PubMed Health⌕ Search

Biomedical subjects

P R Nader

Publications and source records attributed to P R Nader.

At least 19 recordsLinked to original sources
PubMed1992

Parental behavior in relation to physical activity and fitness in 9-year-old children.

OBJECTIVE: To examine the relationship between parental behaviors and physical activity and fitness in elementary school-aged children. DESIGN: Cross-sectional survey of students and parents. SETTING: Seven public elementary schools in a suburban southern California city. PARTICIPANTS: One hundred forty-eight fourth-grade girls and 149 fourth-grade boys and their parents. Eighty-four percent were white. INTERVENTIONS: None. MEASUREMENTS/MAIN RESULTS: Children's physical activity was indicated by self-report, data obtained from a monitor (accelerometer), and results of the mile run/walk. Multiple regression analysis, controlling for ethnicity and body mass index, was conducted separately for girls and boys to explain variation in child activity and fitness. Parents' reported physical activity was not associated with child activity or fitness. However, availability of transportation by parents to sport and fitness activities was significant (or nearly so) in two regressions for boys and in one regression for girls. Parents who played with their children had more active boys, based on self-report, but verbal encouragement to be active was not significant in any model. CONCLUSION: The parental role as gatekeeper of access to activity and sport facilities deserves further study.

Behavior↗
PubMed1992

Infant-feeding practices and adiposity in 4-y-old Anglo- and Mexican-Americans.

A longer duration of breast-feeding and later introduction to solids may protect against excessive adiposity in infancy. This study investigated infant feeding practices and their relationship to two measures of adiposity--body mass index (BMI) and sum of skinfold thicknesses (SUMSF)--in 331 4-y-old Anglo- (43%) and Mexican-American (57%) children. No associations were detected between any of the infant feeding variables of duration of breast-feeding and introduction to solids and formula and measures of the child's adiposity. Mother's physical measures of BMI and SUMSF explained the largest portion of variance for both measures of childhood adiposity, BMI (9.5%), and SUMSF (8.3%). Genetic and environmental factors other than infant feeding practices appear to have a greater influence on a 4-y-olds' adiposity.

Adipose Tissue↗
PubMed1992

Anglo- and Mexican-American preschoolers at home and at recess: activity patterns and environmental influences.

Habitual physical activity in children is related to physical fitness and appears to mediate cardiovascular disease (CVD) risk factors. We studied the physical activity patterns and associated variables of a large bi-ethnic cohort of 4-year-old children from low to middle socioeconomic families. Trained observers coded the behavior of 351 children (150 Anglo-American, 201 Mexican-American; 182 boys, 169 girls) during two 60-minute home visits and two unstructured recesses lasting up to 30 minutes each at 63 different preschools. Findings indicated that although children were much less active at home, there were low but significant correlations between their activity patterns at home and during recess (r = .13). Children who had activity-promoting toys at home also tended to have them available during preschool recess (r = .20). Ethnic differences were evident for both activity and environmental variables. Mexican-American children were less active than Anglo children at home (p less than .002) and during recess (p less than .03), thus adding to the adult literature that has found Mexican-Americans to be less active than Anglos, and supporting to the notion that physical activity life-style habits may be established in early childhood. In both settings, Mexican-American children spent more time in presence of adults (home, p less than .04; recess, p less than .03) and had access to fewer active toys (home, p less than .001; recess, p less than .05). Gender differences were also evident for both activity and environmental variables.(ABSTRACT TRUNCATED AT 250 WORDS)

California↗
PubMed1991

A national survey on pediatric training and activities in school health.

National trends in school health practice and training were assessed 10 years after the report of the 1978 American Academy of Pediatrics Task Force on Pediatric Education. A questionnaire was sent to 2,237 randomly selected AAP Fellows and was returned by 1,068 (48%). Seventy-seven percent of practicing pediatricians reported involvement in some type of school-based or school consultant activity. Those having residency training in school health and those practicing in rural areas were most likely to be involved. The most common types of activity were school-based pre-athletic exams (56%), consultant to special education placement (26%), and game/event physician (23%). Pediatricians were paid for 20% of sports-related school consultation and 25% of nonsports school health activities. Didactic or clinical training in school health was offered during residency to 19%. Specific didactic topics in school health included learning and attention deficit disorders (32%), physician role in health education (15%), and sports medicine (12%). Preathletic participation exams were the most commonly performed school health activity during residency (23%), followed by serving as a school consultant (11%), and attending an individual education plan meeting (7%). Most pediatricians engaged in school health activities. However, they did so without preparation during residency and without payment for their services.

