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Gilles de la Londe J, Aïm-Eusébi A, Cadwallader D, Rincon Murillo G, Cadwallader JS, Aubert JP. The Experience of HIV-Positive Transgender Women Engaging in Physical Activity: An Interpretative Phenomenological Analysis. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:3541-3552. [PMID: 37452265 DOI: 10.1007/s10508-023-02655-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 06/19/2023] [Accepted: 06/20/2023] [Indexed: 07/18/2023]
Abstract
Regular physical activity should benefit HIV-positive transgender women because they are a particularly vulnerable population. However, engaging in physical activity seems particularly difficult among this population. To inform the development of interventions to increase adherence to physical activity, we explored perceptions of physical activity in 10 semi-structured interviews with HIV-positive transgender women. Interviews were subjected to a qualitative approach named interpretative phenomenological analysis (IPA). Inspired by Cooley's theory, we chose to illustrate the results according to a three-level structure, i.e., confronting oneself to oneself with a specific identity, then confronting oneself with others on an interpersonal level, and eventually confronting oneself with society as a normative frame through the specific prism of physical activity, and thus relationship to one's body. The idea of practicing physical activity meant for them: having to face what they tried to be kept hidden, being ostracized by the cis population, and facing social heteronormativity. The fears about health were mostly about HIV and the transitioning process side effects. The psychological issues were mostly about the fear of developing male shaped bodies and worsened by traumatic life stories. External factors were often related to the passing concept and violence caused by stigma and discrimination. The group appeared as a strong motivation factor, facilitating self-acceptance and socialization.
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Affiliation(s)
| | - Amélie Aïm-Eusébi
- Département de Médecine Générale, Université Paris Cité, Paris, France
| | | | | | - Jean Sébastien Cadwallader
- Department of General Practice, Sorbonne University, Paris, France.
- Institut Pierre Louis d'Épidémiologie Et de Santé Publique, INSERM, Sorbonne University, 75012, Paris, France.
| | - Jean Pierre Aubert
- Département de Médecine Générale, Université Paris Diderot, Paris, France
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Augustine JM, Pivnick L, Olson JS, Crosnoe R. Concentrated Poverty in U.S. Schools and Adolescents' Risk of Being Overweight. SOCIAL CURRENTS 2021; 8:270-292. [PMID: 36685012 PMCID: PMC9851149 DOI: 10.1177/2329496520978540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
The economic segregation of U.S. schools undermines the academic performance of students, particularly students from low-income families who are often concentrated in high-poverty schools. Yet it also fuels the reproduction of inequality by harming their physical health. Integrating research on school effects with social psychological and ecological theories on how local contexts shape life course outcomes, we examined a conceptual model linking school poverty and adolescent students' weight. Applying multilevel modeling techniques to the first wave of data (1994-1995) from the National Longitudinal Study of Adolescent to Adult Health (Add Health; n = 18,924), the results revealed that individual students' likelihood of being overweight increased as the concentration of students from low-income families in their schools increased, net of their own background characteristics. This linkage was connected to a key contextual factor: the exposure of students in high-poverty schools to other overweight students. This exposure may partly matter because of the lower prevalence of dieting norms in such schools, although future research should continue to examine potential mechanisms.
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Rajbhandari-Thapa J, Ingels J, Thapa K, Davis M, Corso P. Longitudinal evaluation of the impact of school characteristics on changes in physical activity opportunities. PLoS One 2020; 15:e0228716. [PMID: 32027725 PMCID: PMC7004365 DOI: 10.1371/journal.pone.0228716] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 01/22/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Even as many states adopt physical activity policies to promote physical activity and prevent childhood obesity, little is known about differences in policy implementation based on school characteristics. We studied association of school characteristics and changes in physical activity opportunities at the school level during the implementation of a statewide physical activity policy in the state of Georgia. METHODS A web-based school survey was administered to elementary schools at two time points (before and during policy execution). Matched respondents (289 classroom teachers, 234 administrators) reported the frequency and duration of recess and integrated physical activity time. We used paired t-test to assess changes in physical activity opportunities and chi-square tests to assess the association of change in physical activity opportunities with school characteristics. We then constructed a multiple linear regression model following a change score method to identify school-level factors that predict the magnitude of change in physical activity opportunities. RESULTS There was an overall significant increase in total physical activity opportunities across time; however, schools with higher poverty showed a decrease in physical activity time by 5.3 minutes per day (95% CI: -9.2, -1.3). Further, the changes in physical activity time for schools in suburban Georgia were smaller (-5.7, 95% CI: -9.5, -1.9) compared to schools located in towns. CONCLUSIONS The change in physical activity opportunities was not the same across schools and school characteristics predicted the magnitude of change. Additional efforts at the local level might be needed for equitable policy implementation based on schools' geographical location and poverty level of the student population.
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Affiliation(s)
- Janani Rajbhandari-Thapa
- Department of Health Policy and Management, College of Public Health, University of Georgia, Athens, GA, United States of America
- * E-mail:
| | - Justin Ingels
- Department of Health Policy and Management, College of Public Health, University of Georgia, Athens, GA, United States of America
| | - Kiran Thapa
- Department of Health Policy and Management, College of Public Health, University of Georgia, Athens, GA, United States of America
| | - Marsha Davis
- Department of Health Promotion and Behavior, College of Public Health, University of Georgia, Athens, GA, United States of America
| | - Phaedra Corso
- Kennesaw State University, Kennesaw, GA, United States of America
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Papachristou E, Flouri E, Midouhas E, Lewis G, Joshi H. The Role of Primary School Composition in the Trajectories of Internalising and Externalising Problems across Childhood and Adolescence. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2019; 48:197-211. [PMID: 31541374 PMCID: PMC6969860 DOI: 10.1007/s10802-019-00584-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
There is little research on the role of school and its composition in explaining individual children’s psychological outcomes. This study examined for the first time the role of several primary-school compositional characteristics, and their interactions with individual level characteristics, in the development of two such outcomes, internalising and externalising problems, at ages 7, 11 and 14 years in 4794 children in England participating in the Millennium Cohort Study. Using hierarchical (multilevel) linear models, we found that, even after adjusting for individual and family characteristics, children in schools with higher proportions of pupils eligible for free school meals had more externalising problems. In general, children with special educational needs, lower academic performance, more distressed mothers, and those in non-intact families had more internalising and externalising problems. Our results underline the importance of targeting schools with less affluent overall intakes, but also highlight the key role of individual and family characteristics in the development of their pupils’ psychological functioning.
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Affiliation(s)
- Efstathios Papachristou
- Department of Psychology and Human Development, UCL Institute of Education, University College London, 25 Woburn Square, WC1H 0AA, London, UK.
| | - Eirini Flouri
- Department of Psychology and Human Development, UCL Institute of Education, University College London, 25 Woburn Square, WC1H 0AA, London, UK
| | - Emily Midouhas
- Department of Psychology and Human Development, UCL Institute of Education, University College London, 25 Woburn Square, WC1H 0AA, London, UK
| | - Glyn Lewis
- Division of Psychiatry, University College London, London, UK
| | - Heather Joshi
- Department of Psychology and Human Development, UCL Institute of Education, University College London, 25 Woburn Square, WC1H 0AA, London, UK
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Gray HL, Buro AW, Barrera Ikan J, Wang W, Stern M. School-level factors associated with obesity: A systematic review of longitudinal studies. Obes Rev 2019; 20:1016-1032. [PMID: 31013544 DOI: 10.1111/obr.12852] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Revised: 02/16/2019] [Accepted: 02/25/2019] [Indexed: 01/27/2023]
Abstract
Although school has been an important intervention venue for obesity prevention, the role of school-level factors in obesity development or prevention has not been well-documented. This study aimed to systematically examine the current evidence on school-level factors associated with obesity outcomes in longitudinal studies. The literature search was performed in PubMed, EMBASE, CINHAL, and PsycINFO. Peer-reviewed articles using longitudinal study designs and published in English from 1991 to 2018 were eligible. Twelve articles met eligibility criteria for final systematic review. Nine studies reported significant long-term associations between school-level factors and obesity outcomes. Higher parental education, longer minutes of recess, meeting recommended recess and physical education time, higher socio-economic status, suburban compared with rural area, higher parental involvement in school, and healthful school food environment were significantly associated with lower rates of obesity or obesity trajectory. However, due to the small number of studies and heterogeneity of measures and variables used in their analytic models, the overall level of evidence from this review suggests the importance of further, systematic study. Empirically rigorous research is needed to identify additional aspects of the school context and environment that may contribute to the risk of obesity throughout the life course.
