Staff Publications

Staff Publications

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    'Staff publications' is the digital repository of Wageningen University & Research

    'Staff publications' contains references to publications authored by Wageningen University staff from 1976 onward.

    Publications authored by the staff of the Research Institutes are available from 1995 onwards.

    Full text documents are added when available. The database is updated daily and currently holds about 240,000 items, of which 72,000 in open access.

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Agro-ecological zone and farm diversity are factors associated with haemoglobin and anaemia among rural school-aged children and adolescents in Ghana
Azupogo, Fusta ; Aurino, Elisabetta ; Gelli, Aulo ; Bosompem, Kwabena M. ; Ayi, Irene ; Osendarp, Saskia J.M. ; Brouwer, Inge D. ; Folson, Gloria - \ 2019
Maternal and Child Nutrition 15 (2019)1. - ISSN 1740-8695
adolescents - agro-ecological zone - anaemia - Ghana - Haemoglobin (Hb) - school-aged children

Understanding contextual risk factors for haemoglobin (Hb) status and anaemia of rural school-aged children (SAC) and adolescents is critical in developing appropriate interventions to prevent anaemia. We analysed secondary data from the baseline of an impact evaluation of the Ghana School Feeding Programme to determine the severity of anaemia and contextual factors associated with anaemia and Hb status among rural SAC (6–9 years; n = 323) and adolescents (10–17 years; n = 319) in Ghana. We used regression models with variable selection based on backward elimination in our analyses. The mean Hb was 113.8 ± 13.1 g/L, and the overall prevalence of anaemia was 52.3%, being 55.1% and 49.5% among SAC and adolescents, respectively. We identified child's age (β = 2.21, P < 0.001); farm diversity score (β = 0.59, P = 0.036); and agro-ecological zone (P trend <0.001) as the main predictors of Hb of SAC. Household asset index (P trend = 0.042) and agro-ecological zone (P trend <0.001) were predictors of Hb in adolescents. Agro-ecological zone and age were predictors of anaemia, but the effect of age was only significant for girls and not boys (prevalence odds ratio [POR] = 1.35, 95% CI [1.04, 1.76] vs. POR = 1.14, 95% CI [0.88, 1.46]). SAC in households with maize stock were less likely to be anaemic (POR = 0.55, 95% CI [0.32, 0.97]). Household dietary diversity score (β = 0.59, P = 0.033) was associated with Hb status for the full sample only. Anaemia is a severe public health problem among SAC and adolescents in rural Ghana irrespective of sex. Farm diversity score, availability of maize stock in the household, household asset index, and agro-ecological zone were the main predictors of Hb and anaemia among the rural SAC and adolescents.

The potential of peer social norms to shape food intake in adolescents and young adults : a systematic review of effects and moderators
Stok, Marijn F. ; Vet, Emely de; Ridder, Denise T.D. de; Wit, John B.F. de - \ 2016
Health Psychology Review 10 (2016)3. - ISSN 1743-7199 - p. 326 - 340.
adolescents - food intake - implications for interventions - Social norms - systematic review - young adults

This systematic review aims to assess the role that peer social norms play in shaping young people's food intake, focusing on the important questions of for whom and when peer social norms are related to how much young people eat. Thirty-three eligible studies were reviewed (17 correlational, 16 experimental). All but one correlational studies found significant associations between norms and food intake. All experimental studies found effects of norm manipulations on food intake, and some evidence was found of behavioural spillover effects of norms. Four moderators were distilled from our literature synthesis that stipulate for whom and when peer social norms are related to food intake: identification with the norm referent group and eating-related habit strength were found to moderate the effects of social norms on food intake; forceful injunctive norms were found not to be related to food intake; and the influence of norms seemed restricted to types of foods typically consumed in the presence of peers. The findings from this literature synthesis have important implications for research, and moderators are discussed in light of psychological theory. Where applicable, potential implications for the development of social norm-based interventions to improve young people's food intake are also highlighted.