Chi-Square Distribution↗
PubMed1991

BEACHES: an observational system for assessing children's eating and physical activity behaviors and associated events.

An integrated system for coding direct observations of children's dietary and physical activity behaviors was developed. Associated environmental events were also coded, including physical location, antecedents, and consequences. To assess the instrument's reliability and validity, 42 children, aged 4 to 8 years, were observed for 8 consecutive weeks at home and at school. Results indicated that four 60-min observations at home produced relatively stable estimates for most of the 10 dimensions. Interobserver reliabilities during live and videotaped observations were high, with the exception of "consequences" categories that occurred in less than 1% of observed intervals. Evidence of validity was provided by findings that antecedents were associated with respective dietary and physical activity behaviors. The five physical activity categories were validated by heartrate monitoring in a second study. The Behaviors of Eating and Activity for Children's Health Evaluation System is appropriate for studying influences on diet and physical activity in children in a variety of settings.

Behavior Therapy↗
PubMed1991

Blood pressure reactivity to exercise: stability, determinants, family aggregation, and prediction.

Previous studies have shown blood pressure reactivity to exercise predicts future resting blood pressure. Subjects in this study were 206 healthy Mexican-American and Anglo-American families with fifth or sixth grade children. A total of 539 children (mean age = 12 years) and parents (mean age = 37 years) had complete data at baseline, and 79% were remeasured 48 months later. Blood pressure was measured during a submaximal cycle ergometer fitness test. Reactivity measures included systolic blood pressure at 70% of maximal heart rate (SBP70) and slope of the blood pressure-heart rate association during exercise (SLOPE). Stability of reactivity measures over 24 months varied from .22 to .63 (all p less than 0.001). Correlates of blood pressure reactivity in parents included resting heart rate, gender, age, and sodium intake. Correlates of reactivity in children included resting heart rate, body mass index, and age. Modest but significant levels of family aggregation of blood pressure reactivity were observed. In stepwise multiple regression analyses, SBP70 at baseline predicted resting blood pressure 48 months later in parents but not in children. The present results confirm previous studies indicating systolic blood pressure reactivity to exercise is a significant predictor of later resting blood pressure.

Adaptation, Psychological↗
PubMed1991

The development of scales to measure knowledge and preference for diet and physical activity behavior in 4- to 8-year-old children.

Although there is a sizable literature on determinants of health-related habits in adults, relatively little attention has been paid to influences on health habits in children. The purpose of this study was to (a) develop practical, reliable, and valid measures of knowledge of and preference for cardiovascular disease-related diet and exercise behaviors in children, and (b) assess parental influences on children's knowledge and preference. Eighty-one 4- to 8-year-old children from diverse ethnic backgrounds and their parent or legal guardian participated. Children were presented with 15 attractive photo-pairs of foods. One photograph was of a "healthful" food or activity, and the other was "unhealthful." They were asked to identify which food/activity of the pair they preferred, and which one they thought was more healthy. Children were retested after 1 week to determine test-retest reliability. Validity of the preference tests was determined by giving the child actual choices of the same activity and food pairs. Validity of knowledge tests was determined by testing children after an educational intervention session. The alpha coefficients, test-retest reliabilities, and validity data generally indicated that food preference and knowledge tests had adequate psychometric properties, but the physical activity scales did not. Very few parental influences on health-related behavior were detected.

Cardiovascular Diseases↗
PubMed1991

Fat and cholesterol avoidance among Mexican-American and Anglo preschool children and parents.

