Introduction
There is growing interest in the role of children’s play in supporting children’s mental health. Children’s opportunitities for play vary according to the space available to them for ...play, with more adventurous play happening outdoors (Dodd et al., 2021). The area close to children’s home, such as the street outside their home, can provide an important play space but, with increasing traffic, there has been a decrease in the use of local streets for play over the past generation or two. At the same time we have seen significant increases in children’s mental health problems.
Objectives
Our objectives were: 1) to examine how trends in street play have changed over time; 2) to examine how children’s self-reported wellbeing is associated with their use of streets for play; 3) to examine how adult mental health is associated with their childhood street play experiences.
Methods
Working in collaboration with Save the Children and Play England, we surveyed a nationally representative sample of 1000 children and young people aged 6-16 years, 1000 adults aged 18+ and 1000 parents of children aged 6-16 years about children’s play in their local area and their memories of play during their own childhood. All participants also completed measures of wellbeing (children) or mental health (adults). Participants were recruited from Great Britian.
Results
We found striking differences in the use of streets and local areas for play. For example, across all adults, 62% told us that they regularly played out in their street or area close to home as a child. In contrast 27% of children told us that they regularly play out now. By breaking down the proportion of participants who said they regularly played in their street or local area by their age group, their is a clear decline in outdoor street play over the past 70 years. We asked children about their wellbeing using the Stirling Children’s Wellbeing Scale. Children who said that they regularly played out in their street had higher levels of positive emotion but this was only true for children under 13 years. Adults who told us that they regularly played out in their street or area close to their home as a child had better mental health as adults (lower scores on the K6). Similarly, adults who told us that there was freedom for children to go and explore in the neighbourhood they lived in as a child had better mental health as adults.
Conclusions
Taken together these findings suggest that being able to play in the street or area close to home is linked to wellbeing during childhood and early adolescence and further, that having these expriences during childhood may be beneficial for mental health into adulthood. This indicates that when considering how to support the development of good mental health we should keep in mind the importance of children’s opportunities for play and the role that access to their local enviornment plays in supporting play.
Disclosure of Interest
None Declared
Behavioural interventions incorporating features that are culturally salient to African American women have emerged as one approach to address the high rates of obesity in this group. Yet, the ...systematic evaluation of this research is lacking. This review identified culturally adapted strategies reported in behavioural interventions using a prescribed framework and examined the effectiveness of these interventions for diet and weight outcomes among African American women. Publications from 1 January 1990 through 31 December 2012 were retrieved from four databases, yielding 28 interventions. Seventeen of 28 studies reported significant improvements in diet and/or weight change outcomes in treatment over comparison groups. The most commonly identified strategies reported were ‘sociocultural’ (reflecting a group's values and beliefs) and ‘constituent involving’ (drawing from a group's experiences). Studies with significant findings commonly reported constituent‐involving strategies during the formative phases of the intervention. Involving constituents early on may uncover key attributes of a target group and contribute to a greater understanding of the heterogeneity that exists even within racial/ethnic groups. Available evidence does not, however, explain how culturally adapted strategies specifically influence outcomes. Greater attention to defining and measuring cultural variables and linking them to outcomes or related mediators are important next steps.
The excess burden of obesity among African–American women is well documented. However, the behavioural weight loss intervention literature often does not report results by ethnic group or gender. The ...purpose of this article is to conduct a systematic review of all behavioural weight loss intervention trials published between 1990 and 2010 that included and reported results separately for African–American women. The criteria for inclusion included (i) participants age ≥18 years; (ii) a behavioural weight loss intervention; (iii) weight as an outcome variable; (iv) inclusion of African–American women; and (v) weight loss results reported separately by ethnicity and gender. The literature search identified 25 studies that met inclusion criteria. Our findings suggest that more intensive randomized behavioural weight loss trials with medically at‐risk populations yield better results. Well‐designed and more intensive multi‐site trials with medically at‐risk populations currently offer the most promising results for African–American women. Still, African–American women lose less weight than other subgroups in behavioural weight loss interventions. It is now critical to expand on individual‐level approaches and incorporate the biological, social and environmental factors that influence obesity. This will help enable the adoption of healthier behaviours for this group of women disproportionately affected by obesity.
