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Background: Many institutions offer introductory personal health courses to fulfill a general requirement; however, gaps may exist regarding health education and information students receive and what they find relevant to their lives. Purpose: Identification of topics of salience/relevance to college students in introductory personal health courses, including delivery improvement recommendations. Methods: We interviewed students (ages 18-25) who completed an introductory personal health course. MAXQDA© was used for organizing codes and themes responsive to research questions. Results: Emergent themes related to mental health, exercise, nutrition, stress, sexual health, and alcohol substance use were uncovered. Students preferred interactive learning and harm reduction approaches to passive learning. Discussion: A disconnect exists between students' interests and what is taught. Formats for presenting topics alienated students, making them feel judged if pursuing questions. The gap between the product desired and that delivered occurred across delivery platforms, syllabi, and textbooks. Translation to Health Education Practice: We heard praise for examples of active, skills-based learning. Students were eager to improve content and delivery and enumerated examples of how to make courses more relevant and applicable. Instructors may need to be better prepared in content, pedagogy, and health-based philosophy to accommodate the diverse student population at collegiate institutions. A AJHE Self-Study quiz is online for this article via the SHAPE America Online Institute (SAOI) http:// portal.shapeamerica.org/trn-Webinars.

Background: The relationship between health and learning generally goes without question in developed countries, and has a philosophic, economic, and statutory basis. Historically, school health and school health education have evolved in response to addressing the public health needs of the times. Health literacy skills are more important now than ever. Living in an ongoing COVID-19 global pandemic reminds us of the vital role of being in control of our health, wherein health literacy plays a "life or death" role in our daily lives. Methods: Considering the evolution of school health education, we examine the significance of health literacy in our society and schools in contemporary times. Results: We must take a critical look at a place for education for health literacy and why it should be an innovative path in adaptive, reimagined, and revitalized schools. Conclusions: It is time to rebrand school health in general, and school health education specifically. Improved health literacy is an asset leading to greater opportunities for health and life-long learning.

Background: Branding involves "labeling" (for identification) and "meaning" (for understanding) to a product, service, person, idea, or other entity. We are familiar with "brands" of soft drinks, automobiles, mobile phones, soups, cigarettes, and sports teams, and some brands have greater "market share" than others. Methods: In this commentary, we review some of the ways that school health has been branded over the past 50+ years. Results: The brand we know as school health education has failed to compete successfully with other school subject areas (eg, the so-called STEM subjects) for the attention of school board members, administrators, legislators, and other policymakers. Perhaps more importantly, school health education advocates have lost the market share game to subject areas that school board members and legislators see as ones with better return on investment, at least politically speaking. In short, we have failed to make the sale. Conclusion: An alternative is to re-brand and re-frame school health education as "education for health literacy." Literacy as a brand commands the attention of education gatekeepers, and may be more strongly related conceptually to what gatekeepers see as education-centric programs deserving of funding. Adopting a marketing mindset may elevate "education for health literacy" to a place where key stakeholders are more likely to "purchase" it as a relevant school "product."

The objective of this study was to examine attributes assigned by university undergraduates to 12 contraception options, determine if dimensions used to evaluate options differed for women and men, and assess whether these dimensions have changed over time. This study was cross-sectional and involved a written survey. The sample (N = 792) was drawn from two large universities in the southeastern United States and data collection was completed in classroom settings. Students rated 12 methods on 40 semantic differential scales. Scale scores were summed and a principal components analysis was performed, yielding separate factor structures (evaluative dimensions) for men and women. Three factors emerged for women accounting for 40.85%, 8.00%, and 5.78% of the variance respectively. Three factors also emerged for men accounting for 37.39%, 8.51%, and 7.15% of the variance respectively. Manipulating item loading criteria increased factor interpretability. In contrast to some previous research, the interpretative schemes of men and women for assessing contraception options held more similarities than differences. This apparent confluence in evaluating contraception may facilitate improved negotiation and agreement about the eventual choice of methods.

