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Biomedical subjects

Nancy E Sherwood

Publications and source records attributed to Nancy E Sherwood.

At least 19 recordsLinked to original sources
PubMed2006

Specific food intake, fat and fiber intake, and behavioral correlates of BMI among overweight and obese members of a managed care organization.

BACKGROUND: The study examined correlates of body mass index (BMI) in overweight and obese members of a managed care organization seeking treatment for obesity. It assessed intake of specific foods, dietary fat or fiber, and behaviors attempted to control weight. METHODS: Participants were 508 men and 1293 women who were > 18 years and had a self-reported BMI > 27.0. This paper reports analyses of baseline and 24-month follow-up data from a randomized weight-loss trial. Cross-sectional and prospective relationships between BMI and behaviors were examined with regression analyses controlling for age and education. RESULTS: At baseline, hamburger and beef consumption were associated with higher BMI for men; for women, hamburger, fried chicken, hot dog, bacon or sausage, egg, French fry, and overall fat consumption were associated with higher BMI, while eating high fiber cereal, fruit, and overall fiber intake were associated with lower BMI. Virtually all forms of weight control behavior were reported more often in heavier people. Subscribing to exercise magazines, however, was associated with lower BMI. Decreased fat intake and increased fruit/vegetable/fiber intake over the course of the study were associated with reductions in BMI at 24 months. CONCLUSION: The same behaviors that differentiate individuals with different body weight in the general population also differentiate between individuals of different body weights at the high end of the weight distribution. Educational efforts aimed at preventing weight gain and reducing obesity might benefit from focusing on specific foods known to be associated empirically with body weight and weight change over time.

Journal Article↗
PubMed2004

Meeting recommendations for multiple healthy lifestyle factors. Prevalence, clustering, and predictors among adolescent, adult, and senior health plan members.

BACKGROUND: Whereas much is known about single lifestyle-related health risk factor prevalence and covariates, more research is needed to elucidate the interactions among multiple healthy lifestyle factors and variables that may predict adherence to these factors. Such data may guide both clinical and health policy decision making and person-centered approaches to population health improvement. METHODS: We document the prevalence and cluster patterns of multiple healthy lifestyle factors among a random sample of adolescents (n =616), adults (n =585), and seniors (n =685) from a large Midwestern health plan. Modifiable, lifestyle-related health factors assessed included physical activity, nonsmoking, high-quality diet, and healthy weight for all subjects; adults and seniors were also asked about their alcohol consumption. Second, we sought to identify characteristics associated with the likelihood of meeting recommendations for healthy lifestyle factors. The healthy lifestyle factors sum score was categorized into three levels, that is, 0 to 2, 3, or 4 to 5 healthy lifestyle factors (4 for adolescents), and we used ordinal logistic regression to estimate the odds of meeting each of these criteria from several demographic characteristics and disease states. RESULTS: Overall, only 14.5% of adolescent, adult, and senior health plan members meet recommended guidelines for four common healthy lifestyle factors. Only 10.8% of adults and 12.8% of seniors met all five behavior-related factors. For adolescents, only being nondepressed was associated with an increased likelihood to be in adherence to multiple healthy lifestyle factors (odds ratio [OR]=2.15; p <0.05). For adults, being in the 50- to 64-year-old cohort (OR=1.46, p<0.05), having a college degree (OR=1.65; p <0.05), and having no chronic disease (OR=1.92; p <0.05) were all associated with an increased likelihood to be in adherence to multiple healthy lifestyle factors. For seniors, having a college degree (OR=1.61; p <0.05), was the only variable associated with an increased likelihood to be in adherence to multiple healthy lifestyle factors. CONCLUSIONS: A small proportion of health plan members meet multiple recommended healthy lifestyle guidelines at once. This analysis identifies population subgroups of specific interest and importance based on adherence to multiple healthy lifestyle factors, and predictors for increased likelihood to be in adherence to multiple healthy lifestyle factors. It presents a potentially useful summary measure based on person-centered measures of healthy lifestyle factors. Clinicians may derive meaningful information from analyses that address adherence to multiple healthy lifestyle factors. Health systems administrators may use this information to influence health policy and resource allocation decisions. Further studies are needed to assess the usefulness of this comprehensive lifestyle-related health measure as a metric of progress toward public health goals, or as a clinical metric that conveys information on future health status and directs interventions at the individual level.