Effectiveness of a Dutch community-based alcohol intervention: changes in alcohol use of adolescents after 1 and 5 years
Jansen, S.C. ; Haveman-Nies, A. ; Bos-Oude Groeniger, I. ; Izeboud, C. ; Rover, C. de; Veer, P. van 't - \ 2016
Drug and Alcohol Dependence 159 (2016). - ISSN 0376-8716 - p. 125 - 132.
Community-based intervention - alcohol reduction - adolescents
Background: Underage alcohol drinking is a severe public health problem. The aim of this study was to evaluate the short- and long-term effects of a Dutch community-based alcohol intervention on alcohol use of adolescents in the second and fourth grade of high school. Methods: The community intervention integrated health education, regulation, and enforcement in multiple settings, targeting adolescents as well as their environments. In order to evaluate effectiveness, a quasi-experimental pretest posttest design was used based on three independent cross-sectional surveys in 2003, 2007 and 2011, resulting in an analytical sample of approximately 5,700 and 3,100 adolescents in the intervention and reference region, respectively. For the main analyses, we compared the change in recent alcohol use and binge drinking in the intervention region with the reference region. Lineair regression was used to obtain (adjusted) prevalences of alcohol use. Results: During the study period, there was an overall decline in the prevalence of alcohol use. After 1 year of intervention, the decline was 11% (P<0.01) and 6% (P<0.01) stronger in the intervention region as compared to the reference region, for recent alcohol use and binge drinking respectively. This effect was restricted to the second grade and remained after 5 years of intervention. No clear subgroup effects or confounding were observed for ethnicity, gender or educational level. Conclusions: The Dutch community intervention appears to be effective on the short- and long-term in reducing the prevalence of recent alcohol use and binge drinking of (underage) adolescents in the second grade of high school.
I was totally there! : understanding engagement in entertainment-ducation narratives
Leeuwen, L. van - \ 2015
Wageningen University. Promotor(en): Cees Leeuwis; S.J.H.M. Putte, co-promotor(en): Reint-Jan Renes. - Wageningen : Wageningen University - ISBN 9789462573369 - 153
communicatie - communicatietheorie - volksgezondheid - alcoholisme - vertier - onderwijs - drinken - gedrag - psychologie - adolescenten - educatieve televisie - communication - communication theory - public health - alcoholism - entertainment - education - drinking - behaviour - psychology - adolescents - educational television


I was totally there!: Understanding engagement in entertainment-education narratives

By Lonneke van Leeuwen

Narratives have the power to influence their recipients’ health behaviors. With the entertainment-education (E-E) strategy, health organizations turn this narrative power to good account by employing narratives in their health promoting campaigns. E-E programs, mostly in the form of televised narratives, have been shown to effectively encourage a variety of health-related behaviors. Because of these positive results, the E-E strategy is considered a promising communication strategy to encourage healthy behaviors. One quality of E-E narratives that has been shown to be crucial for narrative impact is the ability of E-E narratives to engage target recipients. Engaged recipients may experience four dimensions of narrative engagement (NE): narrative understanding, attentional focus, emotional engagement, and narrative presence. Although evidence is growing that NE plays a role in E-E narratives’ impact (hereafter: E-E impact), little is known about how NE leads to E-E impact and about how NE emerges in recipients of narratives.

The objective of this dissertation is to provide a better understanding of NE in E-E narratives, by investigating how NE is associated with E-E narratives’ impact, and by investigating the processes that contribute to experiencing NE.

The studies described in this dissertation are conducted within the context of NE in E-E narratives aiming to discourage alcohol (binge) drinking among adolescents and young adults. In 2008, the televised E-E drama series Roes (High in English) was broadcast on national television. Roes consists of 11 case stories (25 minutes each) portraying negative experiences and outcomes of adolescent protagonist(s) drinking alcohol and/or using other drugs.

Research questions
Three research questions are addressed in this dissertation:
RQ1: Does Roes discourage alcohol (binge) drinking in E-E narrative recipients?
RQ2a: Are NE dimensions associated with E-E impact on alcohol (binge) drinking?
And, if so:
RQ2b: Do negative and positive thoughts about alcohol (binge) drinking mediate associations between NE dimensions and E-E impact on alcohol (binge) drinking?
RQ3: Which psychological processes experienced during narrative reception contribute to experiencing NE dimensions?

Main findings
This dissertation has shown that Roes discouraged alcohol (binge) drinking. Viewing multiple episodes of Roes positively predicted a decrease in alcoholic drinks consumed per occasion, an increase in the intention to decrease alcohol use, and an increase in perceived normative pressure. One year after exposure, the impact on the intention to decrease alcohol use was still present. One of the Roes episodes, Verliefd (In love in English), was further examined. After the participants had viewed this episode, their beliefs relating to the negative outcomes of alcohol binge drinking (BD) were more contra-BD as compared to their beliefs prior to viewing the episode. Attitudes towards BD and willingness to engage in BD also became more contra-BD.

