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Biomedical subjects

Terry L Conway

Publications and source records attributed to Terry L Conway.

17 recordsLinked to original sources
PubMed2006

Active transportation to school over 2 years in relation to weight status and physical activity.

OBJECTIVE: To prospectively examine potential benefits of active commuting to school on measures of weight status and physical activity in a sample of youth. RESEARCH METHODS AND PROCEDURES: A cohort of students from seven elementary schools was measured four times--in the fall and spring of fourth grade (N = 1083) and fifth grade (N = 924). Participants were classified as active (walking, biking, or skateboarding to school almost every day for baseline analyses or at least 2 d/wk for analyses of consistent active commuting) or non-active commuters to school. Accelerometers were used to measure physical activity. Height, weight, and skinfolds were objectively assessed. RESULTS: Boys who actively commuted to school had lower BMI (p < 0.01) and skinfolds (p < 0.05) than non-active commuters to school in the fourth grade. Active commuting to school over 2 years was not associated with BMI change or overweight status. DISCUSSION: Walking and cycling to school may contribute to preventing excessive weight gain, or leaner children may walk or cycle to school.

Analysis of Variance↗
PubMed2006

Active commuting to school: Associations with environment and parental concerns.

PURPOSE: This study examined the association of objective and perceived neighborhood environmental characteristics and parent concerns with active commuting to school, investigated whether parental concerns varied by environmental characteristics, and compared the association of the perceived environment, parental concerns, and objective environment on the outcome active commuting to school. METHODS: Randomly selected parents of children (aged 5-18 yr), in neighborhoods chosen for their variability in objectively measured walkability and income, completed questionnaires about their neighborhood environment, concerns about children walking to school, and children's behavior (N = 259). Objective measures of the environment were available for each participant and each neighborhood. Logistic regression analyses were used to investigate the relationships among environment, parental concerns, and walking or biking to or from school at least once a week. RESULTS: A parental concerns scale was most strongly associated with child active commuting (odds ratio: 5.2, 95% CI: 2.71-9.96). In high-income neighborhoods, more children actively commuted in high-walkable (34%) than in low-walkable neighborhoods (23%) (odds ratio: 2.1, 95% CI: 1.12-3.97), but no differences were noted in low-income neighborhoods. Parent concerns and neighborhood aesthetics were independently associated with active commuting. Perceived access to local stores and biking or walking facilities accounted for some of the effect of walkability on active commuting. CONCLUSION: Both parent concerns and the built environment were associated with children's active commuting to school. To increase active commuting to school, interventions that include both environmental change and education campaigns may be needed.

Adolescent↗
PubMed2006

School-level intraclass correlation for physical activity in sixth grade girls.

PURPOSE: The Trial for Activity in Adolescent Girls (TAAG) is a group-randomized trial (GRT) to reduce the usual decline in moderate to vigorous physical activity (MVPA) among middle school girls. We report the school-level intraclass correlation (ICC) for MVPA from the TAAG baseline survey of sixth grade girls and describe the relationship between the schedule of data collection and the ICC. METHODS: Each of six sites recruited six schools and randomly selected 60 sixth grade girls from each school; 74.2% participated. Girls were grouped in waves defined by the date measurements began and asked to wear an Actigraph accelerometer for 6 d. Occasional missing data were replaced by imputation, and counts above 1500 per 30 s were treated as MVPA, converted into metabolic equivalents (METs), and summed over 6 a.m.-midnight to provide MET-minutes per 18-h day. Mixed-model regression was used to estimate ICC. RESULTS: The school-level ICC were higher when estimated from a single wave compared with three waves (e.g., 0.057 vs 0.022) and across weekdays compared with weekend days (e.g., 0.024 vs 0.012). Power in a new trial would be greater with some schedules (e.g., 88% given three waves and 6 d) than with others (e.g., 23% given one wave and Tuesday only). CONCLUSIONS: The schedule of data collection can have a dramatic effect on the ICC for MVPA. In turn, this can have a dramatic effect on the standard error for an intervention effect and on power. Investigators will need to consider the expected magnitude of the ICC and the validity of the MVPA estimates associated with their data collection schedule in planning a new study.