Adolescent↗
PubMed2004

Physical activity self-report and accelerometry measures from the Girls health Enrichment Multi-site Studies.

BACKGROUND: Valid and reliable physical activity checklists are needed to assess effectiveness of interventions. This study tested the validity and reliability of the Girls health Enrichment Multi-site Studies (GEMS) Activity Questionnaire. METHODS: Two-hundred and ten African-American girls completed the GEMS Activity Questionnaire (GAQ), a checklist of 28 physical and 7 sedentary activities, including TV viewing, inquiring whether performed on the previous day ("yesterday"), and whether usually performed ("usual"). The girls wore an accelerometer (used as the criterion for validity) for three consecutive days at baseline and after a 12-week pilot intervention. Data from 172 girls at baseline and follow-up were usable for this report. RESULTS: Girls were (mean +/- SD) 8.8 +/- 0.8 years old with a BMI of 22.3 +/- 5.9 kg/m2. The intraclass correlation (ICC) examining reliability for the accelerometer across 3 days at baseline for the combined group was fair (ICC = 0.33, P < 0.21). The test-retest reliability coefficient for the 18-item MET-weighted GAQ yesterday scores for the comparison group of girls was 0.57 (P < 0.001). At baseline and follow-up, nonsignificant correlations were observed between 3-day accelerometer counts/minute and GAQ 18-item usual score for both comparison and intervention groups. A significant correlation was found between change in accelerometer minutes of moderate-to-vigorous activity (MVPA) between 12 noon and 6 PM and change in GAQ physical activities in the comparison girls (R = 0.35, P < 0.01). The TV-usual score was correlated with 3-day accelerometer counts/minute (R = -0.19, P = 0.02) at baseline for the total sample. CONCLUSIONS: Correlations between the GAQ and accelerometer were low, indicating low validity. Although the GAQ may be helpful in describing types of physical activities performed, it needs further development to improve its psychometric properties.

Black or African American↗
PubMed2004

Measurement characteristics of diet-related psychosocial questionnaires among African-American parents and their 8- to 10-year-old daughters: results from the Girls' health Enrichment Multi-site Studies.

OBJECTIVE: This paper presents the reliability and validity of several diet-related psychosocial questionnaires. METHODS: At baseline and 12 weeks follow-up, parents/caregivers of one hundred fifty 8- to 10-year-old African-American completed questionnaires on food preparation habits for their daughter, perceived home barriers to healthy eating, and fruit, juice, vegetable (FJV), low-fat and high-fat food availability. Girls completed a sweetened beverage preferences questionnaire and two 24-h dietary recalls to assess intake. Principal components analyses were conducted for two newly designed measures. Internal consistency was calculated and construct validity was assessed between the psychosocial scales and obesity-related dietary variables. RESULTS: Low-fat and high-fat food preparation for daughters, and perceived home barriers to eating low-fat food and FJV subscales were derived from the new questionnaires. Internal consistency reliabilities were moderate (0.58) to substantial (0.80) across all new and existing scales. Test-retest reliabilities were moderate (0.44) to substantial (0.79). Girls' intake of fat as a percentage of energy was positively related to parental high-fat food preparation for daughters (P < 0.01) and negatively related to parental low-fat food preparation practices for daughters (P < 0.05). CONCLUSIONS: Measures of family influences on FJV, fat, and sweetened beverage consumption were internally consistent with moderate to substantial stability. Scales for low-fat and high-fat food preparation practices for daughters achieved construct validity with fat consumption in the hypothesized direction. Family food preparation habits appear to be important targets for future interventions.

Black or African American↗
PubMed2004

Depressive symptoms and adolescent eating and health behaviors: a multifaceted view in a population-based sample.