Is a fat-avoidance scale a useful tool for monitoring and tracking dietary fat selections of adults and children? Using a seven-point scale, we addressed this question with 341 preschool children and 421 of their parents participating in a longitudinal study of childhood behaviors in San Diego County, California. Milk type and cooking fat reported in the fat-avoidance scale was compared with data reported in a 24-hour food intake record. An overall 86% agreement for milk type and a 78% agreement for cooking fat were noted. Anglo preschoolers (n = 143) had significantly greater mean scores for fat and cholesterol avoidance than did Mexican-American preschoolers (n = 198). Anglo, but not Mexican-American, women avoided fat and cholesterol more often than did their male counterparts. A significantly higher sum score was noted for Anglo men and women and Mexican-American men as education increased. These findings indicate that the fat-avoidance scale has a relative validity compared with a 1-day food record, that fat avoidance can be measured, that differences can be noted in a biethnic sample of children and adults, and that the scale has potential for monitoring success in achieving a lower fat and cholesterol intake.

Adult↗
PubMed1991

The role of the pediatrician in abolishing corporal punishment in schools. Committee on School Health, American Academy of Pediatrics.

Corporal punishment in school is allowed in 30 states in the United States. The American Academy of Pediatrics, together with numerous other child-advocacy groups, has reaffirmed its position that corporal punishment in schools should be prohibited by state statute in all states. This article provides background information and recommendations regarding the potential role for pediatricians in attaining this goal.

Academies and Institutes↗
PubMed1990

Children's television-viewing habits and the family environment.

Pediatricians are encouraged to modify the impact of television on children, based on the assumption that parents mediate children's viewing habits through the home environment. Sixty-six parents of children aged 3 to 8 years responded to an interviewer-administered questionnaire. Responses to questions on family environment were compared with reported childhood viewing of educational programming (Public Broadcasting Service) and the child's television-viewing hours. Most homes surveyed had a videocassette recorder, cable television, and more than one television set. Frequent parental discussion of program content with children was reported by 38% of respondents. Availability of television and parent-child discussion of content were not correlated with viewing hours or viewing Public Broadcasting Service. Frequent use of television as a distraction for the child correlated positively with viewing hours. Viewing Public Broadcasting Service correlated negatively with parent-child coviewing and with use of television as a form of entertainment. Children's own television viewing content correlated positively with viewing Public Broadcasting Service. Of all measured factors in the home environment, parental attitudes were most closely associated with children's viewing habits.

Attitude↗
PubMed1990

Ten years of graduates evaluate a pediatric residency program.

Ten years of graduates (1979 through 1988) from a pediatric residency program with a primary care track were surveyed for their perceived level of comfort gained in training for 28 different content/specialty areas of pediatrics and for their recommendations for increasing emphasis/time during residency for these areas. The response rate was 73%. The highest levels of comfort and fewest recommendations for increasing emphasis were for neonatal problems and health maintenance. The lowest perceived comfort levels and the most recommendations for increasing emphasis were for economics of pediatric practice and sports medicine/orthopedics. Graduates from the primary care track of the pediatric residency program expressed more comfort than did regular track graduates for some, but not all, areas of pediatrics emphasized in the primary care track program. Graduates of the first 5 years of study were not as comfortable with their training overall as were graduates from the most recent 5 years. This survey method and its results can provide useful information to medical educators faced with evaluation and revision of pediatric residency training programs.

California↗
PubMed1990

School-based cardiovascular health promotion: the child and adolescent trial for cardiovascular health (CATCH).

The Child and Adolescent Trial for Cardiovascular Health (CATCH) is a multisite intervention research study that builds on significant progress made in school health education research in the 1980s. The study has three phases: Phase I deals with study design, intervention, and measurement development, Phase II involves the main trial in 96 schools in four states, and Phase III focuses on analysis. The intervention program targets third-fifth grade students and focuses on multiple cardiovascular health behaviors, including eating habits, physical activity, and cigarette smoking. Classroom curricula, school environmental change, and family involvement programs are developed for each grade level and behavioral focus. This paper describes Phase II of CATCH with a rationale for cardiovascular health promotion with youth. The process of change that appears to be necessary for school-based health promotion and that will be tested in CATCH are presented as a framework to guide these efforts.

Adolescent↗
PubMed1990

Attendance at health promotion programs: baseline predictors and program outcomes.

