African American female adolescents and antecedents of pregnancy

Although the pregnancy rate of teenage girls in the United States has decreased in recent years, African American female adolescents still have one of the highest teen pregnancy rates among girls in the United States. Previous studies report inconsistent relationships between adolescent pregnancy and self-esteem and parental communication, caring, and closeness. The purpose of this study was to assess relationships between pregnancy among African American female adolescents (7th to 12th grades) and self-esteem, communication levels and type of relationships with their parents. This study used data collected from The National Longitudinal Study of Adolescent Health (Add Health). Logistic regression analysis was used to determine if the independent variables of self-esteem, levels of parental caring and closeness and levels of communication with parents predicted the dependent variable of pregnancy. After controlling for age and levels of parental education, self-esteem was the only statistically significant variable that was associated with pregnancy. The findings of this study indicate that levels of self-esteem should be further investigated and that self-esteem may be an important factor when designing interventions to prevent adolescent pregnancy, particularly for African American females. ^

Psychosocial and environmental predictors of calcium intake, physical activity and bone health among adolescent girls

Objectives. The purpose of this study was to identify the psychosocial and environmental predictors and the pathways they use to influence calcium intake, physical activity and bone health among adolescent girls. Methods. A secondary data analysis using a cross-sectional and longitudinal study design was implemented to examine the associations of interest. Data from the Incorporating More Physical Activity and Calcium in Teens (IMPACT) study collected in 2001-2003 were utilized for the analyses. IMPACT was a 1½ year nutrition and physical activity intervention study conducted among 718 middle-school girls in central Texas. Hierarchical regression modeling and Structural Equation Modeling (SEM) were used to determine the psychosocial predictors of calcium intake, physical activity and bone health at baseline. Hierarchical regression was used to determine if psychosocial factors at baseline were significant predictors of calcium intake and physical activity at follow-up. Data was adjusted for included BMI, lactose intolerance, ethnicity, menarchal status, intervention and participation in 7th grade PE/athletics. Results. Results of the baseline regression analysis revealed that calcium self-efficacy and milk availability at home were the strongest predictors of calcium intake. Friend engagement in physical activity, physical activity self-efficacy and participation in sports teams were the strongest predictors of physical activity. Finally, physical activity outcome expectations, social support and participation in sports teams were significant predictors of stiffness index at baseline. Results of the baseline SEM path analysis found that outcome expectations and milk availability at home directly influenced calcium intake. Knowledge and calcium self-efficacy indirectly influenced calcium intake with outcome expectations as the mediator. Physical activity self-efficacy and social support had significant direct and indirect influence on physical activity with participation in sports teams as the mediator. Participation in sports teams had a direct effect on both physical activity and stiffness index. Results of regression analysis for baseline predicting follow-up showed that participation in sports teams, self-efficacy, outcome expectations and social support at baseline were significant predictors of physical activity at follow-up. Conclusion. Results of this study reinforce the relevance of addressing both, psychosocial and environmental factors which are critical when developing interventions to improve bone health among adolescent girls. ^

Team: Bee Me. A formulative evaluation of a negative eating attitudes and behaviors primary prevention curriculum targeted at 5 th grade elementary school girls

Objective. To evaluate a school-based intervention aimed at the primary prevention of negative eating attitudes and behaviors among preadolescent girls, and to revise curriculum lessons based on quantitative and qualitative findings. ^ Intervention Design. A formative evaluation was conducted on four Team: Bee Me curriculum lessons at a Houston elementary school. Evaluation focused on program satisfaction and short-term effect on knowledge and eating attitudes and behaviors. ^ Results. Sixteen girls participated in the five-day project. Statistically significant improvements in overall knowledge were observed (p<0.05), however only modest changes were observed in eating attitudes and behaviors. Program satisfaction was high among student participants and the teacher who implemented it. Insight for future modifications to this program and for similar interventions was provided by the students and teacher. ^ Conclusions. This program led to positive trends in outcome variables; however longer and more intensive testing of this program is needed to better evaluate its effectiveness.^

