Point-of-sale machines in school cafeterias and parental influence on child food choices

The prevalence of obesity has reached epidemic proportions in the United States. Twenty-five percent of school aged students are overweight. Schools have the opportunity to help slow this epidemic. School cafeterias in the United States feed millions of students every day through the National School Lunch Program.^ Point-of-sale machines are used in most school cafeterias to help streamline the process of purchasing school lunches. The point-of-sale software allows school personnel to place special notes on student's accounts to provide alerts about parental requests. This study investigated what the alerts are used for, who uses the alerts, and if there are any patterns by demographic characteristics. ^ Counts and percentages were used to determine what the alerts were used for and who used them. This study found that students who were white non-Hispanic, paid status, or in elementary school were most likely to have alerts placed on their accounts. Also, the majority of point-of-sale alerts were used as allowances (i.e., allowed to purchase snacks from the balance on the school lunch account), rather than restrictions (i.e., restricted from purchasing high calorie foods or specific food items). Using chi-square analysis, a total of 688 alerts were analyzed. There were significant differences in alert frequencies for intent category by grade level (p=0.000), snack access (p=0.000), and gender (p=0.002). Therefore, the results are significant, and one can conclude there is a significant relationship between gender, grade level, and snack access, and the presence of an alert on the school lunch account.^ Also, school administrators may want to take into consideration possible changes to their program, such as requiring more time to run the software. The results of this study can assist school administrators to better understand that a point-of-sale alert program may help their school lunch programs run more efficiently, while also providing parental influence on students’ food choices at the point-of-sale.^ School food service authorities should consider implementing a structured point-of-sale alert policy to encourage parental input on their children's food choices. When implementing the point-of-sale policy, schools should publicize this policy online, through school lunch menus, and parent communications increase participation throughout the school district.^

Investigating the structure and form of condom decisional balance in an alternative school sample using confirmatory factor analysis

Teen pregnancy is a continuing problem, bringing with it a host of associated health and social risks. Alternative school students are especially at risk, but are historically under-represented in research. This is especially problematic in that instruments are needed to guide effective intervention development, but psychometrics for these instruments cannot be assumed when used in new populations. Decisional balance from the transtheoretical model offers a framework for understanding condom decision making, but has not been tested with alternative school students. Using responses from 640 subjects from Safer Choices 2 (a school-based HIV/STD/pregnancy prevention program implemented in 10 urban, southwestern alternative schools), a decisional balance scale for condom use was examined. A two-factor, mildly correlated model fit the data well. Tests of invariance examined scale functioning within gender and racial/ethnic groups. The underlying structure varied slightly based on subgroup, but on a practical level the impact on the use of scales was minimal. The structure and loadings were invariant across experimental condition. The pro scale was associated with a lower probability of having engaged in unprotected sexual behavior for sexually active subjects, and this association remained significant while controlling for demographic variables. The con scale did not show a significant association with engagement in unprotected sexual behaviors. Limitations and directions for future research were also discussed.^

Future pandemic influenza control (FPIC) related strategic management plan based on the 2009 H1N1 pandemic influenza review of health policy decisions, their practice and implications