Then, the roles of the NE dimensions attentional focus, narrative understanding, emotional engagement, and narrative presence in E-E impact were investigated. It was shown that the NE dimensions attentional focus, emotional engagement, and narrative presence were positively associated with E-E impact. Attentional focus was associated both with stronger beliefs about the severity of the negative outcomes of BD and with a lowered intention to engage in BD. Emotional engagement and narrative presence were associated with stronger beliefs that BD leads to negative outcomes (negative outcome beliefs), and with stronger beliefs about being vulnerable to these negative outcomes (vulnerability beliefs). Surprisingly, the NE dimension narrative understanding was associated with increased willingness to engage in BD.

No evidence was found that negative thoughts about BD mediated associations between NE dimensions and E-E impact. Relations between NE dimensions, positive thoughts about BD, and E-E impact could not be investigated: only one participant reported a positive thought about BD in response to Verliefd. Based on these findings we conclude that attentional focus, emotional engagement, and narrative presence are important for E-E impact, and that thoughts about BD do not play a role therein.

Because NE dimensions were found to be associated with E-E impact, it was investigated which psychological processes contribute to NE dimensions. Negative thoughts about the perceptual persuasiveness of Verliefd negatively associated with emotional engagement and narrative presence. Furthermore, it was shown that enjoyment of Verliefd was a strong contributor to NE, mainly through contributing to attentional focus. Another strong contributor to NE was narrative realism, mainly through contributing to narrative understanding. Finally, personal relevance, character involvement, and perceived severity contributed mainly through emotional engagement.

This dissertation shows that E-E narratives can be an effective health communication strategy to discourage alcohol (binge) drinking in young people. Furthermore, this dissertation provides health communication researchers and media psychologists with insights into the role of NE in E-E impact, and offers E-E developers practical recommendations about how to create engaging and impactful E-E narratives.

