GIS-based walkability measures designed to explain active travel fail to capture &amp... more GIS-based walkability measures designed to explain active travel fail to capture "playability" and proximity to healthy food. These constructs should be considered when measuring potential child obesogenic environments. The aim of this study was to describe the development of GIS-based multicomponent physical activity and nutrition environment indicators of child obesogenic environments in the San Diego and Seattle regions. Block group-level walkability (street connectivity, residential density, land-use mix, and retail floor area ratio) measures were constructed in each region. Multiple sources were used to enumerate parks (∼900-1600 per region) and food establishments (∼10,000 per region). Physical activity environments were evaluated on the basis of walkability and presence and quality of parks. Nutrition environments were evaluated based on presence and density of fast-food restaurants and distance to supermarkets. Four neighborhood types were defined using high/low cut points for physical activity and nutrition environments defined through an iterative process dependent on regional counts of fast-food outlets and overall distance to parks and grocery stores from census block groups where youth live. To identify sufficient numbers of children aged 6-11 years, high physical activity environment block groups had at least one high-quality park within 0.25 miles and were above median walkability, whereas low physical activity environment groups had no parks and were below median walkability. High nutrition environment block groups had a supermarket within 0.5 miles, and fewer than 16 (Seattle) and 31 (San Diego) fast-food restaurants within 0.5 miles. Low nutrition environments had either no supermarket, or a supermarket and more than 16 (Seattle) and 31 (San Diego) fast-food restaurants within 0.5 miles. Income, educational attainment, and ethnicity varied across physical activity and nutrition environments. These approaches to defining neighborhood environments can be used to study physical activity, nutrition, and obesity outcomes. Findings presented in a companion paper validate these GIS methods for measuring obesogenic environments.
Macro level built environment factors (eg, street connectivity, walkability) are correlated with ... more Macro level built environment factors (eg, street connectivity, walkability) are correlated with physical activity. Less studied but more modifiable microscale elements of the environment (eg, crosswalks) may also affect physical activity, but short audit measures of microscale elements are needed to promote wider use. This study evaluated the relation of a 15-item neighborhood environment audit tool with a full version of the tool to assess neighborhood design on physical activity in 4 age groups. From the 120-item Microscale Audit of Pedestrian Streetscapes (MAPS) measure of street design, sidewalks, and street crossings, we developed the 15-item version (MAPS-Mini) on the basis of associations with physical activity and attribute modifiability. As a sample of a likely walking route, MAPS-Mini was conducted on a 0.25-mile route from participant residences toward the nearest nonresidential destination for children (n = 758), adolescents (n = 897), younger adults (n = 1,655), and older adults (n = 367). Active transportation and leisure physical activity were measured with age-appropriate surveys, and accelerometers provided objective physical activity measures. Mixed-model regressions were conducted for each MAPS item and a total environment score, adjusted for demographics, participant clustering, and macrolevel walkability. Total scores of MAPS-Mini and the 120-item MAPS correlated at r = .85. Total microscale environment scores were significantly related to active transportation in all age groups. Items related to active transport in 3 age groups were presence of sidewalks, curb cuts, street lights, benches, and buffer between street and sidewalk. The total score was related to leisure physical activity and accelerometer measures only in children. The MAPS-Mini environment measure is short enough to be practical for use by community groups and planning agencies and is a valid substitute for the full version that is 8 times longer.
Walking is a popular form of physical activity associated with clear health benefits. Promoting s... more Walking is a popular form of physical activity associated with clear health benefits. Promoting safe walking for pedestrians requires evaluating the risk of pedestrian-motor vehicle collisions at specific roadway locations in order to identify where road improvements and other interventions may be needed. The objective of this analysis was to estimate the risk of pedestrian collisions at intersections and mid-blocks in Seattle, WA. The study used 2007-2013 pedestrian-motor vehicle collision data from police reports and detailed characteristics of the microenvironment and macroenvironment at intersection and mid-block locations. The primary outcome was the number of pedestrian-motor vehicle collisions over time at each location (incident rate ratio [IRR] and 95% confidence interval [95% CI]). Multilevel mixed effects Poisson models accounted for correlation within and between locations and census blocks over time. Analysis accounted for pedestrian and vehicle activity (e.g., resident...
