National Center for Education in Maternal and Child Health
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June 25, 2004
1. Web Site Provides Resources for Parents to Help Their
Daughters Develop Bone-Healthy Habits
2. Reports Analyze Effects of Mothers' Employment on
Children's Nutrition
3. Authors Describe a Social Marketing Campaign to
Increase Physical Activity Among Children
4. Study Reveals Inconsistencies in Assessing Mothers'
Beliefs or Behaviors Associated with Childhood Obesity
5. Article Compares Adolescent-Violence-Related Behaviors
Across Five Countries
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1. WEB SITE PROVIDES RESOURCES FOR PARENTS TO HELP THEIR DAUGHTERS
DEVELOP BONE-HEALTHY HABITS
The Powerful Bones, Powerful Girls campaign promotes optimal bone
health in girls ages 9 to 12 in an effort to reduce their risk of
developing osteoporosis later in life. The campaign Web site for
parents, which is part of the National Bone Health Campaign, offers
suggestions on ways parents can integrate healthy behaviors into their
daughter's social lifestyles. The Web site provides information on
calcium and physical activity, and also includes the Powerful Bones
Toolbox. The toolbox contains recipes and shopping lists, explanations
of nutritional requirements, examples of weight-bearing physical
activities, and question-and-answer sections providing parents with an
array of resources. The Web site is available at http://www.cdc.gov/powerfulbones/parents/index.html.
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2. REPORTS ANALYZE EFFECTS OF MOTHERS' EMPLOYMENT ON CHILDREN'S
NUTRITION
Maternal Employment and Children's Nutrition presents findings from a
study designed to explore the effects of mothers' work on their
children's nutrition. The study, funded by the U.S. Department of
Agriculture's (USDA's) Economic Research Service, analyzed differences
in nutrition and nutrition-related outcomes among children whose
mothers work full time, part time, and not at all. The findings are
presented in two volumes. The first volume includes an analysis of the
role the USDA's Child and Adult Care Food Program plays in meeting the
nutrition needs of participating children, especially those whose
mothers work. The second volume includes information on food program
participation, children's eating patterns, household food acquisition
and sufficiency, and children's physical activity and risk of
overweight. The reports are available at http://www.ers.usda.gov/publications/efan04006.
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3. AUTHORS DESCRIBE A SOCIAL MARKETING CAMPAIGN TO INCREASE PHYSICAL
ACTIVITY AMONG CHILDREN
"Success in changing behavior among tweens is more likely to be
achieved when the following conditions are met: consumers have an
in-depth understanding of the product and price associated with it,
they have easy access to appropriate places where they can perform the
behavior in everyday life, and product promotion portrays benefits in a
positive, appealing fashion and reaches audiences through channels they
value," state the authors of an article published in the July 2004
issue of Preventing Chronic Disease. The article describes how the four
principles of social marketing (product, price, place, and promotion)
were applied to formulate the strategies and tactics of VERB, a
multiethnic media campaign to increase and maintain physical activity
among children ages 9 to 13 (tweens). The article also provides
examples of the multimedia materials that were created for the campaign.
VERB was launched by the Centers for Disease Control and Prevention in
June 2002 with a goal of increasing and maintaining physical activity
among tweens. Parents (especially mothers) ages 29 to 46 and other
individuals who influence tweens are the secondary audiences of the
VERB initiative. Before launching the campaign, planners conducted
extensive research to gain an understanding of
physical-activity-related attitudes, beliefs, and behaviors of tweens
and their parents. Campaign planners applied findings from the audience
research, along with the four principles of commercial marketing, to
develop VERB as a social marketing campaign.
Product -- Product is the desired behavior for the targeted audience.
The VERB campaign's product is physical activity. Early VERB
advertising stimulated curiosity about the brand and enticed tweens to
identify and try the activities that most appealed to them.
Price -- Price represents a balance of product benefits and costs. For
physical activity, the costs of changing behavior can be financial,
psychological, environmental, or time related. VERB messages are
designed to convince tweens and their parents that physical activity
has the "right price" -- that benefits outweigh costs.
Place -- Place is where the target audience either performs the
behavior or accesses programs or services. Place must be readily
available. A VERB place is where tweens can be physically active in a
safe environment. Keeping VERB a "cool brand for tweens" is a
critically important goal for partners (e.g., parks, schools,
youth-serving organizations) as they collaborate on the campaign.