Breakfast benefits for children and adolescents
Vingerhoeds, M.H. - \ 2015
Wageningen : Wageningen UR (Report / Wageningen UR Food &amp; Biobased Research 1564) - ISBN 9789462575158 - 26
kinderen - kindervoedering - adolescenten - voedingsgewoonten - ontbijt - gezondheid - voeding en gezondheid - voedselconsumptie - overgewicht - children - child feeding - adolescents - feeding habits - breakfast - health - nutrition and health - food consumption - overweight
This literature review aimed to give some insight in the benefits of breakfast for children and adolescents, with a focus on overweight, food intake and cognition. In addition, we explored the magnitude of skipping breakfast in the Netherlands and factors associated with this behaviour.
The Effects of Repeated Exposure to Graphic Fear Appeals on Cigarette Packages: A Field Experiment
Dijkstra, A. ; Bos, C. - \ 2015
Psychology of Addictive Behaviors 29 (2015)1. - ISSN 0893-164X - p. 82 - 90.
public-health campaigns - warning labels - smoking-cessation - disengagement beliefs - behavior-change - smokers - impact - messages - metaanalysis - adolescents
Experimental studies on the effects of graphic fear appeals on cigarette packages typically expose smokers in a single session to a fear appeal, although in practice the exposure is always repeated. The present study applied an improved study design with repeated exposure to fear appeals on cigarette packages. In this field-experiment, 118 smokers were assigned to 1 of 2 conditions with either graphic fear appeals or textual warnings on their cigarette packages. During 3 weeks, fear and disgust were assessed 6 times. The intention to quit smoking after 3 weeks and quitting activity during the 3 weeks were the dependent measures. The effects of 3 pretest individual difference moderators were tested: disengagement beliefs, number of cigarettes smoked a day, and readiness to quit. Three weeks of exposure to the graphic fear appeals led to a stronger intention to quit, but only when smokers scored low on disengagement beliefs, or were heavier smokers. In addition, smokers low in disengagement more often reported to have cut down on smoking in the graphic condition. There were no indications of habituation of fear and disgust over the 3 weeks. The effects of graphic fear appeals depended on smokers' characteristics: The moderators may explain the mixed findings in the literature. The lack of habituation may be caused by the renewal of the graphics every few days. The used field-experimental design with natural repeated exposure to graphics is promising.
The Development of a Diet Quality Score for Preschool Children and Its Validation and Determinants in the Generation R Study
Voortman, T. ; Kiefte-de Jong, J.C. ; Geelen, A. ; Villamor, G.B. ; Moll, H.A. ; Jongste, J.C. de; Raat, H. ; Hofman, A. ; Jaddoe, V.W.V. ; Franco, O.H. ; Hooven, E.H. van den - \ 2015
The Journal of Nutrition 145 (2015)2. - ISSN 0022-3166 - p. 306 - 314.
healthy eating index - multiple imputation - measurement error - pattern-analysis - food - adolescents - associations - childhood - nutrition - validity
Background: Although many studies have examined health effects of infant feeding, studies on diet quality shortly after the weaning and lactation period are scarce. Objectives: Our aims were to develop and evaluate a diet score that measures overall diet quality in preschool children and to examine the sociodemographic and lifestyle determinants of this score. Methods: On the basis of national and international dietary guidelines for young children, we developed a diet score containing 10 components: intake of vegetables; fruit; bread and cereals; rice, pasta, potatoes, and legumes; dairy; meat and eggs; fish; oils and fats; candy and snacks; and sugar-sweetened beverages. The total score ranged from 0 to 10 on a continuous scale and was standardized to an energy intake of 1200 kcal/d with the residual method. The score was evaluated in 3629 children participating in the Generation R Study, a population-based prospective cohort study. Food consumption was assessed with a food-frequency questionnaire (FFQ) at a median age of 13 mo. Results: The mean +/- SD diet score was 4.1 +/- 1.3. The food-based diet score was positively associated with intakes of many nutrients, including n-3 (omega-3)-31 fatty acids [FAs; 0.25 SD increase 195% CI: 0.22, 0.27) per 1 point increase in the diet score], dietary fiber [0.32 (95% CI: 0.30, 0.34)], and calcium [0.13 (95% CI: 0.11, 0.16)], and was inversely associated with intakes of sugars [-0.28(95% CI: -0.31, -0.26)] and saturated fat [-0.03 (95% CI: -0.05, -0.01)]. A higher diet score was associated with several health-conscious behaviors, such as maternal folic acid supplement use during pregnancy, no smoking during pregnancy, and children watching less television. Conclusion: We developed a novel food-based diet score for preschool children that could be applied in future studies to compare diet quality in early childhood and to investigate associations between diet in early childhood and growth, health, and development.
It's my party and I eat if I want to. Reasons for unhealthy snacking
Verhoeven, A.A.C. ; Adriaanse, M.A. ; Vet, E. de; Fennis, B.M. ; Ridder, D.T.D. de - \ 2015
Appetite 84 (2015). - ISSN 0195-6663 - p. 20 - 27.
implementation intentions - self-regulation - food-intake - behavior - questionnaire - consequences - adolescents - overweight - habit - plans
