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Open Access Publications from the University of California

Scholarly Works (7 results)

  • Article
  • Peer Reviewed
UCLA Previously Published Works (2007)

Objective

To review the research literature on physical activity (PA) intervention trials, with an emphasis on underserved populations.

Data source

Research studies, review articles, and books.

Conclusion

PA intervention studies have generally shown statistically significant but modest outcomes. Comprehensive intervention designs combining individual-level and physical environmental changes have posted the largest effect sizes, and emerging models are incorporating sociocultural and organizational environmental changes with promising results. Research including or targeting underserved populations poses unique challenges at each stage of the intervention process: design, recruitment, implementation, and evaluation. Synthesis of evidence-based approaches to address these challenges is presented.

Implications for nursing practice

Promoting PA in underserved communities is essential in improving population-level cancer outcomes. Additional resources are becoming available to nursing researchers and practitioners to aid in the conduct of PA intervention in understudied groups.
    Cover page: Physical Activity as Primary Prevention to Address Cancer Disparities
    • Thesis
    • Peer Reviewed
    UCLA Electronic Theses and Dissertations (2012)

    Background: Integrating physical activity "active-by-default" or "push" strategies into the standard conduct of organizational settings is a promising approach to engage sedentary and overweight individuals in regular physical activity. However, organizations must navigate a number of factors to ensure these strategies remain sustainable over time and elicit favorable outcomes. This project examined the implementation process health and human services worksites undertook while participating in the UCLA WORKING Project, a NIH-funded physical activity and healthy eating promotion intervention.

    Methods: Process evaluation notes and descriptive summaries obtained from worksites assigned to an active intervention group (N=24) were used to assign worksites to four implementation success categories. Key informant interviews (n=13) with employee program champions and middle managers provided insight and context to roles and responsibilities, organizational dynamics, and factors associated with implementation success and failure. Individual clinical indicator and survey data collected on a voluntary sample of individuals (n=989) employed at participating worksites (N=40) were analyzed to determine any associations between the degree to which a worksite implemented strategies and changes in individual outcomes over a 6-month observation period. Organizational-level data collected from worksite representatives (n=4) were assessed to determine any associations between degree of implementation success and changes in organizational-level physical activity policies and practices over time.

    Results: Middle managers played a crucial role in translating and enforcing priorities for their worksites, supporting the efforts of program champions, participating in PA breaks, and advocating for the prioritization of PA strategies. Clear and explicit PA policies, leadership support, pre-existing wellness infrastructure, and negotiating heavy workloads were cited as factors most strongly associated with successful implementation. Worksites that most successfully implemented the PA strategies had greater improvements over time in employees' BMI, systolic blood pressure, weight, and perception of co-workers initiating PA breaks than less successful worksites.

    Conclusion: These findings suggest that implementation success may be linked to favorable outcomes, and that the WORKING Project may have successfully elicited favorable changes among employees with the poorest outcomes and highest risk of obesity and its related co-morbidities. Lessons learned from this project will inform future physical activity implementation and dissemination efforts within organizational settings.

      Cover page: Understanding Key Players and Factors Involved in the Implementation of Physical Activity Push Strategies into Organizational Settings
      • Thesis
      • Peer Reviewed
      UCLA Electronic Theses and Dissertations (2012)

      Background: The health implications of overweight and obesity warrant preventive action at the local level. Fiscal challenges have underlined the need for innovative partnerships between public and private sectors to address population health. The FriarFit initiative is a partnership between a professional sports franchise and public health organizations aiming to promote nutrition and physical activity in San Diego, California.

      Methods: Key stakeholder interviews (N=21) with partners as well as staff from local school districts informed a case study on motives for engagement, initiative implementation and sustainability, and partner outcomes. A survey conducted with participants enrolled in university-based behavioral labs in Los Angeles and San Diego (N=551) explored partnership outcomes for private partners by assessing whether the fit of a fictitious initiative with the mission of the San Diego Padres influenced consumer evaluation of the franchise and patronization intentions. Participants were randomized to read a brief history of the San Diego Padres (control), a summary of a low-fit initiative (breast cancer), or a summary of a high-fit initiative (childhood obesity).

      Results: The case study found that partnering organizations shared common motives. The involvement of program champions, leadership buy-in, and use of existing infrastructure helped sustain core activities over a four-year period. Co-branding helped drive participation in a partner's public health program, but sustainability of these efforts was dependent on funding for incentives. Stakeholders desired to establish open communication and review their mission, activities, and desired outcomes moving forward. School respondents reported significant barriers to promoting nutrition and physical activity, and requested additional resources to drive the implementation of FriarFit Instant Recess®, a physical activity DVD, in schools. The partner engagement survey demonstrated that the presence of an outreach initiative, regardless of its fit with the organization mission, positively influenced consumer evaluation of the franchise. However, respondents who were exposed to the high-fit initiative, were from the San Diego survey site, or had a high level of interest in baseball were significantly more likely to express future intentions to patronize the organization.

