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Blaine RE, Franckle RL, Ganter C, Falbe J, Giles C, Criss S, Kwass JA, Land T, Gortmaker SL, Chuang E, Davison KK. Using School Staff Members to Implement a Childhood Obesity Prevention Intervention in Low-Income School Districts: the Massachusetts Childhood Obesity Research Demonstration (MA-CORD Project), 2012-2014. Prev Chronic Dis 2017; 14:E03. [PMID: 28084989 PMCID: PMC5234440 DOI: 10.5888/pcd14.160381] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Introduction Although evidence-based interventions to prevent childhood obesity in school settings exist, few studies have identified factors that enhance school districts’ capacity to undertake such efforts. We describe the implementation of a school-based intervention using classroom lessons based on existing “Eat Well and Keep Moving” and “Planet Health” behavior change interventions and schoolwide activities to target 5,144 children in 4th through 7th grade in 2 low-income school districts. Methods The intervention was part of the Massachusetts Childhood Obesity Research Demonstration (MA-CORD) project, a multisector community-based intervention implemented from 2012 through 2014. Using mixed methods, we operationalized key implementation outcomes, including acceptability, adoption, appropriateness, feasibility, implementation fidelity, perceived implementation cost, reach, and sustainability. Results MA-CORD was adopted in 2 school districts that were facing resource limitations and competing priorities. Although strong leadership support existed in both communities at baseline, one district’s staff reported less schoolwide readiness and commitment. Consequently, fewer teachers reported engaging in training, teaching lessons, or planning to sustain the lessons after MA-CORD. Interviews showed that principal and superintendent turnover, statewide testing, and teacher burnout limited implementation; passionate wellness champions in schools appeared to offset implementation barriers. Conclusion Future interventions should assess adoption readiness at both leadership and staff levels, offer curriculum training sessions during school hours, use school nurses or health teachers as wellness champions to support teachers, and offer incentives such as staff stipends or play equipment to encourage school participation and sustained intervention activities.
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Affiliation(s)
- Rachel E Blaine
- Department of Family and Consumer Sciences, California State University, Long Beach, 1250 Bellflower Blvd. FCS FA-15, Long Beach, California 90840.
| | - Rebecca L Franckle
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Claudia Ganter
- Medical Faculty Mannheim, Heidelberg University, Mannheim Institute of Public Health, Social and Preventive Medicine, Mannheim, Germany
| | - Jennifer Falbe
- University of California, Berkeley, Berkeley, California
| | - Catherine Giles
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Shaniece Criss
- Health Sciences Department, Furman University, Greenville, South Carolina
| | - Jo-Ann Kwass
- Bureau of Community Health and Prevention, Massachusetts Department of Public Health, Boston, Massachusetts
| | - Thomas Land
- Office of Data Management and Outcomes Assessment, Massachusetts Department of Public Health, Boston, Massachusetts
| | - Steven L Gortmaker
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Emmeline Chuang
- University of California, Los Angeles, Fielding School of Public Health, Los Angeles, California
| | - Kirsten K Davison
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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Lyles AA, Loomis C, Mama SK, Siddiqi S, Lee RE. Longitudinal analysis of virtual community perceptions of cohesion: The role of cooperation, communication, and competition. J Health Psychol 2016; 23:1677-1688. [PMID: 27630255 DOI: 10.1177/1359105316667794] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Online, virtual group interactions may help adherence to health promotion programs. The purpose of this study was to explore longitudinal relationships among dimensions of group cohesion and group-interaction variables to inform and improve group-based strategies within programs aimed at promoting physical activity in virtual communities. In all, 56 online virtual users completed a group dynamics-based physical activity promotion intervention and assessments of group cohesion and group interaction at baseline and 4 weeks. Friendly competition and cooperation were consistently strong predictors of cohesion. Facilitating a sense of friendly competition and cooperation may increase engagement in physical activity programs by bolstering group cohesion.
