The development of a web- and a print-based decision aid for prostate cancer screening

Background Whether early detection and treatment of prostate cancer (PCa) will reduce disease-related mortality remains uncertain. As a result, tools are needed to facilitate informed decision making. While there have been several decision aids (DAs) developed and tested, very few have included an exercise to help men clarify their values and preferences about PCa screening. Further, only one DA has utilized an interactive web-based format, which allows for an expansion and customization of the material. We describe the development of two DAs, a booklet and an interactive website, each with a values clarification component and designed for use in diverse settings. Methods We conducted two feasibility studies to assess men\u27s (45-70 years) Internet access and their willingness to use a web- vs. a print-based tool. The booklet was adapted from two previous versions evaluated in randomized controlled trials (RCTs) and the website was created to closely match the content of the revised booklet. Usability testing was conducted to obtain feedback regarding draft versions of the materials. The tools were also reviewed by a plain language expert and the interdisciplinary research team. Feedback on the content and presentation led to iterative modifications of the tools. Results The feasibility studies confirmed that the Internet was a viable medium, as the majority of men used a computer, had access to the Internet, and Internet use increased over time. Feedback from the usability testing on the length, presentation, and content of the materials was incorporated into the final versions of the booklet and website. Both the feasibility studies and the usability testing highlighted the need to address men\u27s informed decision making regarding screening. Conclusions Informed decision making for PCa screening is crucial at present and may be important for some time, particularly if a definitive recommendation either for or against screening does not emerge from ongoing prostate cancer screening trials. We have detailed our efforts at developing print- and web-based DAs to assist men in determining how to best meet their PCa screening preferences. Following completion of our ongoing RCT designed to test these materials, our goal will be to develop a dissemination project for the more effective tool

The mediating role of physical self-concept on relations between biological maturity status and physical activity in adolescent females

The current study examined the mediating role of physical self-concept on relations between biological maturity status and self-reported physical activity in adolescent British females. Biological maturity status, physical self-concept and physical activity were assessed in 407 female British year 7-9 pupils (M age = 13.2 years, SD = 1.0). Participants completed the Physical Activity Questionnaire for Adolescents (Kowalski, Crocker, & Donen, 2004) and the Children and Youth Physical Self-Perceptions Profile (Whitehead, 1995). Percentage of predicted adult height attained at measurement was used as an estimate of biological maturity status. Structural equation modelling using maximum likelihood estimation and bootstrapping procedures revealed that perceptions of sports competence, body attractiveness and physical self-worth mediated an inverse relation between maturity status and physical activity. The results provide partial support for Petersen and Taylor's (1980) Mediated Effects Model of Psychological and Behavioural Adaptation to Puberty within the context of physical activity

Public health policy and walking in England - analysis of the 2008 'policy window'.

Although the government in England has a long-standing interest in walking promotion, this has not been accompanied by a coherent strategic plan or investment to support physical activity behaviour change. However, in 2008 the government announced its intention to invest £7 million into walking promotion. This article utilises Kingdon's Multiple Streams framework as an organising principle through which to interrogate the reasons behind the increased emphasis on walking promotion as part of the public health policy agenda in England.The research adopted a case study design. Data were obtained through document analysis of relevant policies and semi-structured interviews with experts in the walking sector, including both government and non-government representatives.Kingdon's Multiple Streams theory proposes that at certain points in time, 'policy windows' are created through the convergence of a problem, an appropriate solution, and a receptive political environment, and this policy window presents an opportunity for major policy change. The findings of this research suggest that the success of London in securing the 2012 Olympic and Paralympic Games was the primary trigger in the creation of a policy window for walking promotion in recent years.Despite previous interest in walking promotion from the health and transport sectors, it was the recent alignment with the sports agenda that led to increased political commitment. This raises concerns that the research evidence on the health benefits of physical activity and rising levels of inactivity in England, are insufficient to secure government support and investment, and that multi-sector lobbying and joined-up political action may be critical in advancing this agenda

Strengthening policy capability: New Zealand's Policy Project

Policy practitioners apply tools and frameworks to policy chal- lenges in order to improve social, economic, and environmental outcomes. Could such tools and frameworks be applied to improve the quality of policy design itself? In 2014, prompted by evidence of widespread inconsistency in the quality of policy advice being produced across agencies, the New Zealand Government launched the Policy Project. It deployed policy ana- lytic tools and frameworks to investigate current practice in policy design to improve the quality of policy advice across the whole of government. Through collaborative methods, the Policy Project identified and codified what quality policy advice looks like and the skills and processes needed to produce it. We review the con- text and creation of the Policy Project, its contributions, evidence of its impacts, and prospects for its replication across other public sectors

Sensible Treatment of Obesity in Rural Youth (STORY): Design and methods

Project STORY is a 3-arm, randomized, planning and feasibility study assessing the effectiveness of two behavioral weight management interventions in an important and at-risk population, overweight children and their parents in medically underserved rural counties. Participants will include 90 parent-child dyads from rural counties in north central Florida. Families will be randomized to one of three conditions: (a) a Family-Based Behavioral Group Intervention, (b) a Parent-Only Behavioral Group Intervention, and (c) a waitlist control condition. Child and parent participants will be assessed at baseline (month 0), post-treatment (month 4) and follow-up (month 10). Assessment and intervention sessions will be held at Cooperative Extension offices within each local participating county. The primary outcome measure is change in child body mass index (BMI) z-score. Additional key outcome measures include child dietary intake, physical activity, self-esteem, body image, and parent BMI. The goals of the study are to (a) assess the feasibility of recruitment in rural settings, (b) develop and evaluate training protocol for group leaders, (c) determine strategies to increase adherence to monitoring and goal setting protocol, (d) evaluate strategies for participant retention, (e) assess the relative cost-effectiveness of the interventions, (f) assess the acceptability of the intervention to families and Cooperative Extension administrators and personnel, and (g) if successful, estimate the sample size needed for a full scale trial. This research has potential implications for medically underserved rural communities with limited resources and preventive health care services. If successful, a Parent-Only intervention program may provide a cost-effective and practical intervention for families in underserved rural communities