PubMed Health⌕ Search

Biomedical subjects

Ken Resnicow

Publications and source records attributed to Ken Resnicow.

At least 19 recordsLinked to original sources
PubMed2007

Church-based health promotion interventions: evidence and lessons learned.

Church-based health promotion (CBHP) interventions can reach broad populations and have great potential for reducing health disparities. From a socioecological perspective, churches and other religious organizations can influence members' behaviors at multiple levels of change. Formative research is essential to determine appropriate strategies and messages for diverse groups and denominations. A collaborative partnership approach utilizing principles of community-based participatory research, and involving churches in program design and delivery, is essential for recruitment, participation, and sustainability. For African Americans, health interventions that incorporate spiritual and cultural contextualization have been effective. Evidence indicates that CBHP programs have produced significant impacts on a variety of health behaviors. Key elements of CBHP are described with illustrations from the authors' research projects.

Black or African American↗
PubMed2006

Process evaluation of an effective church-based diet intervention: Body & Soul.

Body & Soul has demonstrated effectiveness as a dietary intervention among African American church members. The process evaluation assessed relationships between program exposure and implementation factors and study outcomes and characterized factors important for adoption, implementation, and maintenance. Data sources included participant surveys and qualitative interviews with program staff, church liaisons, and volunteer advisors who conducted motivational interviewing (MI) calls. Outcomes included changes in dietary intake and psychosocial variables. Process variables included program exposure, participation, and dose and perceptions about MI calls. Results showed that attendance at project events, receiving educational materials, and self-reported quality of the MI calls were associated with significantly (p < .05) greater fruit and vegetable intake, decreased fat consumption, and other secondary outcomes. Interviews indicated implementation and sustainability issues and needs including more training to enhance MI implementation as well as ongoing support and resources. The results have implications for future dissemination efforts of Body & Soul.

Adolescent↗
PubMed2006

A chaotic view of behavior change: a quantum leap for health promotion.

BACKGROUND: The study of health behavior change, including nutrition and physical activity behaviors, has been rooted in a cognitive-rational paradigm. Change is conceptualized as a linear, deterministic process where individuals weigh pros and cons, and at the point at which the benefits outweigh the cost change occurs. Consistent with this paradigm, the associated statistical models have almost exclusively assumed a linear relationship between psychosocial predictors and behavior. Such a perspective however, fails to account for non-linear, quantum influences on human thought and action. Consider why after years of false starts and failed attempts, a person succeeds at increasing their physical activity, eating healthier or losing weight. Or, why after years of success a person relapses. This paper discusses a competing view of health behavior change that was presented at the 2006 annual ISBNPA meeting in Boston. DISCUSSION: Rather than viewing behavior change from a linear perspective it can be viewed as a quantum event that can be understood through the lens of Chaos Theory and Complex Dynamic Systems. Key principles of Chaos Theory and Complex Dynamic Systems relevant to understanding health behavior change include: 1) Chaotic systems can be mathematically modeled but are nearly impossible to predict; 2) Chaotic systems are sensitive to initial conditions; 3) Complex Systems involve multiple component parts that interact in a nonlinear fashion; and 4) The results of Complex Systems are often greater than the sum of their parts. Accordingly, small changes in knowledge, attitude, efficacy, etc may dramatically alter motivation and behavioral outcomes. And the interaction of such variables can yield almost infinite potential patterns of motivation and behavior change. In the linear paradigm unaccounted for variance is generally relegated to the catch all "error" term, when in fact such "error" may represent the chaotic component of the process. The linear and chaotic paradigms are however, not mutually exclusive, as behavior change may include both chaotic and cognitive processes. Studies of addiction suggest that many decisions to change are quantum rather than planned events; motivation arrives as opposed to being planned. Moreover, changes made through quantum processes appear more enduring than those that involve more rational, planned processes. How such processes may apply to nutrition and physical activity behavior and related interventions merits examination.

Journal Article↗
PubMed2006

Confirmatory factor analysis of the child-feeding questionnaire among parents of adolescents.

