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Judith L. Warren

Other affiliations: Texas A&M University
Bio: Judith L. Warren is an academic researcher from Texas A&M AgriLife Extension Service. The author has contributed to research in topics: Psychological intervention & Childhood obesity. The author has an hindex of 7, co-authored 11 publications receiving 124 citations. Previous affiliations of Judith L. Warren include Texas A&M University.

Papers
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Journal ArticleDOI
TL;DR: The TGEG study targets a population of students and parents at high risk of obesity and related chronic conditions, utilizing a novel and collaborative approach to program formulation and delivery, and a rigorous, randomized study design.
Abstract: Coordinated, multi-component school-based interventions can improve health behaviors in children, as well as parents, and impact the weight status of students. By leveraging a unique collaboration between Texas AgriLife Extension (a federal, state and county funded educational outreach organization) and the University of Texas School of Public Health, the Texas Grow! Eat! Go! Study (TGEG) modeled the effectiveness of utilizing existing programs and volunteer infrastructure to disseminate an enhanced Coordinated School Health program. The five-year TGEG study was developed to assess the independent and combined impact of gardening, nutrition and physical activity intervention(s) on the prevalence of healthy eating, physical activity and weight status among low-income elementary students. The purpose of this paper is to report on study design, baseline characteristics, intervention approaches, data collection and baseline data. The study design for the TGEG study consisted of a factorial group randomized controlled trial (RCT) in which 28 schools were randomly assigned to one of 4 treatment groups: (1) Coordinated Approach to Child Health (CATCH) only (Comparison), (2) CATCH plus school garden intervention [Learn, Grow, Eat & Go! (LGEG)], (3) CATCH plus physical activity intervention [Walk Across Texas (WAT)], and (4) CATCH plus LGEG plus WAT (Combined). The outcome variables include student’s weight status, vegetable and sugar sweetened beverage consumption, physical activity, and sedentary behavior. Parents were assessed for home environmental variables including availability of certain foods, social support of student health behaviors, parent engagement and behavior modeling. Descriptive data are presented for students (n = 1369) and parents (n = 1206) at baseline. The sample consisted primarily of Hispanic and African American (53 % and 18 %, respectively) and low-income (i.e., 78 % eligible for Free and Reduced Price School Meals program and 43 % food insecure) students. On average, students did not meet national guidelines for vegetable consumption or physical activity. At baseline, no statistical differences for demographic or key outcome variables among the 4 treatment groups were observed. The TGEG study targets a population of students and parents at high risk of obesity and related chronic conditions, utilizing a novel and collaborative approach to program formulation and delivery, and a rigorous, randomized study design.

33 citations

Journal ArticleDOI
TL;DR: Implementation of both interventions occurred at a very high fidelity level, which led to positive changes in BMI status, and several dietary and PA behaviors, and guided revisions to the TGEG program and its survey instruments.
Abstract: Background: The TEXAS! GROW! EAT! GO! (TGEG) randomized, control trial is a 5-year study to measure the impact of a nutrition and gardening intervention and/or physical activity (PA) intervention on the weight status of third-grade students. This article describes the results of the pilot study to test the feasibility of two interventions and test the measures to be used in the main trial. Methods: The pilot study was conducted in one school with third-grade students and their parents or guardians. The Junior Master Gardner (JMG) and Walk Across Texas (WAT) interventions were implemented over a 5-month period in three third-grade classrooms during spring 2012. The respective interventions focused on improving healthy eating and PA behaviors of children and their families. Baseline and immediate post-test data were collected from students and parents/guardians to measure four child, four parent, and four parent-child interaction behaviors. Process data regarding implementation were also collected ...

23 citations

Journal ArticleDOI
TL;DR: It is indicated that the association of various types of social support with children’s physical activity and eating behaviors differ across racial/ethnic groups, and considerations for future interventions that aim to enhance parental support to improve children's energy balance-related behaviors are provided.
Abstract: Parents play an important role in providing their children with social support for healthy eating and physical activity. However, different types of social support (e.g., instrumental, emotional, modeling, rules) might have different results on children’s actual behavior. The purpose of this study was to assess the association of the different types of social support with children’s physical activity and eating behaviors, as well as to examine whether these associations differ across racial/ethnic groups. We surveyed 1169 low-income, ethnically diverse third graders and their caregivers to assess how children’s physical activity and eating behaviors (fruit and vegetable and sugar-sweetened beverage intake) were associated with instrumental social support, emotional social support, modeling, rules and availability of certain foods in the home. We used sequential linear regression to test the association of parental social support with a child’s physical activity and eating behaviors, adjusting for covariates, and then stratified to assess the differences in this association between racial/ethnic groups. Parental social support and covariates explained 9–13% of the variance in children’s energy balance-related behaviors. Family food culture was significantly associated with fruit and vegetable and sugar-sweetened beverage intake, with availability of sugar-sweetened beverages in the home also associated with sugar-sweetened beverage intake. Instrumental and emotional support for physical activity were significantly associated with the child’s physical activity. Results indicate that the association of various types of social support with children’s physical activity and eating behaviors differ across racial/ethnic groups. These results provide considerations for future interventions that aim to enhance parental support to improve children’s energy balance-related behaviors.

