This article examines health promotion and disease prevention from the perspective of social cognitive theory. This theory posits a multifaceted causal structure in which self-efficacy beliefs operate together with goals, outcome expectations, and perceived environmental impediments and facilitators in the regulation of human motivation, behavior, and well-being. Belief in one’s efficacy to exercise control is a common pathway through which psychosocial influences affect health functioning. This core belief affects each of the basic processes of personal change—whether people even consider changing their health habits, whether they mobilize the motivation and perseverance needed to succeed should they do so, their ability to recover from setbacks and relapses, and how well they maintain the habit changes they have achieved. Human health is a social matter, not just an individual one. A comprehensive approach to health promotion also requires changing the practices of social systems that have widespread effects on human health.

https://www.uky.edu/~eushe2/Bandura/Bandura2004HEB.pdf

Health Promotion by Social Cognitive Means

SALLIS, J. F., J. J. PROCHASKA, and W. C. TAYLOR. A review of correlates of physical activity of children and adolescents. Med. Sci. Sports Exerc., Vol. 32, No. 5, pp. 963‐975, 2000. Background: Understanding the factors that influence physical activity can aid the design of more effective interventions. Previous reviews of correlates of youth physical activity have produced conflicting results. Methods: A comprehensive review of correlates of physical activity was conducted, and semiquantitative results were summarized separately for children (ages 3‐12) and adolescents (ages 13‐18). The 108 studies evaluated 40 variables for children and 48 variables for adolescents. Results: About 60% of all reported associations with physical activity were statistically significant. Variables that were consistently associated with children’s physical activity were sex (male), parental overweight status, physical activity preferences, intention to be active, perceived barriers (inverse), previous physical activity, healthy diet, program/facility access, and time spent outdoors. Variables that were consistently associated with adolescents’ physical activity were sex (male), ethnicity (white), age (inverse), perceived activity competence, intentions, depression (inverse), previous physical activity, community sports, sensation seeking, sedentary after school and on weekends (inverse), parent support, support from others, sibling physical activity, direct help from parents, and opportunities to exercise. Conclusion: These consistently related variables should be confirmed in prospective

A review of correlates of physical activity of children and adolescents.

The first purpose of this review was to assess the impact of implementation on program outcomes, and the second purpose was to identify factors affecting the implementation process. Results from over quantitative 500 studies offered strong empirical support to the conclusion that the level of implementation affects the outcomes obtained in promotion and prevention programs. Findings from 81 additional reports indicate there are at least 23 contextual factors that influence implementation. The implementation process is affected by variables related to communities, providers and innovations, and aspects of the prevention delivery system (i.e., organizational functioning) and the prevention support system (i.e., training and technical assistance). The collection of implementation data is an essential feature of program evaluations, and more information is needed on which and how various factors influence implementation in different community settings.

/pdf/implementation-matters-a-review-of-research-on-the-influence-1wt0xfs3gm.pdf

Implementation Matters: A Review of Research on the Influence of Implementation on Program Outcomes and the Factors Affecting Implementation

Ten per cent of the world’s school-aged children are estimated to be carrying excess body fat (Fig. 1), with an increased risk for developing chronic disease. Of these overweight children, a quarter are obese, with a significant likelihood of some having multiple risk factors for type 2 diabetes, heart disease and a variety of other co-morbidities before or during early adulthood. The prevalence of overweight is dramatically higher in economically developed regions, but is rising significantly in most parts of the world. In many countries the problem of childhood obesity is worsening at a dramatic rate. Surveys during the 1990s show that in Brazil and the USA, an additional 0.5% of the entire child population became overweight each year. In Canada, Australia and parts of Europe the rates were higher, with an additional 1% of all children becoming overweight each year. The burden upon the health services cannot yet be estimated. Although childhood obesity brings a number of additional problems in its train – hyperinsulinaemia, poor glucose tolerance and a raised risk of type 2 diabetes, hypertension, sleep apnoea, social exclusion and depression – the greatest health problems will be seen in the next generation of adults as the present childhood obesity epidemic passes through to adulthood. Greatly increased rates of heart disease, diabetes, certain cancers, gall bladder disease, osteoarthritis, endocrine disorders and other obesityrelated conditions will be found in young adult populations, and their need for medical treatment may last for their remaining life-times. The costs to the health services, the losses to society and the burdens carried by the individuals involved will be great. The present report has been written to focus attention on the issue and to urge policy-makers to consider taking action before it is too late. Specifically, the report:

https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1467-789X.2004.00133.x

Obesity in children and young people: a crisis in public health.

https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(02)09678-2.pdf

Childhood obesity: public-health crisis, common sense cure

The development of scales to measure social support for diet and exercise behaviors