We investigated the validity of the child-feeding questionnaire (CFQ) among parents of adolescents. The original CFQ was developed to assess perceptions of obesity-proneness and child-feeding practices among parents of 2- to 11-year-old children. We modified the CFQ to make it applicable to parents of adolescents and added one item on monitoring sugared beverages. Confirmatory factor analysis was conducted using the latent variable approach. Factor scores were related to adolescent body mass index percentiles (BMI%) using structural equation modeling. The modified CFQ was completed by 260 parent/guardians (mean age 39.8 years; 92% female; 55% Black, 35% White, 10% Other). The original published measurement model was fit to our sample and yielded an acceptable fit (CFI = 0.95, TLI = 0.93, RMSEA = 0.05). Adding the extra variables decreased the fit; however, minor modifications improved the fit without changing the factor structure (CFI = 0.95, TLI = 0.94, RMSEA = 0.05). Cronbach's alphas for the subscales ranged from 0.60 to 0.88. The factors, parental perceptions of child weight, concern for child weight, monitoring and restriction were positively associated, and pressure to eat was inversely associated with adolescent BMI%. In conclusion, the psychometric properties of the modified CFQ tested among parents of a multi-ethnic adolescent sample were similar to those of the original CFQ.

Adolescent↗
PubMed2006

Motivational interviewing for pediatric obesity: Conceptual issues and evidence review.

Counseling by health care professionals represents a potentially important intervention for the prevention and treatment of pediatric obesity. One promising approach to weight-control counseling in pediatric practice is motivational interviewing. This article explores conceptual issues related to the application of motivational interviewing for the prevention and treatment of pediatric obesity. Given the paucity of studies on motivational interviewing and pediatric obesity, we examine what is known about the application of motivational interviewing to modify diet, physical activity, and other behaviors in children and adolescents. We begin with a brief overview of motivational interviewing, describe some nuances of applying this approach to pediatric overweight, and conclude with research and clinical recommendations.

Adolescent↗
PubMed2006

Psychosocial mediation of fruit and vegetable consumption in the body and soul effectiveness trial.

In this study the authors examined psychosocial variables as mediators for fruit and vegetable (FV) intake in a clustered, randomized effectiveness trial conducted in African American churches. The study sample included 14 churches (8 intervention and 6 control) with 470 participants from the intervention churches and 285 participants from the control churches. The outcome of FV intake and the proposed mediators were measured at baseline and at 6-month follow-up. Structural equation modeling indicated that the intervention had direct effects on social support, self-efficacy, and autonomous motivation; these variables also had direct effects on FV intake. Applying the M. E. Sobel (1982) formula to test significant mediated effects, the authors confirmed that social support and self-efficacy were significant mediators but that autonomous motivation was not. Social support and self-efficacy partially mediated 20.9% of the total effect of the intervention on changes in FV intake. The results support the use of strategies to increase social support and self-efficacy in dietary intervention programs.

Feeding Behavior↗
PubMed2005

Results of the healthy body healthy spirit trial.

Healthy Body Healthy Spirit was a multicomponent intervention to increase fruit and vegetable (F & V) consumption and physical activity (PA) delivered through Black churches. Sixteen churches were randomly assigned to 3 intervention conditions. At baseline, 1,056 individuals were recruited across the 16 churches, of which 906 (86%) were assessed at 1-year follow-up. Group 1 received standard educational materials, Group 2 received culturally targeted self-help nutrition and PA materials, and Group 3 received the same intervention as did Group 2 as well as 4 telephone counseling calls based on motivational interviewing (MI) delivered over the course of 1 year. At 1-year follow-up, Groups 2 and 3 showed significant changes in both F & V intake and PA. Changes were somewhat larger for F & V. For F & V, but not PA, there was a clear additive effect for the MI intervention.

Adolescent↗
PubMed2005

Results of go girls: a weight control program for overweight African-American adolescent females.