Veterans, especially those using U.S. Department of Veterans Affairs (VA) healthcare, have poorer... more Veterans, especially those using U.S. Department of Veterans Affairs (VA) healthcare, have poorer health than the general population. In addition, Veterans using VA services are more likely than non-VA users to be physically inactive. Little is known about physical activity correlates among Veterans. To identify targets for health promotion interventions, understanding barriers to and facilitators of physical activity in this population is critical. This study examined individual-, social-, and perceived neighborhood-level associations of meeting weekly physical activity recommendations (150 min/week of combined leisure and transportation activity) based on the International Physical Activity Questionnaire (IPAQ) among N = 717 patients from VA Puget Sound, Seattle Division using a mailed survey sent 2012-2013 (response rate = 40%). Independent associations were identified with direct estimation of relative risks using generalized linear models (dichotomous outcome), and linear regression (continuous outcome), including variables associated in bivariate tests (p < .05). Most participants were male, Caucasian, and unemployed, and had an annual income ≤$40,000. Over two-thirds (69.9%) reported meeting physical activity recommendations. Fewer days of limitations due to physical or mental health (Relative Risk (RR) = 0.99 per day; 95% Confidence Interval (CI) = 0.98, 0.99; p = .01), others doing physical activity with the Veteran (RR = 1.18; 95% CI = 1.04, 1.33; p = .01), receiving ideas from others regarding physical activity (RR = 1.14; 95% CI = 1.01, 1.29; p = .03) and better perceived neighborhood aesthetics (RR = 1.14; 95% CI = 1.06, 1.24; p = .001) were associated with meeting physical activity recommendations. Findings were comparable for total weekly physical activity, but lower depression symptom severity was also associated with increased physical activity. This study identified individual and contextual correlates of physical activity among VA-using Veterans. Targeting these factors will be important in promoting physical activity in order to address the disproportionate disease burden facing U.S. Veterans. Existing VA interventions targeting physical activity may need to be adapted to account for the influence of contextual factors.
American journal of preventive medicine, Jan 21, 2015
The community food environment may contribute to obesity by influencing food choice. Store and re... more The community food environment may contribute to obesity by influencing food choice. Store and restaurant audits are increasingly common methods for assessing food environments, but are time consuming and costly. A valid, reliable brief measurement tool is needed. The purpose of this study was to develop and validate reduced-item food environment audit tools for stores and restaurants. Nutrition Environment Measures Surveys for stores (NEMS-S) and restaurants (NEMS-R) were completed in 820 stores and 1,795 restaurants in West Virginia, San Diego, and Seattle. Data mining techniques (correlation-based feature selection and linear regression) were used to identify survey items highly correlated to total survey scores and produce reduced-item audit tools that were subsequently validated against full NEMS surveys. Regression coefficients were used as weights that were applied to reduced-item tool items to generate comparable scores to full NEMS surveys. Data were collected and analyzed ...
CERIN, E., B. E. SAELENS, J. F. SALLIS, and L. D. FRANK. Neighborhood Environment Walkability Sca... more CERIN, E., B. E. SAELENS, J. F. SALLIS, and L. D. FRANK. Neighborhood Environment Walkability Scale: Validity and Development of a Short Form. Med. Sci. Sports Exerc., Vol. 38, No. 9, pp. 1682-1691, 2006. Purpose: The aim of this study was to examine the factorial and criterion validity of the Neighborhood Environment Walkability Scale (NEWS) and to develop an abbreviated
Body image, eating disorders, and obesity in youth: Assessment, prevention, and treatment., 2001
... BEHAVIORAL TREATMENT OF CHILDHOOD AND ADOLESCENT OBESITY: CURRENT STATUS, CHALLENGES, AND FUT... more ... BEHAVIORAL TREATMENT OF CHILDHOOD AND ADOLESCENT OBESITY: CURRENT STATUS, CHALLENGES, AND FUTURE DIRECTIONS MYLES S. FAITH ... the sedentary activity of television watching and adiposity among children (Andersen, Crespo, Bartlett, Cheskin, & ...
Journal of consulting and clinical psychology, 2014
To examine general and treatment-specific predictors of children's weight outcomes during a p... more To examine general and treatment-specific predictors of children's weight outcomes during a pediatric weight management trial. One hundred fifty overweight children-69.3% female; M body mass index (BMI) z score (z-BMI) = 2.21 ± 0.30-completed family-based behavioral weight loss treatment (FBT), followed by randomization to social facilitation maintenance (SFM) treatment addressing social support and body image; behavioral skills maintenance treatment (BSM), which extended FBT skills to maintenance; or a control condition with no maintenance treatment. Regression and mixed-effects repeated-measures analysis of covariance (ANCOVA) examined child and parent anthropometric, demographic, and psychosocial variables in predicting relative weight outcomes over short- and long-term follow-ups. Among FBT completers, lower child baseline z-BMI and age, and greater parent BMI reductions during FBT and baseline self-efficacy, predicted better child relative weight loss following FBT, F(6, 13...
