March / April 2018



AJHE: American Journal of Health Education

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  March/April 2018 (Volume 49, Issue 2)

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Table of Contents

Free Access Article
/Physical Activity and Psychological Correlates During an After-School Running Club
 – David Kahan and Thomas L. McKenzie

Background/Purpose: After-school programs (ASPs) have the potential to contribute to moderate-tovigorous physical activity (MVPA), but there is limited empirical evidence to guide their development and implementation.
Methods: We used pedometry to measure participant PA%, MVPA%, and MVPA% of PA during a 20-session alternating treatments design and examined associations between various psychological constructs and MVPA levels using odds ratios.
Results: : PA% (62.2% vs 76.1%, effect size [ES] = −0.65) was lower and MVPA% (33.3% vs 15.8%, ES = 0.75) and MVPA% of PA (53.6% vs 20.2%, ES = 0.91) were higher during game vs lap running conditions. The constructs of recognition, ego orientation, and expectancy beliefs distinguished between children with high and low MVPA.
Discussion: The replication of results for MVPA with a different cohort provides evidence of program generalizability. Only game days met the ASP national recommendation for providing activities at an intensity of 50% MVPA% or greater.
Translation to Health Education Practice: Running laps and running games both contribute to PA accrual, but they do so in different ways. ASP providers should weigh the demands and outcomes of each format.

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Research Articles

STEPS to a Healthier Heart: Improving Coronary Heart Disease (CHD) Knowledge Among African American Women
Cynthia Williams Brown, Dayna S. Alexander, Kayla Cummins, Amanda Alise Price, and Marian Anderson-Booker
Background: African American women have the highest risk of death from heart disease among all racial, ethnic, and gender groups due to sedentary behaviors.
Purpose: This article describes an intervention among 2 groups—a program group and an information group (intervention and comparison)—that assessed cardiovascular risk factor knowledge among African American women.
Methods: The Coronary Heart Disease Knowledge Test was administered to participants prior to study participation. Participants (N = 345) aged 34–66 self-selected into either the intervention group (n = 166) or the comparison group (n = 179). Repeated-measures analyses of variance (ANOVAs) were performed to assess participant characteristics and determine whether changes occurred in participants’ knowledge.
Results: Data analysis indicated no significant differences between the groups regarding knowledge; however, significant differences appeared between pre- and posttest scores over time. The 3-way repeated-measures ANOVA indicated differences based on education.
Discussion: Results suggest that intervention duration should be longer to ensure that participants understand cardiovascular risk factors. Future research could assess African American women’s current cardiovascular preventative practices and add a qualitative component to provide context on knowledge and actions.
Translation to Health Education Practice: Results confirm the need for culturally tailored, gender-specific programming to help close awareness and knowledge gaps.

Sustained Intervention Effects on Older Adults’ Attitudes Toward Alcohol and Medication Interactions
Faika Zanjani, Hannah Allen, Nancy Schoenberg, Catherine Martin, and Richard Clayton
Background: Older adults are at risk for experiencing alcohol and medication interactions (AMIs) given their concomitant alcohol and medication use. However, there have been limited efforts to develop and evaluate AMI prevention interventions.
Purpose: The current study examined sustained intervention effects on older adults’ attitudes, awareness, and intentions regarding AMI.
Methods:A sample of N = 134 older adults completed assessments before and after exposure to AMI risk educational materials (times 1 and 2). N = 97 participants (72%) were reached for a 3-month follow-up phone call (time 3).
Results: There was a positive linear trend over time in the number of identified AMI side effects. Though knowledge of intervention messages remained high and stable over time, quadratic trends for perceived importance of AMI messages indicated positive short-term effects that were not sustained over time. Few differences by drinking status were found.
Discussion: This intervention had positive short-term effects on AMI awareness, intentions, and perceived messaging importance, but these short-term effects were only maintained over time for awareness.
Translation to Health Education Practice: This study provides Certified Health Education Specialists with a model for planning and evaluating a brief intervention to prevent AMI among older adults.

