Using a customer discovery process to enhance the potential dissemination and scalability of a family healthy weight program for rural communities and small towns.

Aim: Customer discovery, an entrepreneurial and iterative process to understand the context and needs of potential adoption agencies, may be an innovative strategy to improve broader dissemination of evidence-based interventions. This paper describes the customer discovery process for the Building Healthy Families (BHF) Online Training Resources and Program Package (BHF Resource Package) to support rural community adoption of an evidence-based, family healthy weight program.

Methods: The customer discovery process was completed as part of a SPeeding Research-tested INTerventions (SPRINT) training supported by the U.

Building Healthy Families: Outcomes of an Adapted Family Healthy Weight Program Among Children in a Rural Mid-Western Community.

This study aimed to evaluate the effectiveness of implementing an adapted, evidence-based 12-week Family Healthy Weight Program (FHWP), Building Healthy Families, on reducing BMI metrics and clinical health indicators in a real-world community setting. Ninety child participants with a BMI percentile greater or equal to the 95th percentile for gender and age and their parents/guardians ( = 137) enrolled in the program. Families attended 12 weekly group-based sessions of nutrition education, family lifestyle physical activity, and behavior modification.

Adaptations of an Effective Evidence-Based Pediatric Weight Management Intervention.

Current childhood obesity treatment programs do not address medically underserved populations or settings where all members of an interdisciplinary team may not exist-either within one organization or within the community. In this paper, we describe the use of a community-academic partnership to iteratively adapt Epstein's Traffic Light Diet (TLD), into Building Healthy Families (BHF), a community-placed evidence-based pediatric weight management intervention (PWMI) and evaluate its effectiveness in reducing BMI z scores. Nine cohorts of families completed BHF.

Understanding implementation costs of a pediatric weight management intervention: an economic evaluation protocol.

Background: Understanding the cost and/or cost-effectiveness of implementation strategies is crucial for organizations to make informed decisions about the resources needed to implement and sustain evidence-based interventions (EBIs). This economic evaluation protocol describes the methods and processes that will be used to assess costs and cost-effectiveness across implementation strategies used to improve the reach, adoption, implementation, and organizational maintenance of an evidence-based pediatric weight management intervention- Building Health Families (BHF).

Methods: A within-trial cost and cost-effectiveness analysis (CEA) will be completed as part of a hybrid type III effectiveness-implementation trial (HEI) designed to examine the impact of an action Learning Collaborative (LC) strategy consisting of network weaving, consultee-centered training, goal-setting and feedback, and sustainability action planning to improve the adoption, implementation, organizational maintenance, and program reach of BHF in micropolitan and surrounding rural communities in the USA, over a 12-month period.

Qualitative Comparative Analysis of Program and Participant Factors That Explain Success in a Micropolitan Pediatric Weight Management Intervention.

Building Healthy Families (BHF) was developed through a community-academic partnership to provide a 12-week family-based obesity treatment program. Nine cohorts of BHF have been delivered in multiple micropolitan settings between 2009 and 2016, but participant outcomes have varied. This study sought to explore the variation in BHF outcomes to identify the necessary and sufficient conditions that are associated with larger 12-week reductions in BMI z-scores.

A Type III Hybrid Effectiveness-Implementation Pilot Trial Testing Dissemination and Implementation Strategies for a Pediatric Weight Management Intervention: The Nebraska Childhood Obesity Research Demonstration Project.

Several family-based efficacious pediatric weight management interventions (PWMIs) have been developed to reduce child weight status. These programs are typically based in larger cities delivered by an interdisciplinary team in a hospital or medical center. The degree to which these efficacious PWMIs have been translated to, and are feasible in, rural or micropolitan areas is unclear.

Packaging of a Pediatric Weight Management Intervention and Implementation Blueprint for Rural and Micropolitan Communities: The Nebraska CORD 3.0 Project.

Pediatric weight management interventions (PWMIs) have resulted in positive changes among family members and, if widely disseminated, could have an impact on pediatric weight management in rural communities. The purpose of this article is to describe a backward design approach taken to create an online packaged program and implementation blueprint for building healthy families (BHF), an effective PWMI for implementation in rural communities. The backward design process included the identification of end users: primary (facilitators to be trained through the packaged program and implementation blueprint), secondary (researchers and evaluators), terminal (caregivers and children impacted by PWMI participation), tertiary (community support organizations, funding agency promoting widespread PWMI, and payors), as well as, key outcomes for respective end user groups based on the reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) framework.