OBJECTIVE: Go Girls was a church-based nutrition and physical activity program designed for overweight African-American (AA) adolescent females. RESEARCH METHODS AND PROCEDURES: Ten predominantly middle-socioeconomic churches were randomized to either a high-intensity (20 to 26 sessions) or moderate-intensity (six sessions) culturally tailored behavioral group intervention delivered over 6 months. Each session included an experiential behavioral activity, approximately 30 minutes of physical activity, and preparation and tasting of healthy foods. In the high-intensity group, girls also received four to six telephone counseling calls. From the 10 churches, 123 girls completed baseline and 6-month post-test assessments. The primary outcome was BMI; secondary outcomes included waist and hip circumferences, percentage body fat estimated by bioimpedance, serum insulin, glucose, and lipids, and cardiovascular fitness at 6-month follow-up. Selected measures were also collected at 1-year follow-up. RESULTS: At 6-month follow-up, the net difference between the high- and moderate-intensity groups was 0.5 BMI units. This difference was not statistically significant (p = 0.20). There were no significant group differences in secondary outcomes. Girls in the high-intensity condition, however, who attended more than three-quarters of the sessions had significantly lower BMI and percentage body fat relative to girls in the high-intensity group who attended fewer sessions. Findings at 1-year follow-up mirrored those at 6 months. DISCUSSION: We concluded that the intervention was not effective in reducing adiposity, although there were some positive findings among high attenders. Despite the null result, the intervention was generally well received by participants. Future interventions may require greater dose and a more structured dietary change program.

Adiposity↗
PubMed2005

A school-based harm minimization smoking intervention trial: outcome results.

AIMS: To determine the impact of a school-based harm minimization smoking intervention compared to traditional abstinence-based approaches. DESIGN, SETTING AND PARTICIPANTS: A school-based cluster randomized trial was conducted in Perth, Western Australia in 30 government high schools from 1999 to 2000. Over 4000 students were recruited to participate and schools were assigned randomly to either the harm minimization intervention or a standard abstinence-based programme. INTERVENTION: The harm minimization intervention comprised eight 1-hour lessons over 2 years, quitting support from school nurses and enactment of policies to support programme components. Comparison schools implemented standard abstinence-based programmes and policies. MEASURES: Cigarette smoking was categorized at two levels: regular smoking, defined as smoking on 4 or more days in the previous week; and 30-day smoking as any smoking within the previous month. FINDINGS: At immediate post-test (20 months post-baseline), after accounting for baseline differences, school-level clustering effects, socio-economic status, gender and family smoking, intervention students were less likely to smoke regularly [OR = 0.51, 95% confidence interval (CI) = 0.36, 0.71] or to have smoked within the previous 30 days (OR = 0.69, 95% CI = 0.53, 0.91). CONCLUSION: The school-based adolescent harm minimization intervention appears to have been more effective than the abstinence-based social influences programme at reducing regular smoking.

Adolescent↗
PubMed2005

Motivational interviewing in community-based research: experiences from the field.

Motivational Interviewing (MI) has been established as an effective psychotherapeutic treatment for problem drinking in clinical settings. Consequently, there is a growing interest in applying MI to facilitate change across other health behaviors, such as tobacco use, eating habits, and physical activity in a variety of community-based research settings. These extended applications pose new challenges regarding implementation and evaluation. For instance, investigators must consider how best to train intervention counselors; implement strategies for preserving the MI spirit, despite limited client contact time; incorporate adjunctive strategies that support brief MI sessions; and develop a plan for monitoring and evaluating MI treatment fidelity. This article highlights specific examples of how several behavior change research projects applied MI across a variety of settings and populations, provides lessons learned from our experience as a collaborative workgroup, and offers strategies for consideration in future community-based research.

Alcohol Drinking↗
PubMed2004

Body and soul. A dietary intervention conducted through African-American churches.