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Affiliation(s)
- Heewon L Gray
- College of Public Health, University of South Florida, Tampa, Florida
| | - Acadia W Buro
- College of Public Health, University of South Florida, Tampa, Florida
| | | | - Wei Wang
- College of Public Health, University of South Florida, Tampa, Florida.,Centre for Addiction and Mental Health, Ontario, Canada
| | - Marilyn Stern
- Department of Child & Family Studies, College of Behavioral & Community Sciences, University of South Florida, Tampa, Florida
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Adom T, Kengne AP, De Villiers A, Puoane T. Association between school-level attributes and weight status of Ghanaian primary school children. BMC Public Health 2019; 19:577. [PMID: 31092232 PMCID: PMC6521351 DOI: 10.1186/s12889-019-6937-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 05/02/2019] [Indexed: 11/25/2022] Open
Abstract
Background Little is known about the impact of the school environmental context on the emerging trend of childhood obesity in Africa. We examined the association of the schools’ contextual factors with body mass index (BMI), abdominal obesity and overweight (including obesity) in urban Ghana. Method Using cross-sectional data from 543 school children aged 8–11 years attending 14 primary schools, we applied multilevel logistic regressions and linear regression models to investigate the association of child- and school level attributes with overweight, abdominal obesity, and BMI. Results We observed significant variance of the random effects of schools in BMI (2.65, p < 0.05), abdominal obesity (0.85, p < 0.05), and overweight (1.41, p < 0.05), with school contextual levels accounting for 19.7, 20.6, and 30.0% of the total variability observed in BMI, abdominal obesity and overweight respectively. Attending high socioeconomic (SES) level school, private school and school with increased after-school recreational facilities were associated with higher BMI. Children were more likely to be overweight if they attended a high SES level school, had access to healthful foods at school, and after-school recreational facilities. With regards to abdominal obesity, attending a school with increased physical activity facilities decreased the odds of abdominal obesity; however the odds increased if they attended a school with access to after-school recreational facilities. Conclusion A number of school-level factors were associated with BMI, overweight and abdominal obesity of children in the present study. Our results provide support for improved school environment to reduce overweight.
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Affiliation(s)
- Theodosia Adom
- School of Public Health, Faculty of Community and Health Sciences, University of the Western Cape, Cape Town, South Africa. .,Nutrition Research Centre, Radiological and Medical Sciences Research Institute, Ghana Atomic Energy Commission, Accra, Ghana.
| | - André Pascal Kengne
- Non-communicable Disease Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Anniza De Villiers
- Division of Research Capacity Development, South African Medical Research Council, Cape Town, South Africa
| | - Thandi Puoane
- School of Public Health, Faculty of Community and Health Sciences, University of the Western Cape, Cape Town, South Africa
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Leal DB, Assis MAAD, Conde WL, Lobo AS, Bellisle F, Andrade DFD. Individual characteristics and public or private schools predict the body mass index of Brazilian children: a multilevel analysis. CAD SAUDE PUBLICA 2018; 34:e00053117. [PMID: 29846407 DOI: 10.1590/0102-311x00053117] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 10/02/2017] [Indexed: 11/21/2022] Open
Abstract
The aim of this study was to determine the contribution of individual and school characteristics to the variability in body mass index (BMI) z-scores of 7 to 10 years old children. Anthropometric and sociodemographic data from two cross-sectional studies conducted with schoolchildren from the 2nd to the 5th grades of elementary schools were analyses (n = 2,936 in 2002, and n = 1,232 in 2007). Multilevel modeling was used to estimate variations in BMI at child and school levels. The contribution of the school context to the overall variability of BMI z-score was small but significant in 2002 (3.3%-4.4%) and in 2007 (2.4%-5.3%), showing that schoolchildren from private schools had a higher BMI compared to those from public schools. The monthly family income showed, in general, a negative association with BMI z-score in 2002 and a positive association in 2007, for both sexes. The consumption of sweets showed a negative effect in the BMIs of children. In both surveys, overweight/obese mothers and excessive birth weight were positively associated with BMI z-score. Mother's weight status had a higher influence on the overall variability of BMI in both surveys. In conclusion, school and child characteristics contributed to the variance in children's weight status. The results imply that overweight/obesity childhood prevention programs should focus on strategies of family engagement to be more effective.
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Sanetti LMH. Increasing equitable care for youth through coordinated school health. PSYCHOLOGY IN THE SCHOOLS 2017. [DOI: 10.1002/pits.22081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Richmond TK, Dunn EC, Milliren CE, Evans CR, Subramanian S. Disentangling overlapping influences of neighborhoods and schools on adolescent body mass index. Obesity (Silver Spring) 2016; 24:2570-2577. [PMID: 27863090 PMCID: PMC5479485 DOI: 10.1002/oby.21672] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Revised: 07/26/2016] [Accepted: 08/03/2016] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To compare the simultaneous influence of schools and neighborhoods on adolescent body mass index (BMI). METHODS Analyzing data from a nationally representative sample of adolescents in grades 7 to 12 (n = 18,200), cross-classified multilevel modeling was used to examine the fixed and random effects of individuals, schools, and neighborhoods on adolescent BMI. Additionally, the ability of school and neighborhood demographics to explain racial/ethnic disparities in BMI was assessed. RESULTS There were 18,200 students nested in 128 schools and 2,259 neighborhoods, with 2,757 unique combinations of schools and neighborhoods. In girls, schools (vojk = 0.18, CI: 0.06-0.33) contributed twice that of neighborhoods (uojk = 0.08, CI: 0.01-0.20) to the variance in BMI, while in males, schools (uojk = 0.15, CI: 0.05-0.30) and neighborhoods (vojk = 0.16, CI: 0.05-0.31) had similar contributions. The interaction of the neighborhood and school random effects contributed significantly to the variance of male and female BMI. Characteristics of neighborhoods and schools explained a large portion of the racial/ethnic disparity in female BMI. CONCLUSIONS In an analysis of a nationally representative sample including multiple racial and ethnic groups, the BMI variance of adolescent females was associated with schools more than neighborhoods. In males, there was no difference in school or neighborhood association with BMI.
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Affiliation(s)
- Tracy K. Richmond
- Division of Adolescent Medicine, Department of Medicine, Boston Children’s Hospital, Boston, MA, USA
| | - Erin C. Dunn
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Stanley Center for Psychiatric Research, The Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - Carly E. Milliren
- Clinical Research Center, Department of Medicine, Boston Children’s Hospital, Boston, MA, USA
| | - Clare Rosenfeld Evans
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA, USA
| | - S.V. Subramanian
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA, USA
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10
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Utley JM, Affuso O, Rucks AC. Adolescent obesity in contextual settings: a scoping study of multilevel and hierarchical examinations. Clin Obes 2016; 6:296-304. [PMID: 27627786 DOI: 10.1111/cob.12163] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Revised: 08/01/2016] [Accepted: 08/03/2016] [Indexed: 01/16/2023]
Abstract
Multilevel/hierarchical obesity studies analyze adolescent and family, neighbourhood and social settings' characteristics to generate data needed to design prevention interventions. This scoping study summarizes such studies' characteristics and key findings to provide information to decision makers, which allows them to quickly grasp the state of the evidence and potential policy implications for adolescent obesity prevention. PubMed, CINAHLplus, PsychINFO and Sociological Abstracts were searched for peer-reviewed studies spanning 1 January 2000-31 August 2014. Inclusion criteria included (i) outcome weight status, physical activity and weight status, or physical activity alone if the aim was obesity prevention; (ii) 12- to 19-year-old participants in a cross-sectional study, a separate analysis in a cross-sectional study or a longitudinal follow-up. Nineteen studies were published in the United States of America; four in Canada; two in Spain, China and Vietnam, respectively; and one in Germany. Self-efficacy, parental physical activity support, perceived neighbourhood support, social cohesion and access to recreational facilities were associated with increased activity levels; neighbourhood physical disorder and perceived lack of safety associated with reduced physical activity levels. Overweight or obesity was associated with sugar-sweetened beverage intake and household availability thereof; reduced odds were reported with fruit and vegetable intake and household availability of these, daily breakfast and family meal frequency. Potential adolescent obesity risk regulators may be found at the individual, family or social contextual levels.