A Dissemination Strategy to Identify Communities Ready to Implement a Pediatric Weight Management Intervention in Medically Underserved Areas.

Purpose And Objectives: We developed a competitive application process to test the feasibility of a fund and contract dissemination strategy to identify and engage communities that demonstrated the necessary resources and motivation to adopt, implement, and sustain a pediatric weight management intervention, Building Healthy Families, in rural and micropolitan (<50,000 residents) communities in Nebraska.

Intervention Approach: From April through December 2019, a community advisory board with representation from rural and micropolitan clinical, public health, education, and recreational organizations collaboratively developed a request for applications, as a fund and contract dissemination strategy, to encourage community adoption of Building Healthy Families.

Evaluation Methods: Quantitative assessments included determining the distribution of requests for applications, evaluating organizational readiness to change assessment (ORCA) ratings (on a scale of 1 to 5, from strongly disagree to strongly agree that the organization is ready to change), and reviewing community advisory board member ratings of applications.

Longitudinal Evaluation of Aerobic Fitness and Academic Achievement Among Schoolchildren.

Background: Research is emerging suggesting that fitness not only improves health, but enhances academic achievement in children. Many studies have found the strongest correlation with academic achievement to be aerobic fitness. The purpose of this study is to examine the influence of aerobic fitness and academic ranking on the association between improvements in students' aerobic fitness and their academic achievement.

Calibration of context-specific survey items to assess youth physical activity behaviour.

This study tests calibration models to re-scale context-specific physical activity (PA) items to accelerometer-derived PA. A total of 195 4th-12th grades children wore an Actigraph monitor and completed the Physical Activity Questionnaire (PAQ) one week later. The relative time spent in moderate-to-vigorous PA (MVPA) obtained from the Actigraph at recess, PE, lunch, after-school, evening and weekend was matched with a respective item score obtained from the PAQ's.

Healthier School Environment Leads to Decreases in Childhood Obesity: The Kearney Nebraska Story.

Background: Schools play a role in addressing childhood obesity by implementing healthy eating and physical activity strategies. The primary aim of this case study was to describe prevalence of overweight and obesity among elementary school students in a rural Mid-western community between 2006 and 2012. The secondary aim was to use a novel approach called "population dose" to retrospectively evaluate the impact dose of each strategy implemented and its estimated potential population level impact on changes in overweight and obesity.

Calibration of self-report tools for physical activity research: the Physical Activity Questionnaire (PAQ).

Background: The utility of self-report measures of physical activity (PA) in youth can be greatly enhanced by calibrating self-report output against objectively measured PA data.This study demonstrates the potential of calibrating self-report output against objectively measured physical activity (PA) in youth by using a commonly used self-report tool called the Physical Activity Questionnaire (PAQ).

Methods: A total of 148 participants (grades 4 through 12) from 9 schools (during the 2009-2010 school year) wore an Actigraph accelerometer for 7 days and then completed the PAQ.

Validity of HydraTrend reagent strips for the assessment of hydration status.

Hydration is used by athletic governing organizations for weight class eligibility. The measurement of urine specific gravity (USG) as a measure of hydration by reagent strips is a controversial issue. The purpose of this study was to determine the validity of HydraTrend reagent strips that facilitate the correction of USG for alkaline urine samples against refractometry for the assessment of USG.

Expedited Synthesis of Benzofuran-2-Carboxylic Acids via Microwave-Assisted Perkin Rearrangement Reaction.

3-Halocoumarins are readily converted into benzofuran-2-carboxylic acids via a Perkin (coumarin-benzofuran ring contraction) rearrangement reaction. This rearrangement entails initial base catalyzed ring fission. The resulting phenoxide anion then attacks a vinyl halide to produce the final benzofuran moiety.

Eight-month follow-up of physical activity and central adiposity: results from an Internet-delivered randomized control trial intervention.

Background: Less than half of U.S. adults engage in the recommended amount of physical activity (PA).

Prevalence of overweight and influence of out-of-school seasonal periods on body mass index among American Indian schoolchildren.

