72 resultados para Students, Medical, Psychology
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Invited commentary on "When Policy Opportunity is not Enough: College Access and Enrollment Patterns among Texas Percent Plan Eligible Students" by Catherine Horn and Stella Flores.
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Purpose: School districts in the U.S. regularly offer foods that compete with the USDA reimbursable meal, known as `a la carte' foods. These foods must adhere to state nutritional regulations; however, the implementation of these regulations often differs across districts. The purpose of this study is to compare two methods of offering a la carte foods on student's lunch intake: 1) an extensive a la carte program in which schools have a separate area for a la carte food sales, that includes non-reimbursable entrees; and 2) a moderate a la carte program, which offers the sale of a la carte foods on the same serving line with reimbursable meals. ^ Methods: Direct observation was used to assess children's lunch consumption in six schools, across two districts in Central Texas (n=373 observations). Schools were matched on socioeconomic status. Data collectors were randomly assigned to students, and recorded foods obtained, foods consumed, source of food, gender, grade, and ethnicity. Observations were entered into a nutrient database program, FIAS Millennium Edition, to obtain nutritional information. Differences in energy and nutrient intake across lunch sources and districts were assessed using ANOVA and independent t-tests. A linear regression model was applied to control for potential confounders. ^ Results: Students at schools with extensive a la carte programs consumed significantly more calories, carbohydrates, total fat, saturated fat, calcium, and sodium compared to students in schools with moderate a la carte offerings (p<.05). Students in the extensive a la carte program consumed approximately 94 calories more than students in the moderate a la carte program. There was no significant difference in the energy consumption in students who consumed any amount of a la carte compared to students who consumed none. In both districts, students who consumed a la carte offerings were more likely to consume sugar-sweetened beverages, sweets, chips, and pizza compared to students who consumed no a la carte foods. ^ Conclusion: The amount, type and method of offering a la carte foods can significantly affect student dietary intake. This pilot study indicates that when a la carte foods are more available, students consume more calories. Findings underscore the need for further investigation on how availability of a la carte foods affects children's diets. Guidelines for school a la carte offerings should be maximized to encourage the consumption of healthful foods and appropriate energy intake.^
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Study 1: Schools provide a range of opportunities for youth to be active, however, over the past decade, these opportunities have been declining. Sports teams are a promising venue to promote physical activity yet limited research has examined the gender an ethnic differences in sport participation. The purpose of this study is to examine trends in sport participation from 1991-2009 among US high school students. Secondly, we examined the association between gender and ethnicity with sports over time. This serial cross-sectional study used surveillance data from the Youth Risk Behavior Survey, a probability based sample weighted to represent gender and race/ethnic subpopulations of US high school students. The findings of this paper reveal persistent gender and ethnic disparities for sports participation among US youth. Since sports teams may provide a substantial source of physical activity, greater efforts should be undertaken to increase the participation of girls, especially minorities, in sports teams. ^ Study 2: Sports team participation is congruent with teaching and supporting healthy eating, yet limited research has examined the association between sports participation and dietary behaviors. This study aims to determine the association between youth sports participation and dietary behaviors among elementary-aged children. Significant dose-response associations were observed between number of sports teams and consumption of most fruits and vegetables. The likelihood of eating fruit for boys increased with the number of sports teams (1 team: OR=1.89; 3 teams: OR=3.44, p<0.001) and the likelihood of consuming green vegetables for girls was higher with the number of sports teams (1 team: OR=1.50; 3 teams: OR=2.39; p<0.001). For boys, the odds of consuming fruit-flavored drinks was higher ( p=0.019) and the odds of drinking soda was lower (p=0.018) with participation in increasing number of sports teams whereas for girls, sports participation was positively associated with diet soda consumption (p=0.006). ^ Study 3: Parents and peers have been shown to have a strong influence over the physical activity, dietary, and sedentary behaviors of youth. Youth sports teams have the potential to offer physical activity, displace sedentary behaviors, and promote a healthy diet. The purpose of this study is to assess how peer and parental support for physical activity and healthy eating, coupled with sport participation, is associated obesity related risk factors including diet and sedentary behaviors. A secondary analysis of data from the School Physical Activity