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Biomedical subjects

James F Sallis

Publications and source records attributed to James F Sallis.

At least 37 records · Page 2Linked to original sources

The role of built environments in physical activity, eating, and obesity in childhood.

Over the past forty years various changes in the U.S. "built environment" have promoted sedentary lifestyles and less healthful diets. James Sallis and Karen Glanz investigate whether these changes have had a direct effect on childhood obesity and whether improvements to encourage more physical activity and more healthful diets are likely to lower rates of childhood obesity. Researchers, say Sallis and Glanz, have found many links between the built environment and children's physical activity, but they have yet to find conclusive evidence that aspects of the built environment promote obesity. For example, certain development patterns, such as a lack of sidewalks, long distances to schools, and the need to cross busy streets, discourage walking and biking to school. Eliminating such barriers can increase rates of active commuting. But researchers cannot yet prove that more active commuting would reduce rates of obesity. Sallis and Glanz note that recent changes in the nutrition environment, including greater reliance on convenience foods and fast foods, a lack of access to fruits and vegetables, and expanding portion sizes, are also widely believed to contribute to the epidemic of childhood obesity. But again, conclusive evidence that changes in the nutrition environment will reduce rates of obesity does not yet exist. Research into the link between the built environment and childhood obesity is still in its infancy. Analysts do not know whether changes in the built environment have increased rates of obesity or whether improvements to the built environment will decrease them. Nevertheless, say Sallis and Glanz, the policy implications are clear. People who have access to safe places to be active, neighborhoods that are walkable, and local markets that offer healthful food are likely to be more active and to eat more healthful food-two types of behavior that can lead to good health and may help avoid obesity.

Child↗

Linking objectively measured physical activity with objectively measured urban form: findings from SMARTRAQ.

BACKGROUND: To date, nearly all research on physical activity and the built environment is based on self-reported physical activity and perceived assessment of the built environment. OBJECTIVE: To assess how objectively measured levels of physical activity are related with objectively measured aspects of the physical environment around each participant's home while controlling for sociodemographic covariates. METHODS: Objective measures of the built environment unique to each household's physical location were developed within a geographic information system to assess land-use mix, residential density, and street connectivity. These measures were then combined into a walkability index. Accelerometers were deployed over a 2-day period to capture objective levels of physical activity in 357 adults. RESULTS: Measures of land-use mix, residential density, and intersection density were positively related with number of minutes of moderate physical activity per day. A combined walkability index of these urban form factors was significant (p =0.002) and explained additional variation in the number of minutes of moderate activity per day over sociodemographic covariates. Thirty-seven percent of individuals in the highest walkability index quartile met the > or =30 minutes of physical activity recommended, compared to only 18% of individuals in the lowest walkability quartile. Individuals in the highest walkability quartile were 2.4 times more likely (confidence interval=1.18-4.88) than individuals in the lowest walkability quartile to meet the recommended > or =30 minutes of moderate physical activity per day. CONCLUSIONS: This research supports the hypothesis that community design is significantly associated with moderate levels of physical activity. These results support the rationale for the development of policy that promotes increased levels of land-use mix, street connectivity, and residential density as interventions that can have lasting public health benefits.

Adult↗

Self-management strategies mediate self-efficacy and physical activity.

BACKGROUND: Self-efficacy theory proposes that girls who have confidence in their capability to be physically active will perceive fewer barriers to physical activity or be less influenced by them, be more likely to pursue perceived benefits of being physically active, and be more likely to enjoy physical activity. Self-efficacy is theorized also to influence physical activity through self-management strategies (e.g., thoughts, goals, plans, and acts) that support physical activity, but this idea has not been empirically tested. METHODS: Confirmatory factor analysis was used to test the factorial validity of a measure of self-management strategies for physical activity. Next, the construct validity of the measure was tested by examining whether self-management strategies mediated the relationship between self-efficacy and self-reported physical activity, independently of several social-cognitive variables (i.e., perceived barriers, outcome expectancy value, and enjoyment), among cross-sectional samples of 6th grade (n=309) and 8th grade (n=296) girls tested between February 14 and March 17, 2002. Data were analyzed in 2004. RESULTS: Consistent with theory, self-efficacy had direct effects on the social-cognitive variables. The primary novel finding is that self-management strategies mediated the association of self-efficacy with physical activity in both samples. CONCLUSIONS: The measure of self-management strategies for physical activity yields valid scores among adolescent girls and warrants experimental study as a mediator of the influence of efficacy beliefs on physical activity.