As part of a family cardiovascular health promotion project, 111 Mexican-American and 95 Anglo-American families with fifth- or sixth-grade children were assigned to either a primary prevention program involving 18 sessions or to a control condition. This article evaluates predictors of attendance at the year long sequence of sessions in the intervention group. In addition it considers the relationship between attendance and program outcomes. Low baseline scores on physical activity and cardiovascular fitness measures were associated with higher attendance for both children and adults. High initial health knowledge and self-motivation were also associated with attendance. Multiple regression analysis showed that adult attendance was significantly predicted by a model including completion of a three-day food record, low exercise, higher socioeconomic status, family adaptability, and self-motivation. Attendance was correlated with greater knowledge gains and larger reductions in blood pressure. The results indicate that motivated families who are in greater need of conditioning attended more sessions in a health promotion program.

Adult↗
PubMed1990

A program for health behavior change in a preventive cardiology center.

The Preventive Cardiology Center at the University of California, San Diego, was designed to conduct training, service activities, and research related to behavioral modification of cardiovascular disease (CVD) risk. A primary aim is to train medical students and other health care professionals in the application of scientifically established methods of behavior change. This training takes place in the context of a behavior-change program for patients with CVD risk factors. Participants at increased risk for CVD and their families are recruited to the Preventive Cardiology Center. A comprehensive assessment of physiological and behavioral risk factors leads to the development of dietary and/or exercise behavior-change targets. A five-session group intervention instructs participants how to change health behaviors. Behavioral techniques included in the program include self-monitoring, goal-setting, social support, self-reward, self-talk, and problem solving. Students and others are trained through readings, videotapes, and coleading of intervention groups.

Academic Medical Centers↗
PubMed1989

Prevention of tobacco use among adolescents in public schools in San Diego County, U.S.A.

Project S.H.O.U.T. (which stands for "Students Helping Others Understand Tobacco") is a tobacco-use prevention project funded by the United States National Cancer Institute for preventing the use of cigarettes and smokeless tobacco (snuff and chewing tobacco) in public schools in San Diego County, California. Based on principles of behavior modification, Project S.H.O.U.T. teaches students how to anticipate and overcome negative peer pressure to use tobacco and reinforces them for having done so. Preliminary results indicate that the prevalence of tobacco use among students receiving peer pressure resistance skills training was somewhat but not statistically significantly lower than the control group after one year of intervention. In addition, students in a third lottery condition, who were reinforced for simply not using tobacco, showed lower prevalence rates compared to controls. Additional support for the efficacy of the intervention program was provided by the refusal skills assessment test, which indicated that students exposed to the intervention were able to refuse tobacco offers more effectively than the control students. Our results indicate that tobacco use prevention experts should do more than provide decision-making and behavioral skills for resisting tobacco use, but should also reinforce the non-use of tobacco.

Adolescent↗
PubMed1989

Comparison of beliefs about AIDS among urban, suburban, incarcerated, and gay adolescents.

Beliefs about AIDS were surveyed among opportunistic samples of 1572 adolescents to compare four subgroups of youth: urban public high school students; suburban private school students; youth incarcerated in a detention facility; and a group who were contacted through a gay youth organization. The questionnaire items formed four important theoretical constructs derived by an expert group extensively involved with AIDS education. The constructs were: 1) agreement with health guidelines; 2) perceived personal threat of AIDS; 3) a sense of personal efficacy to prevent infection and the spread of AIDS; and 4) perceived norms of safe sex behaviors. In all groups, females were more likely to endorse higher norms for safe sex practices than males. Older adolescents of both sexes tended to perceive less personal threat of AIDS, and also rated lower norms for safe sex practices than did the younger adolescents. The incarcerated group of adolescents demonstrated significantly poorer knowledge and lower agreement with health guidelines (p = 0.0000), lower perceived personal threat of AIDS (p = 0.005), lower personal efficacy to prevent AIDS (p = 0.003), and lower perceived norms of safe sex practices (p = 0.0000), compared to the other groups. The education implications of these findings are discussed, including the necessity of program elements directed toward subculture peer norms and support, a realistic sense of vulnerability about AIDS, and self-confidence building as well as specific skills to prevent the infection and spread of the human immunodeficiency virus among adolescents.

Acquired Immunodeficiency Syndrome↗