at lunch time (148.8 vs 36.7). Boys in areas engaged in more moderate to vigorous PA than girls before school (59.6 vs 40%) and at lunch time (67.7 vs 51.7%). CONCLUSIONS: Few students use opportunities to be physically active during lesiure time at school. Policies and environmental manipulations (e.g., supervision, equipment, structured programs) are needed to attract more adolescents, especially girls, to existing activity areas. The feasibility of SOPLAY for measuring group PA was established.

Adolescent↗

Behavioral epidemiology: a systematic framework to classify phases of research on health promotion and disease prevention.

Although the term "behavioral epidemiology" has been used in the literature since the late 1970s, it has not been clearly defined. A behavioral epidemiology framework is proposed to specify a systematic sequence of studies on health-related behaviors, leading to evidence-based interventions directed at populations. The phase are: 1--establish links between behaviors and health; 2--develop measures of the behavior; 3--identify influences on the behavior; 4--evaluate interventions to change the behavior; 5--translate research into practice. Mature research areas are expected to have more studies in the latter phases. Recent volumes of four journals (Annals of Behavioral Medicine, Health Psychology, Journal of Nutrition Education, Tobacco Control) were audited, and empirical studies were classified into these phases. Phase 3 studies were common (identifying influences on behaviors; 27% to 50%), and Phase 2 studies were least common (measurement; 0% to 15%). Annals of Behavioral Medicine and Health Psychology were low on Phase 4 (intervention studies; 9% and 11%, respectively). The Journal of Nutrition Education was the only journal reviewed that had a substantial number (20%) of Phase 5 studies (translating research into practice). The behavioral epidemiology framework can be used to evaluate the status of research on health behaviors and to guide research policies.

Chronic Disease↗

Fat and sugar levels are high in snacks purchased from student stores in middle schools.

OBJECTIVE: Children consume about one third of their daily energy at school, mostly from cafeteria food and bag lunches. Students also shop at student-run stores that generate revenue for extracurricular activities; yet the nutritional value of snacks sold at student stores has not been documented to our knowledge. DESIGN: Cross-sectional study of foods sold at student stores in middle schools. SUBJECTS/SETTING: Twenty-four San Diego County (Calif) public middle schools, grades 6 through 8 (age 11 to 13), from 9 school districts. The schools represent a diversity of ethnic groups and socioeconomic levels. STATISTICAL ANALYSES PERFORMED: Descriptive statistics, Pearson product moment correlations, analysis of variance. RESULTS: Snacks averaged 8.7 g fat and 23.0 g sugar. Overall, 88.5% of store inventory was high in fat and/or high in sugar. Sugar candy accounted for one third of store sales. Chocolate candy was highest in fat content: 15.7 g. Fourteen of the 24 schools had stores that sold food and were run by student organizations. Stores were open daily for about 90 minutes; half sold food during lunch. CONCLUSIONS: Adolescents need opportunities to supplement main meals; however, student stores in middle schools sell primarily high-fat, high-sugar snacks. Key intervention possibilities include limiting sales of chocolate candy and substituting low-fat varieties of cakes, cookies, chips, and crackers. Competition with cafeterias for sales at lunchtime should be addressed.

Adolescent↗

PACE+: interactive communication technology for behavior change in clinical settings.

BACKGROUND: Interactive health communication technologies have the potential to eliminate or greatly reduce many of the barriers to delivery of preventive services. This paper describes the process of developing and evaluating interactive health communication programs for primary care settings. We present as examples the Patient-centered Assessment and Counseling for Exercise plus Nutrition (PACE+) programs, designed to promote physical activity and healthy nutrition with adolescents and adults. METHODS: The PACE+ programs use interactive communication technology to screen multiple behaviors, prioritize areas for intervention, and initiate intervention. Patient information is synthesized for ease of use by clinicians. The patient completes the program on a computer in the clinic waiting room before the provider encounter. Acceptability of the program was evaluated with adolescents (n=252), adults (n=285), and their health care providers. RESULTS: The PACE+ programs were developed, evaluated, modified, and re-evaluated. Feasibility testing indicated that a diverse group of adolescents and adults found the PACE+ computer programs acceptable. Modifications to shorten and refine the programs were identified. CONCLUSIONS: Development of interactive health technologies is an iterative process dependent on feedback from intended users and systems of care. Interactive health communication technologies can be incorporated into clinical settings.

Adolescent↗