Abdominal fat is more related to health risk than is whole-body fat. Determining the factors rela... more Abdominal fat is more related to health risk than is whole-body fat. Determining the factors related to children's visceral fat could result in interventions to improve child health. Given the effects of physical activity on adults' visceral fat, it was hypothesized that, after accounting for whole-body fat, physical activity would be inversely related to children's visceral (VAT), but not to subcutaneous (SAT), abdominal adipose tissue. In this cross-sectional observational study conducted in forty-two 8-y-old children (21 boys, 21 girls) at risk of obesity [>75th body mass index (BMI) percentile, with at least one overweight parent], familial factors (eg, maternal BMI), historic weight-related factors (eg, birth weight), and the children's current physical activity (self-reported and measured with accelerometry) and diet were examined as potential correlates of the children's whole-body composition (measured with BMI and dual-energy X-ray absorptiometry) and...
The primary goal of childhood obesity interventions is regulation of body weight and fat with ade... more The primary goal of childhood obesity interventions is regulation of body weight and fat with adequate nutrition for growth and development. Ideally, these interventions are associated with positive changes in the physiologic and psychological sequelae of obesity. To contribute to long-term weight maintenance, interventions should modify eating and exercise behaviors such that new, healthier behaviors develop and replace unhealthy behaviors, thereby allowing healthier behaviors to persist throughout development and into adulthood. This overview of pediatric obesity treatment, using predominantly randomized, controlled studies, highlights important contributions and developments in primarily dietary, activity, and behavior change interventions, and identifies characteristics of successful treatment and maintenance interventions. Potential positive (eg, reduction in blood pressure, serum lipids, and insulin resistance) and negative (eg, development of disordered eating patterns) side ...
International journal of obesity and related metabolic disorders : journal of the International Association for the Study of Obesity, 1998
This laboratory study examined whether making sedentary activities contingent upon being physical... more This laboratory study examined whether making sedentary activities contingent upon being physically active would increase obese children's physical activity. Fourteen obese children aged 8-12 y participated in a baseline session in which they had free choice among a variety of sedentary activities and riding a stationary bicycle. Children were then randomized to either a contingent group in which watching video cassette recorder (VCR) movies and playing video games were contingent upon riding the bicycle or a control group in which all physical and sedentary activities remained freely available. Contingent group children increased physical activity and decreased television activities in comparison to the control, even though other sedentary activities remained freely available. Findings suggest that highly valued sedentary activities can reinforce physical activities and that sedentary activities do not completely substitute amongst themselves. The automated system used to make ...
Neighborhood environment attributes of walkability and access to recreation facilities have been ... more Neighborhood environment attributes of walkability and access to recreation facilities have been related to physical activity and weight status, but most self-report environment measures are lengthy. The 17-item PANES (Physical Activity Neighborhood Environment Scale) was developed to be comprehensive but brief enough for use in multipurpose surveys. The current study evaluated test-retest and alternate-form reliability of PANES items compared with multi-item subscales from the longer NEWS-A (Neighborhood Environment Walkability Scale--Abbreviated). Participants were 291 adults recruited from neighborhoods that varied in walkability in 3 US cities. Surveys were completed twice with a 27-day interval. Test-retest ICCs for PANES items ranged from .52 to .88. Spearman correlations for the PANES single item vs NEWS-A subscale comparisons ranged from .27 to .81 (all P < .01). PANES items related to land use mix, residential density, pedestrian infrastructure, aesthetic qualities, and ...
In 2011, San Francisco passed the first citywide ordinance to improve the nutritional standards o... more In 2011, San Francisco passed the first citywide ordinance to improve the nutritional standards of children's meals sold at restaurants by preventing the giving away of free toys or other incentives with meals unless nutritional criteria were met. This study examined the impact of the Healthy Food Incentives Ordinance at ordinance-affected restaurants on restaurant response (eg, toy-distribution practices, change in children's menus), and the energy and nutrient content of all orders and children's-meal-only orders purchased for children aged 0 through 12 years. Restaurant responses were examined from January 2010 through March 2012. Parent-caregiver/child dyads (n = 762) who were restaurant customers were surveyed at 2 points before and 1 seasonally matched point after ordinance enactment at Chain A and B restaurants (n = 30) in 2011 and 2012. Both restaurant chains responded to the ordinance by selling toys separately from children's meals, but neither changed thei...