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Affiliation(s)
- J M Utley
- Department of Health Care Organization and Policy, University of Alabama at Birmingham School of Public Health, 1720 2nd Avenue, South, Birmingham, AL, USA.
| | - O Affuso
- Department of Epidemiology, University of Alabama at Birmingham School of Public Health, 1720 2nd Avenue, South, Birmingham, AL, USA
| | - A C Rucks
- Department of Health Care Organization and Policy, University of Alabama at Birmingham School of Public Health, 1720 2nd Avenue, South, Birmingham, AL, USA
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Evans CR, Onnela JP, Williams DR, Subramanian S. Multiple contexts and adolescent body mass index: Schools, neighborhoods, and social networks. Soc Sci Med 2016; 162:21-31. [DOI: 10.1016/j.socscimed.2016.06.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Revised: 04/27/2016] [Accepted: 06/01/2016] [Indexed: 12/20/2022]
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12
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The search for healthy schools: A multilevel latent class analysis of schools and their students. Prev Med Rep 2016; 4:331-7. [PMID: 27462531 PMCID: PMC4957574 DOI: 10.1016/j.pmedr.2016.06.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Revised: 06/22/2016] [Accepted: 06/27/2016] [Indexed: 11/21/2022] Open
Abstract
The objective of this study was to establish and investigate a taxonomy of school health among high school students in Ontario, Canada. Data analyzed were based on 3358 9th–12th graders attending 103 high schools who participated in the 2011 Ontario Student Drug Use and Health Survey. Based on 10 health-related indicators, multilevel latent class analysis was used to extract 4 student-level latent classes and 3 school-level latent classes. Unhealthy schools (19% of schools) had the lowest proportion of healthy students (39%) and the highest proportion of substance-using (31%) and unhealthy (18%) students. Healthy schools (66%) contained the highest proportion of healthy students (56%) and smaller proportions of substance-using (22%) and unhealthy students (8%). Distressed schools (15%) were similar to healthy schools in terms of the proportions of healthy and unhealthy students. Distressed schools, however, were characterized by having the largest proportion of distressed students (35%) and the lowest proportion of substance-using students (4%). Meaningful categories of schools with respect to healthy environments can be identified and these categories could be used for focusing interventions and evaluating school health programs. Multi-level latent class analysis to identify student and school latent classes School-level latent classes include healthy, unhealthy, and distressed schools Importance of school environment as well as student health-related behaviours.
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Kim Y, Kawachi I. School- and Individual-level Predictors of Weight Status Misperception among Korean Adolescents: A National Online Survey. PLoS One 2016; 11:e0154826. [PMID: 27144319 PMCID: PMC4856343 DOI: 10.1371/journal.pone.0154826] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Accepted: 04/19/2016] [Indexed: 12/29/2022] Open
Abstract
Background Growing body of literature has reported that weight status estimation pattern, including accurate-, under-, and overestimation, was associated with weight related behaviors and weight change among adolescents and young adults. However, there have been a few studies investigating the potential role of school contexts in shaping adolescents’ weight status estimation pattern among Korea adolescents. Objective The aim of the present study was to investigate the association between weight status misperception patterns and factors at individual-, family-, and school-level, simultaneously, and whether there was significant between schools variation in the distribution of each weight status misperception pattern, underestimation and overestimation respectively, among Korean adolescents aged 12–18 years. Method Data from the Eighth Korea Youth Risk Behavior Web-based Survey (KYRBS), 2012, a nationally representative online survey of 72,228 students (boys = 37,229, girls = 34,999) from a total of 797 middle and high schools were used. Sex stratified multilevel random intercept multinomial logistic models where adolescents (level 1) were nested within schools (level 2) were performed. Results At the school level, attending a school with higher average BMI (kg/m2) was positively associated with weight status underestimation, and inversely associated with weight status overestimation among boys and girls. Single-sex schooling was positively associated with weight status underestimation among girls. At the family level, higher household income (high/middle versus low) was inversely associated with both weight status under- and overestimation among boys and girls. Higher maternal education (equal to or more than college graduate versus equal to or less than high school graduate) was positively associated with weight status overestimation among boys, and living with both parents (compared to not living with both parents) was inversely associated with weight status underestimation among girls. At the individual level, high academic achievement (compared to low) was positively associated with weight status underestimation among boys and girls. Conclusions While further research with prospective designs and objectively measured anthropometric information is needed, school environmental factors such as sex composition and school average BMI, as well as, family contexts such as socioeconomic status need to be considered when developing and implementing obesity prevention programs.
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Affiliation(s)
- Yongjoo Kim
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, Massachusetts, United States of America
- * E-mail:
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, Massachusetts, United States of America
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Tsitsika AK, Andrie EK, Psaltopoulou T, Tzavara CK, Sergentanis TN, Ntanasis-Stathopoulos I, Bacopoulou F, Richardson C, Chrousos GP, Tsolia M. Association between problematic internet use, socio-demographic variables and obesity among European adolescents. Eur J Public Health 2016; 26:617-22. [PMID: 27114408 DOI: 10.1093/eurpub/ckw028] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Overweight of children and adolescents continues to be an important and alarming global public health problem. As the adolescent's time spent online has increased, problematic internet use (PIU) potentially leads to negative health consequences. This study aimed to examine the relation between PIU and overweight/obesity among adolescents in seven European countries and assess the effect of demographic and lifestyle factors recorded in the European Network for Adolescent Addictive Behaviour (EU NET ADB) survey (www.eunetadb.eu). METHODS A cross-sectional school-based survey of 14- to 17-year-old adolescents was conducted in seven European countries: Germany, Greece, Iceland, the Netherlands, Poland, Romania and Spain. Anonymous self-completed questionnaires included sociodemographic data, internet usage characteristics, school achievement, parental control and the Internet Addiction Test. Associations between overweight/obesity and potential risk factors were investigated by logistic regression analysis, allowing for the complex sample design. RESULTS The study sample consisted of 10 287 adolescents aged 14-17 years. 12.4% were overweight/obese, and 14.1% presented with dysfunctional internet behavior. Greece had the highest percentage of overweight/obese adolescents (19.8%) and the Netherlands the lowest (6.8%). Male sex [odds ratio (OR) = 2.89, 95%CI: 2.46-3.38], heavier use of social networking sites (OR = 1.26, 95%CI: 1.09-1.46) and residence in Greece (OR = 2.32, 95%CI: 1.79-2.99) or Germany (OR = 1.48, 95%CI: 1.12-1.96) were independently associated with higher risk of overweight/obesity. A greater number of siblings (OR = 0.79, 95%CI: 0.64-0.97), higher school grades (OR = 0.74, 95%CI: 0.63-0.88), higher parental education (OR = 0.89, 95%CI: 0.82-0.97) and residence in the Netherlands (OR = 0.49, 95%CI: 0.31-0.77) independently predicted lower risk of overweight/obesity. CONCLUSIONS The results indicate an association of overweight/obesity with PIU and suggest the importance of formulating preventive public health policies that target physical health, education and sedentary online lifestyle early in adolescence with special attention to boys.