OBJECTIVES: Body and Soul was a collaborative effort among two research universities, a national voluntary agency (American Cancer Society), and the National Institutes of Health to disseminate and evaluate under real-world conditions the impact of previously developed dietary interventions for African Americans. METHODS: Body and Soul was constructed from two successful research-based interventions conducted in African-American churches. Components deemed essential from the prior interventions were combined, and then tested in a cluster randomized-effectiveness trial. The primary outcome was fruit and vegetable intake measured with two types of food frequency questionnaires at baseline and 6-month follow-up. RESULTS: At the 6-month follow-up, intervention participants showed significantly greater fruit and vegetable (F&V) intake relative to controls. Post-test differences were 0.7 and 1.4 servings for the 2-item and 17-item F&V frequency measures, respectively. Statistically significant positive changes in fat intake, motivation to eat F&V, social support, and efficacy to eat F&V were also observed. CONCLUSIONS: The results suggest that research-based interventions, delivered collaboratively by community volunteers and a health-related voluntary agency, can be effectively implemented under real-world conditions.

Black or African American↗
PubMed2004

Cigarette smoking among marijuana users in the United States.

The vast majority of drug users smoke cigarettes. Most use marijuana and no other illicit drug. We analyzed adult responses to the 1997 NHSDA (n = 16,661) to explore relationships between marijuana use and cigarette smoking. Multivariate analyses controlled for other illicit drug use and other potential covariates. Nearly three-quarters of current marijuana users (74%) smoked cigarettes. Compared to nonusers, the adjusted odds of being a smoker were 5.43 for current marijuana users, 3.58 for past year marijuana users, and 2.02 for former marijuana users. Odds for cigarette smoking among current poly-drug users, compared to nonusers, were 2.3 to 1. Level of cigarette smoking was directly associated with frequency of marijuana use. Nationwide, an estimated 7 million adults smoke both substances and are at increased risk for respiratory illnesses and mortality. Cigarette smoking is a major co-morbidity of marijuana use and smoking cessation should be addressed among marijuana users in addition to their other illicit drug involvement.

Adult↗
PubMed2003

Does menthol attenuate the effect of bupropion among African American smokers?

BACKGROUND: African Americans have higher tobacco-related morbidity and mortality and are more likely to smoke menthol cigarettes than their white counterparts. This study examined differences between African American menthol and non-menthol smokers in smoking characteristics and cessation. METHODS: The study sample consisted of 600 African American smokers enrolled in a clinical trial that assessed the efficacy of sustained-release bupropion for smoking cessation. Menthol (n = 471) and non-menthol (n = 129) smokers were compared on smoking-related characteristics and abstinence rates at 6 weeks and 6 months. RESULTS: Menthol smokers were younger (41.2 versus 52.9 years), more likely to be female (73.7% versus 56.6%) and more likely to smoke their first cigarette within 30 minutes of waking up (81.7% versus 69.8%) compared to non-menthol smokers (all P < 0.01). Cigarette taste (50% versus 40%, P = 0.054) was rated non-significantly higher by menthol smokers. Seven-day point-prevalence abstinence from smoking at 6 weeks were 28% and 42% (P = 0.006) and at 6 months were 21% and 27% (P = 0.21) for menthol and non-menthol smokers, respectively. At 6 weeks follow-up, stepwise logistic regression revealed that among those younger than 50 years, non-menthol smokers were more likely to quit smoking (odds ratio = 2.0; 95% CI = 1.03-3.95) as were those who received bupropion (odds ratio = 2.12; 95% CI = 1.32-3.39). CONCLUSION: African American menthol smokers had lower smoking cessation rates after 6 weeks of treatment with bupropion-SR, thereby putting menthol smokers at greater risk from the health effects of smoking. Lower overall cessation rates among African Americans menthol smokers may partially explain ethnic differences in smoking-related disease risks.

Adult↗
PubMed2003

Smoking cessation, smoking reduction, and delayed quitting among smokers given nicotine patches and a self-help pamphlet.

Over-the-counter nicotine replacement raises questions regarding its "real world" efficacy. This was an open-label, prospective study of 223 smokers who received 42 free nicotine patches and a self-help booklet via shopping mall distribution. The overall quit rate 6 months following distribution of the nicotine patches was 22% (50/223), almost the same quit rate found 6 weeks following patch distribution (21%, 47/223). Twelve percent (27/223) were abstinent at both 6 weeks and 6 months. Among the 83 participants who did not quit, cigarettes smoked per day dropped from 28 to 18. A substantial subgroup of quitters (14%) who, although still smoking at 6 weeks, were smoke free at 6 months, and it appears they had purposefully delayed a serious quit attempt. These results support the usefulness of nicotine patches in helping smokers quit, even with only minimal intervention such as a self-help manual.