Background: Abdominal fat is more related to health risk than is whole-body fat. Determining the ... more Background: Abdominal fat is more related to health risk than is whole-body fat. Determining the factors related to children's vis- ceral fat could result in interventions to improve child health. Objective: Given the effects of physical activity on adults' visceral fat, it was hypothesized that, after accounting for whole-body fat, physical activity would be inversely related to children's visceral (VAT),
Most public transit users walk to and from transit. We analyzed the relationship between transit ... more Most public transit users walk to and from transit. We analyzed the relationship between transit commuting and objectively measured physical activity. Adults aged 20 to 65 working outside the home (n = 1237) were randomly selected from neighborhoods in Seattle and Baltimore regions. Neighborhoods had high or low median income and high or low mean walkability. Mean daily minutes of accelerometer-measured moderate-intensity physical activity (MPA) were regressed on frequency of commuting by transit and neighborhood walkability, adjusting for demographic factors and enjoyment of physical activity. Interaction terms and stratification were used to assess moderating effect of walkability on the relation between transit commuting and MPA. Associations between transit commuting and self-reported days walked to destinations near home and work were assessed using Chi Square tests. Regardless of neighborhood walkability, those commuting by transit accumulated more MPA (approximately 5 to 10 m...
Recent research highlights the potential value of differentiating between categories of physical ... more Recent research highlights the potential value of differentiating between categories of physical activity intensities as predictors of health and well-being. This study sought to assess reliability and concurrent validity of sedentary (ie, 1 METs), low-light (ie, >1 and ≤2 METs; eg, playing cards), high-light (ie, >2 and <3 METs; eg, light walking), moderate-to-vigorous physical activity (MVPA, ≥3 METs), and "total activity" (≥2 METs) from the CHAMPS survey. Further, this study explored over-reporting and double-reporting. CHAMPS data were gathered from the Seniors Neighborhood Quality of Life Study, an observational study of adults aged 65+ years conducted in 2 US regions. Participants (N = 870) were 75.3 ± 6.8 years old, with 56% women and 71% white. The CHAMPS sedentary, low-light, high-light, total activity, and MVPA variables had acceptable test-retest reliability (ICCs 0.56-0.70). The CHAMPS high-light (ρ = 0.27), total activity (ρ = 0.34), and MVPA (ρ = 0.3...
Journal of the Academy of Nutrition and Dietetics, 2012
Policies on menu labeling have been proposed as a method to improve the food environment. However... more Policies on menu labeling have been proposed as a method to improve the food environment. However, there is little information on the nutrient content of chain restaurant menu items and changes over time. To evaluate the energy, saturated fat, and sodium content of entrées 6 and 18 months post-implementation of restaurant menu labeling in King County of Washington State for items that were on the menu at both time periods, and across all items at 6 and 18 months and to compare energy content to recommendations provided by the 2005 Dietary Guidelines for Americans. Eligible restaurants included sit-down and quick-service chains (eg, burgers, pizza, sandwiches/subs, and Tex-Mex) subject to King County regulations with four or more establishments. One establishment per chain was audited at each time period. Hypothesis one examined entrées that were on the menu at both time periods using a paired t test and hypothesis two compared quartiles at 6 months to the distribution at 18 months using a Mantel-Haentzel odds ratios and 95% CIs, and a Cochrane-Armitage test for trend. The content of entrées at 18 months was compared with one-third (assuming three meals per day) of the nutrient intake recommendations for adults provided by the 2005 Dietary Guidelines for Americans. The audit included 37 eligible chains of 92 regulated chains. Energy contents were lower (all chains -41, sit down -73, and quick service -19; paired t tests P&amp;amp;amp;amp;amp;amp;amp;amp;lt;0.0001) for entrées that were on the menu at both time periods. There was a significant trend across quartiles for a decrease in energy, saturated fat, and sodium for all entrées at sit-down chains only. At 18 months entrées not designated for children exceeded 56%, 77%, and 89% of the energy, saturated fat, and sodium guidelines, respectively. Modest improvements in the nutrient content of sit-down and quick-service restaurant entrées occurred but overall levels for energy, saturated fat, and sodium are excessive.