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Affiliation(s)
- Artemis K Tsitsika
- 1 Adolescent Health Unit, Second Department of Pediatrics, P. and A. Kyriakou Children's Hospital, University of Athens, Athens, Greece
| | - Elisabeth K Andrie
- 1 Adolescent Health Unit, Second Department of Pediatrics, P. and A. Kyriakou Children's Hospital, University of Athens, Athens, Greece
| | - Theodora Psaltopoulou
- 2 Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, University of Athens, Athens, Greece
| | - Chara K Tzavara
- 1 Adolescent Health Unit, Second Department of Pediatrics, P. and A. Kyriakou Children's Hospital, University of Athens, Athens, Greece
| | - Theodoros N Sergentanis
- 2 Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, University of Athens, Athens, Greece
| | - Ioannis Ntanasis-Stathopoulos
- 2 Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, University of Athens, Athens, Greece
| | - Flora Bacopoulou
- 3 Center for Adolescent Medicine and UNESCO Chair Adolescent Health Care, First Department of Pediatrics, University of Athens, Athens, Greece
| | - Clive Richardson
- 4 Panteion University of Social and Political Sciences, Athens, Greece
| | - George P Chrousos
- 3 Center for Adolescent Medicine and UNESCO Chair Adolescent Health Care, First Department of Pediatrics, University of Athens, Athens, Greece
| | - Maria Tsolia
- 5 Second Department of Pediatrics, P. and A. Kyriakou Children's Hospital, University of Athens, Athens, Greece
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Pabayo R, Dunn EC, Gilman SE, Kawachi I, Molnar BE. Income inequality within urban settings and depressive symptoms among adolescents. J Epidemiol Community Health 2016; 70:997-1003. [PMID: 27103664 DOI: 10.1136/jech-2015-206613] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2015] [Accepted: 03/30/2016] [Indexed: 11/04/2022]
Abstract
BACKGROUND Although recent evidence has shown that area-level income inequality is related to increased risk for depression among adults, few studies have tested this association among adolescents. METHODS We analysed the cross-sectional data from a sample of 1878 adolescents living in 38 neighbourhoods participating in the 2008 Boston Youth Survey. Using multilevel linear regression modelling, we: (1) estimated the association between neighbourhood income inequality and depressive symptoms, (2) tested for cross-level interactions between sex and neighbourhood income inequality and (3) examined neighbourhood social cohesion as a mediator of the relationship between income inequality and depressive symptoms. RESULTS The association between neighbourhood income inequality and depressive symptoms varied significantly by sex, with girls in higher income inequality neighbourhood reporting higher depressive symptom scores, but not boys. Among girls, a unit increase in Gini Z-score was associated with more depressive symptoms (β=0.38, 95% CI 0.28 to 0.47, p=0.01) adjusting for nativity, neighbourhood income, social cohesion, crime and social disorder. There was no evidence that the association between income inequality and depressive symptoms was due to neighbourhood-level differences in social cohesion. CONCLUSIONS The distribution of incomes within an urban area adversely affects adolescent girls' mental health; future work is needed to understand why, as well as to examine in greater depth the potential consequences of inequality for males, which may have been difficult to detect here.
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Affiliation(s)
- Roman Pabayo
- University of Nevada, Reno, School of Community Health Sciences, Reno, Nevada, USA Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Erin C Dunn
- Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital, Boston, Massachusetts, USA Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA Stanley Center for Psychiatric Research, The Broad Institute of Harvard and MIT, Boston, Massachusetts, USA
| | - Stephen E Gilman
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA Health Behavior Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, Maryland, USA
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Beth E Molnar
- Bouvé College of Health Sciences, Northeastern University, Boston, Massachusetts, USA
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Bould H, De Stavola B, Magnusson C, Micali N, Dal H, Evans J, Dalman C, Lewis G. The influence of school on whether girls develop eating disorders. Int J Epidemiol 2016; 45:480-8. [PMID: 27097749 PMCID: PMC4864880 DOI: 10.1093/ije/dyw037] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2015] [Indexed: 01/30/2023] Open
Abstract
Background:
Clinical anecdote suggests that rates of eating disorders (ED) vary between schools. Given their high prevalence and mortality, understanding risk factors is important. We hypothesised that rates of ED would vary between schools, and that school proportion of female students and proportion of parents with post-high school education would be associated with ED, after accounting for individual characteristics.
Method:
Multilevel analysis of register-based, record-linkage data on 55 059 females born in Stockholm County, Sweden, from 1983, finishing high school in 2002-10. Outcome was clinical diagnosis of an ED, or attendance at a specialist ED clinic, aged 16-20 years.
Results:
The 5-year cumulative incidence of ED diagnosis aged 16-20 years was 2.4%. Accounting for individual risk factors, with each 10% increase in the proportion of girls at a school, the odds ratio for ED was 1.07 (1.01 to 1.13),
P
= 0.018. With each 10% increase in the proportion of children with at least one parent with post-high school education, the odds ratio for ED was 1.14 (1.09 to 1.19),
P
< 0.0001. Predicted probability of an average girl developing an ED was 1.3% at a school with 25% girls where 25% of parents have post-high school education, and 3.3% at a school with 75% girls where 75% of parents have post-high school education.
Conclusions:
Rates of ED vary between schools; this is not explained by individual characteristics. Girls at schools with high proportions of female students, and students with highly educated parents, have higher odds of ED regardless of individual risk factors.
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Affiliation(s)
- Helen Bould
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK, Centre for Academic Mental Health, School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Bianca De Stavola
- Centre for Statistical Methodology, London School of Hygiene and Tropical Medicine, London, UK
| | - Cecilia Magnusson
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | | | - Henrik Dal
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Jonathan Evans
- Centre for Academic Mental Health, School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Christina Dalman
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Glyn Lewis
- Faculty of Brain Sciences, University College London, London, UK
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Abstract
PURPOSE There is little research on the role of school composition in young children's behaviour. School composition effects may be particularly important for children in disadvantaged circumstances, such as those growing up in poverty. We explored the role of school academic and socio-economic composition in internalising problems, externalising problems and prosocial behaviour at age 7 years, and tested if it moderates the effect of family poverty on these outcomes. METHODS We used data from 7225 7-year-olds of the Millennium Cohort Study who attended state primary schools in England and for whom we had information on these outcomes. In multiple membership models, we allowed for clustering of children in schools and moves between schools since the beginning of school, at age 5. Our school academic and socio-economic composition variables were school-level achievement and % of pupils eligible for free school-meals, respectively. Poverty (family income below the poverty line) was measured in all sweeps until age 7. We explored the roles of both timing and duration of poverty. RESULTS The effects of poverty were strong and robust to adjustment. School socio-economic composition was associated with individual children's internalising and externalising problems, even in adjusted models. School composition did not interact with poverty to predict any of the outcomes. CONCLUSIONS Neither the academic nor the socio-economic composition of the school moderated the effect of family poverty on children's behaviour in primary school. However, children attending schools with more disadvantaged socio-economic intakes had more internalising and externalising problems than their counterparts.
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18
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Sedej K, Lusa L, Battelino T, Kotnik P. Stabilization of Overweight and Obesity in Slovenian Adolescents and Increased Risk in Those Entering Non-Grammar Secondary Schools. Obes Facts 2016; 9:241-50. [PMID: 27454351 PMCID: PMC5644814 DOI: 10.1159/000445382] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Accepted: 03/07/2016] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND/AIM To estimate overweight and obesity prevalence trends in Slovenian adolescents entering secondary schools in the years 2004, 2009 and 2014 and differences in the prevalence between different types of secondary schools. METHODS Data from 17,538 adolescents entering secondary schools (mean age ± standard deviation 15.4 ± 0.5 years) collected during obligatory medical examination in years 2004, 2009 and 2014 was analyzed. Overweight and obesity were defined using International Obesity Task Force criteria. RESULTS In 2004-2009 overweight and obesity prevalence increased, especially in males and stabilized thereafter (2009-2014) in both genders. It was significantly higher (p < 0.0001) in those attending secondary vocational and technical/professional versus grammar schools (2009; 28.7 vs. 16.8% overweight females and 31.6 vs. 22.3% overweight males; 2014: 29.7 vs. 17.9% overweight females and 33.6 vs. 20.4% overweight males). CONCLUSIONS Overweight and obesity prevalence in Slovenian adolescents entering secondary schools stabilized recently. Adolescents attending secondary vocational and technical/professional schools are at an increased risk of overweight and obesity.
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Affiliation(s)
- Katarina Sedej
- Department of Endocrinology, Diabetes and Metabolism, University Childrenʼs Hospital Ljubljana, Ljubljana, Slovenia
| | - Lara Lusa
- Institute of Biostatistics and Medical Informatics, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Tadej Battelino
- Department of Pediatric Endocrinology, Diabetes and Metabolism, UMC-University Childrenʼs Hospital, Ljubljana, Slovenia
| | - Primoz Kotnik
- Department of Endocrinology, Diabetes and Metabolism, University Childrenʼs Hospital Ljubljana, Ljubljana, Slovenia
- *Assist. Prof. Dr. Primoz Kotnik, Department of Endocrinology, Diabetes and Metabolism, University Children's Hospital Ljubljana, Bohoričeva 20, 1000 Ljubljana, Slovenia,
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Barriuso L, Miqueleiz E, Albaladejo R, Villanueva R, Santos JM, Regidor E. Socioeconomic position and childhood-adolescent weight status in rich countries: a systematic review, 1990-2013. BMC Pediatr 2015; 15:129. [PMID: 26391227 PMCID: PMC4578240 DOI: 10.1186/s12887-015-0443-3] [Citation(s) in RCA: 117] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Accepted: 09/04/2015] [Indexed: 01/09/2023] Open
Abstract
Background Childhood obesity is a major problem in rich countries due to its high prevalence and its harmful health consequences. An exploratory analysis conducted in the PubMed database highlighted that the number of papers published on the relationship between socioeconomic position (SEP) and childhood-adolescent weight status had risen substantially with respect to an earlier review which had covered the period 1990–2005. Methods To describe the findings on the relationship between SEP and childhood-adolescent weight status in papers published in rich countries from 1990 through 2013, studies were identified in the following databases: PubMed; Web of Knowledge (WOK); PsycINFO; Global Health; and Embase. We included observational studies from the 27 richest OECD countries, which covered study populations aged 0 to 21 years, and used parental education, income and/or occupation as family SEP indicators. A total of 158 papers met the inclusion criteria and reported 134 bivariable and 90 multivariable analyses. Results Examination of the results yielded by the bivariable analyses showed that 60.4 % of studies found an inverse relationship, 18.7 % of studies did not found relationship, and 20.9 % of studies found a relationship that varied depending on another variable, such as age, sex or ethnic group; the corresponding percentages in the multivariable analyses were 51.1, 20.0 and 27.8 %, respectively. Furthermore, 1.1 % found a positive relationship. Conclusion The relationship between SEP and childhood-adolescent weight status in rich countries is predominantly inverse and the positive relationship almost has disappeared. The SEP indicator that yields the highest proportion of inverse relationships is parents’ education. The proportion of inverse relationships is higher when the weight status is reported by parents instead using objective measurements. Electronic supplementary material The online version of this article (doi:10.1186/s12887-015-0443-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Laura Barriuso
- Instituto de Salud Pública y Laboral de Navarra, Pamplona, Spain.
