September / October 2019

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AJHE: American Journal of Health Education



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  September/October 2019 (Volume 50, Issue 5)


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Table of Contents

 
Free Access Article
/Sedentary Time and Behavior during School: A Systematic Review and Meta-Analysis
 – Catherine A. Egan, Collin A. Webster, Michael W. Beets, R. Glenn Weaver, Laura Russ, Daniel Michael, Danielle Nesbitt, and Karie L. Orendorff
Background: Sedentarism is uniquely associated with numerous health problems (e.g., obesity). School-age youth spend a considerable portion of their time being sedentary, although relatively little attention has been given to examining youth sedentary time or behaviors during school.
Purpose: This systematic review and meta-analysis examined sedentarism (time, behaviors) in children and adolescents during school hours.
Methods: Two separate electronic-databases searches were conducted. The first focused on sedentary time and looked for studies that: (1) were conducted in the U.S., (2) targeted the K-12 setting during school-day hours, (3) were an intervention, (4) included objective measures, and (5) reported sedentary outcomes as a time-based metric. The second search focused on sedentary behavior and looked for studies that: (1) were conducted in the U.S., (2) targeted the K-12 setting during school-day hours, and (3) included reporting of sedentary behaviors. A pooled estimate of percent-time spent sedentary was calculated.
Results: On average, youth spent 63% of their time in school sedentary. There were no studies that met the inclusion criteria for the sedentary behavior portion of the review.
Discussion: The limited number of studies found that report sedentary-time, coupled with the absence of studies describing sedentary behaviors, suggests that further descriptive research is needed to understand school-based sedentarism in youth.
Translation to Health Education Practice: Professional development for school staff and intervention work should encompass sedentary time and behaviors across the school day./div>

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Research Articles

Addressing Bias in Email Surveys on College Students’ Alcohol Use: A Comparison of Strategies and Implications for Health Promotion
– Jeremy D. Penn and Erika L. Beseler Thompson
Background: Email surveys of health behaviors are convenient and low cost, but concerns remain regarding data accuracy and implications for health promotion.
Purpose: Compare the accuracy of email-collected survey data with classroom-collected data on college students’ alcohol use, and compare strategies for addressing inaccuracies, including demographic weighting and continuum of resistance model.
Methods: Data were gathered via email survey of 2,991 community college and research university students in October 2016 and via an in-person survey of 737 students at these same institutions in February 2017.
Results: Classroom respondents were significantly more likely to report alcohol use and high-risk alcohol use, and reported more average weekly drinks than email respondents. Demographic weighting and the continuum of resistance model improved estimates but did not fix all inaccuracies.
Discussion: Use caution in interpreting results from email surveys on alcohol use if those results do not include information on estimated nonresponse bias.
Translation to Health Education Practice: Results from email alcohol surveys should be weighted for demographic differences – particularly age and sex – and should use the continuum of resistance modification if indicated. Recommend collecting additional data through anon-email method to improve accuracy of estimates and inform decision-making about interventions and programs.

A Theoretical Approach to the Development of Instruments to Assess Knowledge and Beliefs of Breast Self-Awareness in Adolescent Females
– Retta R. Evans, Jacqueline A. Horton, and Kara Renee Skelton
Background:The American Academy of Pediatrics and the American Academy of Family Physicians recommends that breast health should be taught during the teen years.
Purpose:The purpose of this paper is to describe the process of developing a revision of the Champion’s Health Belief Model Scale (CHBMS), appropriate for adolescent females, which measures knowledge and beliefs about breast cancer and BSE.
Methods:This study employed the use of focus groups, an expert panel, and a pilot study to develop the Breast Health Knowledge Test and the Breast Health Beliefs Survey. Data analysis included descriptive statistics, test-retest reliability, and internal consistency of the instrumentation scales.
Results: Results suggest that both of the instruments were valid and reliable.
Discussion:Further research should be conducted on the female adolescent population to better understand their knowledge and beliefs on this topic.
Translation to Health Education Practice: Health educators can design tailored interventions once adolescent knowledge and beliefs have been assessed using these instruments.

College Students’ Use and Perceptions of Wearable Fitness Trackers
– Dee A. Kinney, Laura A. Nabors, Ashley L. Merianos, and Rebecca A. Vidourek
Background: Nearly half of all college students do not engage in the recommended amount of physical activity which may contribute to chronic diseases such as obesity.
Purpose: To investigate college students’ use and perceptions of wearable fitness trackers (WFTs) and the impact on confidence and motivation for increasing physical activity. Reasons for non-use were also explored.
Methods: 356 College students completed a 25 -item paper survey.
Results: 22.5% reported using a WFT. Most wore their WFT either “every day without fail” or “most days” and half wore their WFT “all day and while sleeping”. Analyses were significant for those reporting a high increase in physical activity and or a high increase in number of steps as being more likely to report a high motivation for physical activity.
Discussion: Two reasons for use of WFT were weight loss and to track sleep. A common reason for non-use of WFT was cost. WFTs may help to increase motivation to engage in physical activity.
Translation to Health Education Practice: When considering the use of WFTs, Health Educators would do well to identify affordable WFTs for use in interventions and be mindful of the barriers related to discontinuation of use.

An Ecological Investigation of Barriers and Facilitators Impacting Standing Desk Use in Real Working Conditions: A Qualitative Study
– Amanda H. Wilkerson, Shristi Bhochhibhoya, Adriana Dragicevic, and M. Renée Umstattd Meyer
Background: Workplace interventions have utilized standing desks to reduce sedentary behavior. However, minimal information is available concerning factors that impact use of standing desks under real working conditions.
Purpose: To qualitatively explore factors that influence standing desk use under real working conditions.
Methods:Individual interviews were conducted with university employees currently using a standing desk using a semi-structured interview guide. Interviews were audio-recorded, transcribed verbatim, and coded for themes.
Results: Participants (n = 37) identified factors impacting standing desk use across multiple socioecological levels. Intrapersonal-level barriers included forgetting to use the standing desk and pain or fatigue from standing; whereas, knowledge facilitated use. Social support facilitated use at the interpersonal level, but social norms were a barrier to standing. Access to standing desks and a wellness culture facilitated use at the institutional level, but the built environment was a barrier.
Discussion: Findings from this study support a socioecological perspective of sedentary behavior and highlight the importance of incorporating intervention strategies at multiple levels to change sedentary behavior.
Translation to Health Education Practice: The findings from this study may be used to develop multi-level strategies to initiate and maintain use of standing desks in order to overcome and prevent barriers impacting regular use.

The Effects of Open Captions in a Medical Drama on the Acquisition of Medical Terminology about Chronic Health Conditions Related to Physical Injury
– Hyang-Sook Kim and Kyongseok Kim
Background: Despite previous efforts to improve health literacy through entertainment media, current practice seems to address only a few public health topics.
Purpose: We examined the impact of supplementary open captions about medical terminology related to physical injuries that might lead to chronic health conditions on the acquisition and retention of relevant information presented in a medical drama.
Methods:We conducted a two-group, between-subjects experiment (no open captions vs. open captions) with 150 adult participants to measure how open captions might help viewers retain medical information without disrupting their enjoyment of the storyline.
Results: The open captions helped viewers retain the terms and their definitions without disrupting narrative transportation to the events in the episode.
Discussion: As long as the open-captioned medical information was seamlessly woven into the storyline of the episode, it did not prevent the viewers from appreciating the dramatic content of the show.
Translation to Health Education Practice: Health educators are encouraged to collaborate with media producers to implement open captions for health and medical information rather than simply monitoring the accuracy of health and medical topics featured in television shows.