Context Decreased physical activity plays a critical role in the increase in childhood obesity. Although at least 60 minutes per day of moderate-to-vigorous physical activity (MVPA) is recommended, few longitudinal studies have determined the recent patterns of physical activity of youth. Objective To determine the patterns and determinants of MVPA of youth followed from ages 9 to 15 years. Design, Setting, and Participants Longitudinal descriptive analyses of the 1032 participants in the 1991-2007 National Institute of Child Health and Human Development Study of Early Child Care and Youth Development birth cohort from 10 study sites who had accelerometer-determined minutes of MVPA at ages 9 (year 2000), 11 (2002), 12 (2003), and 15 (2006) years. Participants included boys (517 [50.1%]) and girls (515 [49.9%]); 76.6% white (n = 791); and 24.5% (n = 231) lived in low-income families. Main Outcome Measure Mean MVPA minutes per day, determined by 4 to 7 days of monitored activity. Results At age 9 years, children engaged in MVPA approximately 3 hours per day on both weekends and weekdays. Weekday MVPA decreased by 38 minutes per year, while weekend MVPA decreased by 41 minutes per year. By age 15 years, adolescents were only engaging in MVPA for 49 minutes per weekday and 35 minutes per weekend day. Boys were more active than girls, spending 18 and 13 more minutes per day in MVPA on the weekdays and weekends, respectively. The rate of decrease in MVPA was the same for boys and girls. The estimated age at which girls crossed below the recommended 60 minutes of MVPA per day was approximately 13.1 years for weekday activity compared with boys at 14.7 years, and for weekend activity, girls crossed below the recommended 60 minutes of MVPA at 12.6 years compared with boys at 13.4 years. Conclusion In this study cohort, measured physical activity decreased significantly between ages 9 and 15 years.

https://jamanetwork.com/journals/jama/articlepdf/182251/joc80065_295_305.pdf

Moderate-to-vigorous physical activity from ages 9 to 15 years.

grade intervention including school food service modifications, enhanced physical education (PE), and classroom health curricula. Twenty-eight additional schools received these components plus family education. Main Outcome Measures.\p=m-\Atthe school level, the two primary end points were changes in the fat content of food service lunch offerings and the amount of moderate-to-vigorous physical activity in the PE programs. At the level of the individual student, serum cholesterol change was the primary end point and was used for power calculations for the study. Individual level secondary end points included psychosocial factors, recall measures of eating and physical activity patterns, and other physiologic measures. Results.\p=m-\Inintervention school lunches, the percentage of energy intake from fat fell significantly more (from 38.7% to 31.9%) than in control lunches (from 38.9% to 36.2%)(P<.001 ). The intensity of physical activity in PE classes during the Child and Adolescent Trial for Cardiovascular Health (CATCH) intervention increased significantly in the intervention schools compared with the control schools (P<.02). Self-reported daily energy intake from fat among students in the intervention schools was significantly reduced (from 32.7% to 30.3%) compared with that among students in the control schools (from 32.6% to 32.2%) (P<.001). Intervention students reported significantly more daily vigorous activity than controls (58.6 minutes vs 46.5 minutes; P<.003). Blood pressure, body size, and cholesterol measures did not differ significantly between treatment groups. No evidence of deleterious effects of this intervention on growth or development was observed. Conclusion.\p=m-\TheCATCH intervention was able to modify the fat content of school lunches, increase moderate-to-vigorous physical activity in PE, and improve eating and physical activity behaviors in children during 3 school years.

Outcomes of a Field Trial to Improve Children's Dietary Patterns and Physical Activity: The Child and Adolescent Trial for Cardiovascular Health (CATCH)

The development of self-efficacy scales for healthrelated diet and exercise behaviors

This paper describes SOFIT (System for Observing Fitness Instruction Time), an observation instrument designed to assess variables associated with students’ activity levels and opportunities to become physically fit in physical education. SOFIT involves the direct observation of classes while simultaneously recording student physical activity levels, curriculum context variables, and teacher behavior. The paper reports the reliability, validity, and feasibility of using the instrument, as well as data from using SOFIT to assess 88 third- and fourth-grade classes.

Philip R. Nader

Papers

The development of scales to measure social support for diet and exercise behaviors

Moderate-to-vigorous physical activity from ages 9 to 15 years.

Outcomes of a Field Trial to Improve Children's Dietary Patterns and Physical Activity: The Child and Adolescent Trial for Cardiovascular Health (CATCH)

The development of self-efficacy scales for healthrelated diet and exercise behaviors

SOFIT: System for Observing Fitness Instruction Time