Preventive medicine
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Preventive medicine · Feb 2017
Impact of a park-based afterschool program replicated over five years on modifiable cardiovascular disease risk factors.
Major challenges to the current childhood obesity epidemic include availability of prevention and/or treatment programs that are affordable and acc5essible. We evaluated the change in several modifiable, obesity-related cardiovascular disease risk factors after participation in Fit2Play™, a structured afterschool program housed in a large urban county parks system. Children ages 6-14 who participated in Fit2Play™ in one of 34 parks for one school year during a five-year period (2010-2015) had height, weight, 4-site skinfold thicknesses, systolic/diastolic blood pressure (SBP/DBP), fitness tests, and a health/wellness behavior/knowledge test collected at the beginning and end of the school year. ⋯ Department of Health and Human Services, 2016) both the obese and overweight groups significantly decreased their mean body mass index (BMI) percentile (98th to 95th percentile, p<0.001; 91st percentile to 89th percentile, p<0.001, respectively); (Ogden et al. 2015) the normal weight group maintained a healthy BMI percentile (54.6th); (Ogden et al., 2014) mean SBP and DBP significantly decreased (3.6 percentile and 6 percentile points, respectively, p<0.001 for both). Mean number of sit-ups, push-ups, 400meter run time, and nutrition knowledge scores improved in all participants (p<0.001 for all). These findings suggest that parks-based afterschool health/wellness programs can be a low-cost, high value tool in both preventing and treating the current childhood obesity epidemic and among high-risk groups in particular.
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Preventive medicine · Feb 2017
Objective reports versus subjective perceptions of crime and their relationships to accelerometer-measured physical activity in Hispanic caretaker-child dyads.
Crime and safety are commonly cited barriers to physical activity (PA). We had three objectives, 1) describe the association between objective crime measures and perceptions of crime, 2) analyze the relationships between each type of crime and accelerometer-measured physical activity in caretakers and young children (ages 3-5years), and 3) explore for early gender differences in the relationship between crime and physical activity in young children. Data are from the cross-sectional baseline data of an ongoing randomized controlled trial in Nashville, Tennessee spanning September 2012 through May 2014. ⋯ Child PA was not significantly related to caretaker perceptions of crime. However, interactions suggested that the relationship between crime rate and PA was significantly more negative for girls than for boys. Objective and subjective measures of crime rate are expected to be important correlates of PA, but they appear to have complex relationships that are different for adults than they are for young children, as well as for young girls compared to boys, and research has produced conflicting findings.
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Preventive medicine · Feb 2017
Detecting prediabetes among Hispanics/Latinos from diverse heritage groups: Does the test matter? Findings from the Hispanic Community Health Study/Study of Latinos.
The objectives of this analysis were to compare the ability of fasting plasma glucose (FPG), post oral load plasma glucose (2hPG), and hemoglobin A1c (HbA1c) to identify U. S. Hispanic/Latino individuals with prediabetes, and to assess its cardiovascular risk factor correlates. ⋯ Using 2hPG as the gold standard, the sensitivity of FPG was 40.1%, HbA1c was 45.6%, and that of HbA1c+FPG was 62.2%. The number of significant PRs for cardiovascular risk factors was higher among individuals with isolated 2hPG=7.8-11.1mmol/L, FPG=5.6-7.0mmol/L+HbA1c=5.7%-6.4%, or those who met the three prediabetes criteria. Assessing FPG, HbA1c, and cardiovascular risk factors in Hispanics/Latinos at risk might enhance the early prevention of diabetes mellitus and cardiovascular complications in this young and growing population, independent of their heritage group.
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Preventive medicine · Feb 2017
Associations between demographic characteristics and physical activity practices in Nevada schools.
Schools are important settings for not only providing and promoting children's physical activity (PA) but also for reducing PA disparities. We investigated associations between school-level demographic characteristics (racial/ethnic and socioeconomic composition, urban-rural status, and student-to-teacher ratio) and 16 PA-promoting practices in 347 Nevada public elementary, middle, and high schools in 2014. We found that low-cost and easy-to-implement practices are most prevalent. ⋯ Schools with greater percentages of Hispanic students have lower odds of providing before-school PA programs (AOR=0.867, 95% CI=0.761-0.987), whereas schools with greater percentages of low-SES students have greater odds of providing after-school PA programs (AOR=1.135, 95% CI=1.016-1.268). Higher student-to-teacher ratio was also associated with greater odds of providing after-school PA programs (AOR=1.135, 95% CI=1.016-1.268). Urban-rural status was unrelated to all PA practices.
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Preventive medicine · Feb 2017
Shared use agreements between municipalities and public schools in the United States, 2014.
Shared use agreements allow public use of school facilities during non-school hours. Such agreements can cover outdoor facilities alone or may be more comprehensive by also including indoor facilities. Our aim was to: 1) estimate the prevalence of shared use agreements and facility types covered among U. ⋯ Significant differences in prevalence existed by population size, rural/urban status, poverty prevalence, median education level, and census region; however, after adjustment for other municipality characteristics significant differences remained only by population size, median education level, and census region. Among municipalities with a shared use agreement, 59.6% covered both outdoor and indoor facilities, 5.5% covered indoor facilities only, and 34.9% covered outdoor facilities only. Opportunities exist to expand the use of shared use agreements particularly in municipalities with small populations, lower education levels, and in the South, and to promote more comprehensive shared use agreements that include both indoor and outdoor facilities.