Introduction: The prevalence of overweight and obesity among American Indian youth may be 2 to 3 times higher than the national average. Whether weight gain during discrete out-of-school periods is occurring and contributing to the prevalence of overweight and obesity in this population is unknown.

Methods: We obtained repeated cross-sectional body mass index (BMI) samples from third-, fourth-, fifth-, seventh-, and eighth-grade boys and girls who reside on the Wind River Indian Reservation in central Wyoming.

Body mass index in rural first grade schoolchildren: progressive increase in boys.

Context: Childhood overweight is a global health problem. Monitoring of childhood body mass index (BMI) may help identify critical time periods during which excess body weight is accumulated.

Purpose: To examine changes in mean BMI and the prevalence of at-risk-for overweight in repeated cross-sectional samples of rural first grade schoolchildren between 1999 and 2004.

Combined influence of physical activity and television viewing on the risk of overweight in US youth.

Objective: The purpose of this study was to examine the combined influence of physical activity (PA) and television viewing (TV) on the risk of overweight in US youth ages 14-18 years.

Research Design And Methods: Cross-sectional data from a nationally representative sample of approximately 13,600 US high school students participating in the 2001 Centers for Disease Control and Prevention Youth Risk Behavior Survey (YRBS) were examined. Participants were cross-tabulated into nine PA-TV groups according to the level of moderate (MPA) or vigorous PA (VPA) (low: < or = 2 days per week; moderate: 3-5 days per week; high: 6-7 days per week) and TV (low: < or = 1 h per day; moderate: 2-3 h per day; high: > or = 4 h per day).

Internet-delivered behavior change program increases physical activity and improves cardiometabolic disease risk factors in sedentary adults: results of a randomized controlled trial.

Objectives: To determine whether the Active Living Every Day (ALED-I) internet-delivered theory-based physical activity (PA) behavior change program increases PA and improves cardiometabolic disease risk factors (CDRF) in sedentary overweight adults.

Methods: The study was a randomized control trial that took place in southern Wyoming and northern Colorado from 2005-2007. Thirty-two men and women (21-65 years) were randomized to a 16-week ALED-I intervention (n=14; age=41.

Existence of the school health coordinator in a frontier state.

The purpose of this study was to determine whether school districts in a rural western state employed school health coordinators or at least employed individuals who possessed the skills suggested for school health coordinators. Baseline data were collected soliciting the involvement of all 48 state school districts and the state girl's school (N = 49). Thirty-seven districts responded (75.

Does a family history of coronary heart disease modify the relationship between physical activity and blood pressure in young adults?

Background: The purpose of this study was to examine the relationships between physical activity, a family history (FH) of coronary heart disease (CHD), and blood pressure (BP) in young adults. We were specifically interested in determining whether the relationship between moderate-to-vigorous physical activity and BP was modified by a FH of CHD.

Methods: Subjects were 230 (103 males, 127 females) university students.

Assessing competencies of the public health workforce in a frontier state.

The purpose of this study was to determine the level of perceived proficiency of a public health workforce based on the Public Health Practice Core Competencies. The Public Health Profile and Training Needs Assessment questionnaire was mailed out to public health employees representing mostly public health nursing, environmental health, mental health, and public health management/administration (n = 696). Nearly three-quarters (74%) of participants were female and 96% reported being white.

Self-reported alcohol use and sexual behaviors of adolescents.

Research has demonstrated a relation between alcohol use and engaging in high-risk sexual behaviors. Alcohol use, especially binge drinking, has been linked to a host of problems including high-risk sexual behavior, date rape, and academic problems. As such, the purpose of this study was to provide a descriptive profile of alcohol consumption among adolescents and to examine the relations of alcohol use (lifetime, current, binge) with sexual activity variables (sexual initiation, multiple sex partners, condom use, and pregnancy) among adolescents completing the 1993-1999 Youth Risk Behavior Survey.

How can primary concerns of school district superintendents guide school health efforts?

School-based research and health promotion interventions typically require upper administration support and acceptance to succeed. This paper focuses on a recently completed Delphi survey of the majority of school district superintendents in a frontier state. The survey examined superintendent district-level concerns at the elementary, middle/junior high, and high school levels.