Delivering the Science and the Art of Health Promotion

Robert F. Allen
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Editor's Notes: Integrating Health Promotion Into National Health Policy

Call for Conference Proposals

Critical Issues and Trends

Jessica R. Ridpath
Cheryl J. Wiese
Sarah M. Greene

Looking at Research Consent Forms Through a Participant-Centered Lens: The PRISM Readability Toolkit
Making consent forms understandable should be a goal of every institution and scientist involved in research. A well-written consent form explains in clear language such study aspects as randomization, the risks and benefits of participating in the study, and how data and privacy are protected. This paper describes the features of the Project to Review and Improve Study Materials (PRISM) Readability Toolkit, which is designed to help researchers develop consent forms that use familiar vocabulary, simple sentences and a plain layout of text. The toolkit is available online free of charge.

Deborah A. McNeil
Brenda N. Wilson
Jodi E. Siever
Margie Ronca
Jean K. Mah

Connecting Children to Recreational Activities: Results of a Cluster Randomized Trial
The purpose of this trial was to identify whether outreach support increases school aged children’s participation in recreational activities. Schools in economically vulnerable neighborhoods were randomized to intervention (n = 8) or control (n = 8) groups, and children in grades 3 to 5 and their families were invited to participate. Children in intervention schools were assigned a “connector” (outreach worker) to facilitate participation in recreation activities; participation was measured at baseline, mid, and end of one year. Among the 306 children who completed the study, a greater number of children in the intervention group compared to the control group increased participation in physical activity (21% vs. 10%, p = 0.02), suggesting that children living in vulnerable neighborhoods benefit from outreach workers to connect them with physical activity programs.

Diana Redwood
Mary C. Schumacher
Anne P. Lanier
Elizabeth D. Ferucci
Elvin Asay
Laurie J. Helzer
Lillian Tom-Orme
Sandra L. Edwards
Maureen A. Murtaugh
Martha L. Slattery

Physical Activity Patterns of American Indian and Alaska Native People Living in Alaska and the Southwest United States
This study describes current physical activity patterns and their relation to various socio-demographic characteristics and health risk measures among 10,372 American Indian and Alaska Native people aged ≥18 years who participated in the Education and Research Towards Health study. Almost 23% of participants reported less than 30 minutes per week of moderate or vigorous activities.  Half (49%) reported no vigorous activities. Characteristics associated with more time spent performing vigorous activity were: male gender; age less than 40; higher income and education levels; and living in a rural area. Almost 70% of Alaska participants and 36% of Southwest participants engaged in wild food harvesting activities.

Maia Ingram
Maricruz Ruis
Maria Theresa     Mayorga
Cecilia Rosales

The Animadora Project: Identifying Factors Related to the Promotion of Physical Activity Among Mexican Americans With Diabetes
This study used focus groups to identify factors that motivated participation in organized walking groups among Mexican American diabetic women. Self-efficacy, social support and collective efficacy provided the theoretical basis for the examination of their results. Walkers demonstrated a high level of self-efficacy for walking and were motivated by group identity/social cohesion. Collective efficacy, however, defined as a group efficacy combining elements of self-efficacy and social support in a belief that the collective effort can improve their lives emerged as an applicable theoretical model that may be more appropriate in Latino cultures. Physical activity interventions that leverage group dynamics may be especially appropriate for engaging Mexican American populations.

Lisa J. Wood
Michael Rosenberg
Johanna Clarkson
Fiona Phillips
Robert J. Donovan
Trevor Shilton

Encouraging Young West Australians to Be Smarter Than Smoking
This paper provides an overview of the strategies and key results of the Smarter than Smoking project implemented between 1995 and 2005 in Western Australia. The project targeted students aged 12 to 15 years via mass media; school-based education programs; sponsorship of sport and art events; youth-oriented publications, merchandise and website; and advocacy to decrease tobacco promotion, availability and affordability. Outcome evaluation revealed that the percentage of 14- to 15-year-olds who smoked decreased and the proportion of those not wanting to smoke in the future increased.