and Nutrition study, a state-representative survey, was conducted. Eighth (n=3,931) and 11th (n=2,785) grade students were categorized into four groups based upon the level of peer and parental support derived from a three item scale and their participation in sports (sports/high support, sports/low support, no sports/high support, no sports/low support). Linear models were conducted to determine the difference in means between these groups for the following outcome variables: previous day fruit and vegetable intake, scores for an unhealthy and healthy food index, and hours spent watching television, playing video games, and working on a computer. Eighth graders had significantly greater levels of parental support for healthy eating and physical activity compared to 11th grade. Both 8 th and 11th graders in the sport/high support for healthy eating from peers and parents scored significantly higher on the healthy food index than other groups. Eighth and 11th graders in the sport/high support for physical activity from peers participated in fewer hours of sedentary behaviors than any other group (p ≤ 0.032). Although it is thought that sport participation may offer opportunities to support a healthy diet and displace sedentary time by offering providing physical activity, our study found that parental and peer support for activity and healthy eating may further attenuate this association. Parents and peer support should be an important target when developing strategies to improve healthy diets and reduce sedentary time among youth, especially in the context of youth sports. (Abstract shortened by UMI.)^
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Background. Similar to parent support in the home environment, teacher support at school may positively influence children's fruit and vegetable (FV) consumption. This study assessed the relationship between teacher support for FV consumption and the FV intake of 4th and 5th grade students in low-income elementary schools in central Texas. Methods. A secondary analysis was performed on baseline data collected from 496 parent-child dyads during the Marathon Kids study carried out by the Michael & Susan Dell Center for Healthy Living at the University of Texas School of Public Health. A hierarchical linear regression analysis adjusting for key demographic variables, parent support, and home FV availability was conducted. In addition, separate linear regression models stratified by quartiles of home FV availability were conducted to assess the relationship between teacher support and FV intake by level of home FV availability. Results. Teacher support was not significantly related to students' FV intake (p = .44). However, the interaction of teacher support and home FV availability was positively associated with students' FV consumption (p < .05). For students in the lowest quartile of home FV availability, teacher support accounted for approximately 6% of the FV intake variance (p = .02). For higher levels of FV availability, teacher support and FV intake were not related. Conclusions. For lower income elementary school-aged children with low FV availability at home, greater teacher support may lead to modest increases in FV consumption.^
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Adolescent substance use is a serious public health concern with long-lasting consequences. Although specific coping behaviors have been associated with adolescent substance use, less is known about the role of multidimensional coping styles that account for both positive and negative coping behaviors. This study examined the association of coping styles and substance use (alcohol, marijuana, and other illicit drugs) of 1,019 ethnically diverse high school students. Coping styles were categorized by high or low negative coping behaviors (e.g. distraction, social withdrawal, self-criticism, blame others, wishful thinking, resignation, and negative emotional regulation) and high or low positive coping behaviors (e.g. cognitive restructuring, problem-solving, social support, and positive emotional regulation). My hypothesis that high positive coping, regardless of the use of negative coping behaviors, would be protective against substance use was rejected. Logistic regression analyses controlling for age, gender, race, and parent education indicated that adolescents who relied primarily on adaptive coping were 45-67% less likely to report lifetime or past year substance use than any other coping style. However, mixed copers (i.e. high in both positive and negative coping behaviors) were 2 to 3 times as likely to report substance use than their adaptive coping counterparts.^
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Habitual consumption of sugar-sweetened beverages (SSB) has been reliably linked to obesity in adolescents. A wide variety of beverages sweetened with sugar are available to this population. The objective of this secondary data analysis was to assess the consumption of SSB by category and to identify behaviors that occur concurrently with the consumption of soda, sport drinks and fruit-flavored drinks in high school students. The analysis used self-reported survey data from 97 adolescents ages 14 to 18. SSB categories considered in the consumption analysis included regular soda, sports drinks, fruit-flavored drinks (FFD), iced tea, coffee drinks and energy drinks. The mean weekly sweetened beverage load in this population, calculated from the frequency and amount of consumption, was 