Health by Design: Interweaving Health Promotion into Environments and Settings.

The important influence of the environmental context on health and health behavior-which includes place, settings, and the multiple environments within place and settings-has directed health promotion planners from a focus solely on changing individuals, toward a focus on harnessing and changing context for individual and community health promotion. Health promotion planning frameworks such as Intervention Mapping provide helpful guidance in addressing various facets of the environmental context in health intervention design, including the environmental factors that influence a given health condition or behavior, environmental agents that can influence a population's health, and environmental change methods. In further exploring how to harness the environmental context for health promotion, we examine in this paper the concept of , defined as weaving or blending together health promotion strategies, practices, programs, and policies to fit within, complement, and build from existing settings and environments.

Examining the Role of Income Inequality and Neighborhood Walkability on Obesity and Physical Activity among Low-Income Hispanic Adults.

Obesity is a major public health issue affecting rising medical costs and contributing to morbidity and premature mortality. We aimed to identify factors that may play a role in obesity and physical activity at the individual and environmental/neighborhood levels. We analyzed data from an adult sample who were parents of students enrolled in a school-based health and wellness program.

Association of parental social support with energy balance-related behaviors in low-income and ethnically diverse children: a cross-sectional study.

Background: Parents play an important role in providing their children with social support for healthy eating and physical activity. However, different types of social support (e.g.

Assessing environmental assets for health promotion program planning: a practical framework for health promotion practitioners.

Conducting a health needs assessment is an important if not essential first step for health promotion planning. This paper explores how health needs assessments may be further strengthened for health promotion planning via an assessment of environmental assets rooted in the multiple environments (policy, information, social and physical environments) that shape health and behavior. Guided by a behavioral-ecological perspective- one that seeks to identify environmental assets that can influence health behavior, and an implementation science perspective- one that seeks to interweave health promotion strategies into existing environmental assets, we present a basic framework for assessing environmental assets and review examples from the literature to illustrate the incorporation of environmental assets into health program design.

Socioeconomic inequalities in children's diet: the role of the home food environment.

Background: It is well documented in the literature that low socioeconomic status (SES) is associated with lower consumption of healthy foods and that these differences in consumption patterns are influenced by neighborhood food environments. Less understood is the role that SES differences in physical and social aspects of the home food environment play in consumption patterns.

Methods: Using data on 4th grade children from the 2009-2011 Texas School Physical Activity and Nutrition (SPAN) study, we used mixed-effects regression models to test the magnitude of differences in the SPAN Health Eating Index (SHEI) by parental education as an indicator of SES, and the extent to which adjusting for measures of the home food environment, and measures of the neighborhood environment accounted for these SES differences.

Adolescents' awareness and use of menu labels in eating establishments: results from a focus group study.

Objective: Menu labelling has been identified as a potential strategy to help individuals make healthier choices when eating out. Although adolescents eat out often, little research involving menu labelling has been conducted with this population. The objectives of the present study were to: (i) gather qualitative information from adolescents regarding use of menu labels when eating out; (ii) gather adolescents' suggestions for optimal ways to design menu labels; and (iii) examine differences between adolescents living in communities of different socio-economic status.

Individual, social and environmental correlates of physical activity in overweight and obese African American and Hispanic women: A structural equation model analysis.

Objective: Ecologic frameworks account for multilevel factors related to physical activity (PA) and may be used to develop effective interventions for women. The purpose of this study was to examine the influence of individual, social and environmental factors on PA among African American and Hispanic women using structural equation modeling.

Method: Overweight and obese women (=164, 65.

Using community insight to understand physical activity adoption in overweight and obese African American and Hispanic women: a qualitative study.

Ecologic models suggest that multiple levels of influencing factors are important for determining physical activity participation and include individual, social, and environmental factors. The purpose of this qualitative study was to use an ecologic framework to gain a deeper understanding of the underlying behavioral mechanisms that influence physical activity adoption among ethnic minority women. Eighteen African American and Hispanic women completed a 1-hour in-depth interview.