BACKGROUND: Previous research has shown significant associations between depression and substance use and eating disordered behaviors. However, no research to date has described associations between depressive symptoms and nutritional intake or physical activity among adolescents in a nonclinical, population-based sample. METHODS: Classroom surveys were completed by 4,734 ethnically diverse, middle- and high school students. Based on their depressive symptom scores, males and females were categorized with low-, moderate-, or high-depressive symptom status. Linear models were used to examine eating and health behavior variables by depressive symptom groups. RESULTS: Depressive symptoms were positively associated with health-compromising attitudes such as perceived barriers to healthy eating and weight concerns, and health-compromising behaviors such as unhealthy weight-control behaviors and substance use, including caffeine. Depressive symptoms were negatively associated with health-promoting behaviors such as eating breakfast, lunch, and dinner. However, most associations between depressive symptoms and dietary micronutrients were not statistically significant. Health-promoting moderate-to-vigorous physical activity was negatively associated with depressive symptoms among males. CONCLUSIONS: Adolescents who report depressive symptoms are at risk for other health-compromising attitudes and behaviors and are also less likely to engage in health-promoting behaviors. Depressive symptoms may be an underlying trait in the expression of health behaviors among adolescents.

Adolescent↗
PubMed2004

Measurement characteristics of activity-related psychosocial measures in 8- to 10-year-old African-American girls in the Girls Health Enrichment Multisite Study (GEMS).

BACKGROUND: This paper presents reliability and validity analyses of physical activity-related psychosocial questionnaires completed by 8- to 10-year-old African-American girls at baseline and follow-up assessments of pilot intervention studies in the Girls health Enrichment Multi-site Study (GEMS). METHODS: Two hundred ten girls participated in the GEMS 12-week pilot studies and had their height and weight measured, wore an accelerometer for 3 days and completed a measure of their usual physical activity (PA) at baseline and after the 12-week intervention. Subgroups of girls also completed physical activity-related psychosocial measures at these two time points including: (a) self-concept; (b) self-efficacy; (c) outcome expectancies; and d) preferences. Principal components analysis was conducted on the psychosocial measures obtained at baseline. Cronbach's alpha and test-retest reliability were computed. Convergent validity was assessed by correlating the baseline psychosocial measures with baseline physical activity measures and body mass index (BMI). RESULTS: The following sub-scales were derived: Activity Preference, Positive Expectancies and Negative Expectancies for physical activity. Physical Performance Self-Concept and Self-Efficacy for physical activity were kept as single dimensional scales. Sub-scales, derived from principal components analyses, were Activity Preference, Positive Expectancies, and Negative Expectancies for physical activity. Internal consistency estimates for the various scales were substantial to excellent (0.67-0.85), while test-retest reliability estimates were fair to moderate (0.22-0.56). Correlations between the PA psychosocial sub-scales and measured levels of activity measures showed evidence of convergent validity for the Activity Preference sub-scale, although social desirability may have influenced the significant associations observed. CONCLUSIONS: The Activity Preference was a fairly reliable and valid measure. Further studies are needed to examine the utility of activity-related psychosocial measures in interventions to increase physical activity among preadolescent African-American girls.

Black or African American↗
PubMed2004

Measurement characteristics of weight concern and dieting measures in 8-10-year-old African-American girls from GEMS pilot studies.

BACKGROUND: Reliability and validity were established for weight concern measures completed by 8-10-year-old African-American girls participating in a pilot obesity prevention program. METHODS: Two hundred ten girls and parents participated in the program. Girls completed subscales of the McKnight Risk Factor Survey (MRFS) and body silhouette ratings, had height, weight, and body fat measured, wore accelerometers for 3 days, and completed two dietary recalls. Principal components analysis, internal consistency, and test-retest reliability were computed for weight concerns and body image measures along with convergent validity with body mass index (BMI), percent body fat (PBF), physical activity, and dietary intake. RESULTS: A Moderate Weight Control Behaviors (MWCB) subscale was derived from the MRFS. Overconcern with Weight and Shape (OWS) was a stand-alone scale. Internal consistency estimates for the scales were substantial ranging from 0.71 to 0.84. Test-retest reliabilities were moderate (0.45-0.58). OWS, MWCB, body silhouette rating, and body size discrepancy were positively associated with BMI and PBF. The "like to look" silhouette rating was negatively associated with PBF. CONCLUSIONS: Weight concern measures had reasonable levels of internal consistency and promising validity, but only moderate test-retest reliability among preadolescent African-American girls. Refinement and further validation of weight concern measures in this population are warranted.