This cross-sectional study is based on the qualitative and quantitative research design to review health policy decisions, their practice and implications during 2009 H1N1 influenza pandemic in the United States and globally. The “Future Pandemic Influenza Control (FPIC) related Strategic Management Plan” was developed based on the incorporation of the “National Strategy for Pandemic Influenza (2005)” for the United States from the U.S. Homeland Security Council and “The Canadian Pandemic Influenza Plan for the Health Sector (2006)” from the Canadian Pandemic Influenza Committee for use by the public health agencies in the United States as well as globally. The “global influenza experts’ survey” was primarily designed and administered via email through the “Survey Monkey” system to the 2009 H1N1 influenza pandemic experts as the study respondents. The effectiveness of this plan was confirmed and the approach of the study questionnaire was validated to be convenient and the excellent quality of the questions provided an efficient opportunity to the study respondents to evaluate the effectiveness of predefined strategies/interventions for future pandemic influenza control.^ The quantitative analysis of the responses to the Likert-scale based questions in the survey about predefined strategies/interventions, addressing five strategic issues to control future pandemic influenza. The effectiveness of strategies defined as pertinent interventions in this plan was evaluated by targeting five strategic issues regarding pandemic influenza control. For the first strategic issue pertaining influenza prevention and pre pandemic planning; the confirmed effectiveness (agreement) for strategy (1a) 87.5%, strategy (1b) 91.7% and strategy (1c) 83.3%. The assessment of the priority level for strategies to address the strategic issue no. (1); (1b (High Priority) > 1a (Medium Priority) > 1c (Low Priority) based on the available resources of the developing and developed countries. For the second Strategic Issue encompassing the preparedness and communication regarding pandemic influenza control; the confirmed effectiveness (agreement) for the strategy (2a) 95.6%, strategy (2b) 82.6%, strategy (2c) 91.3% and Strategy (2d) 87.0%. The assessment of the priority level for these strategies to address the strategic issue no. (2); (2a (highest priority) > 2c (high priority) >2d (medium priority) > 2b (low priority). For the third strategic issue encompassing the surveillance and detection of pandemic influenza; the confirmed effectiveness (agreement) for the strategy (3a) 90.9% and strategy (3b) 77.3%. The assessment of the priority level for theses strategies to address the strategic Issue No. (3) (3a (high priority) > 3b (medium/low priority). For the fourth strategic issue pertaining the response and containment of pandemic influenza; the confirmed effectiveness (agreement) for the strategy (4a) 63.6%, strategy (4b) 81.8%, strategy (4c) 86.3%, and strategy (4d) 86.4%. The assessment of the priority level for these strategies to address the strategic issue no. (4); (4d (highest priority) > 4c (high priority) > 4b (medium priority) > 4a (low priority). The fifth strategic issue about recovery from influenza and post pandemic planning; the confirmed effectiveness (agreement) for the strategy (5a) 68.2%, strategy (5b) 36.3% and strategy (5c) 40.9%. The assessment of the priority level for strategies to address the strategic issue no. (5); (5a (high priority) > 5c (medium priority) > 5b (low priority).^ The qualitative analysis of responses to the open-ended questions in the study questionnaire was performed by means of thematic content analysis. The following recurrent or common “themes” were determined for the future implementation of various predefined strategies to address five strategic issues from the “FPIC related Strategic Management Plan” to control future influenza pandemics. (1) Pre Pandemic Influenza Prevention, (2) Seasonal Influenza Control, (3) Cost Effectiveness of Non Pharmaceutical Interventions (NPI), (4) Raising Global Public Awareness, (5) Global Influenza Vaccination Campaigns, (6)Priority for High Risk Population, (7) Prompt Accessibility and Distribution of Influenza Vaccines and Antiviral Drugs, (8) The Vital Role of Private Sector, (9) School Based Influenza Containment, (10) Efficient Global Risk Communication, (11) Global Research Collaboration, (12) The Critical Role of Global Public Health Organizations, (13) Global Syndromic Surveillance and Surge Capacity and (14) Post Pandemic Recovery and Lessons Learned. The future implementation of these strategies with confirmed effectiveness to primarily “reduce the overall response time’ in the process of ‘early detection’, ‘strategies (interventions) formulation’ and their ‘implementation’ to eventually ensure the following health outcomes: (a) reduced influenza transmission, (b) prompt and effective influenza treatment and control, (c) reduced influenza related morbidity and mortality.^

Are school nurses effective in the fight against childhood obesity?

Background. With childhood obesity on the rise in the United States, school nurses are faced with the task of preventing, identifying and treating obese children in their schools. This study reviews current literature and examines the effectiveness of the school nurse regarding obesity prevention and treatment services and the barriers they face.^ Methods. Ovid, Ebsco, Google Scholar and other professional websites were searched for school-based obesity interventions that included school nurses and that took place in the United States between 1996 and present day. This resulted in 8 studies.^ Results. Of the 8 studies identified, the majority were conducted in the Midwest, all of the studies were cross-sectional in design or qualitative in nature and only half of these studies were based off theoretical design. The most common barriers school nurses face include: lack of time, lack of support from both the school and parents, lack of confidence in counseling students and their parents and lack of specific guidelines for their role. ^ Conclusions. This study further reflects the need for more research using experimental research designs to evaluate nurse-driven interventions and nurse-related policies for childhood obesity prevention and treatment, the need to create specific guidelines for school nurses, the need for further education for nurses relating to counseling, and the need for more support from the school and community for school-based obesity prevention. ^

Effects of a health advocacy program to promote physical activity and nutrition behaviors among adolescents: An evaluation of the Young Leaders for Healthy Change program