Background: Unhealthy eating contributes to morbidity in adolescents and college students and is an antecedent of premature mortality in adulthood. It has been suggested that the increase in independence (i.e., living away from parents) of adolescents contributes to their poor eating behaviors. Some literature reports that specific parenting styles may reduce the probability of engaging in poor eating practices. Purpose: We investigated the association between college freshmen's eating practices and their perceptions of parenting style. Methods: An Internet-based survey was used to sample 264 college freshmen between the ages of 18 and 20 years from a large southeastern university. Data analysis used univariate and bivariate statistics along with multiple regression analysis. Results: Student eating practices fell short of optimal dietary recommendations. Whereas the literature suggests that parenting style predicts healthy eating during early adolescence, it did not predict healthy eating in this sample of college freshmen, accounting for less than 1% of the variance in eating practices. Nevertheless, responses to an open-ended question suggested that some students believed that parents had influenced their current eating behaviors. Discussion: We found little evidence of any latent effects of parenting style on eating behaviors among college freshmen. Translation to Health Education Practice: Despite positive parental influences, as it relates to health eating, continued reinforcement at the individual (e.g., skill enhancement with regard to meal preparation), interpersonal (e.g., role modeling healthy eating practices among peers), community (e.g., establishing farmers' markets) and organizational (e.g., increased access to healthy food options in cafeterias) levels is needed. (Contains 5 tables.)

Background: Launched 50 years ago, the School Health Education Study (SHES) examined the health education offerings in 135 public school systems, in 38 states, and over 1100 elementary schools and 350 secondary schools. In its second year, knowledge surveys were administered to students in grades 6, 9 and 12 at many of these schools. Analysis of the results in year three led to a one-word description of the state of health education in public schools--"appalling." Subsequent years saw the SHES writing team engage in development of a conceptual approach to health education (through physical, mental and social dimensions) applied at four levels (K-3, 4-6, 7-9, 10-12) and in three learner domains (cognitive, affective and psychomotor). The SHES has been identified time and again for its pioneering effort to bring prominence to school health education. Purpose: We attempted to identify ways that the SHES has influenced health education practice in schools as told by school health education scholars. Methods: Between April and June 2011, we used a snowball sampling approach with saturation to identify individuals believed to have historiographic knowledge of the SHES; we asked them to respond to eight questions (developed by the primary authors and modified though the individual judgments of four school health scholars) about the SHES' influence and legacy, its relevance after 50 years and issues pertinent to today's practice of school health education. Twenty-eight individuals were contacted (based on having been named by at least two people as authorities) through their active email addresses; 22 agreed to participate, and ultimately, 16 responded to the questions (The School Health Education Study Fifty-Year Reflection Group). Three people did not respond to the original invitation and three others indicated they did not believe they had insights to offer. All participants did not respond to each item. Some responses have been edited for length or clarity, or because they intersected with comments already presented by other participants. However, a full transcript of all responses received can be obtained by writing to the primary authors. Results: We found a wide array of thoughts about the SHES. Whereas we see much consensus about the SHES' impact and legacy, we also acknowledge that some disparate opinions emerged. The details of these perspectives are contained herein, mostly in the participants' own words. Discussion: The importance of the SHES continues to be recognized. Participants concur that the SHES: (1) Demonstrated application of an exemplary process and set of principles for curriculum development, including a conceptual approach that minimized the potential impact of content or factual changes over time; and (2) Was the forerunner of the development of the National Health Education Standards, the School Health Policy and Practices Study, and countless other initiatives. Whereas no conclusions can be drawn, participants raised points about the SHES that we see worthy of further note, discussion and debate: (1) The SHES conceptual approach may have been too complex for some school systems to interpret or adopt; (2) It may have lacked thorough description of an implementation strategy; and (3) It may have failed to gain sufficient involvement of administrators and policymakers during development and implementation to achieve more widespread buy-in. With respect to school health education in general, some participants argue that: (1) A more sustained foothold for school health education may have failed due to reliance on K-6 teachers in a vanguard role when so many teacher preparation institutions lack requirements for school health for elementary teachers; and (2) Some academicians have abandoned their advocacy role, contributing to the demise of school health in some communities. At least some participants see gains being accomplished in the future if school health education proponents consider: (1) Marketing health education as education for health literacy, thereby bringing health into better philosophical alignment with core subjects such as reading and mathematics and integrating it more fully into the curriculum, or in a similar vein, focusing more on educational and productivity outcome metrics, rather than on health outcomes alone, whose long-term effects are both difficult to trace and to measure; and (2) Viewing school health education as a component of a broader community or public health construct, thereby drawing the full breadth of health resources and health education venues into a supportive matrix. Whereas these respondents' comments likely represent mainstream historiographic reflections about the SHES and school health education, the collection of remarks is obviously limited to ones made by these 16 participants. Additional invitees may have wanted to participate, but could not because of the timing of the request, their personal obligations, and other constraints. Moreover, other scholars whose names did not surface in the sampling procedure might have different but equally valid remarks to make about the SHES. Because all responses were created independently, alternative interpretations might have emerged had these individuals been part of a face-to-face panel where a discussion ensued. Translation to Health Education Practice: Concerns abound that the legacy of the SHES is already being lost in the rising generation of health education practitioners, and that, therefore, the heritage brought to health education by the SHES and its key personnel needs to be transmitted via identified stewards of the profession. We leave further interpretation and the translation experience of "lessons-to-be-learned" up to readers as a dialogue building exercise related to the SHES and contemporary school health education issues. We recommend that some of these participants or other school health scholars be invited as panelists at forthcoming health education conferences over the next few years and react to questions like ones presented here. Further, we recommend that a similar project be pursued on a recurring basis so that future generations of health educators can glean insights from their historic heritage.