Racial and ethnic differences in the home food environment explain disparities in dietary practices of middle school children in Texas.

Objective: To examine racial and ethnic differences among middle school children in the home food environment (HFE) and the extent to which associations of healthy and unhealthy eating with the HFE differ by race and ethnicity.

Design: Cross-sectional secondary analyses of baseline data from Coordinated Approach to Child Health Middle School, a school-based intervention targeting obesity and obesogenic behaviors among middle school children in Austin, TX.

Participants: A total of 2,502 children (mean age, 13.

Psychosocial factors and theory in physical activity studies in minorities.

Objectives: To summarize the effectiveness of interventions targeting psychosocial factors to increase physical activity (PA) among ethnic minority adults and explore theory use in PA interventions.

Methods: Studies (N = 11) were identified through a systematic review and targeted African American/Hispanic adults, specific psychosocial factors, and PA. Data were extracted using a standard code sheet and the Theory Coding Scheme.

Effects of a structural intervention and implementation on physical activity among youth in residential children's homes.

This study reports the effects of a structural intervention, ENRICH (Environmental Interventions in Children's Homes) which targeted the physical and social environment within residential children's homes (RCHs) to increase physical activity (PA) among residents (n=799). Participating RCHs (n=29) were randomized to Early (n=17) or Delayed (n=12) groups from 2004 to 2006 and 2006 to 2008, respectively. Children's PA was measured at three time periods (2004, 2006, 2008).

Conceptualizing, implementing, and monitoring a structural health promotion intervention in an organizational setting.

This article presents a framework for developing and carrying out an implementation monitoring plan of a complex structural intervention in an organizational setting and describes seven steps for analyzing and reporting results for fidelity and completeness of implementation. This process is illustrated using the Environmental Interventions in Children's Homes (ENRICH) Wellness Project. ENRICH aimed to promote physical activity and healthful nutrition behaviors among children residing in children's group homes by working collaboratively with organizational staff.

Introduction of farm stands in low-income communities increases fruit and vegetable among community residents.

The purpose of this longitudinal pilot study was to measure the impact of introducing farm stands in low-income communities with limited access to fresh and quality fruits and vegetables (F&V) on residents' F&V consumption. Two farm stands were placed outside two local community sites one day a week for 12 weeks. A variety of locally grown, culturally appropriate produce was sold at the stands.

Parent-reported social support for child's fruit and vegetable intake: validity of measures.

Objective: To develop and validate measures of parental social support to increase their child's fruit and vegetable (FV) consumption.

Design: Cross-sectional study design.

Setting: School and home.

Variables associated with fruit and vegetable intake in adolescents.

Objectives: To assess individual, social, and family environmental factors related to fruit and vegetable intake among white and black adolescents aged 11-15 years (n=736).

Methods: Self-report questionnaire.

Results: Preferences, availability at home, family dinner frequency, snack choice, self-efficacy, modeling, normative beliefs, and social outcome expectations were significant associates of fruit and vegetable intake.

Measurement properties of psychosocial and environmental measures associated with fruit and vegetable intake among middle school adolescents.

Objective: To assess the measurement properties of several scales modified or created to assess factors related to fruit and vegetable intake within a young adolescent population.

Design: Cross-sectional with data collected via self-report.

Setting: Data were collected in regularly scheduled classes in the school setting.

A descriptive study of beverage consumption among an ethnically diverse sample of public school students in Texas.

Objective: The purpose of this study was to examine prevalence rates of 5 types of beverage consumption by sociodemographic factors among 4th-, 8th-, and 11th-grade public school students in Texas.

Methods: This study is based on secondary analyses of cross-sectional data from the 2004-2005 School Physical Activity and Nutrition study, a comprehensive surveillance study of energy balance-related behaviors and behavioral antecedents in a state-representative sample of 4th-, 8th-, and 11th-grade public school students in Texas (N = 23,190). Previous-day beverage consumption prevalence estimates were calculated for 5 types of beverages (i.

Dietary and activity correlates of sugar-sweetened beverage consumption among adolescents.