145 ounces when all categories were considered. When SSB categories were considered independently, sports drinks (45 oz.) had the highest contribution to the mean sweetened beverage load followed by FFD (41 oz.), iced tea (27 oz.), soda (26 oz.) coffee drinks (15 oz.) and energy drinks (2 oz.). Sweetened beverage load was higher in boys (151 oz.) than girls (138 oz.) and was highest in Hispanics (159 oz.) followed by whites (152 oz.), blacks (137 oz.) and others (104 oz.). Behaviors that occurred on a usual basis during SSB consumption included watching TV, eating a family meal, eating salty and fried foods, being on the computer and hanging out with friends. Activities concurrent with sports drink consumption included physical activity behaviors whereas soda and FFD did not. Sports drink and FFD consumption commonly co-occurred with fruit consumption. Multiple SSB categories contribute to the total SSB consumption and the common dietary and activity behaviors are distinct between categories. Several of the concurrent behaviors point to the importance of home beverage availability, and to the influence that parents and peers have on SSB consumption. Identifying and assessing intervention strategies targeted to specific beverage categories could be an important step in behavioral intervention research aimed at reducing added sugar consumption, and ultimately, promote a healthy weight in adolescents. ^
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Existing data, collected from 1st-year students enrolled in a major Health Science Community College in the south central United States, for Fall 2010, Spring 2011, Fall 2011 and Spring 2012 semesters as part of the "Online Navigational Assessment Vehicle, Intervention Guidance, and Targeting of Risks (NAVIGATOR) for Undergraduate Minority Student Success" with CPHS approval number HSC-GEN-07-0158, was used for this thesis. The Personal Background and Preparation Survey (PBPS) and a two-question risk self-assessment subscale were administered to students during their 1st-year orientation. The PBPS total risk score, risk self-assessment total and overall scores, and Under Representative Minority Student (URMS) status were recorded. The purpose of this study is to evaluate and report the predictive validity of the indicators identified above for Adverse Academic Status Events (AASE) and Nonadvancement Adverse Academic Status Events (NAASE) as well as the effectiveness of interventions targeted using the PBPS among a diverse population of health science community college students. The predictive validity of the PBPS for AASE has previously been demonstrated among health science professions and graduate students (Johnson, Johnson, Kim, & McKee, 2009a; Johnson, Johnson, McKee, & Kim, 2009b). Data will be analyzed using binary logistic regression and correlation using SPSS 19 statistical package. Independent variables will include baseline- versus intervention-year treatments, PBPS, risk self-assessment, and URMS status. The dependent variables will be binary AASE and NAASE status. ^ The PBPS was the first reliable diagnostic and prescriptive instrument to establish documented predictive validity for student Adverse Academic Status Events (AASE) among students attending health science professional schools. These results extend the documented validity for the PBPS in predicting AASE to a health science community college student population. Results further demonstrated that interventions introduced using the PBPS were followed by approximately one-third reduction in the odds of Nonadvancement Adverse Academic Status Events (NAASE), controlling for URMS status and risk self-assessment scores. These results indicate interventions introduced using the PBPS may have potential to reduce AASE or attrition among URMS and nonURMS attending health science community colleges on a broader scale; positively impacting costs, shortages, and diversity of health science professionals.^
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Objectives: The purpose of this study is to understand the perceived effects of patient-dental staff communication and cultural diversity on the utilization of dental services in the U.S. by Saudi Arabian students who live in the U.S. and enrolled into the King Abdullah Scholarship program. Methods: The study design was an analytical cross-sectional study. Data for this study was obtained from the Saudi Dental Servicers Utilization Survey, a voluntary internet survey available online for one month through Facebook. Ordered logistic regression analyses and multinomial logistic regression analyses were used to measure the relationships between patient-dental staff communication and cultural diversity on the utilization of dental services. Results: Eight hundred and forty-seven responses were analyzed for this study. Overall, the majority of Saudi students reported having excellent communication experience with dental providers in the U.S. More than 58% of respondents reported at least one regular dental visit last year. Factors that influenced the use of regular dental care were: dentist's explanation of treatment plan, response of dental staff to patient's needs, respectful and polite dental staff, dental staff kindness, availability of up-to-date equipment, and overall communication with dentist. However, the utilization of emergency dental care was not associated with any measurement of patient-dental provider communication. Overall future utilization of dental