22.00
Hdl Handle:
http://hdl.handle.net/10755/158132
Type:
Presentation
Title:
Testing Mediators and Moderators of a Cardiovascular School Intervention
Abstract:
Testing Mediators and Moderators of a Cardiovascular School Intervention
Conference Sponsor:Western Institute of Nursing
Conference Year:2005
Author:Bingham, Mona, PhD, RN
P.I. Institution Name:Madigan Army Medical Center Health Outcomes Management Division
Title:Chief
Contact Address:Madigan Army Medical Center, Tacoma, WA, 98431, USA
Contact Telephone:253-968-1271
Co-Authors:Joanne Harrell
Purpose/Aims: The purpose of this study was to examine mediating and moderating variables of the long-term intervention effects of a North Carolina school-based longitudinal, randomized field trial intervention to improve cardiovascular (CV) health in elementary students. Few studies exploring these variables in school-based interventions have been published leaving limited empirical evidence for improving health in children. Major aims included testing the strength and direction of hypothesized pathways, evaluating model fit, and obtaining direct, indirect and total effects to determine who benefits most from the intervention (moderators) and what explains the process by which the intervention influences outcomes (mediators). Rationale/Background: Outcomes of poor dietary habits and sedentary lifestyles are being seen in youth resulting in increased prevalence of obesity, diabetes and other chronic conditions. The need for effective interventions focused on establishing lifelong habits and preferences for youth is recognized, but there is no consensus on the best approach or most significant variable or behavior to target in children and adolescents. Schools provide an excellent environment to promote these behaviors. Yet, like adult interventions, primary outcomes for many school-based intervention studies have been disappointing and most have not reported success with changing behaviors for long-term outcomes. Conceptual Basis: The mediating and moderating variables selected for inclusion in the model were identified in the literature as important in the study of CVD risk factors and physical activity in youth. Using physiological principles and empirical data, a conceptual model was developed and tested to examine whether the intervention effects at one-year after intervention were mediated by either increase in fitness level and/or decrease in obesity, and whether gender, race, SES, and geographic location moderated these effects. Design/Methods: This study examined the effects at one-year post intervention and included 6 schools receiving a classroom-based intervention and 6 control schools. Data from 985 third to fourth grade students (ages 8-10) from 12 North Carolina schools were used to examine whether the intervention effects of this school-based intervention were mediated by either increase in fitness level and/or decrease in obesity, and, whether gender, race, SES, and geographic location moderated these effects. The conceptual model with the hypothesized mediators and moderators was analyzed using structural equation modeling techniques. Results: Findings showed positive changes in total cholesterol (TC) values one year after the intervention. CV fitness partially mediated this relationship. In terms of moderating variables, this school-based intervention was more effective for rural children than for urban children for improving CV fitness and TC levels, and more effective for African American children than for Caucasian children in improving TC levels. Conclusions/Implications: These encouraging results suggest that simple school-based interventions to increase physical activity levels can influence physiologic variables such as CV fitness and TC up to one year later. The partial mediating effect of CV fitness (V02 max) helps to clarify the process by which increased physical activity reduces TC. The study and significance of geographic locale and race as moderators are promising additions to CVD risk factor intervention studies and provide important information for CVD health prevention in rural schools and African American children. Funded in part by Paul Newman's Hole In the Wall Gang Camps, partially supported by grant #30 NR03962 from the National Institute of Nursing Research, NIH.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleTesting Mediators and Moderators of a Cardiovascular School Interventionen_GB
dc.identifier.urihttp://hdl.handle.net/10755/158132-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Testing Mediators and Moderators of a Cardiovascular School Intervention</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Western Institute of Nursing</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2005</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Bingham, Mona, PhD, RN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Madigan Army Medical Center Health Outcomes Management Division</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Chief</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">Madigan Army Medical Center, Tacoma, WA, 98431, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">253-968-1271</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">mona.bingham@nw.amedd.army.mil</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Joanne Harrell</td></tr><tr><td colspan="2" class="item-abstract">Purpose/Aims: The purpose of this study was to examine mediating and moderating variables of the long-term intervention effects of a North Carolina school-based longitudinal, randomized field trial intervention to improve cardiovascular (CV) health in elementary students. Few studies exploring these variables in school-based interventions have been published leaving limited empirical evidence for improving health in children. Major aims included testing the strength and direction of hypothesized pathways, evaluating model fit, and obtaining direct, indirect and total effects to determine who benefits most from the intervention (moderators) and what explains the process by which the intervention influences outcomes (mediators). Rationale/Background: Outcomes of poor dietary habits and sedentary lifestyles are being seen in youth resulting in increased prevalence of obesity, diabetes and other chronic conditions. The need for effective interventions focused on establishing lifelong habits and preferences for youth is recognized, but there is no consensus on the best approach or most significant variable or behavior to target in children and adolescents. Schools provide an excellent environment to promote these behaviors. Yet, like adult interventions, primary outcomes for many school-based intervention studies have been disappointing and most have not reported success with changing behaviors for long-term outcomes. Conceptual Basis: The mediating and moderating variables selected for inclusion in the model were identified in the literature as important in the study of CVD risk factors and physical activity in youth. Using physiological principles and empirical data, a conceptual model was developed and tested to examine whether the intervention effects at one-year after intervention were mediated by either increase in fitness level and/or decrease in obesity, and whether gender, race, SES, and geographic location moderated these effects. Design/Methods: This study examined the effects at one-year post intervention and included 6 schools receiving a classroom-based intervention and 6 control schools. Data from 985 third to fourth grade students (ages 8-10) from 12 North Carolina schools were used to examine whether the intervention effects of this school-based intervention were mediated by either increase in fitness level and/or decrease in obesity, and, whether gender, race, SES, and geographic location moderated these effects. The conceptual model with the hypothesized mediators and moderators was analyzed using structural equation modeling techniques. Results: Findings showed positive changes in total cholesterol (TC) values one year after the intervention. CV fitness partially mediated this relationship. In terms of moderating variables, this school-based intervention was more effective for rural children than for urban children for improving CV fitness and TC levels, and more effective for African American children than for Caucasian children in improving TC levels. Conclusions/Implications: These encouraging results suggest that simple school-based interventions to increase physical activity levels can influence physiologic variables such as CV fitness and TC up to one year later. The partial mediating effect of CV fitness (V02 max) helps to clarify the process by which increased physical activity reduces TC. The study and significance of geographic locale and race as moderators are promising additions to CVD risk factor intervention studies and provide important information for CVD health prevention in rural schools and African American children. Funded in part by Paul Newman's Hole In the Wall Gang Camps, partially supported by grant #30 NR03962 from the National Institute of Nursing Research, NIH.</td></tr></table>en_GB
dc.date.available2011-10-26T20:32:29Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T20:32:29Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
All Items in this repository are protected by copyright, with all rights reserved, unless otherwise indicated.