Adolescent↗

Comparability and reliability of paper- and computer-based measures of psychosocial constructs for adolescent fruit and vegetable and dietary fat intake.

BACKGROUND: This study investigated the comparability and reliability of computer- and paper-based measures of psychosocial constructs related to fruit and vegetable and dietary fat intake among adolescents. METHODS: An ethnically diverse sample of 76 adolescents was studied (mean age 13 years). Scales measured use of change strategies, self-efficacy, decisional balance, family influences, and peer influences separately for the two dietary outcomes. RESULTS: Comparability analyses indicated that responses for each of the 12 diet-related scales were not significantly different between the computer- and paper-based surveys. Internal consistencies were generally high (alpha from .61 to .97) with slightly better reliability on the computer- vs paper-based surveys. Test-retest reliabilities were adequate to good for most multiple-item scales (interclass correlation coefficients from .43 to .85 and .48 to .90 for paper and computer formats, respectively). CONCLUSIONS: Computer- and paper-based measures of psychosocial constructs are appropriate and ready for use in either format for studies of dietary behaviors in young people.

Adolescent↗

Salad bars and fruit and vegetable consumption in elementary schools: a plate waste study.

The object of this study was to determine whether students attending schools with self-service salad bars consume a greater amount of fruits and vegetables compared with students using preportioned servings and to evaluate the relationship between number of items offered and fruit and vegetable consumption. Two hundred ninety-four students in first through fifth grade were randomly selected from two schools with salad bars and two with preportioned servings. Weights of fruit and vegetable items were measured pre- and postconsumption and interobserver agreement +/-1 g was > or =95%. Presence of a salad bar was not associated with greater fruit and vegetable consumption. Fruit and vegetable consumption was positively related to the number of fruit and vegetable items offered at salad bars (P < .05), adjusting for sex and grade. Fruit and vegetable variety was associated with elementary school-age children's fruit and vegetable consumption when using salad bars.

Analysis of Variance↗

Evaluating the sustainability of SPARK physical education: a case study of translating research into practice.

Dissemination and sustainability of evidence-based physical education programs (PE) has been studied rarely. The sustainability of a health-related PE program (SPARK) was independently evaluated in 111 elementary schools in 7 states. Surveys were mailed to schools that had received SPARK curriculum books, training and follow-up (response rate = 47%). Up to 80% of schools that adopted SPARK PE reported sustained use up to 4 years later. Schools using SPARK had more frequent PE classes. Sustained use was related to support from the principal, not previously having a standard PE program, having adequate equipment, and teachers being physically active. Program sustainability was similar in advantaged and disadvantaged schools. Evidence-based PE programs can be sustained up to 4 years.

Curriculum↗

Comparability and reliability of paper- and computer-based measures of psychosocial constructs for adolescent physical activity and sedentary behaviors.

This study assessed the comparability and reliability of paper-based and computer-based administration of psychosocial construct measures related to adolescents engaging in physical activity and sedentary behaviors. Adolescents (n = 76; 55% girls, 49% Hispanic, 18% non-Hispanic-white; M age = 13 years) completed measures of behavior change strategies, self-efficacy, decisional balance, family and peer influences, enjoyment, activity choices, and environmental influences. Overall, the adolescents provided equivalent responses on paper and computer formats. Reliability estimates were generally good for the multiple-item constructs, but single-item measures tended to demonstrate low reliability. Average scale internal consistency was significantly higher for measures administered with the computer format compared to the paper format, but test-rest reliability estimates were not significantly different between formats.