| | - Estrella Miqueleiz
- Department of Sociology, Universidad Pública de Navarra, Campus de Arrosadía, s/n, 31006, Pamplona, Spain.
| | - Romana Albaladejo
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain.
| | - Rosa Villanueva
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain.
| | - Juana M Santos
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain. .,Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain.
| | - Enrique Regidor
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain. .,Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain. .,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
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20
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Gray HL, Burgermaster M, Tipton E, Contento IR, Koch PA, Di Noia J. Intraclass Correlation Coefficients for Obesity Indicators and Energy Balance-Related Behaviors Among New York City Public Elementary Schools. HEALTH EDUCATION & BEHAVIOR 2015; 43:172-81. [PMID: 26286297 DOI: 10.1177/1090198115598987] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Sample size and statistical power calculation should consider clustering effects when schools are the unit of randomization in intervention studies. The objective of the current study was to investigate how student outcomes are clustered within schools in an obesity prevention trial. METHOD Baseline data from the Food, Health & Choices project were used. Participants were 9- to 13-year-old students enrolled in 20 New York City public schools (n= 1,387). Body mass index (BMI) was calculated based on measures of height and weight, and body fat percentage was measured with a Tanita® body composition analyzer (Model SC-331s). Energy balance-related behaviors were self-reported with a frequency questionnaire. To examine the cluster effects, intraclass correlation coefficients (ICCs) were calculated as school variance over total variance for outcome variables. School-level covariates, percentage students eligible for free and reduced-price lunch, percentage Black or Hispanic, and English language learners were added in the model to examine ICC changes. RESULTS The ICCs for obesity indicators are: .026 for BMI-percentile, .031 for BMIz-score, .035 for percentage of overweight students, .037 for body fat percentage, and .041 for absolute BMI. The ICC range for the six energy balance-related behaviors are .008 to .044 for fruit and vegetables, .013 to .055 for physical activity, .031 to .052 for recreational screen time, .013 to .091 for sweetened beverages, .033 to .121 for processed packaged snacks, and .020 to .083 for fast food. When school-level covariates were included in the model, ICC changes varied from -95% to 85%. CONCLUSIONS This is the first study reporting ICCs for obesity-related anthropometric and behavioral outcomes among New York City public schools. The results of the study may aid sample size estimation for future school-based cluster randomized controlled trials in similar urban setting and population. Additionally, identifying school-level covariates that can reduce cluster effects is important when analyzing data.
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Affiliation(s)
| | | | | | | | - Pamela A Koch
- Teachers College Columbia University, New York, NY, USA
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21
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Evans CR, Lippert AM, Subramanian SV. The persistent clustering of adult body mass index by school attended in adolescence. J Epidemiol Community Health 2015. [DOI: 10.1136/jech-2015-205833] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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22
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Sanchez-Vaznaugh EV, Sánchez BN, Crawford PB, Egerter S. Association between competitive food and beverage policies in elementary schools and childhood overweight/obesity trends: differences by neighborhood socioeconomic resources. JAMA Pediatr 2015; 169:e150781. [PMID: 25938657 PMCID: PMC4449257 DOI: 10.1001/jamapediatrics.2015.0781] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
IMPORTANCE To our knowledge, few published studies have examined the influence of competitive food and beverage (CF&B) policies on student weight outcomes; none have investigated disparities in the influence of CF&B policies on children's body weight by school neighborhood socioeconomic resources. OBJECTIVE To investigate whether the association between CF&B policies and population-level trends in childhood overweight/obesity differed by school neighborhood income and education levels. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study, from July 2013 to October 2014, compared overweight/obesity prevalence trends before (2001-2005) and after (2006-2010) implementation of CF&B policies in public elementary schools in California. The study included 2 700 880 fifth-grade students in 5362 public schools from 2001 to 2010. EXPOSURES California CF&B policies (effective July 1, 2004, and July 1, 2007) and school neighborhood income and education levels. MAIN OUTCOMES AND MEASURES Overweight/obesity defined as a body mass index at or greater than the 85th percentile for age and sex. RESULTS Overall rates of overweight/obesity ranged from 43.5% in 2001 to 45.8% in 2010. Compared with the period before the introduction of CF&B policies, overweight/obesity trends changed in a favorable direction after the policies took effect (2005-2010); these changes occurred for all children across all school neighborhood socioeconomic levels. In the postpolicy period, these trends differed by school neighborhood socioeconomic advantage. From 2005-2010, trends in overweight/obesity prevalence leveled off among students at schools in socioeconomically disadvantaged neighborhoods but declined in socioeconomically advantaged neighborhoods. Students in the lowest-income neighborhoods experienced zero or near zero change in the odds of overweight/obesity over time: the annual percentage change in overweight/obesity odds was 0.1% for females (95% CI, -0.7 to 0.9) and -0.3% for males (95% CI, -1.1 to 0.5). In contrast, in the highest-income neighborhoods, the annual percentage decline in the odds of overweight was 1.2% for females (95% CI, 0.4 to 1.9) and 1.0% for males (95% CI, 0.3 to 1.8). Findings were similar for school neighborhood education. CONCLUSIONS AND RELEVANCE Our study found population-level improvements in the prevalence of childhood overweight/obesity that coincided with the period following implementation of statewide CF&B policies (2005-2010). However, these improvements were greatest at schools in the most advantaged neighborhoods. This suggests that CF&B policies may help prevent child obesity; however, the degree of their effectiveness is likely to depend on socioeconomic and other contextual factors in school neighborhoods. To reduce disparities and prevent obesity, school policies and environmental interventions must address relevant contextual factors in school neighborhoods.
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Affiliation(s)
- Emma V Sanchez-Vaznaugh
- Department of Health Education, San Francisco State University, San Francisco, California4Center on Social Disparities in Health, University of California, San Francisco
| | - Brisa N Sánchez
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor
| | | | - Susan Egerter
- Center on Social Disparities in Health, University of California, San Francisco
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23
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Novak D, Kawachi I. Influence of different domains of social capital on psychological distress among Croatian high school students. Int J Ment Health Syst 2015; 9:18. [PMID: 25901179 PMCID: PMC4404674 DOI: 10.1186/s13033-015-0010-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Accepted: 03/19/2015] [Indexed: 11/10/2022] Open
Abstract
Background Social capital has been shown to have positive effects on multiple health outcomes among young people (i.e., obesity, diabetes, cardiovascular disease and infectious diseases). Studies are suggesting that social capital is an important asset for the health and wellbeing of children and adolescents, including for their mental health. We sought to examine the influences of different domains of social capital – in the family, in the neighbourhood, and at school – on levels of psychological distress among high school students in Croatia. Methods Cross-sectional survey of 3427 high school students (1688 males and 1739 females), aged 17–18 years, was carried out in the 2013/14 school year (response rate: 93.8%). Logistic regression was used to examine the influence of family, neighbourhood and school social capital on the risk of high psychological distress, measured by the Kessler-6 scale. Results Adjusting for age, school, gender, body mass index, self-perceived socioeconomic status, self-rated health and physical activity, high family support in school (OR 0.37; 95% CI: 0.27-0.51), high neighbourhood trust (OR 0.62; 95% CI: 0.53-0.73), high teacher-student interpersonal trust (OR 0.74; 95% CI: 0.62-0.89) and high student interpersonal trust (OR 0.79; 95% CI: 0.65-0.97) was each associated with lower odds of psychological distress. When all of the social capital variables were entered simultaneously, higher social capital in each domain was inversely associated with psychological distress. Conclusions Family support in school, neighbourhood trust, teacher-student interpersonal trust and student interpersonal trust were significantly inversely associated with psychological distress among adolescents. Intervention and policies that leverage community social capital might serve as means of mental health promotion among youth.
