To significantly improve the current state of affairs, substantial changes will be required on the part of researchers, funding agencies, and review and editorial boards. In conclusion, recommendations for each of these entities are provided.
Current public health and medical evidence rely heavily on efficacy information to make decisions regarding intervention impact. This evidence base could be enhanced by research studies that evaluate and report multiple indicators of internal and external validity such as Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) as well as their combined impact. However, indices that summarize the combined impact of, and complex interactions among, intervention outcome dimensions are not currently available. We propose and discuss a series of composite metrics that combine two or more RE-AIM dimensions, and can be used to estimate overall intervention impact. Although speculative and, at this point, there have been limited empirical data on these metrics, they extend current methods and are offered to yield more integrated composite outcomes relevant to public health. Such approaches offer potential to help identify interventions most likely to meaningfully impact population health.
After-school programs seem to be an important contributor to the PA of attending children. Nevertheless, ample room for improvement exists by making better use of existing time devoted to physical activity.
The home food environment can be conceptualized as overlapping interactive domains composed of built and natural, sociocultural, political and economic, micro‐level and macro‐level environments. Each type and level of environment uniquely contributes influence through a mosaic of determinants depicting the home food environment as a major setting for shaping child dietary behavior and the development of obesity. Obesity is a multifactorial problem, and the home food environmental aspects described here represent a substantial part of the full environmental context in which a child grows, develops, eats, and behaves. The present review includes selected literature relevant to the home food environment's influence on obesity with the aim of presenting an ecologically informed model for future research and intervention in the home food environment.
Failing to retain an adequate number of study participants in behavioral intervention trials poses a threat to interpretation of study results and its external validity. This qualitative investigation describes the retention strategies promoted by the recruitment and retention committee of the Behavior Change Consortium, a group of 15 university-based sites funded by the National Institutes of Health to implement studies targeted toward disease prevention through behavior change. During biannual meetings, focus groups were conducted with all sites to determine barriers encountered in retaining study participants and strategies employed to address these barriers. All of the retention strategies reported were combined into 8 thematic retention categories. Those categories perceived to be most effective for retaining study participants were summarized and consistencies noted among site populations across the life course (e.g., older adults, adults, children, and adolescents). Further, possible discrepancies between site populations of varying health statuses are discussed, and an ecological framework is proposed for use in future investigations on retention.
The translation of the national CATCH program to low-income schools with Hispanic students successfully slowed the epidemic increase in risk of overweight or overweight seen in control school children. An emphasis should be placed on community organizing and evaluation feedback when implementing evidence-based school health programs in low-income Hispanic communities.
Social cognitive theory and the theories of reasoned action and planned behavior were examined in the prediction of 4 weeks of physical activity participation. The theories of reasoned action and planned behavior were supported. Attitude and perceived control predicted intention, and intention predicted physical activity participation. The social cognitive theory variables significantly predicted physical activity participation, with self-efficacy and self-evaluation of the behavior significantly contributing to the prediction. The greater the confidence in participating in physical activity and the greater the satisfaction with present physical activity, the more physical activity performed. Hierarchical regression analyses indicated that perceived control and intentions did not account for any unique variation in physical activity participation over self-efficacy. Therefore the social cognitive theory constructs were better predictors of physical activity than those from the theories of reasoned action and planned behavior.
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