Child↗
PubMed2005

Imputation of missing data when measuring physical activity by accelerometry.

PURPOSE: We consider the issue of summarizing accelerometer activity count data accumulated over multiple days when the time interval in which the monitor is worn is not uniform for every subject on every day. The fact that counts are not being recorded during periods in which the monitor is not worn means that many common estimators of daily physical activity are biased downward. METHODS: Data from the Trial for Activity in Adolescent Girls (TAAG), a multicenter group-randomized trial to reduce the decline in physical activity among middle-school girls, were used to illustrate the problem of bias in estimation of physical activity due to missing accelerometer data. The effectiveness of two imputation procedures to reduce bias was investigated in a simulation experiment. Count data for an entire day, or a segment of the day were deleted at random or in an informative way with higher probability of missingness at upper levels of body mass index (BMI) and lower levels of physical activity. RESULTS: When data were deleted at random, estimates of activity computed from the observed data and those based on a data set in which the missing data have been imputed were equally unbiased; however, imputation estimates were more precise. When the data were deleted in a systematic fashion, the bias in estimated activity was lower using imputation procedures. Both imputation techniques, single imputation using the EM algorithm and multiple imputation (MI), performed similarly, with no significant differences in bias or precision. CONCLUSIONS: Researchers are encouraged to take advantage of software to implement missing value imputation, as estimates of activity are more precise and less biased in the presence of intermittent missing accelerometer data than those derived from an observed data analysis approach.

Acceleration↗
PubMed2004

Viability of parks and recreation centers as sites for youth physical activity promotion.

This descriptive study explored the potential for public parks and recreation centers as intervention sites for promoting physical activity among youth. Directors (55% women) of 44 recreation centers in San Diego County completed a survey of their centers' physical activity programming for youths ages 3 to 17 years (response rate = 60%). On an average weekday, 373 (SD = 782) youths participated in physical activity at a center. More boys attended than girls (p <.05). Some centers sponsored after-school programs at elementary (41%) and middle (11%) schools but not at high schools (0%). Primary barriers to providing physical activity programs were inadequate staffing (54%), funding (39%), and facilities (32%). Girls and low-income youth were identified as the most difficult populations to reach. Directors reported considerable interest in collaborating on interventions to improve youth activity programs. Public parks and recreation centers are understudied settings with the potential for substantial involvement in efforts to promote youth physical activity.

Adolescent↗
PubMed2004

School-level intraclass correlation for physical activity in adolescent girls.

PURPOSE: The Trial for Activity in Adolescent Girls (TAAG) is a multi-center group-randomized trial to reduce the usual decline in moderate to vigorous physical activity (MVPA) among middle-school girls. In group-randomized trials, the group-level intraclass correlation (ICC) has a strong inverse relationship to power and a good estimate of ICC is needed to determine sample size. As a result, we conducted a substudy to estimate the school-level ICC for intensity-weighted minutes of MVPA measured using an accelerometer. METHODS: To estimate the ICC, each of six sites recruited two schools and randomly selected 45 eighth grade girls from each school; 80.7% participated. Each girl wore an Actigraph accelerometer for 7 d. Readings above 1500 counts per half minute were counted as MVPA. These counts were converted into metabolic equivalents (MET) and summed over 6 a.m. to midnight to provide MET-minutes per 18-h day of MVPA. Minutes of MVPA per 18-h day also were calculated ignoring the MET value. RESULTS: The unadjusted school-level ICC for minutes of MVPA was 0.0205 (95%CI: -0.0079, 0.1727) and for MET-minutes of MVPA was 0.0045 (95% CI: -0.0147, 0.1145). Adjustment for age and BMI had no measurable effect, whereas adjustment for ethnicity reduced both ICC; adjusted values were 0.0175 (95% CI: -0.0092, 0.1622) for minutes of MVPA and 0.0000 (95% CI: -0.0166, 0.0968) for MET-minutes of MVPA. This information was used to calculate the number of schools and girls needed for TAAG to have 90% power to detect a 50% reduction in the decline of MET-minutes of MVPA between sixth and eighth grade. CONCLUSIONS: The results called for 36 schools in TAAG, with 120 girls invited for measurements at each school, and a minimum participation rate of 80%.