Numerous reports and studies have touted the benefits of school health education for over five decades and extensive public health data support an association between education levels and health outcomes. This paper recounts the "tacit" approval given to school health education historically by reviewing reports issued by various governmental and nongovernmental organizations from the 1960s to the present. Whereas these reports and studies demonstrate an influence on the status of modern school health education programs, many of the barriers to effective school-based programs described 50 or more years ago continue to be challenges for school health education advocates. Additional elements that may further impact the delivery and of quality of school health education negatively in the next decade include legislation that places pressure on schools to improve students' performance on subject areas that do not include health; a declining tax base for funding education programs in general; the deterioration or complete disappearance of school health education professional preparations programs; and evolving technology that alter the ways in which students learn.

Background: Preordinate attitudes and beliefs about contraception may influence acceptance or rejection of a particular method. Purpose: We examined the attitudes about contraception methods held by undergraduate students (N=792) at two large southeastern universities in the United States. Methods: Twelve methods were rated on 40 semantic differential scales. Means of the scale sum scores for men and women were compared using t-tests. Results: Among women the most favorably rated methods were: abstinence, oral contraceptive, male condom, Nuva ring, contraceptive patch, emergency contraception, male sterilization, female sterilization, diaphragm and female condom, each yielding a mean above the scale midpoint. The most negatively rated methods were withdrawal and douche. For men, the ratings in descending order were: oral contraceptive, male condom, abstinence, contraceptive patch, emergency contraception, female sterilization, Nuva ring, female condom, diaphragm, withdrawal, male sterilization and douche. There were four statistically significant (P less than 0.05) gender differences, with abstinence, male condom, male sterilization and Nuva ring all rated more favorably by women. Discussion: These evaluative indices suggest that contraceptive methods elicit varied responses among potential users that theoretically could manifest themselves in acceptance or rejection of a particular method. Improved understanding of the traits by which potential users judge contraception may be beneficial in fostering communication between potential users and practitioners who provide relevant advice. Translation to Health Education Practice: Health educators and other practitioners engaged in contraception counseling must consider that persons may already hold strong feelings about some methods before they enter the clinical setting. (Contains 3 tables.)

Conducting evaluations that are both valid and ethical is imperative for the support and sustainability of programs that address underserved and vulnerable populations. A key component is to have evaluators who are knowledgeable about relevant cultural issues and sensitive to population needs. Hispanics in rural settings are vulnerable for many reasons but especially because of language issues, differences in cultural beliefs and socioeconomic barriers. Additional factors, such as cultural proclivity to be deferential to authority figures and the possibility of having an undocumented alien status also are important issues for Hispanics living and working in rural communities. Because migrant farm workers comprise a large part of Hispanics living in rural areas, attention to the sensitive issues surrounding this population is paramount during program evaluations. This paper highlights ethical issues pertinent to program evaluations involving Hispanics residing in rural settings.