The association of food sources of calcium with weight class in adolescent girls

To determine the association of food sources of calcium with weight class in adolescent girls, the major food sources of calcium were determined for 718 sixth grade girls at three different time periods during an 18 month school-based health intervention program using a FFQ. To determine weight class, the BMI of each girl was stratified using CDC age and gender specific criteria at each time period. The percent contribution of the major food sources of calcium to total calcium intake was compared among the different weight classes at each time period, among those girls who had changed weight class at the different time periods and for those girls who did not change weight class at the different time periods. The mean total calcium intake increased by 20% between the first two time periods and by 12% between the first and last time periods with the intervention despite baseline total calcium intake already being greater than the recommended 1300 mg/day. The percent contribution of the major food sources of calcium were highly correlated among the weight classes that were compared throughout the study. Those girls who remained in the normal weight class throughout the study had the most consistent intake of food sources of calcium. Their top four food sources of calcium were different types of milk which provided greater than 50% of their total calcium intake. Despite there being no significant differences in the major food sources of calcium among the different weight classes, these data show a successful intervention for increasing calcium intake among adolescent girls. ^

Development and evaluation of a nutrition education program designed to increase fruit and vegetable consumption in girls, ages 9--12

The purpose of this study is to evaluate the theory-based Eat 5 nutrition badge. It is designed to increase fruit and vegetable (F&V) intake in 4th-6th grade junior Girl Scouts. Twenty-two troops were recruited and randomized by grade level (4th, 5th, 6th, or mixed) into either the intervention or control conditions. The leaders in the intervention condition received a brief training and the materials and conducted the program with their troops during four meetings. The Girl Scouts in the intervention condition completed 1-day Food Frequency Questionnaires and Nutrition Questionnaires both before and after completing the Eat 5 badge, and a third measurement of F&V intake three months after the posttest. Girl Scouts in the control condition were only evaluated at the three time periods.^ The primary hypotheses were that the Girl Scouts in the intervention condition would increase their daily intake of fruits and vegetables at both the posttest and three months later, compared to the Girl Scouts in the control condition. Other study questions investigated the impact of the Eat 5 program on intervening variables such as knowledge, self-efficacy, barriers, norms, F&V preference, and F&V selection and preparation skills.^ A nested ANOVA, with troop as the unit of analysis nested within condition, was used to assess the effects of the program. Pretest F&V intake and grade level were used as covariates. Pretest mean F&V intake for the total sample of 210 girls was 2.50 servings per day; 3.0 for the intervention group (n = 101). Significant increases in F&V intake (to 3.4 servings per day), knowledge, and fruit and vegetable preference were found for the intervention condition troops compared to the troops in the control condition. Three months later, the mean F&V intake had returned to pretest levels.^ This study indicates that social groups such as Girl Scouts can provide a channel for nutrition education. Long term effects were not sustained by the intervention; a possible cause was the lack of change in self-efficacy. Therefore, additional interventions are recommended such as booster lessons to maintain increased F&V intake by Girl Scouts. ^

Addressing teenage pregnancy in rural areas: A case study from Liberty County, Texas

This study explores the issue of teenage pregnancy in a case study of Liberty County, a rural area in Texas with no public health department. It also describes the decision-making process and barriers faced in the beginning phases of adopting a sexual education program, and sets forth an implementation plan for two school districts on disseminating an evidence-based, comprehensive curriculum. Methods include a review of epidemiological data surrounding teenage pregnancy on the national, state, and county level; a literature review of factors related to teenage pregnancy and past interventions implemented in a rural community; a policy review of past and current bills in Legislature; and an analysis of barriers and decision making in implementing an evidence based program through qualitative observations, discussions with community members during meetings, presentations, and discussions. Results of this study indicate that there is a lack of research conducted in rural areas in the field of teenage pregnancy prevention and sexual education programs. Barriers experienced in Liberty County are shown to be consistent in scientific literature such as funding, logistical issues, and problems approaching the School Board in adopting a comprehensive sexual education program. This study fills a large gap in the literature on rural adolescents and attempts to analyze the process of decision-making in a rural area related to adoption of sexual education programming. In order to relieve this health disparity, further research should focus on rural areas to gain insight on the attitudes and behaviors of rural adolescents and beliefs among community stakeholders.^