November /December 2018



AJHE: American Journal of Health Education

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  November/December 2018 (Volume 49, Issue 6)

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Table of Contents

Free Access Article
/Physical Activity and Academic Performance Among Adolescents in Low-SES Schools
 – Jonathan M. Cosgrove and Darla M. Castelli

Background: Physical fitness and activity (PA) are related to academic performance, yet little is known about these relationships among Hispanic adolescents in low–socioeconomic status (SES), urban communities.
Purpose: To evaluate the relationship of objectively measured PA and academic performance (AP) among Hispanic adolescents in one urban school district.
Methods: One hundred sixty students were recruited from 6 Title I schools. Participants were instructed to wear a GT3X accelerometer for 5 weekdays. The district provided demographic and academic scores.
Results: Pearson correlations yielded a weak and negative relationship existing between PA and AP, and the linear regression indicated that our predictor variables explained 15.2% of the variance, R2 = 0.152, F(7,144) = 2.352, P < .001. Only the very vigorous PA intensity had a significant, negative effect on the relationship between PA and AP (β = −1.241, p = .04).
Discussion: Despite the positive findings in previous research regarding PA and AP, our data suggest that in urban schools, the benefits of chronic PA may be secondary to the effects of SES and time spent engaged with academics with regards to AP.
Translation to Health Education Practice: Efforts to address inequalities should be embedded in health education lessons and physical activity programs for adolescents.

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Research Articles

A Quantitative Exploration of Alcohol-Related Regret Among Undergraduate Students
– Daphne E. Pedersen and Samantha Feroni
Background: Heavy drinking is linked to a number of deleterious consequences, many of which carry the possibility of regret: a negative cognitive emotion involving self-blame.
Purpose: The purpose of this study is to determine who among undergraduates is most likely to experience alcohol-related regret.
Method:Data were taken from an online survey of undergraduates (N = 354) from a Midwestern university.
Results: OuThough both men and women were more likely to report alcohol-related regret when they engaged in drinking to get drunk, participation in Greek life and intercollegiate sports were significant predictors of alcohol-related regret for women.
Discussion: Behavioral intentions matter, and when students drink with the intention of getting drunk, they are more likely to experience situations that can compromise their health and safety and jeopardize the networks that bind them to the university. The strength of reference groups and peer norms may also influence college women’s behavioral choices.
Translation to Health Education Practice: A harm reduction approach may be best suited to the effective management of student alcohol use. When centered within the social contexts that are most influential to students (eg, sororities/fraternities, sports teams), group programming efforts may have the greatest potential impact.

University Students’ Perspectives on Mindfulness and mHealth: A Qualitative Exploratory Study
– Lynnette Nathalie Lyzwinski, Liam Caffery, Matthew Bambling, and Sisira Edirippulige
Background: Mindfulness can help college students with key challenges they face relating to weight gain and stress-induced emotional eating and binge eating. Little is presently known about the extent to which students are aware of mindfulness, their conceptualization and understanding of it, and the barriers as well as the facilitators of mindfulness on campus. Understanding the barriers and facilitators may also inform future Health Education and promotions campaigns. Additionally, promoting mindfulness through mHealth is a novel and accessible intervention medium. Though there have been qualitative studies on mHealth for weight loss, there has not been a study on mHealth for weight loss using mindfulness that has explored student perspectives on mHealth for promoting mindfulness.
Methods:: An exploratory pilot study with a participatory design using qualitative methods was undertaken at the St. Lucia campus at the University of Queensland in March 2017. Data were analyzed with the assistance of NVivo software.
Results: Participants identified a number of barriers to a mindful lifestyle: social, cultural, knowledge, and time management related. Environmental barriers included the food environment because it promoted a fast food mentality over slow, mindful eating. The mindfulness-based sample text messages were positively received by students. Students preferred messages with practical tips about how to be mindful and how to integrate mindful reflection on both one’s body and one’s environment while on campus. Students preferred a theoretical future student-centered mindfulness app that had the following design features: a simple design interface, a focus on education/practical tips, and real-life practical exercises. Social media should be avoided.
Discussion: This study is important because it identified a number of potential barriers to and facilitators of mindfulness in students that should ideally be targeted by maximizing the facilitators and by aiming to minimize potential roadblocks. Mindfulness can be made more accessible to students by targeting educational, social, and environmental barriers. Future mHealth studies may consider integrating mindfulness-based text messages in their interventions for weight and stress because this is a novel feature that appears to be acceptable for students.
Translation to Health Education Practice: Health Educators should aim to increase knowledge dissemination efforts and improve the campus social and built environments to promote mindfulness by making it accessible. Sending tailored inspirational mindfulness-based, educational text messages that have a student context is also a good idea.