Female↗
PubMed2003

Successful recruitment of minorities into clinical trials: The Kick It at Swope project.

Ethnic minorities are often underrepresented in clinical trials, and their recruitment can challenge researchers. Developing and communicating effective and efficient recruitment strategies may help researchers enroll more minorities into research studies. Kick It at Swope was a double-blind, randomized trial that evaluated bupropion for smoking cessation among 600 adult African Americans who smoked 10 or more cigarettes a day. Proactive recruitment strategies (in-person appeals by study staff and health care providers) and reactive recruitment strategies (disseminating information that asked people to call a study hotline) were implemented sequentially in an additive fashion over 16 months. Resulting patterns of recruitment are described and the two phases are compared based on their relative effectiveness, efficiency, and cost. More enrollees were recruited in the reactive phase (n=534) than in the proactive phase (n=66). Those recruited in the reactive phase were more likely to be eligible (OR=4.8) and more likely to be enrolled (OR=4.2) than those recruited in the proactive phase. Participants recruited in the reactive phase reported significantly higher levels of education and income, better health, and significantly lower indicators of depression and life hassles, compared with those recruited in the proactive phase. The reactive recruitment phase was less expensive than the proactive recruitment phase (22 US Dollars/enrollee vs. 159 US Dollars/enrollee). Reactive recruitment strategies added to multiple proactive clinic-based recruitment strategies were more effective, more efficient, and less costly than proactive recruitment alone. Close monitoring combined with the use of multiple recruitment methods and flexible recruitment plans can lead to successful, efficient, and low-cost recruitment of minorities into clinical trials.

Adult↗
PubMed2003

School policy: what helps to reduce teenage smoking?

This study examined the degree to which different policy-based whole-school smoking actions were associated with cigarette smoking among 4,697 ninth-grade students in 31 schools in Perth, Australia. Smoking is banned in all schools in Western Australia. Cross-sectional self-report surveys measured student smoking prevalence and intensity and its correlates. Simultaneously, school policies and practices related to cigarette smoking were assessed by interviews with principals from each of the 31 schools. The relationship between school policies and practices and cigarette smoking were evaluated using logistic regression. After controlling for socioeconomic status, family smoking, and gender, no differences in "ever smoking" and "regular smoking" rates were seen among schools that reported having a school health policy, a school drug policy, or school health committee. Both ever smoking (p<.001) and regular smoking (p<.001) rates among students were lower at schools that provided education or counseling as well as discipline measures for students caught smoking at school, compared with schools that used discipline-only approaches. Although school health policies, drug policies, and health committees appeared to be associated with some psychosocial correlates of smoking, the associations of an education/counseling approach with these correlates was more consistent. These findings suggest that the actions taken to deal with students who violate smoking policy restrictions may be more important in reducing cigarette smoking than the presence of health or drug policies or health committees. Using education/counseling and discipline strategies rather than discipline only may help to reduce teenage smoking.

Administrative Personnel↗
PubMed2003

Are precontemplators less likely to change their dietary behavior? A prospective analysis.

The association between baseline stage of change and intervention outcomes is examined in a sample of African-American adults who participated in the Eat for Life Trial, a study to increase fruit and vegetable (F & V) intake conducted through Black churches. We explore whether precontemplators responded differently over time than those in the preparation stage, a group assumed to be more likely to change their behavior. Stage of change, F & V intake (by food-frequency questionnaires) and psychosocial variables were assessed at baseline and 1-year follow-up. Individuals initially classified as precontemplators reported an increase in F & V intake as large as those in the preparation stage and precontemplators' post-test intake was equivalent to those in preparation. Precontemplators' change in psychosocial outcomes was also as large or larger than those in the preparation stage. At least with regard to F & V, these findings raise questions regarding the validity of stage of change, one element of the Transtheoretical Model, as a predictor of future behavior and intervention response.

Adaptation, Psychological↗