Background: Participation in free-time play, including individual and group activities, is important during youth as patterns of physical activity established then persist into adulthood. The VERB Summer Scorecard (VSS) intervention is an innovative physical activity promotion initiative that offers tweens (8-13 year-olds) opportunities to be active during the summer months when increased sedentariness can occur, leading to weight gain and a predisposition for further inactivity. Purpose: This study identified factors associated with intentions to participate in VSS among tweens previously exposed to the intervention. Methods: We conducted a cross-sectional study of 1,063 middle school youth using a 39-item survey and performed a multi-level analysis. Results: Being female (OR=1.43), having tried a new physical activity (OR=1.59), not currently participating in out-of-school activities but wanting to (OR=2.60), and self-monitoring of physical activity (OR=4.42 to 7.50) were associated with future intention to participate in VSS. Discussion: Adoption of the VSS seemed to inspire some tweens to initiate and sustain activity. VSS appealed to tween girls, an especially important priority audience because of the observed tendency of girls' physical activity to decline during the teen years. Moreover, VSS offered youth the opportunity for trying a variety of games, sports, and other activities. Additionally, the tangible practice of monitoring physical activity (via the scorecard) appeared to have a favorable impact on intention to participate again in VSS. Translation to Health Education Practice: Implications for school and community based physical activity interventions include structures that incorporate trialabilty and observability as mechanisms for increasing likelihood of intervention adoption. (Contains 3 tables and 1 figure.)

Background: Following the occurrence of natural or man-made disaster, relief worker priorities include providing water, food, shelter, and immunizations for displaced persons. Like these essential initiatives, reproductive health education and services must also be incorporated into recovery efforts. Purpose: This study examined reproductive health care indicators, including the key areas of HIV/AIDS and other sexually transmitted infection (STI) transmission, family planning and pregnancy-related health services, and selected reproductive health education knowledge among refugees and internally displaced persons residing in southern Belize following Hurricane Mitch's assault on the region in 1998. In addition, the occurrence of gender-based violence was measured. Methods: Internally displaced persons and refugee men and women were interviewed about prenatal care and delivery services, family planning knowledge and utilization, HIV/AIDS and other STI transmission knowledge, and sexual violence. Results: Numerous misconceptions about HIV/AIDS and other STIs existed. Most persons had never used any family planning method. Oral contraceptive use declined as length of stay at refugee camps increased. Most women were able to access prenatal services. Violence against women, including sexual violence, was reported. Discussion: Better access to medical services and education about reproductive health issues are needed following disasters. Translation to Health Education Practice: Health educators can contribute to relief efforts. Moreover, other relief workers should be equipped with skills and knowledge to help meet the reproductive health needs of disaster victims. (Contains 3 tables.)

Stem cells are being touted as the greatest discovery for the potential treatment of a myriad of diseases in the new millennium, but there is still much research to be done before it will be known whether they can live up to this description. There is also an ethical debate over the production of one of the most valuable types of stem cell: the embryonic form. Consequently, there is public confusion over the benefits currently being derived from the use of stem cells and what can potentially be expected from their use in the future. The health educator's role is to give an unbiased account of the current state of stem cell research. This paper provides the groundwork by discussing the types of cells currently identified, their potential use, and some of the political and ethical pitfalls resulting from such use. (Contains 2 tables.)

In this paper, the author shares some thoughts about health education profession, including some things that educators need to do to keep the profession "vital". He also offers some thoughts that educators need to consider as they attempt to respond effectively to the challenges that lie before them now, and face them in the future. He discusses five actions that will ensure that those who are in the health education profession will continue to have a professional pulse and vitality. These are: (1) they need to be responsive to the public health's workforce development needs; (2) they need to advance the political action skills of health education professionals; (3) they need to broaden the way in which they define health; (4) they need to advance the research foundation and evidence base of the profession; and (5) they need to develop a strategic plan for the profession. (Contains 2 tables.)

Background: Publication is the primary means of contributing to and establishing credibility within the scientific community. Some researchers have reported an increase in the average number of authors per manuscript for some scholarly journals in the past two decades. Whereas author proliferation may be warranted in some cases, other reasons for increasing the overall number of authors per manuscript may have more dubious motives, including gratuitous authorship for embellishing curriculum vitae. Purpose: The purpose of this study was to determine whether there was evidence of authorship proliferation in the "American Journal of Health Education" during 1996-2006. In addition, other selected authorship information was identified. Methods: A content analysis of original articles published from January 1996 through December 2006 (N = 755) was performed. Results: There has not been a statistically significant change in the number of authors per manuscript for the time period studied. Discussion: Although no significant change in number of authors was found, other investigative methods may be necessary to estimate the practice of gratuitous authorship. Translation to Health Education Practice: Health educators should be cognizant of the International Committee of Medical Journal Editors (ICMJE) criteria for authorship and endeavor to ensure that all authors meet these criteria. (Contains 2 tables and 2 figures.)