Investigating the reasons that people give for unhealthy snacking behavior is important for developing effective health interventions. Little research, however, has identified reasons that apply to a large audience and most studies do not integrate multiple factors, precluding any conclusions regarding their relative importance. The present study explored reasons for unhealthy snacking among a representative community sample. Participants (N¿=¿1544) filled out the newly developed Reasons to Snack inventory assessing an elaborate range of motives at baseline and 1-month follow-up. Exploratory and replication factor analyses identified six categories: opportunity induced eating, coping with negative emotions, enjoying a special occasion, rewarding oneself, social pressure, and gaining energy. The highest mean scores were obtained for enjoying a special occasion and opportunity induced eating. Regression analyses with participant characteristics as independent variables and each category of reasons as dependent variables showed differences for age. For all reasons except to enjoy a special occasion, younger people reported a higher score. Women indicated a higher score than men on coping with negative emotions, enjoying a special occasion and gaining energy. People who diet to a stronger extent reported a higher score for snacking because of social pressure, to reward oneself and to cope with negative emotions, with the latter also being related to a higher BMI. Finally, a higher education was associated with enjoying a special occasion. Future health interventions could allocate more attention to diminishing unhealthy snacking with regard to the six identified categories, specifically focusing on enjoying a special occasion and opportunity induced eating.
Food culture in the home environment: Family meal practices and values can support healthy eating and self-regulation in young people in four European countries
Wit, J.B.F. ; Stok, F.M. ; Smolenski, D.J. ; Ridder, D.T.D. de; Vet, E. de; Gaspar, T. ; Johnson, F. ; Nureeva, L. ; Luszczynska, A. - \ 2015
Applied Psychology : Health and Well-Being 7 (2015)1. - ISSN 1758-0846 - p. 22 - 40.
childhood overweight - adolescents - obesity - behaviors - attitudes - children - diet - worldwide - quality - weight
Background: Overweight epidemics, including among children and adolescents, are fuelled by contemporary obesogenic environments. Recent research and theory highlight the importance of socio-cultural factors in mitigating adverse impacts of the abundance of food in high-income countries. The current study examines whether family meal culture shapes young people's eating behaviors and self-regulation. Methods: Young people aged 10–17 years were recruited through schools in four European countries: the Netherlands, Poland, Portugal and the United Kingdom. A total of 2,764 participants (mean age 13.2 years; 49.1% girls) completed a self-report questionnaire in class, providing information on healthy and unhealthy eating, joint family meals and communal meal values and use of eating-related self-regulation strategies. Results: Path analysis found that family meal culture variables were significantly associated with young people's eating behaviors, as was self-regulation. Significant indirect effects of family meal culture were also found, through self-regulation. Conclusions: Results confirm that family meal culture, encompassing values as well as practices, shapes young people's eating behaviors. Findings extend and link previously separate lines of enquiry by showing how food cultures can play out in the home environment. Importantly, the study contributes novel evidence suggesting that self-regulation is shaped by the home environment and mediates its influence.
Health on impulse: when low self-control promotes healthy food choices
Salmon, S.J. ; Fennis, B.M. ; Ridder, D.T.D. de; Adriaanse, M.A. ; Vet, E. de - \ 2014
Health Psychology 33 (2014)2. - ISSN 0278-6133 - p. 103 - 109.
physical-activity - limited-resource - ego depletion - behavior - interventions - metaanalysis - adolescents - success
OBJECTIVE: Food choices are often made mindlessly, when individuals are not able or willing to exert self-control. Under low self-control, individuals have difficulties to resist palatable but unhealthy food products. In contrast to previous research aiming to foster healthy choices by promoting high self-control, this study exploits situations of low self-control, by strategically using the tendency under these conditions to rely on heuristics (simple decision rules) as quick guides to action. More specifically, the authors associated healthy food products with the social proof heuristic (i.e., normative cues that convey majority endorsement for those products). METHOD: One hundred seventy-seven students (119 men), with an average age of 20.47 years (SD = 2.25) participated in the experiment. This study used a 2 (low vs. high self-control) × 2 (social proof vs. no heuristic) × 2 (trade-off vs. control choice) design, with the latter as within-subjects factor. The dependent variable was the number of healthy food choices in a food-choice task. RESULTS: In line with previous studies, people made fewer healthy food choices under low self-control. However, this negative effect of low self-control on food choice was reversed when the healthy option was associated with the social proof heuristic. In that case, people made more healthy choices under conditions of low self-control. CONCLUSION: Low self-control may be even more beneficial for healthy food choices than high self-control in the presence of a heuristic. Exploiting situations of low self-control is a new and promising method to promote health on impulse.
Applying Intervention Mapping to develop a community-based intervention aimed at improved psychological and social well-being of unmarried teenage mothers in Uganda
Leerlooijer, J.N. ; Kok, G. ; Weyusya, J. ; Bos, A.E.R. ; Ruiter, R.A.C. ; Rijsdijk, E. ; Nshakira, N. ; Bartholomew, L.K. - \ 2014
Health Education Research 29 (2014)4. - ISSN 0268-1153 - p. 598 - 610.
hiv-1 infection - parenting teens - rural uganda - pregnancy - stigma - metaanalysis - adolescents - prevention - behavior - program