GIS-based walkability measures designed to explain active travel fail to capture &amp;amp;amp... more GIS-based walkability measures designed to explain active travel fail to capture &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;playability&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; and proximity to healthy food. These constructs should be considered when measuring potential child obesogenic environments. The aim of this study was to describe the development of GIS-based multicomponent physical activity and nutrition environment indicators of child obesogenic environments in the San Diego and Seattle regions. Block group-level walkability (street connectivity, residential density, land-use mix, and retail floor area ratio) measures were constructed in each region. Multiple sources were used to enumerate parks (∼900-1600 per region) and food establishments (∼10,000 per region). Physical activity environments were evaluated on the basis of walkability and presence and quality of parks. Nutrition environments were evaluated based on presence and density of fast-food restaurants and distance to supermarkets. Four neighborhood types were defined using high/low cut points for physical activity and nutrition environments defined through an iterative process dependent on regional counts of fast-food outlets and overall distance to parks and grocery stores from census block groups where youth live. To identify sufficient numbers of children aged 6-11 years, high physical activity environment block groups had at least one high-quality park within 0.25 miles and were above median walkability, whereas low physical activity environment groups had no parks and were below median walkability. High nutrition environment block groups had a supermarket within 0.5 miles, and fewer than 16 (Seattle) and 31 (San Diego) fast-food restaurants within 0.5 miles. Low nutrition environments had either no supermarket, or a supermarket and more than 16 (Seattle) and 31 (San Diego) fast-food restaurants within 0.5 miles. Income, educational attainment, and ethnicity varied across physical activity and nutrition environments. These approaches to defining neighborhood environments can be used to study physical activity, nutrition, and obesity outcomes. Findings presented in a companion paper validate these GIS methods for measuring obesogenic environments.
Macro level built environment factors (eg, street connectivity, walkability) are correlated with ... more Macro level built environment factors (eg, street connectivity, walkability) are correlated with physical activity. Less studied but more modifiable microscale elements of the environment (eg, crosswalks) may also affect physical activity, but short audit measures of microscale elements are needed to promote wider use. This study evaluated the relation of a 15-item neighborhood environment audit tool with a full version of the tool to assess neighborhood design on physical activity in 4 age groups. From the 120-item Microscale Audit of Pedestrian Streetscapes (MAPS) measure of street design, sidewalks, and street crossings, we developed the 15-item version (MAPS-Mini) on the basis of associations with physical activity and attribute modifiability. As a sample of a likely walking route, MAPS-Mini was conducted on a 0.25-mile route from participant residences toward the nearest nonresidential destination for children (n = 758), adolescents (n = 897), younger adults (n = 1,655), and older adults (n = 367). Active transportation and leisure physical activity were measured with age-appropriate surveys, and accelerometers provided objective physical activity measures. Mixed-model regressions were conducted for each MAPS item and a total environment score, adjusted for demographics, participant clustering, and macrolevel walkability. Total scores of MAPS-Mini and the 120-item MAPS correlated at r = .85. Total microscale environment scores were significantly related to active transportation in all age groups. Items related to active transport in 3 age groups were presence of sidewalks, curb cuts, street lights, benches, and buffer between street and sidewalk. The total score was related to leisure physical activity and accelerometer measures only in children. The MAPS-Mini environment measure is short enough to be practical for use by community groups and planning agencies and is a valid substitute for the full version that is 8 times longer.
Walking is a popular form of physical activity associated with clear health benefits. Promoting s... more Walking is a popular form of physical activity associated with clear health benefits. Promoting safe walking for pedestrians requires evaluating the risk of pedestrian-motor vehicle collisions at specific roadway locations in order to identify where road improvements and other interventions may be needed. The objective of this analysis was to estimate the risk of pedestrian collisions at intersections and mid-blocks in Seattle, WA. The study used 2007-2013 pedestrian-motor vehicle collision data from police reports and detailed characteristics of the microenvironment and macroenvironment at intersection and mid-block locations. The primary outcome was the number of pedestrian-motor vehicle collisions over time at each location (incident rate ratio [IRR] and 95% confidence interval [95% CI]). Multilevel mixed effects Poisson models accounted for correlation within and between locations and census blocks over time. Analysis accounted for pedestrian and vehicle activity (e.g., resident...