This study identified youth and adult perceptions of factors that influence initiation of youth drinking, access to alcohol, strategies for deterring youth drinking, and parents' role in prevention. A combination of qualitative (focus group and individual interview) and quantitative (written survey) community-based participatory research methods was used. Results showed that parents and other adults influence youth decisions about alcohol use both positively and negatively. Parental strategies identified by both youths and adults as important for the prevention of youth alcohol use includes communication, modeling positive behavior, monitoring youths, and controlling youths' access to alcohol. Communication was considered the most effective strategy, especially if parents do not lecture or nag their children. Both parents and students viewed monitoring as important but in need of improvement. Most youths and adults believed it is easy for minors to obtain alcohol, usually from their own or friends' parents. However, few parents had talked with other parents about youth drinking. Youths' perceptions of alcohol use norms were assimilated from adults, but many parents reported difficulty in modeling positive drinking behavior. Parent education and support are needed to encourage parents to confront the extent of youth drinking and to improve their own prevention skills. (Contains 1 table.)

Objective: In this historical brief about the journal, we examine the original and future intentions of Health Behavior and Policy Review as a contributor to the scholarly literature and look back at some of the challenges faced by academic journals. Methods: We review the purpose and principles upon which the journal was founded and offer some of the journal's highlights of the past decade. Results: We report some specific benchmarks of achievement -- notably major coverage of historically relevant and emerging public health issues, linkage with World Health Organization and Healthy People 2030 objectives, articulation of health behavior and policy, and recognition of the journal's impact factor and rank among peer journals in social sciences and humanities. Conclusion: The journal has evolved into an outlet for reporting the results of scientific research and learned opinion that is international in scope [ABSTRACT FROM AUTHOR]

Objective: We assessed changes in the frequency of self-reported physical activity (PA) among tween girls exposed and not exposed to the VERB [TM] Summer Scorecard (VSS) intervention in Lexington, Kentucky, during 2004, 2006, and 2007. Methods: Girls who reported 0-1 day per week of PA were classi?ed as having "little or no" PA. Girls who reported 2-3 days of PA were classi?ed as "low" PA performers; 4-5 days of PA were labeled as "moderate" performers; and 6-7 days of PA were identi?ed as "high" performers. Logit regression analysis of survey data from girls identi?ed trends in PA frequency across time. Results: In 2004, participant girls were more likely than girls unfamiliar with VSS (reference group girls) to report "high" frequency of PA (OR = 1.44, CI = 1.18, 1.70). In 2006, participants were statistically less likely than reference group girls to report "low" frequency of PA (OR = 1.75, CI = 1.33, 2.21). In 2007, VSS participants were consistently more likely to report "moderate" frequency (OR = 1.56, CI = 1.35, 1.77) and "high" frequency of PA (OR = 1.44, CI = 1.24, 1.64) than reference group girls. Conclusion: An innovative, community-driven intervention demonstrated promise for increasing PA among tween girls. VSS may have transportability to other communities to help reverse the secular trend of declining PA for this population segment. (Contains 2 tables.)

Background: The prevalence of obesity among high school students has risen in recent decades. Many high school students report trying to lose weight and some engage in disordered eating to do so. The obesity proneness model suggests that parents may influence their offspring's development of disordered eating. This study examined the viability of a modified obesity proneness model in a high school population. Methods: Cross-sectional survey data from a random cluster sample of 1533 students in grades 9-12 from a Florida school district were analyzed using structural equation modeling. Variables included adolescents' weight concerns; inability to self-regulate eating; and perceptions about maternal comments about adolescents' weight, restrictive feeding practices, and maternal weight-related concern and values. Results: All the model's originally proposed relationships were statistically significant, for example perceived maternal weight comments were associated with adolescents' weight concerns ([beta] = 0.64; p less than 0.0001), and perceived maternal restrictive feeding practices were associated with adolescents' inability to self-regulate eating ([beta] = 0.22; p less than 0.001). Conclusion: Some points of intervention should be subjected to empirical study. These interventions should give mothers guidance about appropriate feeding practices and discourage mothers from making weight-related comments to their offspring. Together, as 1 component of a multilevel intervention, these behaviors may help prevent disordered eating and obesity. (Contains 2 figures and 2 tables.)

