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Biomedical subjects

Tom Baranowski

Publications and source records attributed to Tom Baranowski.

At least 19 recordsLinked to original sources

Innovative application of a multidimensional item response model in assessing the influence of social desirability on the pseudo-relationship between self-efficacy and behavior.

This study examined multidimensional item response theory (MIRT) modeling to assess social desirability (SocD) influences on self-reported physical activity self-efficacy (PASE) and fruit and vegetable self-efficacy (FVSE). The observed sample included 473 Houston-area adolescent males (10-14 years). SocD (nine items), PASE (19 items) and FVSE (21 items) were measured with previously validated self-report instruments containing Likert-type responses. Physical activity was objectively measured using the Computer Science Application Incorporated/Manufacturing Technology Incorporated (CSA/MTI) accelerometer. Total fruit, juice and vegetable consumption was measured with a food frequency questionnaire. Correlations between self-efficacy and behaviors were minimal, regardless of controlling for SocD. However, in a simulated sample derived to demonstrate the utility of MIRT when relationships exist, the pseudo-relationships between self-efficacy and behaviors were substantially weaker after controlling for SocD. MIRT provided disattenuated correlations between SocD and self-efficacy, thereby providing more precise estimates of the real influence of SocD on the relationship between self-efficacy and behavior. However, as shown in the observed sample, more research is needed to understand the influence of SocD on the relationship between self-efficacy and behaviors for different populations and for different degrees of SocD response bias.

Child↗

Item response modeling: an evaluation of the children's fruit and vegetable self-efficacy questionnaire.

Perceived self-efficacy (SE) for eating fruit and vegetables (FV) is a key variable mediating FV change in interventions. This study applies item response modeling (IRM) to a fruit, juice and vegetable self-efficacy questionnaire (FVSEQ) previously validated with classical test theory (CTT) procedures. The 24-item (five-point Likert scale) FVSEQ was administered to 1578 fourth graders from 26 Houston schools. The IRM partial credit model indicated the five-point response options were not fully utilized. The questionnaire exhibited acceptable (>0.70) reliability except at the extremes of the SE scale. Differential item functioning (DIF) analyses revealed no response bias due to gender. However, DIF was detected by ethnic groups in 10 items. IRM of this scale expanded what was known from CTT methods in three ways: (i) areas of the scale were identified that were not as reliable, (ii) limitations were found in the response format and (c) areas of the SE scale levels were not measured. The FVSEQ can be improved by including items at the extreme levels of difficulty. DIF analyses identified areas where IRM can be useful to improve the functioning of measures.

Child↗

Does participation in an intervention affect responses on self-report questionnaires?

There has been some concern that participation in an intervention and exposure to a measurement instrument can change participants' interpretation of the items on a self-report questionnaire thereby distorting subsequent responses and biasing results. Differential item functioning (DIF) analysis using item response modeling can ascertain possible differences in item interpretation by testing for differences in item location between groups. The DIF for treatment versus control group differences at post-intervention assessment and the Time 1 and Time 2 differences in a control group were analyzed using data from a dietary change intervention trial for Boy Scouts. The measures included fruit and vegetable (FV) frequency of consumption, preferences and self-efficacy. Treatment-control group DIF at post-intervention assessment was detected in a higher percentage of items for FV frequency than for preference or self-efficacy. Time 1 to Time 2 differences in items for the control group were detected in one item for each of the three scales. Further research will need to clarify whether the obtained DIFs reflected true changes in frequency, preference or self-efficacy or some reinterpretation of items by participants following an intervention or merely after previous exposure to the measure.

Bias↗

Social desirability is associated with some physical activity, psychosocial variables and sedentary behavior but not self-reported physical activity among adolescent males.

This study examined whether controlling for social desirability improved the association between self-reported and objectively measured physical activity among adolescent males and the extent that psychosocial variables predict physical activity after controlling for social desirability. Participants (n=447) were 10- to 14-year old Houston Boy Scouts. Participants completed self-reports of physical activity, sedentary behavior, preferences, self-efficacy and social desirability and wore an MTI accelerometer for 3 days. Correlations were conducted among variables. Regression models were performed to examine the relationships between objectively measured (accelerometer) and self-reported physical activity, objectively measured physical activity and psychosocial variables and self-reports of physical activity and psychosocial variables. All models controlled for social desirability. There were weak associations between self-reported and objectively measured physical activity measures that were slightly improved after controlling for social desirability. Psychosocial variables were strongly associated with self-reports of physical activity, but weakly associated with accelerometer physical activity. Social desirability was positively associated with physical activity preferences (r=0.169) and self-efficacy (r=0.118) and negatively associated (r=-0.158) with self-reported sedentary behavior. Differences in the strength of relationships between self-reported and objectively measured physical activity and psychosocial variables were not a function of social desirability.