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Dinkel DM, Huberty J, Beets MW. Qualitative evaluation of GoGirlGo! Insights from staff on using a curriculum within after-school programs to improve physical activity. Health Promot Pract 2014; 16:184-92. [PMID: 25326435 DOI: 10.1177/1524839914555571] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND After-school programs (ASPs) are a promising opportunity for increasing girls' physical activity (PA). Few curricula are targeted specifically for the needs of girls, and the effectiveness of most of these curricula is unknown. One curriculum that is specifically designed to facilitate PA in girls in the ASP setting but has not been formally evaluated is GoGirlGo! (GGG). The purpose of the qualitative assessment was to explore staff's overall satisfaction with GGG and to identify best practices for implementation. METHOD A qualitative case study consisting of semistructured interviews with staff (n = 21) was conducted. Data were analyzed using the process of immersion/crystallization. RESULTS A majority of participants reported being satisfied with GGG. Best practices for implementation included having site directors schedule time and space for GGG and adapting GGG to fit the needs of the girls. Suggested improvements included increasing the intensity of the PA offered, adding visuals (e.g., videos), and providing interactive staff training. DISCUSSION This qualitative exploration of GGG provided several suggested modifications for GGG. These modifications may strengthen GGG and other girl-focused ASP programs to improve girls' ability to obtain recommended levels of PA in ASPs.
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Harden SM, Estabrooks PA, Mama SK, Lee RE. Longitudinal analysis of minority women's perceptions of cohesion: the role of cooperation, communication, and competition. Int J Behav Nutr Phys Act 2014; 11:57. [PMID: 24779959 PMCID: PMC4108125 DOI: 10.1186/1479-5868-11-57] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2013] [Accepted: 04/09/2014] [Indexed: 11/25/2022] Open
Abstract
Background Interaction in the form of cooperation, communication, and friendly competition theoretically precede the development of group cohesion, which often precedes adherence to health promotion programs. The purpose of this manuscript was to explore longitudinal relationships among dimensions of group cohesion and group-interaction variables to inform and improve group-based strategies within programs aimed at promoting physical activity. Methods Ethnic minority women completed a group dynamics-based physical activity promotion intervention (N = 103; 73% African American; 27% Hispanic/Latina; mage = 47.89 + 8.17 years; mBMI = 34.43+ 8.07 kg/m2) and assessments of group cohesion and group-interaction variables at baseline, 6 months (post-program), and 12 months (follow-up). Results All four dimensions of group cohesion had significant (ps < 0.01) relationships with the group-interaction variables. Competition was a consistently strong predictor of cohesion, while cooperation did not demonstrate consistent patterns of prediction. Conclusions Facilitating a sense of friendly competition may increase engagement in physical activity programs by bolstering group cohesion.
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Affiliation(s)
| | - Paul A Estabrooks
- Virginia Tech, Department of Human Nutrition, Foods and Exercise, Virginia Tech, Blacksburg, VA, USA.
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Shepherd J, Dewhirst S, Pickett K, Byrne J, Speller V, Grace M, Almond P, Hartwell D, Roderick P. Factors facilitating and constraining the delivery of effective teacher training to promote health and well-being in schools: a survey of current practice and systematic review. PUBLIC HEALTH RESEARCH 2013. [DOI: 10.3310/phr01020] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BackgroundSchools are an important setting for health promotion and teachers have an integral role to play in promoting children and young people’s health and well-being. Adequate initial teacher training (ITT) and continuing professional development in health is therefore important.ObjectivesTo conduct a survey of initial teacher training providers in England and a systematic review of effectiveness to assess how health and well-being is covered on courses, and to identify barriers and facilitators to effective training.MethodsMethods included an online questionnaire survey with a sample of 220 ITT course managers in England; interviews with a purposive sample of 19 of the course managers responding to the questionnaire; and a two-stage systematic review comprising a descriptive map of the characteristics of international research studies of health teacher training and a detailed synthesis of a subset of studies specifically on pre-service training. Databases (including MEDLINE, EMBASE, The Campbell Library and PsycINFO) were searched from the period of database inception up to May 2011.ResultsThe overall response rate for the survey was 34%. The majority (89%) of respondents agreed that it was either important or very important to cover health within the ITT curriculum. The most commonly covered topics on courses wereEvery Child Matters(100%), child protection (100%), emotional health (99%) and antibullying (97%). Fewer course managers reported covering healthy eating (63%), sex and relationships (62%), drugs (56%), alcohol (41%) and smoking (34%). Many interviewees expressed a holistic view of education and believed that health was important in the ITT curriculum. However, there was variability in how health was addressed across and within institutions. Trainee teachers' experience of addressing child health on school placement was also variable. Facilitators to covering health included interests and backgrounds of ITT staff; staff health-related professional experience; availability of health expertise from external agencies; supportive government policy frameworks; and interprofessional and interdepartmental working. The main barriers were limited curriculum time; health being perceived to be a lower priority than other aspects of training; health no longer a high government priority in education; and lack of funding. A total of 170 studies met the eligibility criteria for the descriptive map. The majority covered teacher training in relation to sexual and reproductive health, drugs and alcohol or mental and emotional health. A total of 21 publications (20 studies) were prioritised for the synthesis. All were evaluations of health training for pre-service teachers, and just under half were from the UK. Twelve studies reported outcomes (impact of training on teachers, but not pupils), many of which were single cohort before-and-after studies. Sixteen studies reported processes. Following training there were some increases in trainee teachers' factual knowledge of health and a general increase in their confidence to address health issues. In general, training was acceptable and well received by trainees. Evidence suggested that effective training should include practical experience and skills and be personally relevant and take into account individual needs. Barriers to health training identified from the studies included lack of time, balancing breadth and depth, and variation in training provision.ConclusionsAmong those surveyed there appears to be general support for health and well-being in ITT. However, further research on the longer-term impact of ITT around health and well-being is needed, particularly in the early career period. The main limitation of this research was the low response rate (34%) to the survey.Study registrationPROSPERO number CRD42012001977.FundingThe National Institute for Health Research Public Health Research programme.