In this paper, we use game theory to understand decisions to cooperate or to compete in the delivery of public health services. Health care is a quasi-public good that is often associated with altruistic behavior, yet it operates in an increasingly competitive environment. With mounting health care regulation and changes in privatization, altruistic arguments give way to more competitive rationales for market decisions. Profit and not-for-profit institutions must address widespread health care needs while balancing the needs of more lucrative markets against the needs of lesser ones. Recognizing the roles of cooperation and competition as motivators in the delivery of health care to the public is imperative. We explore two game theory models (Nash's Equilibrium and the Prisoner's Dilemma) and their related concepts of simultaneous interdependence and rationality to examine decision-making. Four hypothetical public health case studies are presented. We conclude that understanding game theory and the factors influencing decision-making allows potential competitors to make more efficient decisions, including decisions to cooperate or compete. As public health agencies move toward more collaborative models of service delivery, such understanding may help enhance efficient and effective service delivery. (Contains 6 tables.)

Background: Understanding how "health issues" are socially constructed may be useful for creating culturally relevant programs for Hispanic/Latino populations. Purpose: We explored the constructed meanings of cervical cancer and cervical cancer screening among Panamanian women, as well as socio-cultural factors that deter or encourage screening services. Women in this age group have the highest rate of HPV in Panama, placing them at elevated risk for cervical cancer. Methods: Using a social construction approach, four qualitative research techniques were employed to assess the meaning of cervical cancer in the lives of 132 Panamanian women between 20 and 40 years of age. Results: Emergent themes included the importance of religion and family, the relationship between sexuality and health, influence of media, and the influence of husbands and of other women in helping to construct screening knowledge. Also, the generalized belief that cancer signifies death was clear. Discussion: Cervical cancer and cancer screening arouse fears, embarrassment, and shame that serve as barriers to screening and impede better screening rates and earlier diagnosis of disease. Cervical cancer screening guidelines are not promoted causing lack of awareness. Translation to Health Education Practice: Culturally relevant health education interventions and programs delivered in a participatory group format at the community level may be effective in reaching Panamanian women. Women themselves may be good resources for identifying appropriate health education messages, interventions and delivery modes. (Contains 5 tables.)

Background: This study explored school personnel's perceptions of school refusal, as it has been described as a "common educational and public health problem" that is less tolerated due to increasing awareness of the potential socioeconomic consequences of this phenomenon. Methods: In-depth interviews were conducted with school personnel at the middle school (N = 42), high school (N = 40), and district levels (N = 10). The findings focus on emergent themes from interviews with school health personnel (N = 12), particularly those themes related to their perceptions of and role in working with school-refusing students. Results: Personnel, especially school health services staff, constructed a typification of the school-refusing student as "the sick student," which conceptualized student refusal due to reasons related to illness. Personnel further delineated sick students by whether they considered the illness legitimate. School health personnel referenced the infamous "frequent fliers" and "school phobics" within this categorization of students. Overarching dynamics of this typification included parental control, parental awareness, student locus of control, blame, and victim status. These typifications influenced how personnel reacted to students they encountered, particularly in deciding which students need "help" versus "discipline," thus presenting implications for students and screening of students. Conclusions: Overall, findings suggest school health personnel play a pivotal role in screening students who are refusing school as well as keeping students in school, underscoring policy that supports an increased presence of school health personnel. Recommendations for school health, prevention, and early intervention include the development of screening protocols and staff training. (Contains 1 table.)

Creating community-based opportunities for youth to be physically active is challenging for many municipalities. A Lexington, Kentucky community coalition designed and piloted a physical activity program, "VERB[TM] summer scorecard (VSS)", leveraging the brand equity of the national VERB[TM]--It's What You Do! campaign. Key elements of VSS subsequently were adopted in Sarasota County, FL. This study identified characteristics of Sarasota's VSS participants and non-participants. Students in Grades 5-8 from six randomly selected public schools completed a survey assessing VSS participation, physical activity level, psychosocial variables, parental support for physical activity and demographics. Logistic regression showed that VSS participants were more likely to be from Grades 5 to 6 versus Grades 7 and 8 [odds ratio (OR) = 6.055] and perceive high versus low parental support for physical activity (OR = 4.627). Moreover, for each unit rise in self-efficacy, the odds of VSS participation rose by 1.839. Chi-squared automatic interaction detector (CHAID) analysis suggested an interaction effect between grade and school socioeconomic status (SES), with a large proportion of seventh and eighth graders from high SES schools being non-participants (76.6%). A VSS-style program can be expected to be more effective with tweens who are younger, in a middle SES school, having high self-efficacy and high parental support for physical activity.