Acceleration↗
PubMed2004

Evaluation of a two-year middle-school physical education intervention: M-SPAN.

PURPOSE: School physical education (PE) is highly recommended as a means of promoting physical activity, and randomized studies of health-related PE interventions in middle schools have not been reported. We developed, implemented, and assessed an intervention to increase physical activity during middle-school PE classes. METHODS: Twenty-four middle schools (approximately 25,000 students, 45% nonwhite) in Southern California participated in a randomized trial. Schools were assigned to intervention (N = 12) or control (N = 12) conditions, and school was the unit of analysis. A major component of the intervention was a 2-yr PE program, which consisted of curricular materials, staff development, and on-site follow-up. Control schools continued usual programs. Student activity and lesson context were observed in 1849 PE lessons using a validated instrument during baseline and intervention years 1 and 2. RESULTS: The intervention significantly (P = 0.02) improved student moderate to vigorous physical activity (MVPA) in PE, by approximately 3 min per lesson. Effects were cumulative; by year 2 intervention schools increased MVPA by 18%. Effect sizes were greater for boys (d = 0.98; large) than girls (d = 0.68; medium). CONCLUSIONS: A standardized program increased MVPA in middle schools without requiring an increase in frequency or duration of PE lessons. Program components were well received by teachers and have the potential for generalization to other schools. Additional strategies may be needed for girls.

Adolescent↗
PubMed2004

Operation Stay Quit: evaluation of two smoking relapse prevention strategies for women after involuntary cessation during US Navy recruit training.

The present study evaluated two relapse-prevention interventions intended to help women smokers maintain the "quit status" mandated during Navy basic training. Women with any smoking experience before entering the Navy (N = 2,781) were assigned to either a control group or to one of two intervention groups (access to a telephone help line or receive a series of monthly mailings) after graduating from basic training. Smoking/quit rates at 3, 6, and 12 months after graduation were assessed with mailed surveys. Response rates to the surveys ranged from 39% to 52%. There were no phone or mail intervention effects: cessation rates for the three conditions at the 12-month follow-up were 43% for control, 45% for the mail intervention, and 41% for the phone intervention. Results suggest the need for more aggressive relapse-prevention efforts, although quit rates were higher than expected "spontaneous" quit rates, indicating an impact of the totally smoke-free recruit training environment.

Adolescent↗
PubMed2003

Environmental interventions for eating and physical activity: a randomized controlled trial in middle schools.

BACKGROUND: Our objective was to evaluate the effects of environmental, policy, and social marketing interventions on physical activity and fat intake of middle school students on campus. DESIGN: Twenty-four middle schools were randomly assigned to intervention or control conditions. Baseline measures were collected in spring 1997, and interventions were conducted during the 1997-1998 and 1998-1999 school years SETTING/PARTICIPATION: The schools had mean enrollments of 1109, with 44.5% nonwhite students. Over 2 years, physical activity interventions were designed to increase physical activity in physical education classes and throughout the school day. Nutrition interventions were designed to provide and market low-fat foods at all school food sources, including cafeteria breakfasts and lunches, a la carte sources, school stores, and bag lunches. School staff and students were engaged in policy change efforts, but there was no classroom health education. MAIN OUTCOMES MEASURES: Primary outcomes were measured by direct observation and existing records. RESULTS: Randomized regression models (N =24 schools) revealed a significant intervention effect for physical activity for the total group (p <0.009) and boys (p <0.001), but not girls (p <0.40). The intervention was not effective for total fat (p <0.91) or saturated fat (p <0.79). Survey data indicated that the interventions reduced reported body mass index for boys (p <0.05). CONCLUSIONS: Environmental and policy interventions were effective in increasing physical activity at school among boys but not girls. The interventions were not effective in reducing fat intake at school. School environmental and policy interventions have the potential to improve health behavior of the student population, but barriers to full implementation need to be better understood and overcome.

