Healthy-lifestyle behaviors associated with overweight and obesity in US rural children

Background

There are disproportionately higher rates of overweight and obesity in poor rural communities but studies exploring children’s health-related behaviors that may assist in designing effective interventions are limited. We examined the association between overweight and obesity prevalence of 401 ethnically/racially diverse, rural school-aged children and healthy-lifestyle behaviors: improving diet quality, obtaining adequate sleep, limiting screen-time viewing, and consulting a physician about a child’s weight.
Methods

A cross-sectional analysis was conducted on a sample of school-aged children (6–11 years) in rural regions of California, Kentucky, Mississippi, and South Carolina participating in CHANGE (Creating Healthy, Active, and Nurturing Growing-up Environments) Program, created by Save the Children, an independent organization that works with communities to improve overall child health, with the objective to reduce unhealthy weight gain in these school-aged children (grades 1–6) in rural America. After measuring children’s height and weight, we17 assessed overweight and obesity (BMI ≥ 85th percentile) associations with these behaviors: improving diet quality18 (≥ 2 servings of fruits and vegetables/day), reducing whole milk, sweetened beverage consumption/day; obtaining19 adequate night-time sleep on weekdays (≥ 10 hours/night); limiting screen-time (i.e., television, video, computer,20 videogame) viewing on weekdays (≤ 2 hours/day); and consulting a physician about weight. Analyses were adjusted 21 for state of residence, children's race/ethnicity, gender, age, and government assistance.
Results

Overweight or obesity prevalence was 37 percent in Mississippi and nearly 60 percent in Kentucky. Adjusting for covariates, obese children were twice as likely to eat ≥ 2 servings of vegetables per day (OR=2.0,95% CI 1.1-3.4), less likely to consume whole milk (OR=0.4,95% CI 0.2-0.70), Their parents are more likely to be told by their doctor that their child was obese (OR=108.0,95% CI 21.9-541.6), and less likely to report talking to their child about fruits and vegetables a lot/sometimes vs. not very much/never (OR=0.4, 95%CI 0.2-0.98) compared to the parents of healthy-weight children.
Conclusions

Rural children are not meeting recommendations to improve diet, reduce screen time and obtain adequate sleep. Although we expected obese children to be more likely to engage in unhealthy behaviors, we found the opposite to be true. It is possible that these groups of respondent parents were highly aware of their weight status and have been advised to change their children’s health behaviors. Perhaps given the opportunity to participate in an intervention study in combination with a physician recommendation could have resulted in actual behavior change.

Whole grain consumption is inversely associated with BMI Z-score in rural school-aged children

Objective To examine the relationship between intake of whole grains and BMI Z-score in rural children.

Design General linear models and logistic regression were used to examine the cross-sectional associations between whole grain intake and BMI Z-score, prevalence and odds ratios of overweight and obesity. Dietary intake was assessed using the Block Food Screener for ages 2–17 years. Children were classified into three categories according to servings of whole grain intake: <1·0 serving/d, 1·0–1·5 servings/d and >1·5 servings/d.

Setting The CHANGE (Creating Healthy, Active and Nurturing Growing-up Environments) study, an obesity prevention intervention in elementary schools in eight rural US communities in California, Mississippi, Kentucky and South Carolina.

Subjects Seven hundred and ninety-two children attending 3rd–6th grade.

Results After adjusting for age, sex, race/ethnicity, physical activity and state of residence, whole grain intake was inversely associated with BMI Z-score (0·90 v. 0·61 in the lowest v. the highest whole grain intake category; P trend = 0·01). Children who consumed >1·5 servings of whole grains/d had a 40 % lower risk of being obese (OR = 0·60; 95 % CI 0·38, 0·95, P = 0·02) compared with children who consumed <1·0 serving/d. Further adjustment for potential dietary predictors of body weight (fruit, vegetable and dairy intakes) did not change the observed associations.

Conclusions Increasing the intake of whole grains as part of an overall healthy lifestyle may be beneficial for children to achieve and maintain a healthy weight.

A model for enhancing empowerment in farmers using mobile based information system

Farmers living in rural villages of Sri Lanka do not have proper access to information to make informed decisions about their livelihoods and as a result they face constant hardships in their lives. They use mobile phones to communicate but these are not currently connected to the Internet. We are investigating how to provide personalized information to farmers with the aim of empowering them to make informed decisions and take appropriate actions. In this paper we propose an empowerment model that has been designed to achieve their goals which have been identified using a scenario-based approach. The model examines several empowerment processes and supporting tools that would help them to achieve their goals with the hope that they would have an increased sense of control, self-efficacy, knowledge and competency. This empowerment model is applied to the development of a mobile based information system that is being developed by an international collaborative research group to address the issues of the farmers.