Adolescent↗

Crisis and chaos in behavioral nutrition and physical activity.

Resnicow & Vaughn challenged the field of behavioral nutrition and physical activity to conduct research in new ways. They challenged the predictiveness of our models, sensitivity to initial conditions, factors predisposing to change and measurement procedures. While the predictiveness of our models will reflect the sophistication of our thinking and research, and the sensitivity to initial conditions is subsumed under the sophistication of our models, research on conditions predisposing to change (e.g. epiphanies), more longitudinal designs, refined measurement procedures and testing of critical issues can only enhance the quality of our research. Improved research quality should lead to enhanced efficacy and effectiveness of our interventions, and thereby our making meaningful contributions to mitigating the chaos in our field and the crisis from the rising epidemic of obesity.

Comment↗

Fit for Life Boy Scout badge: outcome evaluation of a troop and Internet intervention.

BACKGROUND: This study reports the results of a 9-week intervention on the physical activity levels of adolescent males. METHODS: Participants were 473 10- to 14-year-old Houston Boy Scouts (42 troops) with troops randomly assigned to intervention or control conditions. Data were collected in spring (16 troops) and fall (26 troop) waves during 2003. Intervention participants received a 9-week troop and Internet program to increase physical activity skills, self-efficacy and goal-setting. Physical activity was assessed at baseline, end of the intervention (Post#1) and post-6 months (Post#2) by accelerometer. Minutes of sedentary, light and moderate to vigorous physical activity were calculated. Repeated measure analyses were performed to test differences in physical activity over time between groups with participants nested in troops. RESULTS: A three-way interaction (group * time * wave) that approached significance (P = 0.051) indicated a 12-min reduction in sedentary behavior among spring intervention participants. A significant three-way interaction (P = 0.011) (group * time * wave) indicated a 12-min increase in light intensity activity among the spring intervention group. CONCLUSION: Participation in the Fit for Life badge program resulted in a trend towards a small decrease in sedentary behavior and increased light intensity physical activity among spring participants only. There was no effect on moderate to vigorous physical activity.

Adolescent↗

Food-purchasing patterns for home: a grocery store-intercept survey.

OBJECTIVES: To identify the most common frequency of food-purchasing patterns and relate this pattern to characteristics of individuals and families. DESIGN: A customer-intercept survey was conducted in the greater Houston area, Texas, USA, in 2002. The frequency of food shopping at supermarkets, convenience stores and restaurants to buy food for eating at home was assessed. SUBJECTS: A total of 823 adults (78.5% female; mean age 37.4 years) who went to any of several grocery or convenience stores, including European, Hispanic and African Americans, and Asian/Pacific Islanders. RESULTS: Major food-shopping patterns were a weekly big trip with a few small trips (34.9%), biweekly big trips with a few small trips (21.9%), no big shopping trips (15.4%), a weekly big trip without small trips (13.9%), a monthly big trip (8.3%), and biweekly big trips without small trips (6.4%). While 61.1% of participants never went to convenience stores to buy fruit and vegetables (F&V) for eating at home, 67% went to restaurants for F&V. African American families shopped for food least frequently, while Asian American families shopped for food most frequently. Educational level was negatively associated with the use of convenience stores and positively associated with take-away from restaurants. CONCLUSIONS: There is substantial variability in the frequency of food shopping. Future research on food shopping should incorporate this variable.

Adult↗

Pedometer reliability, validity and daily activity targets among 10- to 15-year-old boys.

The aims of this study were to: (1) determine whether the number of pedometer counts recorded by adolescents differs according to the adiposity of the participant or location on the body; (2) assess the accuracy and reliability of pedometers during field activity; and (3) set adolescent pedometer-based physical activity targets. Seventy-eight 11- to 15-year-old Boy Scouts completed three types of activity: walking, fast walking and running. Each type was performed twice. Participants wore three pedometers and one activity monitor during all activities. Participants were divided into groups of normal weight (BMI < 85th percentile) and at risk of being overweight (BMI > or = 85th percentile). Intra-class correlations across the three activities indicated reliability (r = 0.51 - 0.92, P < 0.001). This conclusion was supported by narrow limits of agreement that were within a pre-set range that was practically meaningful. Multivariate analysis of covariance indicated adiposity group differences, but this difference was a function of the increased stature among the larger participants (P < 0.001). Ordinary least-squares regression models and multi-level regression models showed positive associations between the number of pedometer and activity monitor counts recorded by the three groups of participants during all activities (all P < 0.001). The mean number of counts recorded for all participants during the fast walk was 127 counts per minute. In conclusion, the pedometers provided an accurate assessment of adolescent physical activity, and a conservative estimate of 8000 pedometer counts in 60 min is equivalent to 60 min of moderate to vigorous physical activity.