20 citations

Journal ArticleDOI
TL;DR: Garden-based interventions can have an important and positive effect on children's vegetable consumption by increasing exposure to fun gardening experiences and those who reported that they enjoyed gardening had the highest levels of vegetable exposure, preference, and consumption.

19 citations

Journal ArticleDOI
TL;DR: Both the garden and PA interventions independently produced significant changes related to healthy lifestyle behaviors, however, combining the two interventions did not show greater impact than the single interventions, underscoring the need for more research to determine how to better implement comprehensive interventions at schools.
Abstract: Background: The purpose of the Texas!Grow!Eat!Go! (TGEG) study was to assess individual and combined effects of school-based gardening and physical activity (PA) interventions on children's eating ...

17 citations


Cited by
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Journal ArticleDOI
TL;DR: The effectiveness of a range of interventions that include diet or physical activity components, or both, designed to prevent obesity in children is evaluated to determine overall certainty of the evidence.
Abstract: The current evidence suggests that many diet and exercise interventions to prevent obesity in children are not effective in preventing weight gain, but can be effective in promoting a healthy diet and increased physical activity levels.Being very overweight (obese) can cause health, psychological and social problems for children. Children who are obese are more likely to have weight and health problems as adults. Programmes designed to prevent obesity focus on modifying one or more of the factors considered to promote obesity.This review included 22 studies that tested a variety of intervention programmes, which involved increased physical activity and dietary changes, singly or in combination. Participants were under 18 and living in Asia, South America, Europe or North America. There is not enough evidence from trials to prove that any one particular programme can prevent obesity in children, although comprehensive strategies to address dietary and physical activity change, together with psycho-social support and environmental change may help. There was a trend for newer interventions to involve their respective communities and to include evaluations.Future research might usefully assess changes made on behalf of entire populations, such as improvements in the types of foods available at schools and in the availability of safe places to run and play, and should assess health effects and costs over several years.The programmes in this review used different strategies to prevent obesity so direct comparisons were difficult. Also, the duration of the studies ranged from 12 weeks to three years, but most lasted less than a year.

2,464 citations

Journal ArticleDOI
TL;DR: In this article, the authors conducted an empirical analysis of the internal dimensionality of the motivation to volunteer and found that when all 28 motives were subjected to various types of factor analysis, most items were grouped together on one factor.
Abstract: In this study, 258 volunteers in human services and 104 nonvolunteers were asked to rank in importance 28 motives for volunteering that had been identified in a thorough literature review. According to the literature, most researchers assume that motivation to volunteer (MMV) is a two-or three-dimensional phenomenon, but very few studies have carried out an empirical analysis of the internal dimensionality of MTV. The present findings indicate that when all 28 motives were subjected to various types of factor analysis, most items were grouped together on one factor. In other words, a unidimensional scale was obtained.

612 citations

Journal ArticleDOI
TL;DR: This meta-analysis of thirty-seven independent studies provided the means of inferring not only that elder volunteers' sense of well-being seemed to be significantly bolstered through volunteering, but also that such relatively healthy older people represent a significant adjunct resource for meeting some of the service needs of more vulnerable elders, as well as those of other similarly vulnerable groups such as disabled children.
Abstract: The current political-economic climate, which is generally supportive of both private and public sector down-sizing, increasingly demands that human service workers assess, engage, and creatively use consumer strengths and resources. This meta-analysis of thirty-seven independent studies provided the means of inferring not only that elder volunteers' sense of well-being seemed to be significantly bolstered through volunteering, but also that such relatively healthy older people represent a significant adjunct resource for meeting some of the service needs of more vulnerable elders, as well as those of other similarly vulnerable groups such as disabled children. Averaging across studies, 85 percent of the "clients" who received service from an older volunteer (e.g., peer-counseling of nursing home residents) scored better on dependent measures (e.g., diminished depression) than the average person in comparison conditions did (U3 = .847 [Cohen, 1988], combined p < .001). The policy implications of such beneficial effects among both older volunteers and the people they serve are discussed.