Adolescent↗
PubMed2003

Pilot test of an assessment instrument for Latina community health advisors conducting an ETS intervention.

Community health advisors (CHAs), also known as promotores, are lay individuals in the community that others tend to look toward for advice and support. Studies incorporating CHAs are relatively rare, and CHAs have not been used in previous intervention studies to reduce environmental tobacco smoke (ETS) exposure. The present study pilot tested a CHA assessment instrument and examined the effects of promotora training on CHAs' knowledge, attitudes, and beliefs concerning ETS reduction. Participants were 11 women recruited from the local community. CHA training produced changes on several psychosocial constructs. Anticipated outcomes regarding ETS reduction and emotional reactions related to volunteering in the community were more positive after training. Self-esteem and self-efficacy showed increases after training. Future research will investigate the relationship between the psychosocial characteristics measured in the assessment instrument and subsequent success implementing the ETS reduction intervention.

Adult↗
PubMed2003

Acceptability and validity of hair collection from Latino children to assess exposure to environmental tobacco smoke.

This study assessed the acceptability of collecting hair from Latino children to measure environmental tobacco smoke (ETS) exposure and examined the concurrent validity between nicotine and cotinine levels in children's hair in relation to adult reports of the children's ETS exposure. Trained Latina lay community health advisors recruited 143 Spanish-speaking Latino adult volunteers and their children. Bilingual-bicultural measurement technicians collected two types of data: (a) the adult's paper-and-pencil report about the child's past-month exposure to cigarettes in the home and car and (b) a sample of the child's hair to be analyzed for nicotine and cotinine. Of the eligible subjects, 8.5% declined to participate because of the hair collection protocol, some citing cultural beliefs. Among participants in the study, few problems arose related to hair collected, probably because of the culturally sensitive approach used during recruitment and measurement. Adults' reports of exposure, hair nicotine, and hair cotinine showed considerable variation and were skewed to the right. Average nicotine levels for these children appeared to be comparable to those reported elsewhere, whereas cotinine levels appeared to be somewhat lower. Hair nicotine was more detectable than hair cotinine and, compared with cotinine, showed a clearer linear relationship with adults' reports. However, associations between adults' reports and both biological measures were modest. Collecting hair samples in the field (i.e., participants' homes) to measure Latino children's ETS exposure is generally acceptable when appropriate methods are used. Hair nicotine may be a more valid and practical biological measure than hair cotinine. Hair sampling may be a potentially useful, noninvasive technique in ETS studies, although the modest associations of constituents in children's hair with adults' reports indicates that each measure provides different information about ETS exposure.

Adult↗
PubMed2003

Teen smoking cessation help via the Internet: a survey of search engines.

The objective of this study was to assess Web sites related to teen smoking cessation on the Internet. Seven Internet search engines were searched using the keywords teen quit smoking. The top 20 hits from each search engine were reviewed and categorized. The keywords teen quit smoking produced between 35 and 400,000 hits depending on the search engine. Of 140 potential hits, 62% were active, unique sites; 85% were listed by only one search engine; and 40% focused on cessation. Findings suggest that legitimate on-line smoking cessation help for teens is constrained by search engine choice and the amount of time teens spend looking through potential sites. Resource listings should be updated regularly. Smoking cessation Web sites need to be picked up on multiple search engine searches. Further evaluation of smoking cessation Web sites need to be conducted to identify the most effective help for teens.