Adolescent↗

Is there an association between sweetened beverages and adiposity?

Four mechanisms were reviewed to explain the possible association between sweetened beverages and increased overweight or obesity: excess caloric intake, glycemic index and glycemic load, lack of effect of liquid calories on satiety, and displacement of milk. The findings were inconsistent across studies. The strongest support was for the excess caloric intake hypothesis, but the findings were not conclusive. Assigning possible links between sweetened beverage consumption and adiposity requires research that compares and contrasts specific mechanisms, especially in populations at risk for obesity, while controlling for likely confounding variables.

Adiposity↗

Evaluation of internal medicine residents as exercise role models and associations with self-reported counseling behavior, confidence, and perceived success.

BACKGROUND: Patients perceive physicians who practice healthy personal behaviors as more credible and better able to motivate patients to make healthy lifestyle choices. PURPOSES: To evaluate internal medicine resident physicians as role models for promoting exercise by an assessment of physician physical activity behavior, cardiovascular fitness, physical activity knowledge, personal use of behavior modification techniques, attitudes toward personal physical activity practice, and confidence (i.e., self-efficacy) in the knowledge and personal utilization of behavior modification techniques and to explore the associations with self-reported patient counseling behavior, confidence, and perceived success. METHODS: Cross-sectional study of internal medicine resident physicians with a self-administered survey, treadmill fitness testing, and a 7-day physical activity recall. RESULTS: Fifty-one resident physicians agreed to participate (response rate = 81%). Fitness levels were below average for 60%, average for 25%, and above average or excellent for 15%. The mean energy expenditure was 234 kcal/kg/week, with 41% of physicians meeting recommended physical activity guidelines. Few reported high self-efficacy (33%) or perceived success (25%) in the ability to be regularly active. Few demonstrated adequate knowledge useful for patient counseling (e.g., listing 3 ways to integrate physical activity into daily life [27%], calculating target heart rate [29%], and identifying personal exercise stages of change [25%]). Personal use of behavior modification techniques was reported infrequently. Although 88% reported confidence in the knowledge of exercise benefits, less than half reported confidence in the knowledge of local facilities, American College of Sports Medicine (ACSM) guidelines, and behavior modification techniques. Multiple linear regression demonstrated that a higher level of training (p = .02) and a greater confidence in the knowledge of ACSM guidelines (p = .048, total R2 = .21) independently predicted more frequent self-reported counseling. Sex (i.e., male; p = .01) and greater physical activity self-efficacy (p = .017, total R2 = .23) independently predicted greater perceived counseling success. Greater physical activity enjoyment (p = .03) and greater perceived success at engaging in regular physical activity (p = .028, total R2 = .28) independently predicted greater counseling self-efficacy. CONCLUSIONS: Most internal medicine resident physicians may not be adequate role models for promoting exercise adherence. Confidence in the knowledge of current guidelines, personal physical activity enjoyment, and perceived success and self-efficacy in engaging in regular physical activity may be useful targets for enhancing resident physician physical activity counseling for their patients.

Adult↗

Effect of 4 weeks of Pilates on the body composition of young girls.

BACKGROUND: There is a need to find ways to increase the physical activity levels and improve the body composition and blood pressure of girls. METHODS: Thirty 11-year-old girls were recruited from two after school programs in Houston Texas in Spring 2005. Participants from one program (16) were randomly assigned to intervention, the other (14) served as controls. BMI, BMI percentile, waist circumference and blood pressure were assessed before and after the intervention. Pilates classes were provided free of charge for an hour per day at the intervention site, 5 days a week, for 4 weeks. Four participants wore heart rate monitors during every session and completed enjoyment and perceived exertion questionnaires. Repeated measures analysis of variance with time (within) and group (between) as factors was performed. RESULTS: Mean attendance was 75%, mean heart rate 104 bpm, mean perceived exertion 5.9 (1-10 scale) and enjoyment 4.4 (1-5 scale). There was a significant (P = 0.039) time by group interaction for BMI percentile. Graphs indicated that this difference was influenced by large reductions in the BMI percentile of healthy girls. CONCLUSIONS: Girls enjoyed Pilates, and participation for 4 weeks lowered BMI percentile. Pilates holds promise as a means of reducing obesity.