care is associated with all aspects of patient-dental staff communication measured in this survey. Furthermore, more utilization of regular dental care was related to respondent's perception of the importance of trustworthiness dental staff and the importance of a dentist's reputation was only marginally associated. Respondent's perception of dentist's reputation was associated with more use of emergency dental services. Respondents are more likely to anticipate using dental care in the future if they perceived trustworthiness dental staff, and the dentist's reputation as influencing factors to their usage of dental services. Conclusions: Patient-dental staff communication was partially associated with utilization of regular dental care, not associated with utilization of emergency dental care, and broadly associated with anticipated future utilization of dental care. In addition, trustworthy dental staff, and a dentist's reputation were considered to be strong influencing factors towards utilization of dental services.^
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Uruguay has some of the strictest tobacco-control laws in Latin America. Despite this, youth smoking rates in Uruguay are amongst the highest in South America. Thus, it is important to identify strategies to prevent youth smoking in Uruguay. The current qualitative research study sought to identify intrapersonal and socioenvironmental factors that are associated with smoking among middle school youth in Uruguay. It also sought to develop potential prevention strategies and media messages that would resonate with youth for a social media campaign. The study was grounded in social cognitive theory and the theory of reasoned action/planned behavior, among other behavioral science theories; anthropological perspectives were also considered. To achieve these goals, 29 group and individual structured interviews were conducted in two private middle schools catering to lower and higher SES youth in Montevideo, Uruguay during the summer of 2012. One hundred and three study participants, including students, parents, and teachers, were interviewed. The structured interviews were recorded, transcribed, translated, back translated, coded and analyzed. The study findings show that positive attitudes towards smoking (i.e. to be seen, to increase status, to ensure women's equality, to looking old, and to service as a rite of passage), delinquent behavior (i.e. transgression/deviant behavior), social norms that support smoking (i.e. peer pressure and modeling, group membership/sense of belonging, parental modeling, and family support), easy access and availability to tobacco (i.e. retails stores) were factors associated with youth smoking. Potential protective factors may include parental support, negative attitudes towards smoking, sports/music, and smoke-free environments. Because study participants are accustomed to government-sponsored strong countermarketing graphic imaging, study participants selected even stronger images and messages as the preferred way to receive tobacco prevention messages. Something Real ("Algo Real") was a theme that resonated with the participants and chosen as the name for the proposed campaign. This campaign was designed as a multiple component intervention that included mass, school base, and family based strategies to prevent tobacco use. Some intervention materials specific to these intervention components were developed to target relevant intrapersonal and socioenvironmental factors identified above. These materials will be tested in future pilot studies and larger scale evaluation with this population, outside the scope of this dissertation. ^
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For adolescents, unprotected sexual intercourse is the primary cause of sexually transmitted disease (STD), including Human Immunodeficiency Virus (HIV) infection (virus which causes Acquired Immunodeficiency Syndrome (AIDS)), and pregnancy. Although many studies on adolescent sexual behavior have addressed racial/ethnic differences, few studies have examined the relation between race/ethnicity while controlling for other sociocultural and psychosocial variables. The purpose of this study is to examine the relationship between racial/ethnic categories and selected sociocultural and psychosocial variables, with reported adolescent sexual risk-taking and preventive behavior.^ A self-administered questionnaire was used to collect information from 3132 students in a Texas school district (Section 3.5.2). The instrument contained approximately 100 questions on demographic characteristics, sexual behavior, and psychosocial determinants of sexual behavior. Based on the findings of this study, the following major conclusions are made: (1) There are differences in reported sexual risk-taking and preventive behavior among Black, Hispanic and White adolescents in this study. The stratified analysis by gender further suggests significant gender differences in reported sexual behavior among the three racial/ethnic groups. (2) Gender, living arrangement, academic grades, and language spoken at home modified the association between reported sexual risk-taking and preventive behavior and race/ethnicity in this study. This suggests that these sociocultural variables should be considered in future research and practice involving multicultural populations. (3) There are differences in selected psychosocial determinants among the three racial/ethnic groups and between males and females. These differences were consistent with the reported sexual risk-taking and preventive behaviors among race/ethnicity and gender for adolescents in this study. The findings support the consideration of psychosocial determinants in research and interventions addressing adolescent sexual behavior among different racial/ethnic groups.