Training and experience of nurses in responding to alcohol misuse in rural communities

Objective Alcohol misuse by farmers continues to challenge rural nurses. This article reports on the experiences of Australian nurses participating in the Alcohol Intervention Training Program (AITP).

Design and Sample Qualitative interviews of 15 rural and remote nurses.

Measures Semi-structured phone interviews were utilized to assess the response to and implementation of the AITP—an intervention designed to build nurses' knowledge, confidence and skills when responding to alcohol misuse. It comprises practical and theoretical components and was designed for rural and remote settings where nurses encounter alcohol misuse.

Results Nurses found the training provided new—or built on existing—knowledge of alcohol misuse and offered practical hands-on “real life” skills. A range of workplace and personal situations where the content of the training was now being utilized were identified, and future use anticipated. Barriers to using the new knowledge and skills included both rural and generic issues. Constructive feedback to increasingly target the training to rural settings was recommended.

Conclusions The AITP is an effective training program. It can be further tailored to meet common needs of rural and remote nurses working with farmers who misuse alcohol, while recognizing diversity in rural practice.

Associations between behavior regulation, competence, physical activity, and health for adolescent females

This study investigated the association between the different types of behavior regulation and competence on sport and physical activity (PA) and perceived health, and the influence of school year level (ie, year 7 and year 11) and setting (ie, metropolitan and rural) on these relationships.

Urbanicity and lifestyle risk factors for cardiometabolic diseases in rural Uganda: a cross-sectional study

Urban living is associated with unhealthy lifestyles that can increase the risk of cardiometabolic diseases. In sub-Saharan Africa (SSA), where the majority of people live in rural areas, it is still unclear if there is a corresponding increase in unhealthy lifestyles as rural areas adopt urban characteristics. This study examines the distribution of urban characteristics across rural communities in Uganda and their associations with lifestyle risk factors for chronic diseases.

Dementia in older people admitted to hospital: a regional multi-hospital observational study of prevalence, associations and case recognition

BACKGROUND: previous studies have indicated a prevalence of dementia in older admissions of ∼42% in a single London teaching hospital, and 21% in four Queensland hospitals. However, there is a lack of published data from any European country on the prevalence of dementia across hospitals and between patient groups. OBJECTIVE: to determine the prevalence and associations of dementia in older patients admitted to acute hospitals in Ireland. METHODS: six hundred and six patients aged ≥70 years were recruited on admission to six hospitals in Cork County. Screening consisted of Standardised Mini-Mental State Examination (SMMSE); patients with scores <27/30 had further assessment with the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE). Final expert diagnosis was based on SMMSE, IQCODE and relevant medical and demographic history. Patients were screened for delirium and depression, and assessed for co-morbidity, functional ability and nutritional status. RESULTS: of 598 older patients admitted to acute hospitals, 25% overall had dementia; with 29% in public hospitals. Prevalence varied between hospitals (P < 0.001); most common in rural hospitals and acute medical admissions. Only 35.6% of patients with dementia had a previous diagnosis. Patients with dementia were older and frailer, with higher co-morbidity, malnutrition and lower functional status (P < 0.001). Delirium was commonly superimposed on dementia (57%) on admission. CONCLUSION: dementia is common in older people admitted to acute hospitals, particularly in acute medical admissions, and rural hospitals, where services may be less available. Most dementia is not previously diagnosed, emphasising the necessity for cognitive assessment in older people on presentation to hospital.

A qualitative study of environmental factors important for physical activity in rural adults

PURPOSE: Despite increasing evidence that the physical environment impacts on physical activity among urban-dwellers, little attention has been devoted to understanding this relationship in rural populations. Work in this area is further hindered by a lack of environmental measures specifically designed for rural settings. This qualitative study aimed to explore the salience of urban physical activity environment constructs among rural adults. METHODS: In 2011, 49 rural men and women from three distinct areas (coastal, animal-based farming, forestry/plant-based farming) of rural Tasmania, Australia, were purposively recruited to participate in semi-structured interviews. Interviews explored features of the built and social environment commonly examined in studies of urban adults, including functional characteristics (eg, lighting, footpaths, roads/verges), road and personal safety, availability and accessibility of places to be active, destinations, and aesthetics. Interviews were recorded, transcribed verbatim and analysed using a content-thematic approach using QSR NVivo software. FINDINGS: While some urban environmental constructs were salient to these rural adults, such as availability of and accessibility to places to be active, some constructs were operationalised differently, such as road safety (where large trucks and winding roads rather than traffic density was of concern), or were not considered relevant (eg, personal safety related to crime, availability of walkable destinations, aesthetics). CONCLUSIONS: The measurement of the physical environment in rural populations may require reconsideration and/or modification to ensure salience and appropriate quantification of associations with physical activity in future studies.