Background: Community-based prevention marketing (CBPM) is a program planning framework that blends community-organizing principles with a social marketing mind-set to design, implement, and evaluate public health interventions. A community coalition used CBPM to create a physical activity promotion program for tweens (youth 9-13 years of age) called VERB[TM] Summer Scorecard. Based on the national VERB[TM] media campaign, the program offered opportunities for tweens to try new types of physical activity during the summer months. Methods: The VERB[TM] Summer Scorecard was implemented and monitored between 2004 and 2007 using the 9-step CBPM framework. Program performance was assessed through in-depth interviews and a school-based survey of youth. Results: The CBPM process and principles used by school and community personnel to promote physical activity among tweens are presented. Observed declines may become less steep if school officials adopt a marketing mind-set to encourage youth physical activity: deemphasizing health benefits but promoting activity as something fun that fosters spending time with friends while trying and mastering new skills. Conclusions: Community-based programs can augment and provide continuity to school-based prevention programs to increase physical activity among tweens. (Contains 2 tables and 1 figure.)

In this study, the associations between Internet use and the social networks of adults over 50 years of age were examined. A sample (n = 2284) from the 2004 wave of the "Health and Retirement Survey" was used. In regression models considering a number of control variables, frequency of contact with friends, frequency of contact with family, and attendance at organizational meetings (not including religious services) were found to have a significant positive association with Internet use for adults over 50. Results add to the body of research that suggests Internet use can strengthen social networks, looking specifically at adults over 50. (Contains 5 tables.)

Theater has been used as an educational tool since the Great Depression era, and it is currently considered an effective tool for health promotion and reducing risk-taking behaviors among youth. Theater projects are well suited for communicating prevention messages to youth audiences because they can depict real-life settings and characters who can change during the performance in different ways as the story unfolds. Although theater-as-education may be effective for addressing a wide range of health and risk behaviors, previous programs that have used this strategy have experienced limitations. First, many programs fail to use a theoretical foundation, thereby ignoring principles that can be transferred to teaching and practice settings. Second, theater-as-education projects often lack systematic assessment of their impacts on audience attitudes, beliefs, and behaviors, so the effects of these programs are not well documented. Last, many theater-delivered programs fail to employ a community-based process, which limits their contextual validity. This article describes the development and assessment of the theater-as-education component of a prevention marketing campaign that addresses attitudes toward tobacco and alcohol use, the demonstration of refusal skills, and the clarification of norms regarding use of these products among young adolescents. This program addresses above limitations, and it provides a replicable model for developing a theater-as-education production for schools and communities to follow. (Contains 3 figures.)

Background: Human papillomavirus (HPV), the virus responsible for cervical cancer, is the most common viral sexually transmitted infection in the United States. A vaccine was approved in 2006 that is effective in preventing the types of HPV responsible for 70% of cervical cancers and 90% of genital warts. Proposals for routine and mandatory HPV vaccination of girls have become sources of controversy for parents of school-aged youth, legislators, members of the medical community, and the public at large. Methods: The purpose of this article was to articulate the arguments used by advocates who either oppose or endorse routine, mandatory administration of the vaccine to school-aged girls, thereby assisting school health personnel in being effective participants in framing the relevant issues. Results: Controversy is grounded in moral, religious, political, economic, and sociocultural arguments including whether concerns that the vaccine increases sexual risk taking, sends mixed messages about abstaining from sexual intercourse, usurps parental authority, and increases the potential for development of new health disparities are offset by the value of administering a cost-effective, age-appropriate public health measure targeting a life-threatening problem. Conclusions: Careful consideration of the medical evidence and public health implications is critical but understanding the context of the debate is no less important to the task of responding to public concerns. School health personnel have a role in the discussion about HPV immunization. Being able to articulate the arguments presented herein can help authorities' responsiveness to parents and community groups as the dialogue about this particular health issue evolves further.

Background: Obesity has become a national epidemic among youth. Declining physical activity and poor nutrition contribute to this epidemic. The purpose of this study was to obtain data on middle school students' physical activity and nutrition knowledge and practices. Methods: The Youth Physical Activity and Nutrition Survey was developed and distributed to a probability sample of Florida public middle schools (n = 73) in spring 2003, producing data from 4452 students in grades 6-8. Results: Results showed that less than one fourth of youth met expert recommendations for daily fruit and vegetable intake and less than one fifth identified the daily fruit and vegetable serving recommendation. Less than half of students reported eating breakfast daily. More non-Hispanic black youth reported not engaging in vigorous or moderate physical activity during the previous 7 days, and more girls and Hispanic youth reported not attending any physical education classes during the average school week. Conclusion: These findings demonstrate that dietary and physical activity behaviors and knowledge among these middle school youth are setting the stage for the obesity epidemic to continue. (Contains 4 tables.)