To assess the impact of a culturally proficient dietary/physical activity intervention on changes in body mass index (BMI) (kg/m
2).
Randomized controlled trial (Hip-Hop to Health Jr.) conducted ...between September 1999 and June 2002 in 12 Head Start preschool programs in Chicago, Illinois.
Intervention children had significantly smaller increases in BMI compared with control children at 1-year follow-up, 0.06 vs 0.59 kg/m
2; difference −0.53 kg/m
2 (95% CI −0.91 to −0.14),
P
=
.01; and at 2-year follow-up, 0.54 vs 1.08 kg/m
2; difference −0.54 kg/m
2 (95% CI −0.98 to −0.10),
P
=
.02, with adjustment for baseline age and BMI. The only significant difference between intervention and control children in food intake/physical activity was the Year 1 difference in percent of calories from saturated fat, 11.6% vs 12.8% (
P
=
.002).
Hip-Hop to Health Jr. was effective in reducing subsequent increases in BMI in preschool children. This represents a promising approach to prevention of overweight among minority children in the preschool years.
Behavior Matters Fisher, Edwin B., PhD; Fitzgibbon, Marian L., PhD; Glasgow, Russell E., PhD ...
American journal of preventive medicine,
05/2011, Letnik:
40, Številka:
5
Journal Article
Recenzirano
Odprti dostop
Abstract Behavior has a broad and central role in health. Behavioral interventions can be effectively used to prevent disease, improve management of existing disease, increase quality of life, and ...reduce healthcare costs. A summary is presented of evidence for these conclusions in cardiovascular disease/diabetes, cancer, and HIV/AIDS as well as with key risk factors: tobacco use, poor diet, physical inactivity, and excessive alcohol consumption. For each, documentation is made of (1) moderation of genetic and other fundamental biological influences by behaviors and social–environmental factors; (2) impacts of behaviors on health; (3) success of behavioral interventions in prevention; (4) disease management; (5) quality of life, and (6) improvements in the health of populations through behavioral health promotion programs. Evidence indicates the cost effectiveness and value of behavioral interventions, especially relative to other common health services as well as the value they add in terms of quality of life. Pertinent to clinicians and their patients as well as to health policy and population health, the benefits of behavioral interventions extend beyond impacts on a particular disease or risk factor. Rather, they include broad effects and benefits on prevention, disease management, and well-being across the life span. Among priorities for dissemination research, the application of behavioral approaches is challenged by diverse barriers, including socioeconomic barriers linked to health disparities. However, behavioral approaches including those emphasizing community and social influences appear to be useful in addressing such challenges. In sum, behavioral approaches should have a central place in prevention and health care of the 21st century.
Objective: This study sought to examine at what body mass index (BMI) body image discrepancy (BD) was reported in a community sample of 389 white, Hispanic, and black women. In addition, we assessed ...the trajectory of the BMI–BD relationship as BMI increases by ethnic group.
Research Methods and Procedures: All participants were assessed on height and weight and completed the Figure Rating Scale.
Results: We found no difference in the proportion of women in each ethnic group reporting BD. However, white women experienced BD at a lower BMI level (BMI = 24.6), and below the criterion for overweight (BMI = 25). In contrast, black and Hispanic women did not report BD until they were overweight (BMIs of 29.2 and 28.5, respectively). Compared with black and white women, Hispanic women registered increases in BD at smaller increases in BMI.
Discussion: These findings could have unhealthful implications for weight control behavior. The results encourage a closer look at ethnicity and BD, and their relationship to obesity and weight control.
There is a need to disseminate evidence-based childhood obesity prevention interventions on a broader scale to reduce obesity-related disparities among underserved children. The purpose of this study ...was to test the comparative effectiveness of an evidence-based obesity prevention intervention, Hip-Hop to Health (HH), delivered through Expanded Food and Nutrition Education Program (EFNEP) and the Supplemental Nutrition Assistance Program-Education (SNAP-Ed) versus the standard curriculum delivered by the programs (Standard Nutrition Education (NE)). A nonequivalent control group design was delivered to compare the effectiveness of HH to NE on weight gain prevention and health behavior outcomes at EFNEP and SNAP-Ed sites. One hundred and fifty-three caregiver-child dyads (
= 103 in the HH group;
= 50 in the NE group) participated in the study. HH is an evidence-based dietary and physical activity intervention for low-income preschool children. The NE curriculum provided lessons for children that are consistent with the Dietary Guidelines for Americans 2010. Data were collected on demographics, anthropometrics, and behavioral variables for parent-child dyads at baseline and postintervention. Mixed model methods with random effects for site and participant were utilized. No differences in child or caregiver diet, physical activity, or screen time by group were found. No between-group differences in child BMI z-score were found; however, caregivers in the HH group lost significantly more weight than those in the NE group. Results from this trial can inform future dissemination efforts of evidenced-based programs for underserved families.