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Affiliation(s)
- Dario Novak
- Department of General and Applied Kinesiology, University of Zagreb Faculty of Kinesiology, Zagreb, Croatia ; Postdoctoral Fellow at Harvard University, Harvard T.H.Chan School of Public Health, Takemi Program in International Health, Boston, USA
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard T.H.Chan School of Public Health, Boston, Massachusetts USA
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24
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Hale DR, Patalay P, Fitzgerald-Yau N, Hargreaves DS, Bond L, Görzig A, Wolpert M, Stansfeld SA, Viner RM. School-level variation in health outcomes in adolescence: analysis of three longitudinal studies in England. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2015; 15:600-10. [PMID: 23793374 DOI: 10.1007/s11121-013-0414-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
School factors are associated with many health outcomes in adolescence. However, previous studies report inconsistent findings regarding the degree of school-level variation for health outcomes, particularly for risk behaviours. This study uses data from three large longitudinal studies in England to investigate school-level variation in a range of health indicators. Participants were drawn from the Longitudinal Study of Young People in England, the Me and My School Study and the Research with East London Adolescent Community Health Survey. Outcome variables included risk behaviours (smoking, alcohol/cannabis use, sexual behaviour), behavioural difficulties and victimisation, obesity and physical activity, mental and emotional health, and educational attainment. Multi-level models were used to calculate the proportion of variance in outcomes explained at school level, expressed as intraclass correlations (ICCs) adjusted for gender, ethnicity and socio-economic status of the participants. ICCs for health outcomes ranged from nearly nil to .28 and were almost uniformly lower than for attainment (.17-.23). Most adjusted ICCs were smaller than unadjusted values, suggesting that school-level variation partly reflects differences in pupil demographics. School-level variation was highest for risk behaviours. ICCs were largely comparable across datasets, as well as across years within datasets, suggesting that school-level variation in health remains fairly constant across adolescence. School-level variation in health outcomes remains significant after adjustment for individual demographic differences between schools, confirming likely effects for school environment. Variance is highest for risk behaviours, supporting the utility of school environment interventions for these outcomes.
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Affiliation(s)
- Daniel R Hale
- General and Adolescent Pediatrics, Institute of Child Health, UCL, 30 Guilford St, London, WC1N 1EH, UK,
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25
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Miyazaki Y, Stack M. Examining individual and school characteristics associated with child obesity using a multilevel growth model. Soc Sci Med 2015; 128:57-66. [DOI: 10.1016/j.socscimed.2014.12.032] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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26
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Richmond TK, Milliren C, Walls CE, Kawachi I. School social capital and body mass index in the National Longitudinal Study of Adolescent Health. THE JOURNAL OF SCHOOL HEALTH 2014; 84:759-68. [PMID: 25388592 PMCID: PMC4248560 DOI: 10.1111/josh.12213] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Revised: 03/17/2014] [Accepted: 05/12/2014] [Indexed: 06/04/2023]
Abstract
BACKGROUND Social capital in neighborhoods and workplaces positively affects health. Less is known about the influence of school social capital on student health outcomes, in particular weight status. We sought to examine the association between individual- and school-level social capital and student body mass index (BMI). METHODS Analyzing data from the National Longitudinal Study of Adolescent Health, a nationally representative sample of adolescents in grades 7-12 (N = 13,428), we used principal components analysis to define 3 school social capital factors: "connectedness" (feel part of/close to people/safe in school), "treatment" (get along with teachers/students, teachers treat students fairly), and "parental involvement" (school administrator reported percent family/parent self-reported participation in Parent Teacher Organization, average daily school attendance). We examined the associations between individual- and school-level social capital and individual BMI using multilevel modeling techniques. RESULTS In girls, both feeling connected to one's school (β = -0.06, p < .05) and attending schools with overall high connectedness (b = -0.43, p < .01) were associated with lower BMIs. In boys only attending a school with high "treatment" was inversely associated with BMI (b = -0.61, p < .01), adjusting for individual and school demographics. CONCLUSIONS Although further studies are needed, our findings suggest enhancing school social capital as a novel approach to addressing student obesity.
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Affiliation(s)
- Tracy K Richmond
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, 333 Longwood Ave., 6th Floor, Boston, MA 02115.
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27
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Caspi CE, Davey C, Nelson TF, Larson N, Kubik MY, Coombes B, Nanney MS. Disparities persist in nutrition policies and practices in Minnesota secondary schools. J Acad Nutr Diet 2014; 115:419-425.e3. [PMID: 25441964 DOI: 10.1016/j.jand.2014.08.029] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Accepted: 07/29/2014] [Indexed: 01/25/2023]
Abstract
Access to healthy foods among secondary school students is patterned by individual-level socioeconomic status, but few studies have examined how school nutrition policies and practices are patterned by school-level characteristics. The objective of our study was to examine school nutrition policies and practices by school characteristics (eg, location, racial/ethnic composition, and free/reduced priced lunch eligibility) in Minnesota secondary schools between 2008 and 2012. Data from the 2008 to 2012 Minnesota School Health Profiles survey were used to assess school nutrition policies and practices, and National Center for Educational Statistics data were used for school characteristics (n=505 secondary schools). Nutrition policies and practices included the availability of low-nutrient, energy dense (LNED) items, strategies to engage students in healthy eating, and restrictions on advertisements of LNED products in areas around the school. Among school-level characteristics, school location was most strongly related to school nutrition policies. Across all years, city schools were less likely than town/rural schools to have vending machines/school stores (prevalence difference [PD] -13.7, 95% CI -25.0 to -2.3), and less likely to sell sport drinks (PD -36.3, 95% CI -51.8 to -20.7). City schools were also more likely to prohibit advertisements for LNED products in school buildings (PD 17.7, 95% CI 5.5 to 29.9) and on school grounds (PD 15.6, 95% CI 1.7 to 29.5). Between 2008 and 2012, the prevalence of some healthy eating policies/practices (eg, limiting salty snacks, offering taste testing, and banning unhealthy food advertisements in school publications) declined in city schools only, where these policies/practices had previously been more common. Monitoring of these trends is needed to understand the influence of these policies on student outcomes across school settings.
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28
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Richmond TK, Elliott MN, Franzini L, Kawachi I, Caughy MO, Gilliland MJ, Walls CE, Franklin FA, Lowry R, Banspach SW, Schuster MA. School programs and characteristics and their influence on student BMI: findings from healthy passages. PLoS One 2014; 9:e83254. [PMID: 24454697 PMCID: PMC3890265 DOI: 10.1371/journal.pone.0083254] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2013] [Accepted: 10/30/2013] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Little is known about the contribution of school contextual factors to individual student body mass index (BMI). We set out to determine if school characteristics/resources: (1) are associated with student BMI; (2) explain racial/ethnic disparities in student BMI; and (3) explain school-level differences in student BMI. METHODS Using gender-stratified multi-level modeling strategies we examined the association of school characteristics/resources and individual BMI in 4,387 5(th) graders in the Healthy Passages Longitudinal Study of Adolescent Health. Additionally, we examined the association of race/ethnicity and individual BMI as well as the between-school variance in BMI before and after adding individual and school characteristics to test for attenuation. RESULTS The school-level median household income, but not physical activity or nutrition resources, was inversely associated with female BMI (β = -0.12, CI: -0.21,-0.02). Neither school demographics nor physical activity/nutrition resources were predictive of individual BMI in males. In Black females, school characteristics attenuated the association of race/ethnicity and BMI. Individual student characteristics-not school characteristics/resources-reduced the between-school variation in BMI in males by nearly one-third and eliminated it in females. CONCLUSIONS In this cohort of 5(th) graders, school SES was inversely associated with female BMI while school characteristics and resources largely explained Black/White disparities in female weight status. Between-school differences in average student weight status were largely explained by the composition of the student body not by school characteristics or programming.