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Affiliation(s)
- J Shepherd
- Southampton Health Technology Assessments Centre (SHTAC), Faculty of Medicine, University of Southampton, Southampton, UK
| | - S Dewhirst
- Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - K Pickett
- Southampton Health Technology Assessments Centre (SHTAC), Faculty of Medicine, University of Southampton, Southampton, UK
| | - J Byrne
- Southampton Education School, Faculty of Social and Human Sciences, University of Southampton, Southampton, UK
| | - V Speller
- Health Development Consulting Ltd, Waterlooville, UK
| | - M Grace
- Southampton Education School, Faculty of Social and Human Sciences, University of Southampton, Southampton, UK
| | - P Almond
- Faculty of Health and Social Care, Anglia Ruskin University, Cambridge, UK
| | - D Hartwell
- Southampton Health Technology Assessments Centre (SHTAC), Faculty of Medicine, University of Southampton, Southampton, UK
| | - P Roderick
- Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
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Lana A, del Valle MO, López S, Faya-Ornia G, López ML. Study protocol of a randomized controlled trial to improve cancer prevention behaviors in adolescents and adults using a web-based intervention supplemented with SMS. BMC Public Health 2013; 13:357. [PMID: 23594381 PMCID: PMC3637581 DOI: 10.1186/1471-2458-13-357] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2013] [Accepted: 04/10/2013] [Indexed: 11/24/2022] Open
Abstract
Background The overall number of cancer cases is increasing and, therefore, strengthening cancer prevention has become a priority. The institutions responsible for its control establish guidelines for primary prevention. These include recommendations, such as: not smoking, following a healthy diet, doing daily physical exercise or avoiding overweight. Adolescence is a period of adoption and/or consolidation of health behaviors, and both school- and family-based interventions have proven effective to improve them. Furthermore, online and mobile phone educational interventions are encouraging. Consequently, the main aim of this study is to assess the efficacy of an intervention in which these requirements (school, family, the Internet and SMS) are combined to prevent behavioral cancer risk. Methods This protocol describes the design and implementation of a complex online program that includes a randomized controlled trial put into practice in two countries: Spain and Mexico. Adolescents and adults of their environment (relatives and teachers) who voluntarily participate will be randomly assigned to the experimental group or to the control group once they have completed the online pre-test. The experimental group members will have free access to a tailor-made and interactive website (http://www.alertagrumete.com). During the academic year, this website will be periodically updated with different school and leisure activities related to the avoidance of risk behaviors. To encourage participation, the program includes a competition that gives rewards to the winners. SMS are also sent to students to stimulate the adoption of healthy behaviors and as a reminder of participation. Finished the intervention, an online post-test is performed in both groups and the impact on the risk behaviors is therefore assessed. Discussion The program is pioneer, since it combines many components which have already proven effective in previous researches. Moreover, it aims to compare efficacy in two countries with different socio-economic levels to find out if these approaches are equally effective in countries with a lower income level. However, the vertiginous evolution of the Internet and mobile phones may make this tool less attractive for adolescents, who may prefer social networks and other mobile phone applications which are nowadays massively used by their peers. Trial registration ISRCTN27988779
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Affiliation(s)
- Alberto Lana
- University Institute of Oncology of Asturias, Central University Hospital of Asturias, C/Emilio Rodríguez Vigil s/n, 33006 Oviedo, Spain.
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