Adolescent↗

Efficacy of sequential or simultaneous interactive computer-tailored interventions for increasing physical activity and decreasing fat intake.

BACKGROUND: Little evidence exists about the effectiveness of "interactive" computer-tailored interventions and about the combined effectiveness of tailored interventions on physical activity and diet. Furthermore, it is unknown whether they should be executed sequentially or simultaneously. PURPOSE: The purpose of this study was to examine (a) the effectiveness of interactive computer-tailored interventions for increasing physical activity and decreasing fat intake and (b) which intervening mode, sequential or simultaneous, is most effective in behavior change. METHODS: Participants (N = 771) were randomly assigned to receive (a) the physical activity and fat intake interventions simultaneously at baseline, (b) the physical activity intervention at baseline and the fat intake intervention 3 months later, (c) the fat intake intervention at baseline and the physical activity intervention 3 months later, or (d) a place in the control group. RESULTS: Six months postbaseline, the results showed that the tailored interventions produced significantly higher physical activity scores, F(2, 573) = 11.4, p < .001, and lower fat intake scores, F(2, 565) = 31.4, p < .001, in the experimental groups when compared to the control group. CONCLUSIONS: For both behaviors, the sequential and simultaneous intervening modes showed to be effective; however, for the fat intake intervention and for the participants who did not meet the recommendation in the physical activity intervention, the simultaneous mode appeared to work better than the sequential mode.

Adult↗

Psychosocial and environmental correlates of adolescent sedentary behaviors.

OBJECTIVE: To determine correlates of sedentary behaviors in adolescents through the examination of psychosocial and environmental variables. METHOD: The study used a cross-sectional design to evaluate an ethnically diverse clinic-based sample of 878 adolescents who were 11 to 15 years old. Bivariate and multivariate analyses were stratified by gender to assess correlates of sedentary behaviors occurring on the most recent nonschool day (television viewing, computer video games, sitting listening to music, and talking on the phone). RESULTS: For girls, age, family support, television/video rules, and hills in the neighborhood were associated with sedentary behaviors. Furthermore, psychological constructs such as self-efficacy, enjoyment, change strategies, and pros and cons of change emerged as correlates of sedentary behaviors. A moderator effect revealed that the proportion of girls in the low-BMI group decreased with increased self-efficacy, whereas the proportion of girls in the high-BMI group did not vary significantly by self-efficacy. For boys, age, ethnicity, BMI, cons of change, and self-efficacy were associated with sedentary behaviors. CONCLUSIONS: This study provides evidence of factors associated and not associated with adolescent sedentary behaviors. Similar to physical activity, measures of specific psychosocial constructs of sedentary behavior demonstrated important associations. The results highlight the need for additional examination of the correlates of sedentary behavior to determine which correlates are mechanisms of behavior change.

Adolescent↗

Diet, physical activity, and sedentary behaviors as risk factors for overweight in adolescence.