Veterans, especially those using U.S. Department of Veterans Affairs (VA) healthcare, have poorer... more Veterans, especially those using U.S. Department of Veterans Affairs (VA) healthcare, have poorer health than the general population. In addition, Veterans using VA services are more likely than non-VA users to be physically inactive. Little is known about physical activity correlates among Veterans. To identify targets for health promotion interventions, understanding barriers to and facilitators of physical activity in this population is critical. This study examined individual-, social-, and perceived neighborhood-level associations of meeting weekly physical activity recommendations (150 min/week of combined leisure and transportation activity) based on the International Physical Activity Questionnaire (IPAQ) among N = 717 patients from VA Puget Sound, Seattle Division using a mailed survey sent 2012-2013 (response rate = 40%). Independent associations were identified with direct estimation of relative risks using generalized linear models (dichotomous outcome), and linear regression (continuous outcome), including variables associated in bivariate tests (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .05). Most participants were male, Caucasian, and unemployed, and had an annual income ≤$40,000. Over two-thirds (69.9%) reported meeting physical activity recommendations. Fewer days of limitations due to physical or mental health (Relative Risk (RR) = 0.99 per day; 95% Confidence Interval (CI) = 0.98, 0.99; p = .01), others doing physical activity with the Veteran (RR = 1.18; 95% CI = 1.04, 1.33; p = .01), receiving ideas from others regarding physical activity (RR = 1.14; 95% CI = 1.01, 1.29; p = .03) and better perceived neighborhood aesthetics (RR = 1.14; 95% CI = 1.06, 1.24; p = .001) were associated with meeting physical activity recommendations. Findings were comparable for total weekly physical activity, but lower depression symptom severity was also associated with increased physical activity. This study identified individual and contextual correlates of physical activity among VA-using Veterans. Targeting these factors will be important in promoting physical activity in order to address the disproportionate disease burden facing U.S. Veterans. Existing VA interventions targeting physical activity may need to be adapted to account for the influence of contextual factors.
American journal of preventive medicine, Jan 21, 2015
The community food environment may contribute to obesity by influencing food choice. Store and re... more The community food environment may contribute to obesity by influencing food choice. Store and restaurant audits are increasingly common methods for assessing food environments, but are time consuming and costly. A valid, reliable brief measurement tool is needed. The purpose of this study was to develop and validate reduced-item food environment audit tools for stores and restaurants. Nutrition Environment Measures Surveys for stores (NEMS-S) and restaurants (NEMS-R) were completed in 820 stores and 1,795 restaurants in West Virginia, San Diego, and Seattle. Data mining techniques (correlation-based feature selection and linear regression) were used to identify survey items highly correlated to total survey scores and produce reduced-item audit tools that were subsequently validated against full NEMS surveys. Regression coefficients were used as weights that were applied to reduced-item tool items to generate comparable scores to full NEMS surveys. Data were collected and analyzed ...
CERIN, E., B. E. SAELENS, J. F. SALLIS, and L. D. FRANK. Neighborhood Environment Walkability Sca... more CERIN, E., B. E. SAELENS, J. F. SALLIS, and L. D. FRANK. Neighborhood Environment Walkability Scale: Validity and Development of a Short Form. Med. Sci. Sports Exerc., Vol. 38, No. 9, pp. 1682-1691, 2006. Purpose: The aim of this study was to examine the factorial and criterion validity of the Neighborhood Environment Walkability Scale (NEWS) and to develop an abbreviated
Body image, eating disorders, and obesity in youth: Assessment, prevention, and treatment., 2001
... BEHAVIORAL TREATMENT OF CHILDHOOD AND ADOLESCENT OBESITY: CURRENT STATUS, CHALLENGES, AND FUT... more ... BEHAVIORAL TREATMENT OF CHILDHOOD AND ADOLESCENT OBESITY: CURRENT STATUS, CHALLENGES, AND FUTURE DIRECTIONS MYLES S. FAITH ... the sedentary activity of television watching and adiposity among children (Andersen, Crespo, Bartlett, Cheskin, &amp;amp;amp;amp; ...
Journal of consulting and clinical psychology, 2014
To examine general and treatment-specific predictors of children's weight outcomes during a p... more To examine general and treatment-specific predictors of children's weight outcomes during a pediatric weight management trial. One hundred fifty overweight children-69.3% female; M body mass index (BMI) z score (z-BMI) = 2.21 ± 0.30-completed family-based behavioral weight loss treatment (FBT), followed by randomization to social facilitation maintenance (SFM) treatment addressing social support and body image; behavioral skills maintenance treatment (BSM), which extended FBT skills to maintenance; or a control condition with no maintenance treatment. Regression and mixed-effects repeated-measures analysis of covariance (ANCOVA) examined child and parent anthropometric, demographic, and psychosocial variables in predicting relative weight outcomes over short- and long-term follow-ups. Among FBT completers, lower child baseline z-BMI and age, and greater parent BMI reductions during FBT and baseline self-efficacy, predicted better child relative weight loss following FBT, F(6, 13...