Out-of-wedlock pregnancy among adolescents in sub-Saharan Africa is a major concern, because of its association with health, social, psychological, economic and demographic factors. This article describes the development of the Teenage Mothers Project, a community-based intervention to improve psychological and social well-being of unmarried teenage mothers in rural Uganda. We used Intervention Mapping (IM) for systematically developing a theory and evidence-based comprehensive health promotion programme. A planning group consisting of community leaders, teenage mothers, staff of a community-based organization and a health promotion professional was involved in the six steps of IM: needs assessment, programme objectives, methods and applications, intervention design, planning for adoption and implementation and planning for evaluation. The programme includes five intervention components: community awareness raising, teenage mother support groups, formal education and income generation, counselling, and advocacy. The intervention components are based on a variety of theoretical methods, including entertainment education, persuasive communication, mobilization of social networks and social action. In conclusion, IM facilitated the planning group to structure the iterative, bottom-up, participatory design of the project in a real-life setting and to use evidence and theory. The article provides suggestions for the planning of support interventions for unmarried teenage mothers.
Effect of starting weaning exclusively with vegetables on vegetable intake at the age of 12 and 23 months
Barends, C. ; Vries, J.H.M. de; Mojet, J. ; Graaf, C. de - \ 2014
Appetite 81 (2014). - ISSN 0195-6663 - p. 193 - 199.
taste preferences - repeated exposure - food preferences - acceptance - children - fruit - infants - variety - consumption - adolescents
Background: The low vegetable intake in children may be attributed to their low preference for vegetables. During the first year of life, first taste preferences are formed, which may track over time. In a previous study to increase infants' vegetable intake and liking, we found that at the start of weaning, infants had a higher vegetable intake in the lab after repeated exposure to vegetable purées than to fruit purées. The current study is a follow-up of these infants at the age of 12 and 23¿months, and examined whether the group that started weaning with vegetables continued eating more vegetables than the group that started weaning with fruits. Methods: At 12 (n¿=¿86) and 23 (n¿=¿81) months of age the children's daily vegetable consumption was reported by their parents using a 3-day food diary. The intake of green beans and apple purée was measured in the laboratory. Results: Reported daily intake of vegetables at 12¿months of age was 38 % higher (P¿=¿0.02) in the vegetable group (75¿±¿43¿g) than in the fruit group (54¿±¿29¿g), but was similar for both groups at 23¿months of age (49¿±¿43, 57¿±¿35¿g, respectively; NS). Both at 12 and 23¿months of age, apple and green beans intake in the lab did not differ significantly between the groups. Conclusion: These findings suggest that weaning exclusively with vegetables results in a higher daily vegetable consumption until at least 12¿months of age. More research is needed to investigate how to maintain this effect.
Screen time, adiposity and cardiometabolic markers: mediation by physical activity, not snacking, among 11-year-old children
Berendtzen, N.E. ; Smit, H.A. ; Rossem, L. van; Gehring, U. ; Kerkhof, M. van de; Postma, D.S. ; Boshuizen, H.C. - \ 2014
International Journal of Obesity 38 (2014). - ISSN 0307-0565 - p. 1317 - 1323.
body-mass index - sedentary behavior - risk-factors - computer use - television - obesity - health - youth - association - adolescents
Background:There is evidence for a relation of TV viewing with adiposity and increased cardiometabolic risk factors in children and adolescents. It is unclear to what extent this relation is mediated by snacking and lack of physical activity. We determined whether associations of screen time with adiposity and cardiometabolic markers were mediated by these behaviours.Methods:Children from a population-representative Dutch birth cohort (n=1447) reported screen time and other lifestyle factors by a questionnaire around the age of 11 years (range 10-14) and had anthropometry and cardiometabolic markers measured around the age of 12 years (range 12-14). Adjusted associations of screen time with snacking, physical activity, adiposity and cardiometabolic markers (total-to-high-density lipoprotein cholesterol (TC/HDLC) ratio, blood pressure, glycated haemoglobin) were assessed by using formal mediation analysis. We tested the hypothesized paths by structural equation modeling, which allows quantification of the indirect effects associated with potential mediators.Results:Children with ¿20¿h screen time per week consumed more snacks (1.9 vs 1.3 portions per day) and were less physically active (4.3 vs 4.8 days per week) than children with maximum 6¿h screen time. Screen time was directly associated with higher adiposity (standardized ß=0.10-0.12 depending on the outcome, P
Dutch children and parents’ views on active and non-active video gaming
Vet, E. de; Wesselman, M. ; Simons, M. - \ 2014
Health Promotion International 29 (2014)2. - ISSN 0957-4824 - p. 235 - 243.
physical-activity - sedentary behaviors - obesity - overweight - games - adolescents - youth