Black or African American↗
PubMed2004

Parental cultural perspectives in relation to weight-related behaviors and concerns of African-American girls.

OBJECTIVE: To determine whether cultural perspectives of parents may influence children's eating and physical activity behaviors and patterns of weight gain. RESEARCH METHODS AND PROCEDURES: African-American girls (ages 8 to 10 years) and their parents (or caregivers) (n = 210) participated at one of four Girls Health Enrichment Multisite Studies Phase 1 Field Centers. At baseline, parents completed questionnaires adapted from the African-American Acculturation Scale (AAAS), the Multiethnic Identity Scale (MEIS), and an original question on Global Cultural Identity. Girls' baseline measures included physical activity assessment by accelerometer, 24-hour dietary recalls, and questionnaires about body image and weight concerns. RESULTS: Principal components analysis indicated the expected AAAS and MEIS factor structures, with moderate to good internal consistency (Cronbach's alpha = 0.61 to 0.82) and some intercorrelation among these measures (r = 0.17 to 0.57). Overall mean (SD) AAAS subscale scores of 4.1 (2.1) and 5.5 (1.8) of a possible 7 and 3.0 (0.9) of a possible 4 on the MEIS indicated, respectively, moderate to high levels of parental African-American cultural orientation and identity with moderate variability. Parental AAAS and MEIS scores were inversely correlated with girls' body image discrepancy and weight concern. One AAAS subscale was positively associated with total energy intake and percentage energy from fat. Overall, however, parental AAAS and MEIS scores were unrelated or inconsistently related to girls' physical activity and diet measures. DISCUSSION: The AAAS and MEIS measures had acceptable psychometric properties, except for weight concern, but did not give a consistent picture of how parental perspectives related to the girls' baseline attitudes and behaviors.

Acculturation↗
PubMed2004

Anthropometric, parental, and psychosocial correlates of dietary intake of African-American girls.

OBJECTIVE: This paper identifies the anthropometric, parental, and psychosocial characteristics and meal practices (e.g., breakfast skipping and number of meals and snacks consumed) associated with consumption of total energy, percent energy from fat, fruit, 100% fruit juice, vegetables, sweetened beverages, and water among 8- to 10-year-old African-American girls. RESEARCH METHODS AND PROCEDURES: This study included 114 8- to 10-year-old African-American girls and a parent or primary caregiver. Girls and a parent or primary caregiver completed several dietary questionnaires. Two 24-hour dietary recalls were conducted with each girl. Height and weight were measured. Separate hierarchical regression analyses were conducted for each dependent dietary variable; potential field center differences were examined. RESULTS: The number of meals and snacks consumed was correlated with energy intake. Lower BMI was related to higher vegetable consumption, and the number of snacks consumed was positively related to sweetened beverage consumption. Greater low-fat food preparation practices reported by parents were related to lower consumption of fat as a percentage of total energy. DISCUSSION: Dietary behavior differed across geographic areas. Low-fat food preparation practices in the home seemed to be an important influence on the percentage of energy consumed from fat. Greater vegetable consumption was associated with lower BMI. Interventions to prevent excessive weight gain in African-American girls should encourage low-fat food preparation in the home and greater consumption of vegetables.

Black or African American↗
PubMed2004

Physical activity among African-American girls: the role of parents and the home environment.

OBJECTIVES: African-American girls are at increased risk for becoming overweight. Increased physical activity may prevent this. This study examines measurements of girls' physical activity and associations with: BMI, parent's reported self-efficacy and support for helping daughters be active, girl's perceived support from parents for physical activity, parent's and girl's perceived neighborhood safety and access to facilities, and family environment. RESEARCH METHODS AND PROCEDURES: Fifty-two 8- to 10-year-old African-American girls and their primary caregiver in the Minneapolis/St. Paul area participated in the Girls Health Enrichment Multisite Studies pilot intervention to prevent weight gain by promoting healthy eating and physical activity. Data collected included height, weight, physical activity level, and physical activity-related psychosocial measures from girl and parent. Girls wore an activity monitor for 3 days to assess activity level. Correlations were computed among the average minutes per day of moderate to vigorous activity between 12 pm and 6 pm and BMI and psychosocial measures. RESULTS: BMI was inversely correlated with moderate to vigorous activity (r = -0.35, p < 0.01), whereas parent's self-efficacy for supporting daughter to be active was positively correlated with activity (r = 0.45, p < 0.001). There was a trend for parent's reported support of daughter's activity level to be associated with activity (r = 0.26, p < 0.06). Girl's perception of parent's support for physical activity, perceived neighborhood safety and access to facilities, and family environment were not associated with girl's activity levels. DISCUSSION: Interventions to increase physical activity among preadolescent African-American girls may benefit from a parental component to encourage support and self-efficacy for daughters' physical activity.