Background. This study was designed to evaluate the effects of the Young Leaders for Healthy Change program, an internet-delivered program in the school setting that emphasized health advocacy skills-development, on nutrition and physical activity behaviors among older adolescents (13–18 years). The program consisted of online curricular modules, training modules, social media, peer and parental support, and a community service project. Module content was developed based on Social Cognitive Theory and known determinants of behavior for older adolescents. ^ Methods. Of the 283 students who participated in the fall 2011 YL program, 38 students participated in at least ten of the 12 weeks and were eligible for this study. This study used a single group-only pretest/posttest evaluation design. Participants were 68% female, 58% white/Caucasian, 74% 10th or 11th graders, and 89% mostly A and/or B students. The primary behavioral outcomes for this analysis were participation in 60-minutes of physical activity per day, 20-minutes of vigorous- or moderate- intensity physical activity (MVPA) participation per day, television and computer time, fruit and vegetable (FV) intake, sugar-sweetened beverage intake, and consumption of breakfast, home-cooked meals, and fast food. Other outcomes included knowledge, beliefs, and attitudes related to healthy eating, physical activity, and advocacy skills. ^ Findings. Among the 38 participants, no significant changes in any variables were observed. However, among those who did not previously meet behavioral goals there was an 89% increase in students who participated in more than 20 minutes of MVPA per day and a 58% increase in students who ate home-cooked meals 5–7 days per week. The majority of participants met program goals related to knowledge, beliefs, and attitudes prior to the start of the program. Participants reported either maintaining or improving to the goal at posttest for all items except FV intake knowledge, taste and affordability of healthy foods, interest in teaching others about being healthy, and ease of finding ways to advocate in the community. ^ Conclusions. The results of this evaluation indicated that promoting healthy behaviors requires different strategies than maintaining healthy behaviors among high school students. In the school setting, programs need to target the promotion and maintenance of health behaviors to engage all students who participate in the program as part of a class or club activity. Tailoring the program using screening and modifying strategies to meet the needs of all students may increase the potential reach of the program. The Transtheoretical Model may provide information on how to develop a tailored program. Additional research on how to utilize the constructs of TTM effectively among high school students needs to be conducted. Further evaluation studies should employ a more expansive evaluation to assess the long-term effectiveness of health advocacy programming.^

Building an Evidence-Based Approach to Address Dating Violence Prevention

Purpose: To discuss the approach and recommendations related to the adoption of school based curriculum for violence prevention. Findings: Preliminary assessments suggest that middle and high school youth experience a variety of forms of violence in social and dating relationships. Such experiences have negative academic, behavioral and emotional consequences. Conclusions: The authors have clearly illuminated the need for addressing the phenomenon of dating violence. The field could benefit from more robust evidenced-based investigations that substantiate that interventions have an impact beyond attitudinal changes toward the behavior. Such academic endeavors will provide a platform to validate the inclusion of such information in a school based curriculum as act as a call for action for broad based interventions.

Educar en valores a través de programas de deporte escolar: un estudio comparado entre la “Union Nationale du Sport Scolaire” (Francia) y los “Campeonatos Escolares en los IES de la Comunidad de Madrid” (España)

