The association between inflammation and obesity is well documented; however, there is little evidence linking physiological markers of inflammation and psychosocial factors such as body image. This study examined the relation between body image and C-reactive protein (CRP).
Data were available for 1503 adolescents aged 13 and 16 years in a province-wide survey of a representative sample of youth in Quebec, Canada. Participants completed questionnaires assessing body image indicators of social pressures to lose weight and personal body shape discrepancies, provided a fasting blood sample for CRP, and had height and weight measured.
In separate multivariable logistic regression models for girls and boys, body shape discrepancy was positively associated with CRP (boys: OR=2.6, 95% CI=1.4-4.8; girls: OR=2.2, 95% CI=1.2-4.3) independent of body mass index, puberty status and socio-demographic variables.
Adverse biological markers of cardiometabolic risk and negative body image are associated in adolescence. These findings suggest that, in addition to the well-known psychological problems, negative body image perceptions may also threaten adolescent's physical health.
This paper describes the objectives, design, and methods of evaluation of the impact of the coeur en santé St-Henri programme, as well as selected results from the evaluation to date. It discusses the possible effects of study design choices made to maintain the impact evaluation within budget.
The impact of the programme is evaluated in a community trial which compares the prevalence of cardiovascular disease behavioural risk factors before and after programme implementation in the intervention and a matched comparison community, in both longitudinal cohort and independent sample surveys. In addition, repeated independent sample surveys are conducted in the intervention community to monitor awareness of and participation in the programme.
The baseline sample for both the longitudinal cohort and independent sample surveys included 849 subjects from the intervention community (79.3% of 1071 eligible subjects--8.0% could not be contacted and 12.6% refused) and 825 subjects from the comparison community (77.8% of 1066 eligible subjects--6.6% could not be contacted and 15.6% refused). The two surveys on awareness and participation conducted to date, included 461 (71.0% of 649 eligible subjects) and 387 (67.9% of 570 eligible subjects) subjects respectively from the intervention community.
Baseline data for the longitudinal cohort and independent sample surveys on behavioural risk factor outcomes including use of tobacco, physical activity behaviour, high fat diet, and behaviours related to blood pressure and cholesterol control were collected in 35 minute telephone interviews in both the intervention and comparison communities. Data on awareness of and participation in the programme were collected in 10 minute interviews in the intervention community only in two independent sample surveys conducted seven and 22 months respectively after the baseline survey.
With the exception of smoking, the intervention and comparison communities were similar at baseline with regard to the prevalence of behavioural risk factors studied. Awareness of the coeur en santé programme increased from 64.1% in January 1993 to 72.9% 15 months later. Participation in the programme increased from 21.3% to 33.7%.
This paper presents background information on the evaluation of the impact of the coeur en santé programme, as a reference for future publications.
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This research suggests that point-of-choice campaigns can be implemented in low-income communities, although store personnel began to view campaign materials and activities as a nuisance after 2 months, and their enthusiasm and commitment decreased. Employee interest might have been more sustainable if the campaign had been shorter or if it had been implemented 1 or 2 weeks at a time rather than being continually present in the store. This approach would necessitate easily removable displays and materials. Items such as the kiosk were too cumbersome for easy setup and removal. Despite widespread advertisement and 4 months in the community, awareness of the campaign was moderate and use was low. Not surprisingly, awareness and use were higher among women, older persons, and persons who lived in St-Henri, possibly because they do the shopping or have the time and interest to notice promotional messages. Awareness and use of specific campaign components appeared to be higher for easily available, highly visible materials and activities that required little or no effort by consumers. Others have suggested that consumer effort required to recognize, view, read, and internalize point-of-choice messages is important and have recommended methods such as videocassettes of nutrition messages or brand-specific shelf labels that reduce customer effort to absorb information. Both the intervention agent and retailers reported that the cholesterol screening events were very popular and that they should have been offered more frequently. Although these events are relatively complex and costly, this response suggests that they are an appropriate and effective way to increase awareness and heighten interest. By contrast, almost no interest was shown in supermarket tours. Although our publicity might have been ineffective, it is more likely that this kind of activity did not interest the target group, possibly because of lack of time or low perceived need or usefulness.