Jordanian Parents’ Knowledge and Attitudes Regarding Kidney Disease in Children
– Salma Ajarmeh, Nedal Alnawaiseh, Jumana Al Baramki, and Kamal Akl
Background: Renal disease among children has the potential for not only devastating a child’s health but can also place a burden on the whole family. Adequate knowledge regarding kidney disease in children increases parental adherence to treatment, can help with making an earlier diagnosis, and can decrease morbidity.
Purpose: The present study was a cross-sectional assessment of Jordanian parents’ knowledge and attitudes regarding childhood kidney disease.
Methods: A self-administered questionnaire was distributed to caregivers of children receiving treatment at pediatric renal clinics.
Results: Results revealed that parents have some knowledge about kidney disease in children but not at optimum levels, especially in terms of disease risk, disease complications, and dialysis treatment modalities.
Discussion: More parental education is needed on these topics. Greater awareness of childhood kidney disease is needed for more effective early diagnosis, better management, and improved family care and adherence to treatment.
Translation to Health Education Practice: Increased Health Education and awareness should help delay progression toward end-stage renal disease and lead to better outcomes.

Examining Recent Hookah Use, Other Substance Use, and Substance Use Prevention Education Among College Students
– Rebecca A. Vidourek, Keith A. King, and Shu-Tzu Huang
Background: Hookah tobacco use is an emerging public health problem. Purpose: The purpose of the present study is to examine recent hookah tobacco use among college students and potential correlates including other drugs and drug education.
Methods: The paper version of the National College Health Assessment II was completed by 765 students enrolled at one urban university.
Results: Findings indicated that 14.2% of students used hookah in the past 30 days. Significant differences were found based on recent alcohol, recent cigarette use, recent cigar use, recent smokeless tobacco use, and recent marijuana use. Students who received tobacco education were at increased odds for hookah use (χ2 = 5.592, df = 1, P = .018). The final regression model predicted recent hookah use (omnibus χ2 = 129.779, df = 6, P < .001) and accounted for 15.6% to 28.0% of the variance in recent hookah use.
Discussion: Students using hookah were found to use other type of substances, which may warrant attention on college campuses.
Translation to Health Education Practice: Study findings indicate that tobacco education programs may not adequately address hookah use. Health Education professionals may need to implement specific lessons on hookah as part of tobacco education programs.

The Associations Between Leisure, Stress, and Health Behavior Among University Students
- Jong-Ho Kim and Stephen L. Brown
Background: Research on health behavior within the context of leisure and stress coping in university students is limited.
Purpose: This study investigated the associations between leisure, health behavior, and perceived stress in university students. Other impacts, such as gender, grade point average (GPA), body mass index (BMI), and parents’ education on stress and health behavior, were also examined.
Methods:Researchers employed a cross-sectional research design by distributing surveys in classes or outside classes on a Midwestern U.S. university campus.
Results: Leisure satisfaction and intrinsic leisure motivation predicted health behavior positively and predicted perceived stress negatively, and apathy toward leisure was associated with higher perceived stress and lower health behavior. Perceived stress mediated the relationship between leisure satisfaction and health behavior.
Discussion: This study suggests that leisure satisfaction has benefits for health behavior in the form of stress management.
Translation to Health Education Practice: Health Educators should consider incorporating leisure education and/or leisure activities to decrease stress, improve overall health, and decrease health risks.

Assessment of Nutrition Knowledge of Childcare Providers Regarding the Implementation of the 2017 CACFP Meal Pattern Update
– Zainab Rida, Christy Burger, Dipti Dev, Jasmin Smith, and Saima Hasnin
Background: CardWith the release of 2017 Child and Adult Care Food Program (CACFP) meal pattern, states need to determine knowledge gaps in order to develop targeted training materials and resources to aid childcare providers in achieving new regulations.
Purpose: To assess the nutrition knowledge of childcare providers in regards to the implementation of the 2017 CACFP meal pattern.
Methods:Convenience sampling, where CACFP participants (n = 398) completed a self-reported survey at the annual mandatory trainings across the state of Nebraska, was employed in this study. Descriptive statistics including frequencies, means, standard deviations, independent sample t tests, and chi-square tests were used to determine differences in nutrition knowledge by geographical location, for-profit and nonprofit, and program settings.
Results: PoData obtained from this study indicate that CACFP participants scored low on questions regarding yogurt (30%), juice (35%), breakfast cereal (37%), and whole grain (43%) questions. Data also show that there was no significant difference in levels of knowledge among characteristics and demographics of programs, types of facilities, and geographic locations.
Translation to Health Education Practice: The present study results underscore the importance for continued professional development for CACFP participating childcare providers to implement the new CACFP meal pattern for child nutrition standards.