Adolescent↗
PubMed2002

What do middle school children bring in their bag lunches?

BACKGROUND: Limited documentation exists on nutritional characteristics of bag lunches, although about 30% of adolescents take them. This study describes: (a) the prevalence of different types of foods in bag lunches, (b) the number of kilocalories, percentage of kilocalories from fat, amount of total fat, saturated fat, cholesterol, and sugar, and (c) the differences related to gender and grade. METHODS: In 24 middle schools, observations were made on 1,381 bag lunches (about 58 per school) during one semester. RESULTS: The most common bag lunch components were beverages and sandwiches. Fruits were more common than vegetables; non-chip snacks and chips were more common than cookies, candy, and cakes/pies. Bag lunches averaged 596.2 kcal (29.7% from fat), 20.8 g of total fat, 6.2 g of saturated fat, 32.6 mg of cholesterol, and 21.3 g of sugar. Boys' bag lunches had significantly more kilocalories, total fat, saturated fat, cholesterol, and percentage of energy from fat than girls' lunches. Significant grade differences were found only for total fat and cholesterol, with seventh graders bringing more than sixth graders. CONCLUSION: More research on the nutritional quality of foods brought to school in bag lunches is important for gaining a better understanding about how to improve students' nutrition.

Adolescent↗
PubMed2002

Sources of dietary fat in middle schools.

BACKGROUND: The current study uses an ecological approach to describe the food environment at 24 middle schools and multiple food sources' dietary fat contribution. METHODS: Five consecutive days were sampled for collection of school meals, a la carte, and student store data. Bag lunch contents were observed on 3 days. Measurement included grams of saturated and total fat plus sales or participation data. RESULTS: Average total fat grams per meal were 21 g (SD = 2) for bag lunches, 14 g (SD = 5) for Type A breakfast, and 31 g (SD = 8) for Type A lunches. Average fat grams per item were 13 g (SD = 3) for a la carte and 6 g (SD = 2) for student stores. Students purchased or brought to school a mean of 26 g (SD = 3) of total and 8 g (SD = 1) of saturated fat. Contributions to total fat grams were 42% by Type A lunches, 27% by a la carte foods, 25% by bag lunches, 3% by Type A breakfast, and 2% by student stores. Findings for saturated fat were similar. CONCLUSIONS: Middle school students eat excessive amounts of fat at school, and multiple sources of food must be considered to understand the school food environment.

Adolescent↗
PubMed2002

Factors influencing the performance of volunteers who provide physical activity in middle schools.

Increasing physical activity among youth represents a national health goal, and using volunteer activity providers at schools offers one possible solution. This paper describes results from a program to recruit volunteer physical activity providers in middle schools. Twenty-one volunteers provided 850 physical activity hours at seven schools, including 575 activity sessions and 7,186 student contacts. Volunteers who received incentives offered more minutes of activity, conducted more activity sessions, reached a greater number of students, and logged more student-minutes of physical activity than those who received none. Male volunteers provided more activity minutes than female volunteers, but females were marginally more successful in engaging female students. Results can help guide schools to more effectively increase student physical activity throughout the school day.

Adult↗
PubMedDate not supplied

Smoking and quitting history correlates of readiness to quit in multiethnic adolescents.

OBJECTIVES: To describe smoking and quitting history among multiethnic adolescent smokers and examine these as correlates of readiness to quit. METHODS: Data were analyzed from 121 high school smokers. Sociodemographic characteristics, self-reported smoking history, number and duration of recent quit attempts, attitudes toward smoking/quitting, and readiness to quit were included. RESULTS: Smoking and quitting history variables were associated with adolescents' stage of readiness to quit. A reasonably consistent pattern emerged in which those in the preparation stage were significantly different from the precontemplators and contemplators. CONCLUSIONS: Results are discussed in terms of interventions matched to individuals' readiness to quit.

Adolescent↗