Abdominal fat is more related to health risk than is whole-body fat. Determining the factors rela... more Abdominal fat is more related to health risk than is whole-body fat. Determining the factors related to children's visceral fat could result in interventions to improve child health. Given the effects of physical activity on adults' visceral fat, it was hypothesized that, after accounting for whole-body fat, physical activity would be inversely related to children's visceral (VAT), but not to subcutaneous (SAT), abdominal adipose tissue. In this cross-sectional observational study conducted in forty-two 8-y-old children (21 boys, 21 girls) at risk of obesity [>75th body mass index (BMI) percentile, with at least one overweight parent], familial factors (eg, maternal BMI), historic weight-related factors (eg, birth weight), and the children's current physical activity (self-reported and measured with accelerometry) and diet were examined as potential correlates of the children's whole-body composition (measured with BMI and dual-energy X-ray absorptiometry) and...
The primary goal of childhood obesity interventions is regulation of body weight and fat with ade... more The primary goal of childhood obesity interventions is regulation of body weight and fat with adequate nutrition for growth and development. Ideally, these interventions are associated with positive changes in the physiologic and psychological sequelae of obesity. To contribute to long-term weight maintenance, interventions should modify eating and exercise behaviors such that new, healthier behaviors develop and replace unhealthy behaviors, thereby allowing healthier behaviors to persist throughout development and into adulthood. This overview of pediatric obesity treatment, using predominantly randomized, controlled studies, highlights important contributions and developments in primarily dietary, activity, and behavior change interventions, and identifies characteristics of successful treatment and maintenance interventions. Potential positive (eg, reduction in blood pressure, serum lipids, and insulin resistance) and negative (eg, development of disordered eating patterns) side ...
International journal of obesity and related metabolic disorders : journal of the International Association for the Study of Obesity, 1998
This laboratory study examined whether making sedentary activities contingent upon being physical... more This laboratory study examined whether making sedentary activities contingent upon being physically active would increase obese children's physical activity. Fourteen obese children aged 8-12 y participated in a baseline session in which they had free choice among a variety of sedentary activities and riding a stationary bicycle. Children were then randomized to either a contingent group in which watching video cassette recorder (VCR) movies and playing video games were contingent upon riding the bicycle or a control group in which all physical and sedentary activities remained freely available. Contingent group children increased physical activity and decreased television activities in comparison to the control, even though other sedentary activities remained freely available. Findings suggest that highly valued sedentary activities can reinforce physical activities and that sedentary activities do not completely substitute amongst themselves. The automated system used to make ...
Neighborhood environment attributes of walkability and access to recreation facilities have been ... more Neighborhood environment attributes of walkability and access to recreation facilities have been related to physical activity and weight status, but most self-report environment measures are lengthy. The 17-item PANES (Physical Activity Neighborhood Environment Scale) was developed to be comprehensive but brief enough for use in multipurpose surveys. The current study evaluated test-retest and alternate-form reliability of PANES items compared with multi-item subscales from the longer NEWS-A (Neighborhood Environment Walkability Scale--Abbreviated). Participants were 291 adults recruited from neighborhoods that varied in walkability in 3 US cities. Surveys were completed twice with a 27-day interval. Test-retest ICCs for PANES items ranged from .52 to .88. Spearman correlations for the PANES single item vs NEWS-A subscale comparisons ranged from .27 to .81 (all P < .01). PANES items related to land use mix, residential density, pedestrian infrastructure, aesthetic qualities, and ...
In 2011, San Francisco passed the first citywide ordinance to improve the nutritional standards o... more In 2011, San Francisco passed the first citywide ordinance to improve the nutritional standards of children's meals sold at restaurants by preventing the giving away of free toys or other incentives with meals unless nutritional criteria were met. This study examined the impact of the Healthy Food Incentives Ordinance at ordinance-affected restaurants on restaurant response (eg, toy-distribution practices, change in children's menus), and the energy and nutrient content of all orders and children's-meal-only orders purchased for children aged 0 through 12 years. Restaurant responses were examined from January 2010 through March 2012. Parent-caregiver/child dyads (n = 762) who were restaurant customers were surveyed at 2 points before and 1 seasonally matched point after ordinance enactment at Chain A and B restaurants (n = 30) in 2011 and 2012. Both restaurant chains responded to the ordinance by selling toys separately from children's meals, but neither changed thei...