Objective: One in 4 active-duty US military personnel report needing support for mental health issues. This proportion increases to 41% of all US military veterans, suggesting mental health status may worsen by the transition from active duty to civilian life. In this study, we explore the lived experiences of veterans in the South Carolina Lowcountry as they transition from active service to civilian life, with an emphasis on identifying services and support for this population. Methods: We used a qualitative design employing a grounded theory approach. We conducted semi-structured interviews with 20 veterans in the first year of reintegration to civilian life that examined the following areas: (1) social isolation; (2) physical isolation; and (3) self-reported levels of mental distress. Results: Thematic saturation was reached with the following emerging themes: (1) perceived mental distress due to social and physical isolation, (2) difficulty transitioning from the military "family" to one's actual family, (3) confusion regarding identity and place in society, and an expressed (4) need for services to support this critical period in a veteran's life. Conclusions: Our interview data provide insight about the experiences of military veterans as they return to civilian life and offer evidence for the need for better integration into the social and physical fabric of the population using both existing and enhanced community-based support programs. [ABSTRACT FROM AUTHOR]

Alcohol consumption by youth can produce negative health outcomes. This study identified correlates of lifetime alcohol use, recent alcohol use, and binge drinking among youth in sixth through 10th grade (n = 2,004) in Sarasota County, Fla. Results from a closed-ended, quantitative survey acknowledged a range of personal, social and environmental influences. Breadth of these influences supports a need for multifaceted, community-based interventions for effective prevention of youth alcohol use. This study was unique because it represents population-specific research in which community partners are using the findings to develop community-specific social marketing interventions to prevent underage drinking and promote alternative behaviors.

The recent proliferation of tattooing has prompted increased concern for safety and awareness of hazardous conditions. Transmission of infectious diseases can occur when proper sterilization and safety procedures are not followed. Adolescents are a critical high-risk group that need the attention of school health personnel to help them become informed decision makers regarding tattooing. (SM)

A survey of Florida health care professionals before (n=72) and after (n=53) mandated continuing education on domestic violence found no significant changes in awareness and identification of women involved in physically abusive relationships. Availability of patient education materials increased. Respondents desired more professional education on the topic. (SK)

Assessed lifetime and recent alcohol use among fifth graders, examining students' attitudes and beliefs concerning alcohol. Surveys of 813 students indicated that 48.9 percent had ever tried alcohol, and 17.9 percent had consumed alcohol in the past 30 days. Significant differences in alcohol-related attitudes and beliefs were found according to current drinking status, gender, and race/ethnicity. (SM)

Examined middle school students' knowledge, attitudes, beliefs, and behaviors regarding bicycle helmet use. Surveys indicated that most rode bicycles but did not use helmets, despite understanding their protective capabilities, because of poor peer support and helmet design. There was a positive relationship between helmet ownership and use. Most students did not know or believe that bicycle helmet laws existed. (SM)

In this article, the author discusses what life will be like in 2035, and what its implications will be for the way in which health education is practiced. He states that in the next 25 years health educators will have to leave their comfort zones and take a calculated risk with some radical and more creative approaches to health behavior change. More programs, more education and more of what has failed to move the needle in the past 25 years also is unlikely to move it much in the next 25. Health educators should be less enamored with their past "healthedcentrism". Instead, they must: (1) unite with persons from other social and behavioral science professions to perform collaborative research that focuses on the needs of vulnerable populations; (2) focus an interdisciplinary research effort on the graying of America and the world, and the challenges that this phenomenon presents; (3) celebrate the increasing diversity in this country and worldwide at school, at work, in places of worship, and in communities; and (4) note the reality that the world will improve best from policies that support and incentivize cooperation, and that come about as a result of partnerships with the consumers that they wish to reach in health behavior or just about any other task. Long before 2035, however, the health education profession is going to need to come to terms with a series of other issues. The author shares what he thinks his professional colleagues ought to be pondering.

A study that compared selected knowledge, attitudes, beliefs, and practices regarding acquired immune deficiency syndrome (AIDS) of 102 allied health and 134 nonallied health students found that both groups had cognitive deficits and misconceptions. It showed that a higher level of educational preparedness with respect to AIDS is needed. (JOW)