Active video games that require whole body movement to play the game may be an innovative health promotion tool to substitute sedentary pastime with more active time and may therefore contribute to children's health. To inform strategies aimed at reducing sedentary behavior by replacing non-active by active gaming, opinions about active and non-active video games are explored among 8- to 12-year-old children and their parents. Six qualitative, semi-structured focus groups were held with 8- to 12-year-old children (n = 46) and four with their parents (n = 19) at three different primary schools in The Netherlands. The focus groups with children discussed game preferences, gaming context and perceived game-related parenting. The focus groups with parents addressed considerations in purchasing video games, perceived positive and negative consequences of gaming, and game-related parenting. Both children and their parents were very positive about active video games and preferred active games over non-active games. Active video games were considered more social than non-active video games, and active games were played more often together with friends and family than non-active video games. Parenting practices did not differ for active and non-active video games, although some parents were less strict regarding active games. Two conditions for practical implementation were met: children enjoyed active video games, and parents were willing to buy active video games. Active video games were preferred to non-active video games, illustrating that using active video games is a promising health promotion tool to reduce sedentary pastime in youth.
DHA Serum Levels Were Significantly Higher in Celiac Disease Patients Compared to Healthy Controls and Were Unrelated to Depression
Hees, N.J.M. van; Giltay, E.J. ; Geleijnse, J.M. ; Janssen, N. ; Does, A.J.W. van der - \ 2014
PLoS ONE 9 (2014)5. - ISSN 1932-6203
gluten-free diet - fatty-acid-composition - major depression - body-composition - children - omega-3-fatty-acids - adolescents - prevalence - disorders - diagnosis
Objectives: Celiac disease (CD), a genetically predisposed intolerance for gluten, is associated with an increased risk of major depressive disorder (MDD). We investigated whether dietary intake and serum levels of the essential n-3 polyunsaturated fatty acids (PUFA) eicosapentaenoic acid (EPA) and docosahexanoic acid (DHA) found in fatty fish play a role in this association. Methods: Cross-sectional study in 71 adult CD patients and 31 healthy volunteers, matched on age, gender and level of education, who were not using n-3 PUFA supplements. Dietary intake, as assessed using a 203-item food frequency questionnaire, and serum levels of EPA and DHA were compared in analyses of covariance, adjusting for potential confounders. Serum PUFA were determined using gas chromatography. Results: Mean serum DHA was significantly higher in CD patients (1.72 mass%) than controls (1.28 mass%) after multivariable adjustment (mean diff. 0.45 mass%; 95% CI: 0.22-0.68; p = 0.001). The mean intake of EPA plus DHA did not differ between CD patients and controls after multivariable adjustment (0.15 and 0.22 g/d, respectively; p = 0.10). There were no significant differences in intake or serum levels of EPA and DHA between any of the CD patient groups (never depressed, current MDD, minor/partially remitted MDD, remitted MDD) and controls. Conclusions: Patients on a long term gluten-free diet had similar intakes of EPA plus DHA compared to controls. Contrary to expectations, DHA serum levels were significantly higher in CD patients compared to healthy controls and were unrelated to MDD status.
Dinner Rituals That Correlate with Child and Adult BMI
Wansink, B. ; Kleef, E. van - \ 2014
Obesity 22 (2014)5. - ISSN 1930-7381 - p. E91 - E95.
family meals - diet quality - eating behavior - food-intake - adolescents - patterns - television - illusions - program
Objective: What predicts whether a child will be at risk for obesity? Whereas past research has focused on foods, eating habits, feeding styles, and family meal patterns, this study departs from a food-centric approach to examine how various dinner rituals might influence the BMIs of children and adults. Methods: In this study of 190 parents (BMI529.167.2) and 148 children (BMI520.364.4), the relationship between their BMIs and everyday family dinner rituals was examined using both correlation and regression analysis (controlled for educational level of parents). Results: Families who frequently ate dinner in the kitchen or dining room had significantly lower BMIs for both adults (r520.31) and children (r520.24) compared to families who ate elsewhere. Additionally, helping cook dinner was associated with higher BMI for girls (r50.26), and remaining at the table until everyone is finished with eating was associated with lower BMI for boys (r520.31). Conclusions: Dinner tables may be one place where social support and family involvement meet—both of which relate to the BMI of children as well as parents. Family meals and their rituals might be an underappreciated battleground to fight obesity.
‘Getting things done’: an everyday-life perspective towards bridging the gap between intentions and practices in health-related behavior
Woerkum, C.M.J. van; Bouwman, L.I. - \ 2014
Health Promotion International 29 (2014)2. - ISSN 0957-4824 - p. 278 - 286.
goal-directed behavior - implementation intentions - promotion - entertainment - adolescents - psychology - education - context
In this paper, we aim to add a new perspective to supporting health-related behavior. We use the everyday-life view to point at the need to focus on the social and practical organization of the concerned behavior. Where most current approaches act disjointedly on clients and the social and physical context, we take the clients' own behavior within the dynamics of everyday context as the point of departure. From this point, healthy behavior is not a distinguishable action, but a chain of activities, often embedded in other social practices. Therefore, changing behavior means changing the social system in which one lives, changing a shared lifestyle or changing the dominant values or existing norms. Often, clients experience that this is not that easy. From the everyday-life perspective, the basic strategy is to support the client, who already has a positive intention, to ‘get things done’. This strategy might be applied to those cases, where a gap is found between good intentions and bad behavior.
A composite score combining waist circumference and body mass index more accurately predicts body fat percentage in 6-to 13-year-old children