Enhancing Psychosocial Constructs Associated with Technology-Based Physical Activity: A Randomized Trial Among African American Women
Brandonn S. Harris, Bridget Melton, Helen Bland, Ashleigh Carpentier, Jilian Gonzales, and Kelley Catenacci
Background: Minority women have demonstrated higher rates of health disparities associated with lower levels of physical activity, a finding prevalent among college-aged individuals. Though these health disparities occur given a variety of factors, novel, technologybased interventions are being developed to increase physical activity, with Social Cognitive Theory (SCT) serving as a useful framework for guiding such interventions.
Purpose: This investigation sought to evaluate 2 technology-based interventions on physical activity motivation and psychosocial variables among young African American women.
Methods: Forty-nine female African American college students aged 18–24 used an UpBand accelerometer and app or a diet tracker app for 6 weeks. Posttesting occurred at the conclusion of the intervention and 2 months postintervention.
Results: Perceived family support for exercise decreased in both groups, F(2, 94) = 9.90, P < .001, partial η2 = 0.17. Following an initial decrease in exercise self-efficacy scores from pre- to posttest, an increase in exercise self-efficacy was evidenced from posttest to the 2-month follow-up for both groups, F(1, 47) = 10.90, P = .002, partial η2 = 0.188.
Discussion: Although technology-based physical activity apps include social constructs, this study did not find strong support for promoting the psychosocial variables among participants. The use of fitness-promoting technology may facilitate exercise self-efficacy in minority female college students.
Translation to Health Education Practice: Technology-based interventions may be more effective when used in conjunction with traditional physical activity promotion.

Breast Cancer Knowledge Among College Students: Influencing Factors and Resultant Behaviors
Mary F. Justice, Keith A. King, Rebecca A. Vidourek, and Ashley L. Merianos
Background: Many misconceptions about breast cancer exist. College students have the opportunity to perform breast cancer risk-reducing behaviors.
Purpose: The purpose of this study was to assess breast cancer knowledge among university students and examine the influence of breast cancer knowledge on health behaviors for breast cancer prevention.
Methods: Data were collected via survey in which students were asked about health behaviors and 20 true/false statements about breast cancer.
Results: College students were unable to accurately identify all truths and myths about breast cancer. The overall mean knowledge score for the sample was 10.59 (SD = 2.865), based on a potential range of 0–20 correct answers. Breast cancer knowledge was significantly influenced by race. Results of Pearson correlation coefficients indicated an inverse correlation between breast cancer knowledge and health behaviors.
Discussion: Lack of accurate breast cancer knowledge is consistent with current literature. Health communication alone may not be enough to effect behavior change.
Translation to Health Education Practice: This study provides valuable insights into knowledge about breast cancer and associated behaviors among college students. Knowledge, as well as other determinants of behavior, should be examined for their effects on breast cancer prevention. Sources of knowledge available to college students should contain valid information.

Examining the Feasibility and Effectiveness of a Community-Based Obesity Prevention Program
Elizabeth W. Cotter, Victoria Bera, Johanna Elsemore, and Anastasia Snelling
Background: Latinos in the United States are at heightened risk for obesity and health disparities, yet community-based interventions to promote health are limited.
Purpose: This research examined the feasibility and efficacy of a culturally relevant obesity prevention program (Vivir Sano), which included stress reduction and behavioral lifestyle intervention components.
Methods: In phase 1, focus groups were completed with 21 residents of an affordable housing community to assess program needs and interests. In phase 2, 41 primarily Latino adults living in several neighboring affordable housing communities enrolled in the intervention. Twenty-three (56%) completed both pre- and postassessments (per protocol group). We examined pre–post differences in health-related behaviors, knowledge, and attitudes.
Results: Over 96% of participants who completed a posttest satisfaction questionnaire reported that they were likely or very likely to use the skills learned in the program. Approximately 85% reported that the program moderately or significantly improved their health. An analysis of variance (ANOVA) indicated that the per protocol group increased weekly vegetable consumption by 4.2 servings (Cohen’s d = 0.48).
Translation to Health Education Practice: We discuss barriers and lessons learned related to implementing obesity prevention programming in affordable housing communities, where residents are more likely to experience chronic stress and food insecurity.

Motivators of and Barriers to Health-Promoting Behaviors Among Culturally Diverse Middle and High School Students
Guillermo M. Wippold, Carolyn M Tucker, Tasia M. Smith, Victoria A. Rodriguez, Lynda F. Hayes, and Austin C. Folger
Background: Youth obesity in the United States is a major health concern. Obesity can be reduced by increasing health-promoting behaviors.
Purpose: The goals of the present study were to (1) identify the strongest motivators of and barriers to health-promoting behaviors among a culturally diverse group of middle and high school students and (2) determine whether these motivators and barriers differed by age, gender, race, and grade classification.
Methods: Subjects were 591 sixth- through 12th-grade students enrolled in a public school.
Results: A strong motivator for engaging in health-promoting behaviors is awareness of the health benefits of engaging in these behaviors. Strong barriers to engaging in health-promoting behaviors are preferences for unhealthy drinks and temptation to eat unhealthy foods. Additionally, there are significant differences in association with race/ethnicity and grade classification.
Discussion: This study is unique in that youth rather than professional experts were asked to rate the strength of the motivators of and barriers to health-promoting behaviors.
Translation to Health Education Practice: The results of this study have important implications for promoting healthy eating and drinking among middle school and high school students.