Black or African American↗
PubMed2004

Covariability in diet and physical activity in African-American girls.

OBJECTIVE: Our goal was to examine 12-week covariability in diet and physical activity changes among 8- to 10-year-old African-American girls and if these changes predicted percent change in BMI. RESEARCH METHODS AND PROCEDURES: Covariability among percent changes [(post - pre)/pre x 100] in nutrients, food groups, and physical activity was assessed among 127 8- to 10-year-old African-American girls. Pearson correlation and hierarchical linear regression analyses were performed. RESULTS: Percent change in percentage kilocalories from carbohydrate was negatively correlated with percent change in both percentage kilocalories from fat (r = -0.85; p < or = 0.01) and protein (r = -0.51; p < or = 0.01). No statistically significant relationships were observed in percent changes among food group variables. Negative relationships were observed between percent changes in fruit/100% juice and percentage kilocalories from fat (r = -0.20; p < or = 0.05) and between percent changes in minutes of moderate-to-vigorous and sedentary activity (r = -0.60; p < or = 0.01). No significant associations were observed between percent change in moderate-to-vigorous physical activity and diet variables or percent change in BMI or waist circumference and percent change in diet or physical activity. DISCUSSION: No relationships were observed between percent changes in physical activity and dietary variables. Percent change in diet and/or physical activity did not predict percent change in BMI. This may have been due to the small sample size, the small changes in diet or physical activity, the short duration of the intervention, or because data from different interventions were combined. Understanding these relationships could have significant implications for addressing the obesity epidemic.

Black or African American↗
PubMed2004

The weight loss experience: a descriptive analysis.

BACKGROUND: Six months of loss followed by gradual regain to baseline is descriptive of most weight loss attempts. PURPOSE: This study sought to identify thoughts and feelings accompanying weight loss that might explain the phenomenon. METHODS: Thoughts, feelings, and body weight were measured weekly for 6 months in 41 women receiving behavioral treatment for obesity. RESULTS: Overall, the weight loss experience of these women was positive, requiring modest time and effort and being associated with more positive than negative thoughts and experiences. Over time, however, positive but not negative reactions to the weight loss experience decreased, as did the strength of beliefs that the benefits of weight loss were worth the effort. In addition, we found no relation between the women's perception of effort and weight loss results. CONCLUSIONS: Inadequate long-term rewards for behaviors needed for weight control may be an important cause of frequent weight loss failures.

Adult↗
PubMed2004

Well-child visits in the video age: pediatricians and the American Academy of Pediatrics' guidelines for children's media use.