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Affiliation(s)
- Tracy K. Richmond
- Division of Adolescent Medicine, Boston Children's Hospital, Boston, Massachusetts, United States of America
- * E-mail:
| | - Marc N. Elliott
- Statistics, RAND Corporation, Santa Monica, California, United States of America
| | - Luisa Franzini
- Division of Management, Policy, and Community Health, The University of Texas School of Public Health/Blue Cross and Blue Shield of Texas Research Program in Payment Systems and Policies, Houston, Texas, United States of America
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, Massachusetts, United States of America
| | - Margaret O. Caughy
- University of Texas School of Public Health, Dallas, Texas, United States of America
| | | | - Courtney E. Walls
- Epidemiology, Decision Resources, Burlington, Massachusetts, United States of America
| | - Frank A. Franklin
- Department of Maternal and Child Health, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
| | - Richard Lowry
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Stephen W. Banspach
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Mark A. Schuster
- Department of Medicine, Boston Children's Hospital, Boston, Massachusetts, United States of America
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Shih M, Dumke KA, Goran MI, Simon PA. The association between community-level economic hardship and childhood obesity prevalence in Los Angeles. Pediatr Obes 2013; 8:411-7. [PMID: 23239616 DOI: 10.1111/j.2047-6310.2012.00123.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2012] [Revised: 08/31/2012] [Accepted: 10/24/2012] [Indexed: 01/09/2023]
Abstract
WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT Neighbourhood social, economic and environmental factors are associated with childhood obesity. Childhood obesity disproportionately impacts those living in low-income neighbourhoods. WHAT THIS STUDY ADDS Childhood obesity prevalence is strongly associated with community-level social and economic conditions as measured using a composite Economic Hardship Index. Childhood obesity prevalence among communities in the highest hardship quartile was more than double the prevalence among communities in the lowest hardship quartile (26.9 vs. 12.5%). The relationship between economic hardship and obesity differs by race/ethnicity. OBJECTIVE The association between community-level economic hardship and childhood obesity prevalence was examined in Los Angeles County, one of the largest and most racially and ethnically diverse regions in the United States. METHODS Data from the 2008-2009 California Department of Education's Physical Fitness Testing Program were analyzed to assess obesity prevalence among 5th, 7th and 9th grade students attending public schools (n = 298,485). Community-level socioeconomic conditions were compared using a census-tract-based Economic Hardship (EH) index. Mixed-effects modelling was used to examine the association between obesity prevalence and gender, grade, race/ethnicity and EH. RESULTS Higher community-level EH was associated with higher childhood obesity prevalence (P < 0.001). The obesity prevalence among communities in the highest EH quartile (26.9%) was more than double the obesity prevalence among communities in the lowest EH quartile (12.5%). The slope of the association between EH and childhood obesity differed by racial/ethnic group. The slope was higher for non-Hispanic White students, Hispanics, and non-Hispanic Asians, and lower for non-Hispanic Black students. Racial/ethnic disparities were observed across the socioeconomic spectrum. CONCLUSIONS Findings suggest that efforts to improve community socioeconomic conditions could reduce childhood obesity prevalence. Prevention efforts should target communities with high economic hardship and also focus on providing culturally relevant interventions that address disparities in obesity prevalence across communities.
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Affiliation(s)
- M Shih
- Office of Health Assessment and Epidemiology, Los Angeles County Department of Public Health, Los Angeles, CA, USA
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Lee H, Harris KM, Lee J. Multiple levels of social disadvantage and links to obesity in adolescence and young adulthood. THE JOURNAL OF SCHOOL HEALTH 2013; 83:139-49. [PMID: 23343314 PMCID: PMC3731140 DOI: 10.1111/josh.12009] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2012] [Revised: 08/07/2012] [Accepted: 08/09/2012] [Indexed: 06/01/2023]
Abstract
BACKGROUND The rise in adolescent obesity has become a public health concern, especially because of its impact on disadvantaged youth. This article examines the role of disadvantage at the family-, peer-, school-, and neighborhood-level, to determine which contexts are related to obesity in adolescence and young adulthood. METHODS We analyzed longitudinal data from Waves I (1994-1995), II (1996), and III (2001-2002) of the National Longitudinal Study of Adolescent Health, a nationally representative population-based sample of adolescents in grades 7-12 in 1995 who were followed into young adulthood. We assessed the relationship between obesity in adolescence and young adulthood, and disadvantage (measured by low parent education in adolescence) at the family-, peer-, school-, and neighborhood-level using multilevel logistic regression. RESULTS When all levels of disadvantage were modeled simultaneously, school-level disadvantage was significantly associated with obesity in adolescence for males and females and family-level disadvantage was significantly associated with obesity in young adulthood for females. CONCLUSIONS Schools may serve as a primary setting for obesity prevention efforts. Because obesity in adolescence tracks into adulthood, it is important to consider prevention efforts at this stage in the life course, in addition to early childhood, particularly among disadvantaged populations.
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Affiliation(s)
- Hedwig Lee
- Department of Sociology, University of Washington211 Savery Hall, Box 353340, Seattle, WA 98195-3340, USA, Phone: (206) 543-4572 Fax: (206) 543-2516
| | - Kathleen Mullan Harris
- Department of Sociology and the Carolina Population Center, University of North Carolina at Chapel Hill, 403 University Square East, 123 W. Franklin Street, Chapel Hill, North Carolina 27516, Phone: (919) 966-5560 Fax: (919) 962-1007
| | - Joyce Lee
- Pediatric Endocrinology and Health Services Research, Child Health Evaluation and Research Unit, University of Michigan, 300 NIB, Room 6E18, Campus Box 5456 Ann Arbor, MI 48109-5456, Phone: (734) 936-8834 Fax: (734) 615-5153
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Austin SB, Richmond TK, Spadano-Gasbarro J, Greaney ML, Blood EA, Walls C, Wang ML, Mezgebu S, Osganian SK, Peterson KE. The contribution of school environmental factors to individual and school variation in disordered weight control behaviors in a statewide sample of middle schools. Eat Disord 2013; 21:91-108. [PMID: 23421693 DOI: 10.1080/10640266.2013.761080] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
We investigated the contribution of school environmental factors to individual and school variation in disordered weight control behaviors (DWCB). Analyses were based on self-report data gathered from 18,567 middle-school students in 2005 and publicly available data on school characteristics. We observed large differences across schools in percent of students engaging in DWCB in the past month, ranging from less than 1% of the student body to 12%. School-neighborhood poverty was associated with higher odds of DWCB in boys. Preventive strategies need to account for wide variability across schools and environmental factors that may contribute to DWCB in early adolescence.
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Affiliation(s)
- S Bryn Austin
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Massachusetts 02115, USA.
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Martin MA, Frisco ML, Nau C, Burnett K. Social stratification and adolescent overweight in the United States: how income and educational resources matter across families and schools. Soc Sci Med 2011; 74:597-606. [PMID: 22240451 DOI: 10.1016/j.socscimed.2011.11.006] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2010] [Revised: 10/13/2011] [Accepted: 11/09/2011] [Indexed: 10/14/2022]
Abstract
The current study examines how poverty and education in both the family and school contexts influence adolescent weight. Prior research has produced an incomplete and often counterintuitive picture. We develop a framework to better understand how income and education operate alone and in conjunction with each other across families and schools. We test it by analyzing data from Wave 1 of the U.S.-based National Longitudinal Study of Adolescent Health (N = 16,133 in 132 schools) collected in 1994-1995. Using hierarchical logistic regression models and parallel indicators of family- and school-level poverty and educational resources, we find that at the family-level, parent's education, but not poverty status, is associated with adolescent overweight. At the school-level, the concentration of poverty within a school, but not the average level of parent's education, is associated with adolescent overweight. Further, increases in school poverty diminish the effectiveness of adolescents' own parents' education for protecting against the risks of overweight. The findings make a significant contribution by moving beyond the investigation of a single socioeconomic resource or social context. The findings push us to more fully consider when, where, and why money and education matter independently and jointly across health-related contexts.
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Affiliation(s)
- Molly A Martin
- Department of Sociology and the Population Research Institute, Pennsylvania State University, 211 Oswald Tower, University Park, PA 16802, United States.
