Suchergebnisse

Purpose. Describe best practices for implementing a variety of lifestyle interventions targeting cardiovascular disease risk factors. Approach. A mixed-methods approach was used to collect and analyze data. The study was guided by the RE-AIM framework. Setting. Selected Well-Integrated Screening and Intervention for Women Across the Nation (WISEWOMAN) projects funded by the Centers for Disease Control and Prevention. Participants. Five of the 15 currently operating WISEWOMAN projects were selected for study. Selection was based on availability of quantitative performance data, which were used to identify two high-performing and one low-performing sites within each project. Method. Qualitative data collection included a review of program materials; telephone interviews with federal, project, and local staff and site visits. Site visits involved interviews with staff, observations of the lifestyle intervention, and discussions with focus groups of participants. Analysis involved writing site reports, developing theme tables, identifying practices of interest, and applying an algorithm to identify best practices. Results. Eighty-seven best practices were identified. We present a subset of 31 practices applicable to other public health programs and for which differences in how high- and low-performing sites used the practices were identified. Discussion. Many of the best practices identified are applicable to broader audiences. Practitioners interested in strategies to recruit, engage, and retain participants and to facilitate behavior change can learn from these practices.

Purpose. Obesity has reached epidemic proportions. Public health practitioners are distinctly positioned to promote the environmental changes essential to addressing obesity. The Centers for Disease Control and Prevention (CDC) and other entities provide evidence and technical assistance to support this work, yet little is known about how practitioners use evidence and support as they intervene to prevent obesity. The study's purpose was to describe how practitioners and CDC project officers characterized the obesity prevention task, where practitioners accessed support and evidence, and what approaches to support and evidence they found most useful. Approach or Design. Mixed-methods, cross-sectional interviews, and survey. Setting. State-level public health obesity prevention programs. Participants. Public health practitioners and CDC project officers. Method. We conducted 10 in-depth interviews with public health practitioners (n = 7) and project officers (n = 3) followed by an online survey completed by 62 practitioners (50% response rate). We applied content analysis to interview data and descriptive statistics to survey data. Results. Practitioners characterized obesity prevention as uncertain and complex, involving interdependence among actors, multiple levels of activity, an excess of information, and a paucity of evidence. Survey findings provide further detail on the types of evidence and support practitioners used and valued. Conclusion. We recommend approaches to tailoring evidence and support to the needs of practitioners working on obesity prevention and other complex health problems.

Purpose.To describe a 4-year intervention targeting fruit/vegetable consumption by high school students.Design.This is a cohort study involving six pairs of schools (n = 12) matched on gender, race, enrollment, and location with schools randomly assigned within pairs to intervention or control conditions.Setting.Twelve Archdiocese of New Orleans high schools.Subjects.Cohort was defined as students (n = 2339) who were ninth-graders in the 1993–94 school year who provided baseline data.Intervention.Four components of the intervention are: (1) school-wide media-marketing campaign, (2) school-wide meal and snack modification, (3) classroom workshops and supplementary subject matter activities, and (4) parental involvement.Measures.Focus groups were conducted for target population input and program development. Process evaluation included student feedback on media-marketing intervention materials and activities reported here. Process measures also included school meal participation, student characteristics, and verification of intervention activities.Results.Focus groups indentified barriers to increased consumption of fruit and vegetables as lack of availability, variety, and inconsistency in taste. Student attitudes were favorable regarding a school program to improve diet and parental involvement. Low consumption of fruits/vegetables was reported. After a 2-month school-wide program introduction utilizing various media-marketing materials and activities, 93% of students were aware of the program and 96% could identify the healthy eating message.Conclusions.Program development can be guided and enriched by student input via focus groups. Media-marketing activities effectively delivered health messages and attracted students' attention. Materials and activities used were acceptable channels for increasing awareness, positive attitudes, and knowledge about fruits/vegetables.

In response to current dietary recommendations, the "Heart Smart" School Lunch Program has developed a model using the classroom to transfer knowledge and the school lunch program to facilitate cardiovascular healthy eating behavior. Dietary changes focus on reduction in sodium, fat (specifically saturated fat), and sugar in school lunches. Strategies to institutionalize these dietary changes comprise five major areas within quantity food production: menu planning, food purchasing, recipe modification, food preparation, and food production techniques. These recommendations could be applied for use in school health promotion programs throughout the nation.