March / April 2020



AJHE: American Journal of Health Education

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  March/April 2020 (Volume 51, Issue 2)

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Table of Contents

Free Access Article
/Gender Differences in a Youth Physical Activity Intervention: Movement Levels and Children’s Perceptions
 – Jen McGovern, Staci R. Drewson, Andrea Hope & James F. Konopack

Background: Sedentary behavior is a public health issue associated with obesity and other chronic health problems. The need for interventions is especially pressing for girls, who have lower levels of physical activity (PA) than boys do, and who are more likely to be overweight and to experience negative emotional states as they approach adolescence.
Purpose: This study used a mixed-methods approach to examine gender differences in PA levels and perceptions of movement opportunities in an afterschool intervention.
Methods: Data were collected from 22 children (4th-5th grade) who participated in a 15-week afterschool PA intervention (30, 1 hour sessions). PA levels were measured using accelerometers and perceptions of PA were gathered via focus groups.
Results: Boys moved significantly more than girls based on total accelerometer counts (310,617 vs. 279,766, t = − 3.63, p < .01) and step counts per session (2,297 vs. 2,100, t = − 3.40, p < .01). Gender differences in PA perceptions emerged regarding competency and relationships.
Discussion: Understanding gendered differences in PA perceptions are crucial to developing effective afterschool PA interventions.
Translation to Health Education Practice: Interventions that enhance PA enjoyment for girls should incorporate self-efficacy of physical skills, cooperative style games, and activities that offer social interactions.

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Research Articles

Social Cognitive Theory and Accelerometer assessed Physical Activity among Adolescents living in Rural Appalachia
– R. Lingyak Petosa & L. Smith
Background: Rates of PA are low among adolescents living in rural areas.
Purpose: The purpose of this study is to measure 1 week of “free-living” PA via accelerometer among 9th- and 10th-grade students who reside in rural Appalachia. A second purpose was to identify gender differences in Social Cognitive Theory (SCT) variables correlated with PA.
Methods: A sample (n = 633) of students from 20 different high schools in rural Appalachia wore accelerometers for 7 days. They competed a set of valid and reliable instruments assessing SCT variables.
Results: Rates of PA were very low. Accelerometer assessed levels of PA were consistent with self-reported estimates published previously, but lower than estimates reported in government surveys. Several SCT variables were correlated with female PA. Only two SCT variables were not correlated with male PA.
Discussion: SCT determinants of PA are different for adolescent girls and boys. The magnitude of these SCT correlates are lower than previously published studies based on self-reported PA.
Translation to Health Education Practice: There is an acute need for effective instruction to promote PA among rural adolescents residing in Appalachia.

Black First-Year College Students’ Alcohol Outcome Expectancies
– Shemeka Thorpe, Amanda E. Tanner, Samuella Ware, Kate Guastaferro, Jeffrey J. Milroy, and David L. Wyrick
Background:Alcohol outcome expectancies (AOEs) are associated with college students’ varied alcohol consumption. Existing research on AOEs focuses primarily on heterosexual White students. Thus, it is important to explore how the intersection of multiple identities such as race, gender, and sexual orientation influence the endorsement of specific AOEs.
Purpose:This paper examines AOEs among Black first-year college students, with specific attention to the influence of gender and sexual orientation.
Methods:Participants were 307 Black students from four universities in the United States. We conducted bivariate analyses using the 2-factor and 4-factor B-CEOA scale.
Results: Most students did not hold positive AOEs such as tension reduction and sexual enhancement. Students were more likely to endorse negative AOEs such as behavioral and cognitive impairment and social risk.
Discussion:Black first-year college students reported more negative expectations associated with alcohol use, including those related to negative social risks and consequences. Thus, AOEs may serve as a protective factor against alcohol use among Black college students.
Translation to Health Education Practice: Alcohol interventions should be tailored to focus on the intersection of race, gender, and sexual orientation. Culturally relevant alcohol interventions have the potential to reduce the immediate and long-term consequences of alcohol use.

