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The contribution of school environmental factors to individual and school variation in disordered weight control behaviors in a statewide sample of middle schoolsWe investigated the contribution of school environmental factors to individual and school variation in disordered weight control behaviors (DWCB). Analyses were based on self-report data gathered from 18,567 middle-school students in 2005 and publicly available data on school characteristics. We observed large differences across schools in percent of students engaging in DWCB in the past month, ranging from less than 1% of the student body to 12%. School-neighborhood poverty was associated with higher odds of DWCB in boys. Preventive strategies need to account for wide variability across schools and environmental factors that may contribute to DWCB in early adolescence.
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Delay discounting and intake of ready-to-eat and away-from-home foods in overweight and obese womenA shift from home-prepared to away-from-home and ready-to-eat foods has occurred in recent decades, which has implications for obesity and health. This study tested whether delay discounting, a facet of impulsivity reflecting sensitivity to immediate reward, is associated with the frequency of consumption and typical amount consumed of home-prepared, away-from-home, and ready-to-eat foods among overweight and obese women. Seventy-eight participants completed a binary choice task assessing discounting of delayed monetary rewards. Nutrient analysis of weighed food records characterized dietary intake over seven consecutive days. Foods were categorized as home-prepared, away-from-home, or ready-to-eat by a registered dietitian from information provided by participants. Delay discounting was not associated with the frequency of consuming home-prepared, away-from-home, and ready-to-eat foods as reflected in the percentages of recorded foods or total energy intake from each category. However, once consuming away-from-home and ready-to-eat foods (but not home-prepared foods), impulsive women consumed more energy than less impulsive women. Exploratory analyses indicated that more impulsive women chose away-from-home foods with a higher energy density (kcal/g). Impulsivity was associated with the quantity of away-from-home and ready-to-eat foods consumed, but not the frequency of their consumption. Home food preparation may be critical to weight control for impulsive individuals.
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Evaluating and selecting mobile health apps: strategies for healthcare providers and healthcare organizationsMobile applications (apps) to improve health are proliferating, but before healthcare providers or organizations can recommend an app to the patients they serve, they need to be confident the app will be user-friendly and helpful for the target disease or behavior. This paper summarizes seven strategies for evaluating and selecting health-related apps: (1) Review the scientific literature, (2) Search app clearinghouse websites, (3) Search app stores, (4) Review app descriptions, user ratings, and reviews, (5) Conduct a social media query within professional and, if available, patient networks, (6) Pilot the apps, and (7) Elicit feedback from patients. The paper concludes with an illustrative case example. Because of the enormous range of quality among apps, strategies for evaluating them will be necessary for adoption to occur in a way that aligns with core values in healthcare, such as the Hippocratic principles of nonmaleficence and beneficence.