^ Based on the results of this study, two recommendations for practice are made. First, health professionals developing interventions for adolescents from different cultural backgrounds and gender need to be familiar with the specific sociocultural and psychosocial factors which will reduce risky sexual behavior, and promote protective behavior. Second, the need for immediate, realistic, and continuous HIV/STD and pregnancy prevention programs for children and adolescents should be considered. ^
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In recent decades, work has become an increasingly common feature of adolescent life in the United States. Once assumed to be an inherently positive experience for youth, school year work has recently been associated with several adverse effects, especially as the number of hours of weekly work increases. The purpose of this dissertation was to describe the impact of school year work on adolescent development in a sample of high school students from rural South Texas, an area where economically-disadvantaged and Hispanic students are heavily represented.^ The first study described the prevalence and work circumstances of 3,565 10$\rm\sp{th}$ and 12$\rm\sp{th}$ grade students who responded to anonymous surveys conducted in regular classrooms. The overall prevalence of current work was 53%. Prevalence differed by grade, college-noncollege-bound status, and parent education. Fifty percent of employed students worked to support consumer spending.^ The second study examined the effects of four levels of work intensity on the academic, behavioral, social, mental and physical health of students. The following negative effects of intense work were reported: (1) decreased engagement in school, satisfaction with leisure time, and hours of weeknight and weekend sleep, and (2) increased health risk behaviors and psychological stress. The negative effects of intense work differed by gender, grade, ethnicity, but not by parent education.^ The third study described the prevalence of injury in the study population. A dose response effect was observed where increasing hours of weekly work were significantly related to work-related injury. The likelihood of being injured while employed in restaurant, farm/ranch, and construction work was greater than the probability of being injured while working in factory/office/skilled, yard, or retail work when compared to babysitting. Cuts, shocks/burns and sprains were the most common injuries in working teens.^ Students, parents, educators, health professionals and policymakers should continue to monitor the number of weekly hours that students work during the school year. ^
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This cross-sectional study examines the association between health and academic achievement among Hispanic eighth-grade students in the Houston Independent School District. As part of the district's 3 year Safe Schools/Healthy Students Initiative to enhance comprehensive educational programs, a brief anonymous questionnaire was administered in the classroom to 359 students in two schools during a one-month period in the early part of the 2001 school year. ^ The primary study questions are: Among this sample of Hispanic adolescents, is there a significant association between academic achievement and health status? and in this same population, is there a significant association between health risk behavior and health status? The specific aims of this research are: (1) to describe the association between academic achievement and health status; (2) to describe the association between health risk behaviors and health status; and (3) to describe the relative contribution of health risk behaviors and academic achievement to adolescent health status among this sample of Hispanic adolescents. ^ The survey instrument was a 32-item questionnaire that incorporated: several academic achievement questions measuring usual grades, school-related performance, attendance, student and perceived parental satisfaction with academic achievement, and educational aspirations; two health and quality of life scales measuring adolescent self-reported health; and specific measures of health risk behavior, e.g., frequency of tobacco cigarette smoking, alcohol and other drug use, aggression, and suicidal ideation and behavior that were incorporated from the national Youth Risk Behavior Survey. Questions pertaining to sexual behavior and pregnancy were omitted to comply with school district guidelines. ^ Analysis revealed that strong associations between academic achievement and health status and between health risk behaviors and health status were observed after controlling for the covariates. Eight factors were found to be significantly associated with poor health status: usual grades (low), academic performance (low), academic achievement beliefs (low), classroom and homework performance satisfaction (low), ever drinking alcohol (6 or more times), suicidality (ever thought about, planned for, or sought medical help after attempting suicide), gender (female), and age (15 years and older). (Abstract shortened by UMI.) ^