Background: Abdominal fat is more related to health risk than is whole-body fat. Determining the ... more Background: Abdominal fat is more related to health risk than is whole-body fat. Determining the factors related to children's vis- ceral fat could result in interventions to improve child health. Objective: Given the effects of physical activity on adults' visceral fat, it was hypothesized that, after accounting for whole-body fat, physical activity would be inversely related to children's visceral (VAT),
Most public transit users walk to and from transit. We analyzed the relationship between transit ... more Most public transit users walk to and from transit. We analyzed the relationship between transit commuting and objectively measured physical activity. Adults aged 20 to 65 working outside the home (n = 1237) were randomly selected from neighborhoods in Seattle and Baltimore regions. Neighborhoods had high or low median income and high or low mean walkability. Mean daily minutes of accelerometer-measured moderate-intensity physical activity (MPA) were regressed on frequency of commuting by transit and neighborhood walkability, adjusting for demographic factors and enjoyment of physical activity. Interaction terms and stratification were used to assess moderating effect of walkability on the relation between transit commuting and MPA. Associations between transit commuting and self-reported days walked to destinations near home and work were assessed using Chi Square tests. Regardless of neighborhood walkability, those commuting by transit accumulated more MPA (approximately 5 to 10 m...
Recent research highlights the potential value of differentiating between categories of physical ... more Recent research highlights the potential value of differentiating between categories of physical activity intensities as predictors of health and well-being. This study sought to assess reliability and concurrent validity of sedentary (ie, 1 METs), low-light (ie, >1 and ≤2 METs; eg, playing cards), high-light (ie, >2 and <3 METs; eg, light walking), moderate-to-vigorous physical activity (MVPA, ≥3 METs), and "total activity" (≥2 METs) from the CHAMPS survey. Further, this study explored over-reporting and double-reporting. CHAMPS data were gathered from the Seniors Neighborhood Quality of Life Study, an observational study of adults aged 65+ years conducted in 2 US regions. Participants (N = 870) were 75.3 ± 6.8 years old, with 56% women and 71% white. The CHAMPS sedentary, low-light, high-light, total activity, and MVPA variables had acceptable test-retest reliability (ICCs 0.56-0.70). The CHAMPS high-light (ρ = 0.27), total activity (ρ = 0.34), and MVPA (ρ = 0.3...
Journal of the Academy of Nutrition and Dietetics, 2012
Policies on menu labeling have been proposed as a method to improve the food environment. However... more Policies on menu labeling have been proposed as a method to improve the food environment. However, there is little information on the nutrient content of chain restaurant menu items and changes over time. To evaluate the energy, saturated fat, and sodium content of entrées 6 and 18 months post-implementation of restaurant menu labeling in King County of Washington State for items that were on the menu at both time periods, and across all items at 6 and 18 months and to compare energy content to recommendations provided by the 2005 Dietary Guidelines for Americans. Eligible restaurants included sit-down and quick-service chains (eg, burgers, pizza, sandwiches/subs, and Tex-Mex) subject to King County regulations with four or more establishments. One establishment per chain was audited at each time period. Hypothesis one examined entrées that were on the menu at both time periods using a paired t test and hypothesis two compared quartiles at 6 months to the distribution at 18 months using a Mantel-Haentzel odds ratios and 95% CIs, and a Cochrane-Armitage test for trend. The content of entrées at 18 months was compared with one-third (assuming three meals per day) of the nutrient intake recommendations for adults provided by the 2005 Dietary Guidelines for Americans. The audit included 37 eligible chains of 92 regulated chains. Energy contents were lower (all chains -41, sit down -73, and quick service -19; paired t tests P&amp;amp;amp;amp;amp;amp;amp;amp;lt;0.0001) for entrées that were on the menu at both time periods. There was a significant trend across quartiles for a decrease in energy, saturated fat, and sodium for all entrées at sit-down chains only. At 18 months entrées not designated for children exceeded 56%, 77%, and 89% of the energy, saturated fat, and sodium guidelines, respectively. Modest improvements in the nutrient content of sit-down and quick-service restaurant entrées occurred but overall levels for energy, saturated fat, and sodium are excessive.
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