Browsing by Author "Nigg, Claudio R."
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Item A systematic review of single health behavior change interventions vs. multiple health behavior change interventions among older adults(Springer Verlag, 2012) Graham-Tutt, Camonia; Nigg, Claudio R.Multiple behavior change is widely used to reduce targeted health behaviors; however, its effect on behaviors such as physical activity, nutrition, and alcohol and tobacco use among older adults remains inconclusive. The primary purpose of this systematic review was to evaluate the effects of single health behavior change (SHBC) interventions vs. multiple health behavior change (MHBC) interventions among older age individuals. PubMed was searched for publications on health behavior interventions from 2006 to 2011. Twenty-one randomized clinical trials assessed the effects of health behavior change in older individuals. Results were reviewed by a number of health behaviors and effectiveness. Results revealed that within SHBC interventions, physical activity or exercise behavior revealed that interventions were the most common and showed the most promise in influencing positive outcomes in physical activity behavior among community-dwelling older adults. There were too few MHBC studies identified to allow confident comparison to SHBC interventions. The MHBC field is still at an early stage within the older adult literature, and more attention is recommended to investigate if the benefits of MHBC apply to this age group.Item Effect of the Children’s Healthy Living Program on Young Child Overweight, Obesity, and Acanthosis Nigricans in the US-Affiliated Pacific Region(American Medical Association, 2018-10-26) Novotny, Rachel; Davis, James; Butel, Jean; Boushey, Carol J.; Fialkowski, Marie Kainoa; Nigg, Claudio R.; Braun, Kathryn L.; Guerrero, Rachael T. Leon; Coleman, Patricia; Bersamin, Andrea; Areta, Aufai Apulu Ropeti; Barber Jr, Leroy R.; Belyeu-Camacho, Tayna; Greenberg, Joshua; Fleming, Travis; Cruz-Talbert, Elise Dela; Yamanaka, Ashley; Wilkens, Lynne R.Importance Pacific Islanders have among the highest rates of obesity and type 2 diabetes in the world. Targeting children is critical for primary prevention.
Objectives To prevent young child overweight and obesity and to improve health in the US-Affiliated Pacific region via the Children’s Healthy Living Program.
Design, Setting, and Participants In this multijurisdictional, multilevel, multicomponent community randomized clinical trial, where all evaluable children were analyzed according to the random assignment of their community, hierarchical difference-in-difference models accounted for the community randomization, community clustering with jurisdictions, and these models were adjusted for the age and sex distribution of the community. The setting was 27 communities in 5 jurisdictions (Alaska, American Samoa, Commonwealth of the Northern Mariana Islands, Guam, and Hawaii). Participants were 4329 children (time 1) and 4042 children (time 2) aged 2 to 8 years in 27 selected communities from October 7, 2012, to October 25, 2015. Data analysis was completed in June 2018.
Interventions Nineteen activities addressed policy, environment, messaging, training, and 6 target behaviors (sleep time, screen time, physical activity, fruits and vegetables, water, and sugar-sweetened beverages).
Main Outcomes and Measures Primary outcomes were body size measurements. Secondary outcomes were acanthosis nigricans, sleep quality and duration, dietary intake, physical activity, and other questionnaire responses.
Results The study included 27 communities and 8371 evaluable children (mean [SD] age, 5.4 [1.8] years; 50.9% male [n = 4264]). Data analysis included 952 children in the intervention group and 930 children in the control group aged 2 to 5 years at time 1; 825 children in the intervention group and 735 children in the control group aged 2 to 5 years at time 2; 565 children in the intervention group and 561 children in the control group aged 6 to 8 years at time 1; and 517 children in the intervention group and 560 children in the control group aged 6 to 8 years at time 2. The intervention communities showed significant improvement compared with control communities in overweight and obesity prevalence (effect size [d] = −3.95%; 95% CI, −7.47% to −0.43%), waist circumference (d = −0.71 cm; 95% CI, −1.37 to −0.05 cm), and acanthosis nigricans prevalence (d = −2.28%; 95% CI, −2.77% to −1.57%). Age and sex subgroup analysis revealed greater difference among the intervention communities in acanthosis nigricans prevalence in the group aged 2 to 5 years (−3.99%) vs the group aged 6 to 8 years (−3.40%), and the interaction was significant (d = 0.59%, P < .001), as well as the smaller difference in the group aged 2 to 5 years (−0.10%) vs the group aged 6 to 8 years (−1.07%) in screen time (d = −0.97 hour per day, P = .01).
Conclusions and Relevance The intervention reduced the prevalence of young child overweight and obesity and acanthosis nigricans. Comprehensive, effective, and sustainable interventions are needed to improve child health in the US-Affiliated Pacific region.
Trial Registration ClinicalTrials.gov Identifier: NCT01881373
Item What Matters When Children Play(Elsevier, 2014) Graham-Tutt, Camonia; Harmon, Brook E.; Nigg, Claudio R.; Amato, Katie; Anwar, Mahabub-Ul; Kutchman, Eve; Anthamatten, Peter; Browning, Raymond C.; Brink, Lois; Hill, James O.Objectives Social Cognitive Theory (SCT) has often been used as a guide to predict and modify physical activity (PA) behavior. We assessed the ability of commonly investigated SCT variables and perceived school environment variables to predict PA among elementary students. We also examined differences in influences between Hispanic and non-Hispanic students. Design This analysis used baseline data collected from eight schools who participated in a four-year study of a combined school-day curriculum and environmental intervention. Methods Data were collected from 393 students. A 3-step linear regression was used to measure associations between PA level, SCT variables (self-efficacy, social support, enjoyment), and perceived environment variables (schoolyard structures, condition, equipment/supervision). Logistic regression assessed associations between variables and whether students met PA recommendations. Results School and sex explained 6% of the moderate-to-vigorous PA models' variation. SCT variables explained an additional 15% of the models' variation, with much of the model's predictive ability coming from self-efficacy and social support. Sex was more strongly associated with PA level among Hispanic students, while self-efficacy was more strongly associated among non-Hispanic students. Perceived environment variables contributed little to the models. Conclusions Our findings add to the literature on the influences of PA among elementary-aged students. The differences seen in the influence of sex and self-efficacy among non-Hispanic and Hispanic students suggests these are areas where PA interventions could be tailored to improve efficacy. Additional research is needed to understand if different measures of perceived environment or perceptions at different ages may better predict PA.