BACKGROUND: The proportion of overweight adolescents has increased, but the behavioral risk factors for overweight youth are not well understood. OBJECTIVE: To examine how diet, physical activity, and sedentary behaviors relate to overweight status in adolescents. DESIGN AND SETTING: Baseline data from the Patient-Centered Assessment and Counseling for Exercise Plus Nutrition Project, a randomized controlled trial of adolescents to determine the effects of a clinic-based intervention on physical activity and dietary behaviors. PARTICIPANTS: A total of 878 adolescents aged 11 to 15 years, 42% of whom were from minority backgrounds. MAIN OUTCOME MEASURE: Centers for Disease Control and Prevention body mass index-for-age percentiles divided into 2 categories: normal weight (<85th percentile) and at risk for overweight plus overweight (AR + O) (>or=85th percentile). RESULTS: Overall, 45.7% of the sample was classified as AR + O with a body mass index for age at the 85th percentile or higher. More girls from minority backgrounds (54.8%) were AR + O compared with non-Hispanic white girls (42%) (chi(2)(1) = 7.6; P =.006). Bivariate analyses indicated that girls and boys in the AR + O group did fewer minutes per day of vigorous physical activity, consumed fewer total kilojoules per day, and had fewer total grams of fiber per day than those in the normal-weight group. Boys in the AR + O group also did fewer minutes per day of moderate physical activity and watched more minutes per day of television on nonschool days than normal-weight boys. Final multivariate models indicated that independent of socioeconomic status (as assessed by household education level), girls had a greater risk of being AR + O if they were Hispanic or from another minority background (odds ratio [OR] = 1.65; 95% confidence interval [CI], 1.09-2.49) and a reduced risk of being AR + O as minutes per day of vigorous physical activity increased (OR = 0.93; 95% CI, 0.89-0.97). A low level of vigorous physical activity was the only significant risk factor for boys being AR + O (OR = 0.92; 95% CI, 0.89-0.95). Analyses based on meeting behavioral guidelines supported these findings and showed that failing to meet the 60 min/d moderate to vigorous physical activity guideline was associated with overweight status for both girls and boys. In addition, boys who failed to meet sedentary behavior and dietary fiber guidelines were more likely to be overweight. CONCLUSIONS: Of the 7 dietary and physical activity variables examined in this cross-sectional study, insufficient vigorous physical activity was the only risk factor for higher body mass index for adolescent boys and girls. Prospective studies are needed to clarify the relative importance of dietary and physical activity behaviors on overweight in adolescence.

Adolescent↗

Parental prompts as risk factors for adolescent trial smoking: results of a prospective cohort study.

Our earlier cross-sectional research suggested that smoking parents, particularly Latino parents, engage in behaviors that may prompt their children to smoke (e.g., request their child to start the parent's cigarette in his/her own mouth). This prospective study of 478 adolescent never-smokers, mostly Latino, suggests that parental prompts to smoke were not significantly related to smoking initiation among adolescents over a 1-year period.

Adolescent↗

Understanding environmental influences on walking; Review and research agenda.

BACKGROUND: Understanding how environmental attributes can influence particular physical activity behaviors is a public health research priority. Walking is the most common physical activity behavior of adults; environmental innovations may be able to influence rates of participation. METHOD: Review of studies on relationships of objectively assessed and perceived environmental attributes with walking. Associations with environmental attributes were examined separately for exercise and recreational walking, walking to get to and from places, and total walking. RESULTS: Eighteen studies were identified. Aesthetic attributes, convenience of facilities for walking (sidewalks, trails); accessibility of destinations (stores, park, beach); and perceptions about traffic and busy roads were found to be associated with walking for particular purposes. Attributes associated with walking for exercise were different from those associated with walking to get to and from places. CONCLUSIONS: While few studies have examined specific environment-walking relationships, early evidence is promising. Key elements of the research agenda are developing reliable and valid measures of environmental attributes and walking behaviors, determining whether environment-behavior relationships are causal, and developing theoretical models that account for environmental influences and their interactions with other determinants.

Environment↗

Economic analysis of eating and physical activity: a next step for research and policy change.

Poor nutrition and physical inactivity are among the leading causes of morbidity and mortality in the United States, and widespread behavior modification is needed to improve health now and in the future. There is growing evidence that modifications in the physical environment and in social policies will be required to accomplish this goal. There is also growing recognition that economic factors have contributed to current eating and physical activity patterns, and that economic factors need to be considered when developing strategies for improving these behaviors. Identifying where economic and public health priorities converge could suggest new avenues for sustainable policy changes, which will, in turn, promote healthy choices on both an individual and population-wide level. To review the effect that economics has on eating and physical activity behaviors, the Partnership to Promote Healthy Eating and Active Living convened an Economic Analysis Forum. Two working groups were formed-one focusing on eating behaviors and one on physical activity, and both with equal representation from health-related and economic disciplines. The groups examined how economics has contributed to present eating and physical activity patterns and how economics could be used to develop interventions to improve these patterns. This article describes the challenges the groups faced in their work, the way in which the public health and economic approaches were integrated, and the questions left unanswered.