336 citations

Journal ArticleDOI
TL;DR: There was very low-quality evidence child-feeding practice interventions are effective in increasing vegetable consumption of children aged five years and younger, however the effect size was very small and long-term follow-up is required.
Abstract: Background Insufficient consumption of fruits and vegetables in childhood increases the risk of future chronic diseases, including cardiovascular disease. Objectives To assess the effectiveness, cost effectiveness and associated adverse events of interventions designed to increase the consumption of fruit, vegetables or both amongst children aged five years and under. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library, MEDLINE, Embase Classic and Embase to identify eligible trials on 30 September 2016. We searched CINAHL and PsycINFO in July 2016, Proquest Dissertations and Theses in November 2016 and three clinical trial registers in November 2016 and June 2017. We reviewed reference lists of included trials and handsearched three international nutrition journals. We contacted authors of included studies to identify further potentially relevant trials. Selection criteria We included randomised controlled trials, including cluster-randomised controlled trials and cross-over trials, of any intervention primarily targeting consumption of fruit, vegetables or both among children aged five years and under, and incorporating a dietary or biochemical assessment of fruit or vegetable consumption. Two review authors independently screened titles and abstracts of identified papers; a third review author resolved disagreements. Data collection and analysis Two review authors independently extracted data and assessed the risks of bias of included studies; a third review author resolved disagreements. Due to unexplained heterogeneity, we used random-effects models in meta-analyses for the primary review outcomes where we identified sufficient trials. We calculated standardised mean differences (SMDs) to account for the heterogeneity of fruit and vegetable consumption measures.We conducted assessments of risks of bias and evaluated the quality of evidence (GRADE approach) using Cochrane procedures. Main results We included 50 trials with 137 trial arms and 10,267 participants. Thirty trials examined the impact of child-feeding practices (e.g. repeated food exposure) in increasing child vegetable intake. Eleven trials examined the impact of parent nutrition education in increasing child fruit and vegetable intake. Eight studies examined the impact of multicomponent interventions (e.g. parent nutrition education and preschool policy changes) in increasing child fruit and vegetable intake. One study examined the effect of a nutrition intervention delivered to children in increasing child fruit and vegetable intake. Thirteen of the 50 included trials were judged as free from high risks of bias across all domains; performance, detection and attrition bias were the most common domains judged at high risk of bias of remaining studies. Meta-analysis of trials examining child-feeding practices versus no intervention revealed a positive effect on child vegetable consumption (SMD 0.38, 95% CI 0.15 to 0.61; n = 1509; 11 studies; very low-quality evidence), equivalent to a mean difference of 4.03 grams of vegetables. There were no short-term differences in child consumption of fruit and vegetables in meta-analyses of trials examining parent nutrition education versus no intervention (SMD 0.11, 95% CI -0.05 to 0.28; n = 3023; 10 studies; very low-quality evidence) or multicomponent interventions versus no intervention (SMD 0.28, 95% CI -0.06 to 0.63; n = 1861; 4 studies; very low-quality evidence). Insufficient data were available to assess long-term effectiveness, cost effectiveness and unintended adverse consequences of interventions.Studies reported receiving governmental or charitable funds, except for two studies reporting industry funding. Authors' conclusions Despite identifying 50 eligible trials of various intervention approaches, the evidence for how to increase fruit and vegetable consumption of children remains sparse. There was very low-quality evidence child-feeding practice interventions are effective in increasing vegetable consumption of children aged five years and younger, however the effect size was very small and long-term follow-up is required. There was very low-quality evidence that parent nutrition education and multicomponent interventions are not effective in increasing fruit and vegetable consumption of children aged five years and younger. All findings should be considered with caution, given most included trials could not be combined in meta-analyses. Given the very low-quality evidence, future research will very likely change estimates and conclusions. Such research should adopt more rigorous methods to advance the field. This is a living systematic review. Living systematic reviews offer a new approach to review updating, in which the review is continually updated, incorporating relevant new evidence as it becomes available. Please refer to the Cochrane Database of Systematic Reviews for the current status of this review.

249 citations

Journal Article
TL;DR: Looking back to the background and appearing process of the Guidelines will not only help to understand this programmatic document, but also provide reference to the researches on health improvement and tipulation of relative policies in China.
Abstract: On October 27,2006,Michael OLeavitt,Secretary of HHS,announced a package program for the development of the Federal GovernmentThis program includes "Physical Activity Guidelines Advisory Committee Report,2008"(Herein after referred to as Guidelines"),which officially appeared in 2008As the officially appointed reference standard,Guidelines provide scientific guidance and important basis for the physical activity and fitness of the US citizensTherefore,looking back to the background and appearing process of the Guidelines will not only help us understand this programmatic document,but also provide reference to the researches on health improvement and tipulation of relative policies in China

210 citations