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Basch CE. Physical activity and the achievement gap among urban minority youth. THE JOURNAL OF SCHOOL HEALTH 2011; 81:626-634. [PMID: 21923875 DOI: 10.1111/j.1746-1561.2011.00637.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
OBJECTIVES To outline the prevalence and disparities of physical activity among school-aged urban minority youth, causal pathways through which low levels of physical activity and fitness adversely affects academic achievement, and proven or promising approaches for schools to increase physical activity and physical fitness among youth. METHODS Literature review. RESULTS A large proportion of youth is insufficiently physically active. Estimates of population-wide levels of physical activity indicate that Black and Hispanic youth are less physically active than White youth, with disparities particularly evident for females. The population segments of youth with lowest levels of physical activity and fitness also have least access to school-based physical activity opportunities and resources. Physical activity affects metabolism and all major body systems, exerting powerful positive influences on the brain and spinal cord and, consequently, on emotional stability, physical health, and motivation and ability to learn. The cornerstone of school-based physical activity programs should be a high-quality physical education program based on national standards. Such programs are strongly recommended by the Task Force on Community Preventive Services as a way to increase physical activity and physical fitness among youth. CONCLUSIONS Physical inactivity is highly and disproportionately prevalent among school-aged urban minority youth, has a negative impact on academic achievement through its effects on cognition, and effective practices are available for schools to address this problem. Increasing students' physical activity and physical fitness can best be achieved through a comprehensive approach that includes physical education, wise use of recess and after-school times, co-curricular physical activity opportunities, and bicycling or walking to and from school.
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Affiliation(s)
- Charles E Basch
- Department of Health and Behavior Studies, Teachers College, Columbia University, 525 West 120th Street, New York, NY 10027, USA.
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Harrison F, Bentham G, Jones AP, Cassidy A, van Sluijs EMF, Griffin SJ. School level correlates with adiposity in 9-10 year old children. Health Place 2011; 17:710-6. [PMID: 21474361 PMCID: PMC3831574 DOI: 10.1016/j.healthplace.2011.01.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2010] [Revised: 12/06/2010] [Accepted: 01/20/2011] [Indexed: 11/23/2022]
Abstract
We examined the associations between the physical, social, and policy environments of schools and adiposity in 9-10 year old children in Norfolk, UK. The relationships between 56 school-level variables and Fat Mass Index (FMI; fat mass (kg)/height (m(2))) were investigated among 1724 well characterised children from 92 schools in this cross-sectional study. After stepwise removal of variables from multilevel linear regression models stratified by gender, only three variables were significantly associated with FMI. Among girls, attending a school with more pupils in the year group was associated with lower FMI, and attending a school with better cycle provision was associated with higher FMI. In boys being allowed to eat any food at break-time was associated with higher FMI. There was some evidence of moderation of the relationship between cycle provision and FMI by urban-rural location. These data suggest that few school factors are associated with FMI, and provide limited pointers to inform potential future school-based interventions to reduce obesity.
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Affiliation(s)
- Flo Harrison
- School of Environmental Sciences, University of East Anglia, Norwich, UK.
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Individual and school environment factors associated with overweight in adolescents of the municipality of Rio de Janeiro, Brazil. Public Health Nutr 2011; 14:914-22. [DOI: 10.1017/s1368980010003162] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractObjectiveTo identify the association of individual and school environment factors with overweight among adolescents.DesignCross-sectional study. Sociodemographic and behavioural information was collected using an anonymous self-administered questionnaire. Indicators on human and physical resources of the schools were based on information collected in interviews with school principals. Overweight was defined based on the BMI Z-score for age and sex recommended by WHO. Logistic regression models were used for statistical analysis.SettingRio de Janeiro, Brazil.SubjectsBy means of a two-stage (classrooms and students) probabilistic sampling, subjects comprised 1632 students enrolled in the last year of primary education of the municipal public school network, stratified by city region.ResultsThe mean prevalence of overweight at schools was 17·2 %, ranging from 0 % to 50 %. Adolescents more likely to be overweight were those who attended schools without knives and forks or ceramic/glass plates for students in the school refectory (prevalence odds ratio (POR) = 1·40; P = 0·04), those whose head of household had completed between 8 and 10 years of schooling (POR = 1·46; P = 0·03), those who did not live with both parents (POR = 1·24; P = 0·06) and those who had not practised physical activity outside school on at least 1 d in the 7 d before the study (POR = 1·56; P = 0·04).ConclusionsSociodemographic and behavioural variables of adolescents and school characteristics were associated with overweight, confirming individual and context effects on this health disorder. Studies such as the present one, identifying variables in context, may support actions to prevent overweight among adolescents.
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Perkins JM, Perkins HW, Craig DW. Peer weight norm misperception as a risk factor for being over and underweight among UK secondary school students. Eur J Clin Nutr 2010; 64:965-71. [DOI: 10.1038/ejcn.2010.106] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Abstract
In this article, I make the case for using an integrative approach to health, broadly defined as social, emotional, mental, and physical well-being; for studying health among the young as an important marker for future health and well-being across the life course; and for understanding health disparities among the young as both causes and consequences of social stratification. An integrative approach bridges biomedical sciences with social and behavioral sciences by understanding the linkages between social, behavioral, psychological, and biological factors in health. It is furthermore vital that integration occur in all steps of the research process: in theory, design, data collection, and analysis. I use the National Longitudinal Study of Adolescent Health, or Add Health, as an example of an integrative approach to health and of the importance of adolescence and the transition to adulthood years for setting health trajectories into adulthood. Evidence is also presented on the linkages between health trajectories during adolescence and the transition to adulthood and social stratification in adulthood.
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Affiliation(s)
- Kathleen Mullan Harris
- Carolina Population Center, CB# 8120, University Square, 123 W. Franklin Street, Chapel Hill, NC 27516, USA.
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Boardman JD, Blalock CL, Corley RP, Stallings MC, Domingue BW, Mcqueen MB, Crowley TJ, Hewitt JK, Lu Y, Field SH. Ethnicity, body mass, and genome-wide data. BIODEMOGRAPHY AND SOCIAL BIOLOGY 2010; 56:123-136. [PMID: 21387985 PMCID: PMC3155265 DOI: 10.1080/19485565.2010.524589] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
This article combines social and genetic epidemiology to examine the influence of self-reported ethnicity on body mass index (BMI) among a sample of adolescents and young adults. We use genetic information from more than 5,000 single nucleotide polymorphisms in combination with principal components analysis to characterize population ancestry of individuals in this study. We show that non-Hispanic white and Mexican-American respondents differ significantly with respect to BMI and differ on the first principal component from the genetic data. This first component is positively associated with BMI and accounts for roughly 3% of the genetic variance in our sample. However, after controlling for this genetic measure, the observed ethnic differences in BMI remain large and statistically significant. This study demonstrates a parsimonious method to adjust for genetic differences among individual respondents that may contribute to observed differences in outcomes. In this case, adjusting for genetic background has no bearing on the influence of self-identified ethnicity.
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Affiliation(s)
- Jason D Boardman
- Institute of Behavioral Science and University of Colorado Population Center, University of Colorado, Boulder, Colorado 80309-0483, USA.
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Lebel A, Pampalon R, Hamel D, Thériault M. The geography of overweight in Quebec: a multilevel perspective. Canadian Journal of Public Health 2009. [PMID: 19263970 DOI: 10.1007/bf03405486] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Explore the contextual aspects of overweight in Quebec through multilevel modelling, using a purposely designed set of spatial units and a few area-based characteristics. METHODS Data came from the Canadian Community Health Survey (CCHS Cycle 2.1). Multilevel logistic regressions were performed to test for the presence of an independent contextual effect on overweight and obesity (BMI > or = 25 kg/m2), separately for men and women. Modelling considered individual attributes, including some lifestyle aspects, and contextual characteristics. A geographic grid integrating spatial elements related to overweight and obesity in the literature was developed. Also, an area-level residuals analysis was carried out to identify spatial units presenting higher or lower odds of being overweight. RESULTS After accounting for individual and area-level characteristics, there remain significant geographic variations in overweight in Quebec. Although this contextual effect is small for men and women, many spatial units differ significantly from the provincial average. There are differences between the geography of overweight in men and women which suggest that socio-economic mechanisms and land use patterns underlying overweight might be different between genders. Also, there is considerable variability within rural and urban areas. CONCLUSION A complex geography of overweight is revealed. Small-scale studies, as well as methodological and data developments, are needed to deepen our understanding of this geography.
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Affiliation(s)
- Alexandre Lebel
- Centre de recherche en aménagement et développement, Université Laval, Québec, QC.
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