Cost-Benefit Analysis↗

Economic interventions to promote physical activity: application of the SLOTH model.

Physical inactivity is responsible for major health and economic costs in the United States. Despite widespread recognition of the scope and importance of the problem of physical inactivity, only modest progress has been made in improving overall physical activity in the U.S. population. This paper applies a combined economic and public health perspective to better understand physical activity behavior and to guide a search for promising new economically oriented interventions to increase physical activity at the population level. This perspective is operationalized as the SLOTH model-a time-budget model incorporating Sleep, Leisure, Occupation, Transportation, and Home-based activities. Key economic forces that may influence individuals' choices about utilization of time and physical activity are identified. Potential interventions are proposed in response to each of the important forces and are evaluated on four criteria: (1) economic efficiency, (2) equity, (3) effectiveness, and (4) feasibility. The SLOTH model provides guidance regarding interventions that might increase physical activity in each of the four nonsleep domains. Economic intervention strategies are proposed and compared to economic and public health criteria. The results provide a starting point for selecting and evaluating potentially effective and feasible economic interventions that might be implemented as part of a larger effort to address the health crisis of inactive lifestyles and obesity.

Exercise↗

Reliability and validity of a fruit and vegetable screening measure for adolescents.

We developed and evaluated a brief measure of fruit and vegetable consumption for adolescents. The measure was reliable and significantly correlated with 3-day food record data. Correct classification rate (63%) and specificity (63%) were good. Sensitivity (33%) was lower. The measure is recommended, although improvements in classification are still needed.

Adolescent↗

Leisure-time physical activity in university students from 23 countries: associations with health beliefs, risk awareness, and national economic development.

BACKGROUND: Physical inactivity has been linked with chronic disease and obesity in most western populations. However, prevalence of inactivity, health beliefs, and knowledge of the risks of inactivity have rarely been assessed across a wide range of developed and developing countries. METHODS: A cross-sectional survey was carried out with 19,298 university students from 23 countries varying in culture and level of economic development. Data concerning leisure-time physical activity, health beliefs, and health knowledge were collected. RESULTS: The prevalence of inactivity in leisure time varied with cultural and economic developmental factors, averaging 23% (North-Western Europe and the United States), 30% (Central and Eastern Europe), 39% (Mediterranean), 42% (Pacific Asian), and 44% (developing countries). The likelihood of leisure-time physical activity was positively associated with the strength of beliefs in the health benefits of activity and with national economic development (per capita gross domestic product). Knowledge about activity and health was disappointing, with only 40-60% being aware that physical activity was relevant to risk of heart disease. CONCLUSIONS: Leisure-time physical activity is below recommended levels in a substantial proportion of students, and is related to cultural factors and stage of national economic development. The relationship between health beliefs and behavior is robust across cultures, but health knowledge remains deficient.

Adult↗

Validating outdoor workers' self-report of sun protection.

BACKGROUND: Few studies assessing sun safety behaviors have used validated survey instruments. Using an observational strategy, this study measured the validity of self-report of occupational sun protection behaviors. METHODS: Postal workers (N = 1,036) self-reported their frequency of protective clothing and sunglasses use during the past 5 workdays on Likert scales ranging from "Never" to "Always". Responses were dichotomized by Always vs. all other responses. Data collectors observed these same behaviors during mail delivery several days before survey administration. Agreement between the two measures was computed. RESULTS: Self-report for all items was significantly related to observed behaviors, with Kappa values in the good to excellent range (Kappas = 0.51-0.83). CONCLUSIONS: For outdoor postal workers, survey items assessing recent occupational use of sun-protective items had high levels of validity.

Adult↗