Promotion -- Promotion includes multiple ways to reach the target
audience to promote the benefits of the behavior change, including
product, price, and place components. Some of the promotion strategies
and tactics employed by the VERB campaign include paid media
advertising, community-based events, contests and sweepstakes,
community and corporate partnerships, and Web sites.
"A lifestyle or behavior change such as increasing physical activity is
difficult to achieve and even more difficult to sustain," state the
authors. A baseline survey was conducted before the campaign's launch,
and two follow-up surveys, one in 2003 and one in 2004, will measure
the effectiveness of the campaign in motivating tweens to be more
active.
Wong F, Huhman M, Heitzler C, et al. 2004. VERB -- A social marketing
campaign to increase physical activity among youth. Preventing Chronic
Disease: Public Health Research, Practice, and Policy 1(3):1-7.
Available at http://www.cdc.gov/pcd/issues/2004/jul/04_0043.htm.
Readers: Formative research reports about the VERB campaign are
available at http://www.cdc.gov/youthcampaign/research/resources.htm.
More information about physical activity and children and adolescents
is available on the Bright Futures Web site at http://www.brightfutures.org/physicalactivity/about.htm and from the
MCH Library knowledge path, Physical Activity and Children and
Adolescents, at http://www.mchlibrary.info/KnowledgePaths/kp_phys_activity.html.
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4. STUDY REVEALS INCONSISTENCIES IN ASSESSING MOTHERS' BELIEFS OR
BEHAVIORS ASSOCIATED WITH CHILDHOOD OBESITY
"The interviews found instances where urban, low-income African
American mothers of preschool children understood a construct and a
question item differently from the investigators," state the authors of
an article published in the June 2004 issue of Appetite. The authors
developed and employed an instrument called the Preschooler Feeding
Questionnaire (PFQ) to assess specific maternal beliefs and practices
about child feeding perceived to be associated with the development of
obesity in children. However, the results did not reveal consistent
associations between the practices assessed and the weight status of
preschool-age children. The article describes a study to assess
question interpretation and the presence and relevance of particular
feeding constructs.
The PFQ assesses eight factors perceived to be related to childhood
obesity, including (1) difficulty in child feeding, (2) concern about
child overeating or being overweight, (3) pushing the child to eat
more, (4) using food to calm the child, (5) concern about the child
being underweight, (6) the child's control of feeding interactions, (7)
structure during feeding interactions, and (8) age-inappropriate
feeding. Although the original questionnaire was pilot-tested and
revised before implementation, qualitative or open-ended techniques
were not used to assess how respondents understood or interpreted the
questions.
Women considered eligible for this study were enrolled in WIC, were
African American, and were the biological mothers of children ages
25-59 months at the time of the study (July and August 2001). The women
were invited to participate in a 1-hour, audiotaped interview about
"how they feed their child." The authors determined whether the women
interpreted questions similarly and if their interpretations were well
matched with what was intended during item development.
The authors found that three of the eight constructs (difficulty in
child feeding, pushing the child to eat more, and using food to calm
the child) were consistently misunderstood. For example:
Question: Was he/she a picky eater?
Intention: The term "picky eater" was intended to describe a child that
was difficult to feed because he/she either ate less than the mother
expected or ate only a few types of foods.
Interpretation: To these mothers, picky eaters were selective about
what they ate or the manner in which food was prepared; to them; the
term was not associated with how much the children ate and whether
mothers thought they were difficult to feed. Furthermore, to these
mothers, being a picky eater was not necessarily a negative trait.
Question: Did you ever punish him/her or remove privileges to get
him/her to eat more?
Intention: The intention was that the mother would describe what
happened if her child did not eat enough at mealtime.
Interpretation: To these mothers, punishment meant spanking (with
hand), whooping (hitting with another object), or some action like
being given a time-out or being made to stand in the corner. None of
the mothers used what they called "punishment" to encourage eating.
Question: When he/she was fussy, was giving him/her something to eat or
drink the first thing you would do?
Intention: The intention was to determine whether the mother would
readily use feeding as a technique to calm her child's emotional
distress.