      Conclusion: These results provide encouraging evidence that partnerships to address public health issues can yield beneficial outcomes for participating organizations.

        Cover page: Assessment of a Public-Private Partnership Addressing Childhood Obesity in Southern California
        • Article
        • Peer Reviewed
        UCLA Previously Published Works (2008)

        Introduction

        This study evaluated the Los Angeles Unified School District Nutrition Network, a large multicomponent nutrition and physical activity program in an ethnically diverse school district, launched in 2000.

        Methods

        We calculated descriptive statistics and performed hierarchical logistic regression on school-level demographic and implementation data.

        Results

        Thirty-six percent of eligible schools participated in 2001, and 79% of participating schools reapplied the following year. Elementary schools and schools that applied for grant money were more likely to re-apply. Produce sampling was the most frequently cited program highlight, and making purchases with program grant money was the most frequently cited challenge.

        Conclusion

        Our findings suggest that schools serving students of low socioeconomic status and diverse ethnicities can be recruited into a large program to promote healthy dietary choices and physical activity, especially elementary schools. Effectiveness and institutionalization of the program might be positively affected by fostering local ownership, allowing school personnel who apply for the grant to tailor the program to their individual schools.
          Cover page: Process evaluation of the Los Angeles Unified School District Nutrition Network.
          • Article
          • Peer Reviewed
          Spaces for Difference: An Interdisciplinary Journal, Volume 1, Issue 1 (2008)
            Cover page: Career Decisionmaking: Perspectives of Low-Income Urban Youth
            • Article
            • Peer Reviewed
            UCLA Previously Published Works (2012)
            AbstractBackgroundMost preschool centers provide two 30-min sessions of gross-motor/outdoor playtime per preschool day. Within this time frame, children accumulate most of their activity within the first 10 min. This paper describes the design and baseline participant characteristics of the Short bouTs of Exercise for Preschoolers (STEP) study. The STEP study is a cluster randomized controlled study designed to examine the effects of short bouts of structured physical activity (SBS-PA) implemented within the classroom setting as part of designated gross-motor playtime on during-school physical activity (PA) in preschoolers.Methods/DesignTen preschool centers serving low-income families were randomized into SBS-PA versus unstructured PA (UPA). SBS-PA schools were asked to implement age-appropriate 10 min structured PA routines within the classroom setting, twice daily, followed by 20 min of usual unstructured playtime. UPA intervention consisted of 30 min of supervised unstructured free playtime twice daily. Interventions were implemented during the morning and afternoon designated gross-motor playtime for 30 min/session, five days/week for six months. Outcome measures were between group difference in during-preschool PA (accelerometers and direct observation) over six-months. Ten preschool centers, representing 34 classrooms and 315 children, enrolled in the study. The average age and BMI percentile for the participants was 4.1 ± 0.8 years and 69th percentile, respectively. Participants spent 74% and 6% of their preschool day engaged in sedentary and MVPA, respectively.DiscussionResults from the STEP intervention could provide evidence that a PA policy that exposes preschoolers to shorter bouts of structured PA throughout the preschool day could potentially increase preschoolers’ PA levels.Trial registrationClinicaltrials.gov, NCT01588392
              Cover page: Design and baseline characteristics of the Short bouTs of Exercise for Preschoolers (STEP) study
              • Article
              • Peer Reviewed
              UCLA Previously Published Works (2011)

              Background

              Racial/ethnic minority groups have higher risks for disease resulting from obesity.

              Community context

              The University of California, Los Angeles, and the Los Angeles County Department of Public Health partnered with community organizations to disseminate culturally targeted physical activity and nutrition-based interventions in worksites.

              Methods

              We conducted community dialogues with people from 59 government and nonprofit health and social service agencies to develop wellness strategies for implementation in worksites. Strategies included structured group exercise breaks and serving healthy refreshments at organizational functions. During the first 2 years, we subcontracted with 6 community-based organizations (primary partners) who disseminated these wellness strategies to 29 organizations within their own professional networks (secondary worksites) through peer modeling and social support. We analyzed data from the first 2 years of the project to evaluate our dissemination approach.

              Outcome

              Primary partners had difficulty recruiting organizations in their professional network as secondary partners to adopt wellness strategies. Within their own organizations, primary partners reported significant increases in implementation in 2 of the 6 core organizational strategies for promoting physical activity and healthy eating. Twelve secondary worksites that completed organizational assessments on 2 occasions reported significant increases in implementation in 4 of the 6 core organizational strategies.

              Interpretation

              Dissemination of organizational wellness strategies by trained community organizations through their existing networks (train-the-trainer) was only marginally successful. Therefore, we discontinued this dissemination approach and focused on recruiting leaders of organizational networks.
                Cover page: A midpoint process evaluation of the Los Angeles Basin Racial and Ethnic Approaches to Community Health Across the US (REACH US) Disparities Center, 2007-2009.
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