We performed a systematic review of the behavioral lifestyle intervention trials conducted in the United States published between 1990 and 2011 that included a maintenance phase of at least six ...months, to identify intervention features that promote weight loss maintenance in African American women. Seventeen studies met the inclusion criteria. Generally, African American women lost less weight during the intensive weight loss phase and maintained a lower % of their weight loss compared to Caucasian women. The majority of studies failed to describe the specific strategies used in the delivery of the maintenance intervention, adherence to those strategies, and did not incorporate a maintenance phase process evaluation making it difficult to identify intervention characteristics associated with better weight loss maintenance. However, the inclusion of cultural adaptations, particularly in studies with a mixed ethnicity/race sample, resulted in less % weight regain for African American women. Studies with a formal maintenance intervention and weight management as the primary intervention focus reported more positive weight maintenance outcomes for African American women. Nonetheless, our results present both the difficulty in weight loss and maintenance experienced by African American women in behavioral lifestyle interventions.
Colorectal cancer screening is the most underused cancer screening tool in the United States. The purpose of this study was to test whether a health care provider-directed intervention increased ...colorectal cancer screening rates.
The study was a randomized controlled trial conducted at two clinic firms at a Veterans Affairs Medical Center. The records of 5,711 patients were reviewed; 1,978 patients were eligible. Eligible patients were men aged 50 years and older who had no personal or family history of colorectal cancer or polyps, had not received colorectal cancer screening, and had at least one visit to the clinic during the study period. Health care providers in the intervention firm attended a workshop on colorectal cancer screening. Every 4 to 6 months, they attended quality improvement workshops where they received group screening rates, individualized confidential feedback, and training on improving communication with patients with limited literacy skills. Medical records were reviewed for colorectal cancer screening recommendations and completion. Literacy level was assessed in a subset of patients.
Colorectal cancer screening was recommended for 76.0% of patients in the intervention firm and for 69.4% of controls (P = .02). Screening tests were completed by 41.3% of patients in the intervention group versus 32.4% of controls (P = .003). Among patients with health literacy skills less than ninth grade, screening was completed by 55.7% of patients in the intervention group versus 30% of controls (P < .01).
A provider-directed intervention with feedback on individual and firm-specific screening rates significantly increased both recommendations and colorectal cancer screening completion rates among veterans.
To evaluate whether lower literacy is associated with poorer knowledge and more negative attitudes and beliefs toward colorectal cancer screening among veterans without recent colorectal cancer ...screening.
Three hundred seventy-seven male veterans, age 50 years and older, who had not undergone recent colorectal cancer screening, were surveyed about their knowledge, attitudes, and beliefs regarding colorectal cancer screening. Patients' literacy was assessed with the Rapid Estimate of Adult Literacy in Medicine, an individually administered screening test for reading.
Thirty-six percent of the 377 men had an eighth grade literacy level or higher. Men with lower literacy were 3.5 times as likely not to have heard about colorectal cancer (8.8% v 2.5%; P =.006), 1.5 times as likely not to know about screening tests (58.4% v 40.9%; P =.0001), and were more likely to have negative attitudes about fecal occult blood testing (FOBT), but not about flexible sigmoidoscopy. Specifically, men with lower literacy skills were two times as likely to be worried that FOBT was messy (26.7% v 13.3%; P =.008), 1.5 times as likely to feel that FOBT was inconvenient (28.7% v 18%; P =.05), and four times as likely to state they would not use an FOBT kit even if their physician recommended it (17.9% v 4.0%; P =.02).
Limited literacy may be an overlooked barrier in colorectal cancer screening among veterans.
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