Interpretation: Mothers easily revealed friends' behaviors, but the
tone of the question seemed to make them hesitate to admit their own
use of food to calm their child.
The authors suggest that "similar problems in item wording may
characterize other feeding questionnaires, and this may contribute to
the ambiguous relationship between particular maternal feeding
practices and changes in child weight."
Jain A, Sherman SN, Chamberlin LA, et al. 2004. Mothers misunderstand
questions on a feeding questionnaire. Appetite 42(3):249-254.
Readers: More information about child and adolescent nutrition is
available from the Bright Futures Web site at http://www.brightfutures.org/nutrition/about.html and from the MCH
Library's knowledge path, Child and Adolescent Nutrition, at http://www.mchlibrary.info/KnowledgePaths/kp_childnutr.html.
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5. ARTICLE COMPARES ADOLESCENT-VIOLENCE-RELATED BEHAVIORS ACROSS FIVE
COUNTRIES
"In this cross-national comparison of violence-related behaviors in
adolescents, our results show that youth in 5 different countries
behaved remarkably similarly with respect to violent behaviors," state
the authors of an article published in the June 2004 issue of Archives
of Pediatric and Adolescent Medicine. The authors state that violent
behavior among adolescents is a significant problem worldwide and that
three developed countries, Israel, France, and Norway, now join the
United States as nations in which firearms are the second leading
mechanism of death among 15- to 24-year-olds. However, the literature
on violent behavior among adolescents outside the United States is
relatively limited. The study described in this article used
information from the World Health Organization-coordinated
cross-national Study of Health Behavior in School-Aged Children to
derive country-specific distributions of certain violent behaviors and
to assess country-specific explanatory factors, which then provided a
basis for comparing violence-related behaviors in five developed
countries (Ireland, Israel, Portugal, Sweden, and the United States).
The analysis is based on cross-national, school-based surveys conducted
during the 1997-1998 school year of students at mean ages of 11.5,
13.5, and 15.5 years. The numbers of participating students, as well as
the response rate, for each country are as follows: Ireland: 4,398
(response rate: 74%), Israel: 5,054 (response rate: 75.0%), Portugal:
3,721 (response rate: 94.0%), Sweden: 3,802 (response rate: 91.7%), and
United States: 5,168 (response rate: 87.0%). The main outcome measures
were frequency of physical fighting, bullying, weapon carrying, and
fighting injuries in relation to other risk behaviors and
characteristics in home and school settings.
The authors found that
* The frequencies of any fighting, frequent fighting, weapon carrying,
and fighting injuries were remarkably similar across countries.
* The frequency of bullying ranged from 14.8% in Sweden to 42.9% in
Israel for students who bullied once or more per school term.
* Violence-related behaviors often occurred together in adolescents
cross-nationally.
* Fighting was associated with smoking, alcohol use, feeling irritable
or bad tempered, having been bullied, and not living with the father.
The authors concluded that "These findings are particularly important
to today's climate, in which violent behavior in youth has increased to
epidemic proportions and high-publicity school shootings in the United
States and recently in Germany have raised public concern about teenage
violence even further."
Smith-Khuri E, Iachan R, Scheldt PC. 2004. A cross-national study of
violence-related behavior in adolescents. Archives of Pediatric and
Adolescent Medicine 158(6):539-344.
Readers: Information about adolescent violence prevention is available
from the MCH Library's knowledge path at http://www.mchlibrary.info/KnowledgePaths/kp_adolvio.html and the
organizations list at http://www.mchlibrary.info/databases/action.lasso?-database=Organizations&-layout=Web&-response=OrgLists/orgs_adolviolence.lasso&-MaxRecords=all&-DoScript=auto_search_adolviolence&-search.
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MCH Alert © 2004 by
National Center for Education in Maternal and
Child Health and Georgetown University. MCH Alert is produced by
MCH Library Services at the National Center for Education in Maternal
and Child Health under its cooperative agreement (6U02 MC 00001) with
the Maternal and Child Health Bureau, Health Resources and Services
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Please contact us at the address below.
EDITORS: Jolene
Bertness, Tracy Lopez
COPYEDITOR: Ruth
Barzel
National Center for
Education in Maternal and Child Health
Georgetown University
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571272, Washington, DC 20057-1272
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