El interés de las administraciones públicas por promover el deporte escolar, suele justificarse por los beneficios educativos y saludables que los escolares obtendrían de las prácticas físico-deportivas. Mas allá de concepciones neutrales o excesivamente idealizadas sobre su valor educativo, las condiciones socioculturales que lo configuran y las intervenciones pedagógicas en el terreno marcan la orientación de la educación en valores propuesta en los programas de deporte escolar. El objeto de estudio de esta tesis doctoral es comprender la educación en valores desde el punto de vista de la estructura organizativa y de los actores implicados en dos programas de deporte escolar seleccionados de países diferentes: la “Union Nationale du Sport Scolaire” (UNSS) en Francia y los “Campeonatos Escolares en los IES de la Comunidad de Madrid” (CEIESCM) en España. El diseño metodológico es un estudio comparado internacional y de corte cualitativo, donde se han analizado 66 entrevistas semiestructuradas, 28 observaciones directas, 45 documentos y el cuaderno etnográfico del investigador por medio de análisis de contenido temático apoyado con el programa NVivo 10. Los resultados aportan dos concepciones distintas de deporte escolar con repercusión en la educación en valores: la UNSS complementa valores del sistema educativo y deportivo proporcionando cauces de implicación y compromiso del alumnado en el arbitraje y la organización asociativa, mientras que en CEIESCM, eximiéndoles de esas responsabilidades, se prioriza la máxima práctica de actividad físico-deportiva reforzando o sancionando durante la misma las conductas que vayan a promover valores del juego limpio propios del deporte. La explicación de estos resultados, contextualizados en sus países respectivos, permite proyectar un eventual deporte escolar europeo basado en valores ciudadanos y democráticos que recogería la perspectiva moral, jurídica y política propuesta a partir del estudio. RÉSUMÉ L’intérêt des administrations publiques pour promouvoir le sport scolaire est souvent justifié par les bénéfices éducatifs et ceux liés à la santé que les élèves obtiendraient des pratiques physiques et sportives. Au-delà des conceptions neutres et excessivement idéalistes sur sa valeur éducative, les conditions socio-culturelles qui le configurent et les interventions pédagogiques sur le terrain marquent l’orientation de l’éducation des valeurs proposée par les programmes de sport scolaire. L’objet de cette étude est de comprendre l’éducation des valeurs du point de vue de la structure organisationnelle et des acteurs impliqués dans deux programmes de sport scolaire sélectionnés de différents pays: l’« Union Nationale du Sport Scolaire » (UNSS) en France et les « Campeonatos Escolares de los IES de la Comunidad de Madrid » (CEIESCM) en Espagne. L’approche méthodologique est une étude comparée internationale et qualitative, où l’on a analysé 66 entretiens semi-directifs, 28 observations directes, 45 documents et le carnet ethnographique du chercheur par le biais d’une analyse de contenu thématique à l’aide du programme NVivo 10. Les résultats apportent deux conceptions différentes du sport scolaire qui ont des répercussions dans l’éducation des valeurs: l’UNSS regroupe les valeurs du système éducatif et sportif en proposant aux élèves des espaces d’implication et d’engagement avec l’arbitrage et l’organisation associative, alors que les CEISCM, les exemptent de ces responsabilités et donnent la priorité au maximum d’activité physique et sportive pratiquée où l’on renforce ou sanctionne pendant son déroulement les conduites qui encourageront les valeurs de fair-play liées au sport. L’explication des résultats, contextualisée dans leurs pays respectifs, permet de projeter un éventuel sport scolaire européen basé sur des valeurs citoyennes et démocratiques qui recueillerait la perspective morale, juridique et politique proposée suite à cette étude. ABSTRACT The interest of public institutions for promoting school sports is often justified by the educational and healthy benefits that the students obtained through physical activity and sports practice. Beyond neutral or overly idealised conceptions about the educational value of sport, sociocultural conditions and pedagogical interventions shape the orientation of education in values given in school sports programs. The aim of this thesis is to understand the values education from the perspectives of the organizational structure and actors involved in two school sports programs selected from different countries: the "Union Nationale du Sport Scolaire" (UNSS) in France and the "School Championships in the IES of the Community of Madrid" (CEIESCM) in Spain. The methodology is a comparative international and qualitative study, with 66 semistructured interviews, 28 direct observations, 45 documentary resources and the ethnographic research notebook being analysed through thematic content analysis using the program NVivo 10. The results provide two different conceptions of school sport that impact on values education: on the one hand, the UNSS complements values of the educational and sports system providing channels of participation and promoting the involvement of students in refereeing and associative organization; on the other hand, CEIESCM is does not assume these responsibilities and the maximum sportive practice is prioritized reinforcing or punishing behaviours that promote sport fair play. The explanation of these results, contextualized in their respective countries, can project an eventual European school sport based on citizens and democratic values and reflect moral, legal and political perspective proposed in this study.

Efficacy of an Internet-based, individually tailored smoking cessation program: A randomized trial

Introduction: Self-help computer-based programs are easily accessible and cost-effective interventions with a great recruitment potential. However, each program is different and results of meta-analyses may not apply to each new program; therefore, evaluations of new programs are warranted. The aim of this study was to assess the marginal efficacy of a computer-based, individually tailored program (the Coach) over and above the use of a comprehensive Internet smoking cessation website. Methods: A two-group randomized controlled trial was conducted. The control group only accessed the website, whereas the intervention group received the Coach in addition. Follow-up was conducted by e-mail after three and six months (self-administrated questionnaires). Of 1120 participants, 579 (51.7%) responded after three months and 436 (38.9%) after six months. The primary outcome was self-reported smoking abstinence over four weeks. Results: Counting dropouts as smokers, there were no statistically significant differences between intervention and control groups in smoking cessation rates after three months (20.2% vs. 17.5%, p¼0.25, odds ratio (OR)¼1.20) and six months (17% vs. 15.5%, p¼0.52, OR¼1.12). Excluding dropouts from the analysis, there were statistically significant differences after three months (42% vs. 31.6%, p¼0.01, OR¼1.57), but not after six months (46.1% vs. 37.8%, p¼0.081, OR¼1.41). The program also significantly increased motivation to quit after three months and self-efficacy after three and six months. Discussion: An individually tailored program delivered via the Internet and by e-mail in addition to a smoking cessation website did not significantly increase smoking cessation rates, but it increased motivation to quit and self-efficacy.

Cost-benefit, cost-effectiveness research of drug abuse prevention : implications for programming and policy /

Shipping list no.: 99-0004-P.

School of Life Sciences, University of Illinois at Urbana-Champaign.

Cover title.

Special milk program evaluation and national school lunch program survey /

"FNS-167."

Eligibility guidance for school meals manual.

Mode of access: Internet.

Administrative guidance for verification of national school lunch, breakfast and special milk applications.

"Education is everyone's future."

Annual report on school breakfast incentives.

Report submitted in compliance with Public Act 91-0843 (105 ILCS 125/4).

Business-education partnerships in Illinois /

Imprint varies.