Aeberli, I. ; Gut-Knabenhans, M. ; Kusche-Ammann, R.S. ; Molinari, L. ; Zimmermann, M.B. - \ 2013
European Journal of Nutrition 52 (2013)1. - ISSN 1436-6207 - p. 247 - 253.
skinfold-thickness measurements - for-disease-control - metabolic syndrome - visceral fat - obesity - adolescents - overweight - risk - prevalence - prevention
Body mass index (BMI) and waist circumference (WC) are widely used to predict % body fat (BF) and classify degrees of pediatric adiposity. However, both measures have limitations. The aim of this study was to evaluate whether a combination of WC and BMI would more accurately predict %BF than either alone. In a nationally representative sample of 2,303 6- to 13-year-old Swiss children, weight, height, and WC were measured, and %BF was determined from multiple skinfold thicknesses. Regression and receiver operating characteristic (ROC) curves were used to evaluate the combination of WC and BMI in predicting %BF against WC or BMI alone. An optimized composite score (CS) was generated. A quadratic polynomial combination of WC and BMI led to a better prediction of %BF (r (2) = 0.68) compared with the two measures alone (r (2) = 0.58-0.62). The areas under the ROC curve for the CS [0.6 * WC-SDS + 0.4 * BMI-SDS] ranged from 0.962 +/- A 0.0053 (overweight girls) to 0.982 +/- A 0.0046 (obese boys) and were somewhat greater than the AUCs for either BMI or WC alone. At a given specificity, the sensitivity of the prediction of overweight and obesity based on the CS was higher than that based on either WC or BMI alone, although the improvement was small. Both BMI and WC are good predictors of %BF in primary school children. However, a composite score incorporating both measures increased sensitivity at a constant specificity as compared to the individual measures. It may therefore be a useful tool for clinical and epidemiological studies of pediatric adiposity.
Qualitative evaluation of the Teenage Mothers Project in Uganda: a community-based empowerment intervention for unmarried teenage mothers
Leerlooijer, J.N. ; Bos, A.E.R. ; Ruiter, R.A.C. ; Reeuwijk, M.A.J. van; Rijsdijk, E. ; Nshakira, N. ; Kok, G. - \ 2013
BMC Public Health 13 (2013). - ISSN 1471-2458 - 15 p.
intimate-partner violence - sub-saharan africa - hiv prevention - south-africa - health - adolescents - stigma - risk - trends - school
Background A large proportion of unmarried teenage mothers in Uganda face physical, psychological, and social problems after pregnancy and childbirth, such as obstetric complications, lack of education, and stigmatisation in their communities. The Teenage Mothers Project (TMP) in Eastern Uganda empowers unmarried teenage mothers to cope with the consequences of early pregnancy and motherhood. Since 2000, 1036 unmarried teenage mothers, their parents, and community leaders participated in economic and social empowerment interventions. The present study explored the changes resulting from the TMP as well as factors that either enabled or inhibited these changes. Methods Semi-structured interviews (N¿=¿23) were conducted with former teenage mothers , community leaders, and project implementers, and lifeline histories were obtained from former teenage mothers (N¿=¿9). Quantitative monitoring data regarding demographic and social characteristics of teenage mother participants (N¿=¿1036) were analysed. Results The findings suggest that, overall, the TMP seems to have contributed to the well-being of unmarried teenage mothers and to a supportive social environment. It appears that the project contributed to supportive community norms towards teenage mothers’ position and future opportunities, increased agency, improved coping with early motherhood and stigma, continued education, and increased income generation by teenage mothers. The study findings also suggest limited change in disapproving community norms regarding out-of-wedlock sex and pregnancy, late active enrolment of teenage mothers in the project (i.e., ten months after delivery of the child), and differences in the extent to which parents provided support. Conclusions It is concluded that strengths of the community-based TMP seem to be its socio-ecological approach, the participatory planning with community leaders and other stakeholders, counselling of parents and unmarried teenage mothers, and the emphasis on education and income generation. The project can improve by earlier active participation of unmarried pregnant adolescents and increased support for parents.
Tackling the new materialities: Modern food and counter-movements in Ecuador
Sherwood, S. ; Arce, A.M.G. ; Berti, P. ; Bekkering, E. - \ 2013
Food Policy 41 (2013). - ISSN 0306-9192 - p. 1 - 10.
pesticide use - obesity - health - farm - population - overweight - adolescents - transition - impacts
Faced with rising non-communicable diseases (NCDs), the Ecuadorian Government has proposed a model health program targeting individual and environmental level determinants. Drawing on cosmopolitan social theory, the experiences of counter-movements and concerns over food policy, the authors explore how mass pesticide poisoning and obesity can be viewed as the product of the ‘success’ of the modernization policy as well as a specific range of global phenomena configuring civic activity and policy situations. Through the study of NCDs as an emergent social field, the authors examine historical developments and heterogeneity in peoples’ practices for insights on more practical and effective public policy responses. The rise of the consumer–citizen in counter-movements represents a paradoxical, but promising dynamic capable of reconstituting economies, culture, and society. In Ecuador, social action appears to be a largely neglected and under-utilized resource for tackling NCDs and perhaps other highly pressing and seemingly intractable food policy concerns
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