Objective: To examine the dietary and activity correlates of sugar-sweetened beverage consumption by children in middle and high school.

Methods: Data were obtained from a cross-sectional survey of 15,283 children in middle and high schools in Texas. Consumption of sodas and noncarbonated flavored and sports beverages (FSBs) were examined separately for their associations with the level of (1) unhealthy food (fried meats, French fries, desserts) consumption, (2) healthy food (vegetables, fruit, and milk) consumption, (3) physical activity including usual vigorous physical activity and participation in organized physical activity, and (4) sedentary activity, including hours spent watching television, using the computer, and playing video games.

Reductions in child obesity among disadvantaged school children with community involvement: the Travis County CATCH Trial.

The objective of this study was to compare the impact of two intervention approaches on the prevalence of child overweight and obesity: (i) Coordinated Approach To Child Health BasicPlus (CATCH BP), in which schools were provided evidence-based coordinated school health program training, materials, and facilitator support visits, and (ii) CATCH BP and Community (BPC), in which BP schools received additional promotion of community partnerships with the aim of integrating community members and organizations into schools, local decision making and action, and best practices workshops. Schools (n = 97) in four central Texas districts were recruited to participate in the 4-year project. Of the low-income schools (n = 58), 15 schools were selected to receive the BPC intervention and matched with 15 schools in the BP condition.

Cognitive and home environmental predictors of change in sugar-sweetened beverage consumption among adolescents.

Sugar-sweetened beverage (SSB) consumption may increase risk for unnecessary weight gain. To develop interventions discouraging consumption, more insight is needed about cognitive and environmental predictors related to the decrease in SSB consumption. The present paper aims (1) to describe the relationship between potential cognitive determinants of change (attitudes, subjective norms, perceived behavioural control and intentions) and perceived environmental factors (family food rule and home availability of SSB) with changes in SSB consumption between baseline and 4-month follow-up and (2) to study whether the relationships between the environmental factors and SSB consumption are mediated by the cognitive determinants.

Correlates of availability and accessibility of fruits and vegetables in homes of low-income Hispanic families.

Availability and accessibility (AA) has been consistently shown across studies as the most important correlate of fruits and vegetables (FV) intake. However, there is little data on factors that influence AA of FV, especially in Hispanic families. The objective of this cross-sectional study was to examine the association between parental factors, child's preferences for FV and AA of FV in homes of low-income Hispanic families with children 5-12 years old.

Observable weight distributions and children's individual weight assessment.

Social networks theory suggests obesity is "contagious" within peer groups in that known friends highly influence weight. On the other hand, an alternative model suggests that observable weight distributions affect perception of one's own obesity level. We examine whether the BMI levels of the most obese classmates in the individual student's grade by gender is positively associated with "under-assessment" of obesity and overweight (i.

Physical activity and sedentary pursuits of children living in residential children's homes.

Purpose: Our goal was to describe the types of physical activities and sedentary pursuits reported by children living in residential children's homes and make comparisons by age, gender, and race/ethnic groups.

Methods: Participants were 263 children (52% male, 40% 11 to 14 years old, 53% White, 23% African American, and 24% other race/ethnic groups) in 23 residential children's homes in North and South Carolina. The median length of stay in the homes was 6 months.

Associations among food insecurity, acculturation, demographic factors, and fruit and vegetable intake at home in Hispanic children.

The purpose of this cross-sectional pilot study was to examine associations between food insecurity, acculturation, demographic factors, and children's fruit and vegetable intake among a sample of Hispanic children ages 5 to 12 years. A convenience sample of 184 parents of low socioeconomic status completed one-time, self-administered questionnaires assessing demographic information, acculturation, and food insecurity in the spring of 2006. In addition, children's fruit and vegetable intake at home was measured using a validated seven-item index.

Factors associated with exercise participation in adults with arthritis.

Most people with arthritis are not regularly active. Understanding what factors influence exercise is essential for designing programs to increase participation. The objective of this study was to examine the correlates of exercise in people with arthritis.