The association between self-reported diet quality and health-related quality of life in rural and urban Australian adolescents

OBJECTIVE: This study examines the relationship between diet quality and health-related quality of life (HRQoL) in rural and urban Australian adolescents, and gender differences.

DESIGN: Cross-sectional.

SETTING: Secondary schools.

PARTICIPANTS: 722 rural and 422 urban students from 19 secondary schools.

MAIN OUTCOME MEASURES: Self-report dietary-related behaviours, demographic information, HRQoL (AQoL-6D) were collected. Healthy and unhealthy diet quality scores were calculated; multiple linear regression investigated associations between diet quality and HRQoL.

RESULTS: Compared to urban students, rural students had higher HRQoL, higher healthy diet score, lower unhealthy diet score, consumed less soft drink and less frequently, less takeaway and a higher proportion consumed breakfast (P < 0.05). Overall, males had higher unhealthy diet score, poorer dietary behaviours but a higher HRQoL score compared to females (P < 0.05). In all students, final regression models indicated: a unit increase in healthy diet score was associated with an increase in HRQoL (unstandardised coefficient(B)±standard error(SE); B = 0.02 ± 0.01(SE); P < 0.02); and a unit increase in unhealthy diet scores was associated with a decrease in HRQoL (-0.01 ± 0.00; P < 0.05). In rural students alone, a unit increase in unhealthy diet score was associated with a decrease in HRQoL (B = -0.01 ± 0.00; P = 0.002), and in urban students a unit increase in healthy diet score was associated with an increase in HRQoL (B = 0.02 ± 0.00; P < 0.001).

CONCLUSIONS: Cross-sectional associations between diet quality and HRQoL were observed. Dietary modification may offer a target to improve HRQoL and general well-being; and consequently the prevention and treatment of adolescent health problems. Such interventions should consider gender and locality.

Organização de produtores rurais para a gestão da cadeia produtiva da mandioca no nordeste paraense: um estudo de caso na Associação de Desenvolvimento Comunitário e Rural Bom Jesus

A mandioca (Manihot esculenta Crantz) é uma planta cultivada predominantemente para a subsistência dos trabalhadores rurais sendo uma das principais fontes de carboidratos disponíveis aos estratos sociais de baixa renda e tem importante participação na geração de emprego e renda. O Estado do Pará destaca-se pelo volume de produção de mandioca, mas o cultivo ainda está voltado essencialmente para a subsistência sendo pouco explorado como matéria prima em derivados industriais e insumo para enfrentar problemas globais como a fome, a degradação ambiental e a produção de energia, gerando emprego e renda para comunidades locais e rurais. Este estudo tem como objetivo avaliar como está se desenvolvendo a organização de produtores rurais de mandioca da Associação de Desenvolvimento Comunitário e Rural Bom Jesus, através do modelo de gestão de cadeia produtiva e compreender em que medida se justifica economicamente o cultivo de mandioca. A pesquisa é de natureza exploratória e descritiva e por meio do questionário e entrevista aplicado a 17 produtores rurais juntamente com a fundamentação teórica sobre o entendimento contemporâneo de cadeia produtiva foram percebidos evidências que justificam economicamente, em parte, o cultivo da mandioca. A geração de postos de trabalhos para as mulheres, a utilização de resíduos como incremento no arranjo produtivo, a apoio da extensão e do crédito rural, e as vantagens advindas da organização dos produtores rurais proporcionando renda e produção constantes no campo, foram os fatores considerados. Porém, a necessidade de inovações tecnológicas, parcerias com os setores industriais, arranjos produtivos mais rentáveis, mecanização do plantio e da colheita, os problemas ambientais (resíduos tóxicos e desmatamento) e de acesso à pesquisa, o nível de escolaridade, e a cooperação entre os agricultores, são desafios reais a serem enfrentados e o fator decisivo é o apoio governamental. Este estudo demonstra a realidade de uma sociedade quase sempre marginalizada e esquecida pelas políticas públicas. Além da variável econômica, a avaliação das culturas produtivas deve passar pelos filtros de análise social e ambiental, pois assim, nos permite com maior exatidão compreender os problemas reais da nossa sociedade, em especial da vida na Amazônia.