Designing and Implementing an Educational Social Media Campaign to Increase HPV Vaccine Awareness among Men on a Large College Campus
– Connor T. Hughes, Susan Kirtz, Lois M. Ramondetta, Qian Lu, Dalnim Cho, Charlotte Katzin & Lee Ann Kahlor
Background:The human papillomavirus (HPV) causes an estimated 11,600 males to contract HPV-associated cancers in the U.S. every year.
Purpose:We describe the generalized results of a social media marketing campaign. The aim was to identify predictors of self-reported HPV vaccine uptake and target these predictors in a health education campaign for males on a large college campus.
Methods:We conducted an observational cohort study that recorded surveys from 90 college males then analyzed these results to inform the implementation of a campus-wide social media campaign. The survey had good internal consistency (α = 0.83) and assessed the Health Belief Model and Theory of Planned Behavior.
Results: The campaign reached an estimated 2,200 students with in-person presentations, 12,000 students with two student newspaper articles, and over 17,000 views of its three-part social media video series, which was shared 197 times by students and organizations at the university. After the campaign, our cohort survey demonstrated three of five health beliefs targeted had significantly improved: perceived susceptibility (p < .01), perceived severity (p < .05), and self-efficacy (p < .01).
Discussion: : Our study reports the generalized findings of an evidence-based, reproducible approach to implementing an educational campaign on a college campus.
Translation to Health Education Practice: This model for social media marketing and student engagement can be replicated by other university health centers for education of males about vaccines and other chronic diseases.

Suggestions and Preferences for Interventions to Promote Adolescents’ Health: Insights from Focus Groups
– Abdelghaffar El-Ammari, Hicham El Kazdouh, Siham Bouftini, Samira El Fakir & Youness El Achhab
Background: Interventions are needed to improve health behaviors among Moroccan adolescents. Obtaining an understanding of suggestions and preferences of the target population can help develop such interventions.
Purpose: The aim of the present study was twofold: (1) to explore social-ecological suggestions of participants for improving physical activity (PA), dietary behaviors and for reducing substance use among adolescents, and (2) to identify their preferences regarding delivery mode, facilitators and content for a school-based intervention.
Methods:Seventeen focus groups were conducted with 100 adolescents, parents and teachers.
Results:Four themes were about social-ecological (i.e. social, physical, distal and individual environment levels) suggestions on how to improve adolescents’ health behaviors on PA, dietary behaviors and substance use. Three themes were about participants’ preferences regarding delivery mode, content and facilitator of a school-based intervention.
Discussion: A comprehensive approach was perceived as effective to improve adolescents’ health behaviors. Participants’ preferences on a school-based program are useful to develop such a program.
Translation to Health Education Practice: Health educators can use the findings to develop school- or community-based interventions.

One-Session Mindfulness versus Concentrative Meditation: The Effects of Stress Anticipation
– Christina D. Colgary, Shengli Dong & Paige H. Fisher
Background: Mindfulness meditation (MM) is often readily applied in university settings as a practical means to reduce stress associated with academic and environmental uncertainties. Little is known, however, about the ideal prescribed frequency and duration of an MM practice to cultivate safe uncertainty when anticipating a stressful task.
Purpose:This study therefore examined the effectiveness of a single 25-minute MM in reducing stress compared to concentrative meditation (CM).
Methods:The presence of prolonged stress anticipation (A) varied across conditions. Participants (N = 116) were randomly assigned to one of the four groups: MM-A, CM-A, MM, or CM. Both self-reported and physiological stress, assessed by a total distress measure, blood pressure (BP) readings, and heart rate (HR) readings, were recorded pre and post meditation.
Results:Parametric analyses demonstrated that all conditions significantly reduced self-reported stress, but not BP and HR levels. Between group differences emerged on one self-reported distress subscale.
Discussion:The implications of one-session MM’s ability to reduce self-reported stress, but not physiological stress responses, are explored.
Translation to Health Education Practice: Health education approaches may benefit from creating implementation monitoring systems when evaluating the impact of brief meditations and similar interventions.

Health-Related Fitness in Homeschool versus Public School Adolescents
– Laura S. Kabiri, Kendall R. Brice, Augusto X. Rodriguez, Amanda M. Perkins-Ball & Cassandra S. Diep
Background: Despite the known benefits of physical fitness in adolescence, the growing and at-risk homeschool adolescent population has been largely overlooked in current research.
Methods:Homeschool adolescents ages 12–17 years (n = 66) completed the Progressive Aerobic Capacity Endurance Run (PACER), curl-up, and 90° push-up portions of the FitnessGram® to assess cardiorespiratory fitness as well as abdominal and upper body strength and endurance. T-tests and chi-square tests were used to compare results to public school children (n = 66).
Results:There was no significant difference in BMI between groups. Homeschool adolescents had significantly lower cardiorespiratory fitness and abdominal, but not upper body, strength and endurance. They also showed significantly lower health classification rankings in cardiorespiratory fitness and upper body, but not abdominal, strength and endurance.
Discussion:Homeschool adolescents showed significant deficits in health-related fitness that could negatively impact both current and future health.
Translation to Health Education Practice: The homeschool community has a need for health education to address deficits in health-related fitness. This study can aid health educators in planning and implementing targeted, effective interventions in the future.