OBJECTIVES: The goal of this study was to evaluate awareness of, agreement with, and implementation of the American Academy of Pediatrics (AAP) media use guidelines among pediatricians. Pediatricians' beliefs about several media effects were also measured, as was their own media use. Pediatricians were also asked about how often they make media recommendations as part of anticipatory guidance during well-child visits, as well as the perceived efficacy of and barriers to making such recommendations. DESIGN: A cross-sectional survey mailed to all members of the Minnesota chapter of the AAP. PARTICIPANTS: A total of 365 pediatricians completed the survey. MEASURES: The 58-item survey assessed familiarity with, agreement with, and implementation of each of 3 AAP recommendations, to limit children's media time, to discourage television (TV) viewing among children <2 years of age, and to encourage alternative entertainment for children. Pediatricians were also asked about the perceived effectiveness of and barriers to guideline implementation. In addition, pediatricians were asked to report their own TV viewing habits and their opinions about how much media affect children's health and behavior. RESULTS: Most pediatricians were familiar with and also agreed with the 3 AAP recommendations. Their agreement may stem from the fact that pediatricians almost universally believe that children's media use negatively affects children in many different areas, including children's aggressive behavior, eating habits, physical activity levels, risk for obesity, high-risk behaviors, and school performance. Pediatricians were most likely to have encouraged alternative entertainment and were least likely to have discouraged TV viewing for children <2 years of age. The majority of pediatricians provided all 3 recommendations to parents at least sometimes. Most pediatricians reported that their recommendations were at least a little effective when they did make them. The most frequent barrier pediatricians reported facing was a lack of parental motivation or support for the recommendations, with approximately one-third of pediatricians also citing a lack of time and a sense of futility in affecting patients' media habits as barriers. Finally, pediatricians who watched the greatest amounts of TV were significantly more likely than those who watched less to think that the AAP recommendation to limit children's total media time to no more than 1 to 2 hours per day is unrealistic, whereas those who watched less were more likely to agree with the recommendation. CONCLUSIONS: Results suggest that the efforts of the AAP in reaching pediatricians have been largely successful, with the majority of pediatricians in Minnesota being aware of and agreeing with the 3 major recommendations suggested by the AAP policy statement on children, adolescents, and television. However, implementation of the recommendations could be improved, especially because pediatricians usually think that the recommendations are at least a little effective when made. Strategies for overcoming barriers to making recommendations need to be addressed, including the sense of futility in affecting media use that some pediatricians may feel.

Adolescent↗
PubMed2003

Development and implementation of a visual card-sorting technique for assessing food and activity preferences and patterns in African American girls.

OBJECTIVE: Card-sorting tasks for assessing food and activity preferences and patterns among African American girls were developed. Associations among food preference and intake frequency, activity preference and frequency, and body mass index were examined. DESIGN: Participants completed newly developed card-sorting tasks assessing food and activity preferences and patterns. Height and weight were measured. SUBJECTS/SETTING: Ninety-six 8- to 10-year-old African American girls from schools and community centers in Minneapolis-St. Paul. MAIN OUTCOME MEASURES: Preference and frequency data for 64 foods/beverages and 34 activities. STATISTICAL ANALYSES: Frequencies for food and activity preference and frequency categories were computed. Pearson correlations among food and activity preference, frequency, and body mass index were computed. RESULTS: High-sugar (eg, fruit drinks, soda) and/or high-fat (eg, ice cream, cookies) foods were among the most popular and frequently consumed. Ninety-six percent of girls liked fruit drinks, with 35% consuming them "almost every day." Less-structured activities such as biking, games, jump rope, and dance were most popular. Biking was preferred by 85% of girls, with 48% biking "almost every day." Food preference and frequency categories were moderately correlated (r=0.30 to 0.58), as were activity preference and frequency (r=0.37 to 0.49). APPLICATIONS: The card-sorting tasks are useful tools for assessing food and activity preferences and patterns in girls. Obesity prevention programs for African American girls should include preferred activities such as dance, jump rope, and active play. Programs may also benefit from a focus on replacing high fat/high sugar snacks and sweetened beverages with low-fat, lower-calorie snacks and beverages (eg, fruit, vegetables, water).

Black or African American↗
PubMed2003

Physical activity and weight loss: does prescribing higher physical activity goals improve outcome?

BACKGROUND: Recommending increased physical activity facilitates long-term weight loss, but the optimal level of physical activity to recommend is unknown. OBJECTIVE: The objective of the study was to evaluate the efficacy for long-term weight loss of recommendations for much higher physical activity than those normally used in behavioral treatments. DESIGN: Overweight men and women (n = 202) were randomly assigned to either a standard behavior therapy (SBT) for obesity, incorporating an energy expenditure (EE) goal of 1000 kcal/wk, or to a high physical activity (HPA) treatment, in which the goal was an EE of 2500 kcal/wk. To help HPA treatment group participants achieve this high exercise goal, their treatment included encouragement to recruit 1-3 exercise partners into the study, personal counseling from an exercise coach, and small monetary incentives. RESULTS: The HPA treatment group reported achieving higher mean (+/- SD) physical activity levels than did the SBT group at 6 mo (EE of 2399 +/- 1571 kcal/wk compared with 1837 +/- 1431 kcal/wk), 12 mo (EE of 2249 +/- 1751 kcal/wk compared with 1565 +/- 1309 kcal/wk), and 18 mo (EE of 2317 +/- 1854 kcal/wk compared with 1629 +/- 1483 kcal/wk) (all P < 0.01). Mean (+/- SEM) cumulative weight losses at 6, 12, and 18 mo in the HPA treatment group were 9.0 +/- 7.1, 8.5 +/- 7.9, and 6.7 +/- 8.1 kg, respectively. In the SBT group, the corresponding weight losses were 8.1 +/- 7.4, 6.1 +/- 8.8, and 4.1 +/- 7.3 kg, respectively. Between-group differences in weight loss were significant at 12 and 18 mo. CONCLUSION: These results suggest that recommendations of higher levels of physical activity (EE of 2500 kcal/wk) promote long-term weight loss better than do conventional recommendations.