A descentralização das políticas de desenvolvimento rural: uma análise da experiência do Rio Grande do Norte

MATOS FILHO, João. A descentralização das Políticas de desenvolvimento rural - uma análise da experiência do Rio Grande do Norte. 2002. 259f. Tese (Doutorado em Ciências Econômicas)– Instituto de Economia da Universidade Estadual de Campinas, Campinas, 2002.

Associativismo nos municípios rurais: uma alternativa de desenvolvimento local em Portalegre/RN

This work aims to study the associations as mediating the process of social change and its importance for local development. The hypothesis is that associations, but bring dynamism to the smaller cities and improve the living conditions of their members, relegated to the background social sustainability, understood this as a permanent exercise of mobilization and participation in community life. The assumptions of the study are that the practice group has influenced the processes of local development in Brazilian rural municipalities through the mediation of government programs and projects aimed at combating rural poverty require social organization for their achievement. The concept of local development in this work was rescued from studies of political economy and sociology. But the concepts of collective action and partnerships advêem studies of political participation and social development of the theory of alternative or solidarity. The party consisted of an empirical case study conducted with four associations of farmers in the municipality of Portalegre-RN. Why choose qualitative study was used the technique of semi-structured interviews with the chairmen I members of associations and other actors considered essential to understanding the study (religious leaders, local political power and chairman of the union of rural workers), a total of 20 interviews, in addition to the observations of field and documentary research in records of the.ir own organizations. The survey results show that the performance of groups of farmers are key components and determinants for the production I marketing of agricultural products and for boosting the economy, as well as security for minimum levels of citizenship. Yet we are still in a space purpose of social change, which comes to confirm the initial hypothesis of this work

Capital Social e Desenvolvimento Rural: acesso, uso e gestão da água nos Territórios Rurais do Sertão do São Francisco

This study aimed to contribute to the discussion of social capital, seeking to relate that to the access, use and water resources management in the Sao Francisco Vale, specifically in rural areas of the wilderness of San Francisco situated in the State of Bahia and Pernambuco. As, stimulate action possibilities for individuals (family rural) apart by a patrimony public so precious that is water. Besides a theoretical discussion of social capital (networks, trust, participation) and rural development. We applied 387 questionnaires to farmers and some interviews with actors social of territorial forum and committee of the São Francisco basin where it was possible to correlate our variables in order to confirm our hypothesis: social capital is a key element to ensure access, use and management of water for rural families living in irrigated and rainfed areas

Saberes e práticas em experiência de construção da sustentabilidade no meio rural nordestino

The purpose of this work is to analyze the knowledge relationships that articulate in projects of maintainable rural development construction for the paraiban semi-arid, analyzing the farmers daily practices and their relationship with the technological practices spread by ONGs. We took as empirical object the rural community of Lajedo de Timbaúba, municipal district of Soledade-PB, located in the very small region of paraiban Curimataú. It is a community where registers one of the first cases of maintainable rural development planning in the state of Paraíba. The analysis was centered on the farmers experiences of life in sustainability experience, trying to understand how they acquire new knowledge and how they interact with them. In methodological terms, it was considered feasible to place the knowledge interaction between the farmers and technicians from ONGs by placing the analysis according to Paulo Freire s questioning (2006): extension or communication? To understand the farmers daily practices, it was resorted to the theoretical contribution by Michel de Certeau (2008) in order to discern a microresistance movement of inversion/rejection/changing by the farmers in relation to their external knowledge. Just from the theoretical point of view and resorting to the imaginary social by Cornelius Castoriadis (1982), it was considered the way of living of the farmers researched, having as reference the experience in the material and symbolic production of their lives. It became indispensable, therefore, not to dissociate the knowledge relationships between farmers and technicians from ONGs from the sustainability concepts, maintainable rural development, and rural extension. The results of the study revealed that the farmers from Lajedo de Timbaúba while dealing with the technological practices proposed by ONGs that work in the community, express those practices from their daily logic, and they constitute them in survival strategies that are inserted in their own idiosyncrasy. It was verified, therefore, that the external knowledge presented by the proposals of sociability alternatives with the droughts in the perspective of maintainable development while placed in the farmers daily relationship, they are judged as advantageous or disadvantageous when they are confronted with their peculiar way of doing their daily work. The technological practices are incorporated, denied, or recreated starting from evaluative criteria related to the preservation of the soil and to the economical and social reproduction of the unit of production of family agriculture

Genetic associations between stayability and reproductive and growth traits in Canchim beef cattle

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)