Timothy M. Dall
Victor L. Fulgoni III
Yiduo Zhang
Kristin J. Reimers
Patricia T. Packard
James D. Astwood

Potential Health Benefits and Medical Cost Savings From Calorie, Sodium, and Saturated Fat Reductions in the American Diet
The potential health benefits and medical cost savings achieved from reducing dietary calories, sodium and fat in the United States were estimated using data from the NHANES on the dietary consumption habits and data on the link between medical costs and diet related health conditions in a simulation model.  Reducing calorie consumption by 100kcal/day was projected to eliminate 71.2 cases of overweight or obesity and reduce medical costs $58 million per year. Reducing sodium consumption 400mg/day among those with uncontrolled hypertension was projected to eliminate 1.5 million cases of hypertension and reduce medical costs $2.3 billion/year.  Reducing saturated fat consumption 5 grams/day among those with elevated cholesterol was projected to eliminate 3.9 cases of hyperlipidemia and reduce medical costs $2.0 billion per year.

Timothy M. Dall
Victor L. Fulgoni III
Yiduo Zhang
Kristin J. Reimers
Patricia T. Packard
James D. Astwood

Predicted National Productivity Implications of Calorie and Sodium Reductions in the American Diet
The potential health benefits and productivity savings achieved from reducing dietary calories, and sodium in the United States were estimated using data from the NHANES on the dietary consumption habits and data on the link between medical costs and diet related health conditions in a simulation model.  Reducing calorie consumption by 100kcal/day was projected to eliminate 71.2 cases of overweight or obesity and reduce productivity losses by $45.7 billion per year. Reducing sodium consumption 400mg/day among those with uncontrolled hypertension was projected to eliminate 1.5 million cases of hypertension and reduce medical costs $2.5 billion/year.

Special Section: Culturally Appropriate Approaches to Prevention and Treatment of Obesity in Minority Populations

Terry L. Bazzarre

Adapting Physical Activity Interventions to Prevent Obesity in Culturally Diverse Populations

Shiriki K. Kumanyika
Antronette K. Yancey

Physical Activity and Health Equity: Evolving the Science

Nicolette I. Teufel-
  Shone
Carrie Fitzgerald
Louis Teufel-Shone
Michelle Gamber

Systematic Review of Physical Activity Interventions Implemented With American Indian and Alaska Native Populations in the United States and Canada
Increased physical activity reduces the risk of type 2 diabetes and cardiovascular disease among American Indian/Alaska Native (AI/AN) populations. In this review the characteristics of 64 AI/AN interventions – 28 published in peer-reviewed journals and 36 in the gray literature – are described. Effective physical activity interventions in this population group were those implemented as a partnership between a tribal entity and a university or medical institute, and they had an evaluation plan to support their sustainability. Program sustainability was linked with strong tribal leadership and the inclusion of participants of all ages. Offering regular physical activity classes led by local trained instructors was the most sustainable strategy.

Melicia C. Whitt-Glover
Shiriki K. Kumanyika

Systematic Review of Interventions to Increase Physical Activity and Physical Fitness in African-Americans
Physical activity levels of African-American adults and children are often lower than in the general population, while the chronic diseases that can be prevented or ameliorated by regular physical activity occur more frequently among African-Americans. This systematic review examines the effectiveness of interventions designed to increase physical activity or physical fitness among African-Americans. Twenty-nine studies in adults and 14 studies in children were identified and rated for study quality and effectiveness. Effective interventions for African-American adults were randomized, controlled trials that offered structured exercise programs.

The Art of Health Promotion

Sara S. Johnson
Carol O. Cummins
Kerry E. Evers
Janice M. Prochaska
James O. Prochaska

Proactive Health Consumerism: An Important New Tool for Worksite Health Promotion
Consumerism in health care has taken on the form of a major innovation among employers and health plans.  Yet many of our efforts to enhance the skills and attitudes that enable consumerism have met with limited success.  Proactive Health Consumerism is proposed as an approach that utilizes many of the hard-won lessons from health promotion research.  Along with prerequisites that create the motivation and framework for increased health consumerism this article provides a theory-driven example of a new tool for health promotion professionals to employ when enhancing the health consumer skills of working populations.  Strategies for maximization of effectiveness and integration with supporting resources are also described.

Selected Abstracts
Nine (9) selected abstracts are provided in this edition.

Closing Thoughts
Editorial comments on the author’s major premise is offered along with seven (7) key health care reforms seen as necessary for meaningful future health consumerism.

American Journal of Health Promotion |  248-682-0707