Adult↗
PubMed2003

Collaborative planning for formative assessment and cultural appropriateness in the Girls health Enrichment Multi-site Studies (GEMS): a retrospection.

OBJECTIVE: The Girls health Enrichment Multi-site Studies (GEMS), Phase 1, developed and pilot-tested interventions to prevent obesity in African-American preadolescent girls. This article describes the collaborative planning process undertaken to take full advantage of formative assessment activities for improving contextual relevance and cultural appropriateness. DESIGN: Working group activities were designed to stimulate awareness and reflection among group members and, through them, among other field center investigators and staff about developmental, cultural, and contextual issues for formative assessment. SETTING: Telephone, Internet, and face-to-face interactions across GEMS field centers in Houston, Texas; Memphis, Tennessee; Minneapolis, Minnesota; and Palo Alto, California. PARTICIPANTS: Investigators and staff involved in intervention development. MAIN OUTCOME MEASURES: The utility of the process was judged from feedback by participants and field center principal investigators about the contribution of the collaborative effort to improving the perceived relevance and cultural appropriateness of formative assessment data collection and interpretation. RESULTS: A working bibliography was compiled. A detailed matrix of programmatic, child, family, and contextual issues related to ethnicity, socioeconomic status, general health and lifestyle, food, physical activity, and body image/weight control was completed. Additional guidance was derived from a workshop that involved scholars with expertise in aspects of African-American culture, child development, and family processes. CONCLUSIONS: This process improved the breadth and depth of GEMS formative assessment activities by increasing the appreciation of the complex structural, contextual, and personal forces at play. A similar process may be useful to other investigators when attempting to develop culturally appropriate interventions.

Black or African American↗
PubMed2003

An after-school obesity prevention program for African-American girls: the Minnesota GEMS pilot study.

OBJECTIVE: This paper describes the development of an after-school obesity-prevention program for African-American girls, and presents findings from a 12-week pilot trial conducted by the University of Minnesota. This study was part of the GEMS project, created to test interventions designed to reduce excess weight gain in African-American girls. DESIGN: Two-arm parallel group, randomized controlled trial. Measures were taken at baseline and at 12 weeks follow up. SETTING: An after-school community program. PARTICIPANTS: Fifty-four African-American girls, 8- to 10-years of age, and their parents/caregivers. INTERVENTION: The after-school intervention was conducted twice a week for 12 weeks, and focused on increasing physical activity and healthy eating. A family component was also included. Girls in the control group received a program over 12 weeks unrelated to nutrition and physical activity. OUTCOMES: Measures included height and weight (body mass index), percent body fat (DEXA), physical activity, assessed using a CSA accelerometer and self-report, two 24-hour dietary recalls, and psycho-social and demographic variables. Parental data included demographic and psycho-social characteristics, and dietary measures. Additionally, process evaluation data on the intervention were collected. RESULTS: Recruitment goals were met. After adjustment for baseline level, follow-up BMI did not differ between the treatment groups, an expected finding, given that this was a pilot study. At 12 weeks follow up, differences between the intervention and control groups were in the hypothesized direction of change for most variables, among both the girls and their parents. Process evaluation results demonstrated that the program was well attended, and well received, by girls and parents. CONCLUSIONS: An after-school obesity prevention program for low-income African-American girls is a promising model for future efforts.

Adult↗