May / June 2019



AJHE: American Journal of Health Education

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  May/June 2019 (Volume 50, Issue 3)

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Table of Contents

Free Access Article
/Partnership Roles in Early-Learning Providers' Healthy Eating and Physical Activity Programs: A Qualitative Study
 – Angela M. Coppola, Allison L. Voils, Janet Gafkjen & David J. Hancock

Background: The Centers for Disease Control and Prevention (CDC) provide recommendations for children’s physical activity (PA) and nutrition practices. Community partnerships in school-based programs are recommended by the CDC to support children’s opportunities to regularly engage in these practices.
Purpose: Informing the role of Health Educators and community partners, the research purpose was to explore how to support early-learning providers’ healthy eating and PA programs.
Method: Drawing upon interpretive description methodology, 13 Indiana early-learning providers participated in one-on-one interviews. Participants shared experiences of, and recommendations for, building school health partnerships and programs. Three areas for supporting programs were identified and recontextualized into guiding questions for practice.
Results: Health Educators and community partners can support providers by developing or acquiring resources, such as examples of classroom PA delivery. They can contribute by providing program planning services, like co-developing PA programs with teachers and meal planning with staff. By creating networking opportunities, community partners can initiate online or in-person knowledge-sharing and mentor–mentee programs.
Discussion: These findings inform how Health Educators and community partners can be involved in school-based health promotion by providing insight into partnership roles.
Translation to Health Education Practice: The practical questions can be used to guide the development of collaborations.

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Research Articles

Introduction to Sandford Health Children’s Health and Fitness Initiative: A Physical Health and Emotional Health Promotion Intervention
– Suzanne E. Williams & Donna Hardie
Background: The health of children is undeniably important. Especially with the soaring epidemic of childhood overweight and obesity, physical health is a large concern. Emotional health is also an area of great significance, because it is essential to overall health. Children’s health promotion interventions have been developed and implemented; however, the majority either focus on one health aspect and/or the effects of one health aspect on another or research has been limited to very few variables.
Purpose: The Sanford Health Children’s Health & Fitness (fit) initiative was developed with the purpose of engaging children, families, and communities with accessible resources and programs to instill sustainable healthy lifestyle behaviors. Theoretically rooted, its design includes the utilization of key role models and care providers in various settings, including the home, school, childcare, health care, and community.
Translation to Health Education Practice: Though a suite of fit initiative programs and resources have been introduced for multiple settings, there is currently an emphasis on development and implementation of curricular programming in the school setting. fit4Schools is designed to provide additional, practical resources that can be implemented as a component of existing curricula and programming.

Feeding the Student Body: Unequal Food Insecurity Among College Students
– Don E. Willis
Background: A growing but limited body of research has assessed food insecurity among college students. The majority of these studies relied on convenience or nonprobability samples.
Purpose:: The purpose of this study was to assess the prevalence and odds of food insecurity among undergraduate students.
Methods:: Online survey data were collected in the spring of 2017 from a random sample of college students attending a 4-year university. A final sample of 378 undergraduate students was included in this study. Pearson's chi-square and logistic regression analyses were used to examine differences in the prevalence and odds of food insecurity across student groups.
Results: Nearly a third (32%) of undergraduate students were food insecure. Racial and sexual minorities had a higher prevalence of food insecurity and higher odds of food insecurity. Students who had a background of family financial struggles and who lack housing security had a higher prevalence and higher odds of food insecurity.
Discussion:The results are discussed with attention to the role of higher education in reproducing or reducing unequal opportunity in the United States.
Translation to Health Education Practice: Certified Health Education Specialists should consider interventions with the differentiated risk of food insecurity in mind.

Doctor Google, Health Literacy and Individual Behavior: A Study of University Employees Knowledge of Health Guidelines and Normative Practices
– Angela T. Ragusa & Andrea Crampton
Background: The success of public health campaigns to engender healthy behavior depends on effective communication of desired messages that inspire action utilizing health information that must be successfully understood. Research, however, illustrates that health guidelines are differentially interpreted, with health literacy and proclivities varying.
Purpose: This article presents findings from a study examining major Australian health guidelines and behaviors regarding sun exposure, alcohol consumption, physical activity, and smoking.
Methods:An online survey of rural and regional Australian university employees was designed and utilized to gather data about respondent health literacy relative to national guidelines.
Results: Findings reveal disparate health literacy and behaviors among the 60 university employees surveyed, with antismoking being the most effectively communicated health message known and adopted.
Discussion: Given that “Dr. Google” was respondents’ preferred source for health and health risk information, surpassing medical professionals, friends/family, and other media sources, the study raises concerns about the quality, availability, and suitability of Internet-based health information.
Translation to Health Education Practice: Reconceptualizing health messages beyond “lose/gain” frameworks is suggested as a way to improve health knowledge to better assist individuals with negotiating conflicting content/quality of information available, differing health literacy, and differing sociocultural environments.

The San Antonio Sodium Reduction Initiative: Lessons Learned and Recommendations
– Erica T. Sosa, Sarah L. Ullevig, Ellen Spitsen, Anne Heine, Casey Perez & Kathleen Shields
Background: The Sodium Reduction Initiative (SRI), a voluntary collaboration among the local health department and community partners, aimed to reduce sodium in worksites and federally funded meal programs throughout Bexar County.
Purpose: The purpose of this study was to assess sodium-related purchasing, preparation, and policies among food providers before and after the SRI and identify factors impacting implementation.
Methods:Sodium-related practices and policies were assessed using the Sodium Practices Assessment Tool (SPAT). Stakeholder interviews were conducted to identify factors impacting initiative implementation.
Results: SPAT data revealed increased healthy practices in worksites after SRI, including using recipes and measuring salt during food preparation. Qualitative analysis of interviews revealed that implementation was facilitated by the SRI team’s expertise; existing health initiatives; and an organizational culture of wellness but impeded by concerns regarding customer dissatisfaction with lower sodium items; lower sodium ingredient availability and expense; and time constraints.
Discussion: Organizations interested in implementing similar initiatives might consider embedding efforts into existing health initiatives; establishing organizational networks to share resources; and providing new partners with evaluation assistance.
Translation to Health Education Practice: Health Educators can educate foodservice providers on the importance of sodium reduction as well as develop and evaluate sodium reduction initiatives.