Present and immediately foreseeable medical knowledge suggest that HIV infection cannot be avoided by vaccination and that an affordable cure for the resulting syndrome, AIDS, is a long way off. There is a strong possibility that Ukraine is confronted by an HIV epidemic which will spread into the general population and that the most common mode of transmission will be through heterosexual intercourse. The epidemic in the Ukraine is currently concentrated among intravenous drug users. It is estimated that between 60,000 and 180,000 people may currently be infected. In present economic and social circumstances there are many features of Ukrainian society that may add to the probability of the epidemic becoming widespread in the general population. It is likely that this process may have already commenced. The result of this will be numerous additional deaths and illness over the short (5 year) (19,000-23,000 deaths), medium (10-15 year) (61,000-111,000), and longer terms (>20 year) (in excess of 40,000-160,000 deaths). The research reported here was undertaken in 1997-8 and describes the potential medium to long term social and economic impact of an HIV/AIDS epidemic in Ukraine. Using the concepts of risk environment, susceptibility and vulnerability, it reports the problems which might be expected to develop in relation to care of excess orphans, the elderly, vulnerable households and regions as well as among those working in the "third sector", a social sector upon which exponents of the importance of developing sound "civil society" in "transitional economies" place heavy emphasis.
Prevalence and correlates of physical activity behaviors among elementary schoolchildren in multiethnic, low income, inner-city neighborhoods in Montreal, Canada.
To describe the prevalence and correlates of physical inactivity and of participation in organized sports at and outside school among elementary schoolchildren in multiethnic, low income, urban neighborhoods in Montreal, Canada.
As part of the evaluation of a school-based heart health promotion program, baseline data on physical activity behaviors and potential correlates of these behaviors, were collected from 2285 students aged 9-13 in all 130 grade 4 to 6 classes in 24 inner-city elementary schools from May to June 1993.
One-fifth of boys (20.5%) and 24.4% of girls were inactive; 40.0% and 33.3% of boys and girls respectively, participated in school sports teams; 82.5% and 74.7% participated in organized sports outside school. Declines in activity levels with age were apparent in both genders. Children who participated in organized sports programs at and outside school, those with higher perceived self-efficacy for physical activity, and those with more parental support for engaging in physical activity were more active. Children of Asian family origin were less active. Socioeconomic status was related to participation in organized sports outside school.
To reach children in socio-economically disadvantaged areas and to prevent age-related declines in activity levels, interventions promoting physical activity should focus on increasing availability and access to community-based organized sports programs at and outside school. Also they should include components to increase parental support and to improve perceived self-efficacy for physical activity.
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Comment In: Ann Epidemiol. 1999 Oct;9(7):394-610501406
To investigate the reliability of reports of parental smoking by elementary schoolchildren aged 9-13 years, and to identify the correlates of disagreement between student proxy and parent self-reports.
As part of the evaluation of a school-based heart health promotion program, data on parental smoking status were collected from 1240 student-mother pairs and 898 student-father pairs.
Agreement for parental smoking status was 93.1% among student-mother pairs and 86.4% among student-father pairs. Among student-mother pairs, reports by students aged 9 years were more likely to disagree with mothers' self-reports than those of older children (odds ratio (OR) = 3.1). Among student-father pairs, the only significant correlate of disagreement was living in a single-parent family headed by the mother (OR = 2.6).
Children 10-years or older can provide reliable reports of the smoking status of cohabiting parents.
The objectives were to evaluate the impact of "Yes, I Quit" (a smoking cessation course tailored for women in a low income, low education community), and to identify baseline predictors of short and longer-term self-reported cessation. The impact was evaluated in a before-after study design with no comparison group. Baseline data were collected in self-administered questionnaires at the beginning of the first session of the course. Follow-up data were collected in telephone interviews at one, three and six months after the designated Quit Day. Self-reported quit rates among 122 participants were 31.1%, 24.7% and 22.3% at one, three and six months. Non-quitters reduced their consumption by 10.3, 8.3, and 7.1 cigarettes per day at one, three and six months. Multivariate logistic regression analyses showed that being in excellent/good health was significantly associated with cessation at one month (odds ratio (OR) = 2.4). Being married (OR = 13.0) and no other smokers in the household (OR = 3.6) were associated with three-month cessation. Only being married was associated with six-month cessation (OR = 6.8). "Yes, I Quit" produced quit rates among low income, low education participants comparable to those reported for cessation programs directed at the general population of smokers. Good health is associated with early cessation, while support from a spouse is important to maintaining a non-smoking status among quitters.