Analysis of Variance↗

Adolescent patterns of physical activity differences by gender, day, and time of day.

BACKGROUND: More information about the physical activity of adolescents is needed. This study used objective measurement to investigate differences in activity patterns related to gender, body mass index (BMI), day, and time of day. METHODS: Eighth-grade adolescents (37 boys, 44 girls) wore the Manufacturing Technologies Inc. (MTI) accelerometer for 4 days and kept a previous-day physical activity recall diary in the fall of 2002. Minutes per hour in sedentary, light, and moderate/vigorous activity, as recorded by the MTI, and in nine activity categories, as recorded by the diary, were calculated for three time periods (6:00 am to 2:59 pm, 3:00 pm to 6:59 pm, 7:00 pm to midnight) on each day (Thursday through Sunday). RESULTS: Doubly multivariate analysis of variance revealed significant gender by day by time differences in sedentary (p =0.005) and moderate/vigorous (p <0.001) activity, but no significant BMI interactions. Except on Sunday, boys were less sedentary and more active than girls during the late afternoon period. Significant gender by category (p <0.001) and day by category (p <0.001) interactions were also found in the log data. Boys spent more time engaged in TV/electronics and sports, while girls spent more time in personal care. Three activity categories (sports, social interaction, active transportation) stayed at consistent levels across days, while others varied widely by day of the week. CONCLUSIONS: Except on Sunday, consistent gender differences were found in activity levels, especially for the late afternoon period. Significant increases in sitting, TV/electronic games, and chores were seen for weekend days. Results support strategies to reduce sitting and electronic recreation, which may increase physical activity.

Adolescent↗

Observed environmental features and the physical activity of adolescent males.

BACKGROUND: It has recently been reported that adult physical activity was associated with environmental features. The aim of this study was to determine whether environmental features were associated with physical activity among male adolescents. METHODS: Physical activity levels of 210 Boy Scouts were assessed for 3 days by accelerometry during 2003 and 2004. Mean minutes of sedentary, light, and moderate-to-vigorous intensity activity were calculated. Environmental features within a 400-meter radius of each participant's home address were assessed by direct observation using the Systematic Pedestrian and Cycling Environmental Scan (SPACES) instrument. Principal component factor analysis reduced the 35 SPACES items to four factors. Hierarchical and spatial regressions were conducted with physical activity as the dependent variable and environmental factors, age, body mass index, and ethnicity as independent variables. RESULTS: Four factors were obtained: walking/cycling ease, tidiness, sidewalk characteristics, and street access and condition. Sidewalk characteristics were negatively associated with minutes of sedentary behavior while age was positively associated. Sidewalk characteristics were positively associated with minutes of light-intensity physical activity and age negatively associated. No environmental factor correlated with moderate-to-vigorous physical activity. CONCLUSIONS: A sidewalk characteristics factor, composed of sidewalk location, sidewalk material, presence of streetlights, and number and height of trees, was positively associated with light-intensity physical activity among male adolescents.

Adolescent↗

Squire's Quest: intervention changes occurred at lunch and snack meals.

This study identified fruit, 100% juice and vegetables (FJV) consumption changes by meal among fourth grade students participating in Squire's Quest!, a 10-session individually focused psychoeducational multimedia game with many meal/environment specific behavioral change techniques incorporated into the programming. Participants in 26 elementary schools were randomly assigned to treatment or control groups. Four days of dietary intake were assessed before and after the intervention to determine FJV servings consumed by meal. Overall, students receiving the intervention consumed 1.0 serving FJV more per day compared with control condition students. Using mixed model analysis of covariance, significant increases were found for servings of fruit and 100% fruit juice at snacks, and regular vegetables at lunch for intervention school children compared with children in control condition schools. These meals and snacks were targeted by the intervention activities and appear to represent eating occasions for which the children might have had more control. Interventions need to incorporate new procedures to more directly target intake at breakfast and dinner.

Beverages↗

Understanding the mechanisms of change in children's physical activity programs.

There is a lack of understanding of why childhood physical activity interventions succeed or fail. A model is proposed that relates program process to mediating variables and outcomes. Using the model to design and evaluate interventions could result in a greater understanding of the mechanisms of children's physical activity behavior change and how to tailor programs to them.

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