Ronald J. Iannotti - US grants

Lifestyle plays a significant role in the development of CVD risk factors. Some of these risk factors (obesity, cholesterol, hypertension) track from childhood into adulthood, which argues for early intervention. Although it is known that there are familial relationships among these risk factors, it is uncertain how much can be attributed to environment and how much to interprsonal interaction patterns within families. The goal of this longitudinal study is to test a model hypothesizing that the CVD risk status of black children is influenced by predisposing factors (e.g., the CVD risk status of an older sibling), and environmental factors (e.g., day care vs. home care) on the child's food intake and activity levels, primarily through interpersonal interaction between the child and significant others. Within this model a number of hypotheses will be tested. A pilot phase involving 60 black children, age 2-4 years, stratified on the CVD risk status of an older sibling, will be used to evaluate and adapt existing instruments to measure food intake and activity levels, physiologic values, family CV disease history, 24-hour diet history, and environmental and psychosocial questionnaires, in the children's homes, day care centers, and schools. In years 2-5, a cohort of 300 black children, ages 42-48 months will be recruited through an older sibling in a D.C. elemetary school, and observed 4 times. Measurement includes video-taping eating events, recording activity levels, obtaining physiological measurements (height, weight, cholesterol, HDL, systolic and diastolic blood pressure, skinfold, fitness of the child, sibling and parent(s); performing 24-hour diet recalls, and questionnaires to record family CV disease history and environmental and psychosocial factors. The results should help determine where it is possible to intervent to reduce the risk of children developing CVD when they are older. The research team include a psychologist, pediatrician, nutritionist-anthropologist, medical sociologist, health educator, and biostatistician.

The propose of this cross-sectional study of black and white children is to investigate children's knowledge, attitudes and feelings regarding the final stage of HIV disease, Acquired Immunodeficiency Syndrome (AIDS), as an illness and its health consequences. A particular focus is on information which facilitates development of age-appropriate interventions in educational pediatric, and community settings. The sample population permits examination of the potential influence of developmental, ethnic, familial, and socioeconomic factors on childrens' understanding and knowledge of aids. The goals of the study are to: 1. Develop instruments and techniques for assessment of children's knowledge, attitudes and feelings regarding AIDS. 2. Determine children's understanding and potential for acquiring developmentally-appropriate information about disease and health processes, particularly those relating to AIDS. 3. Examine children's perceptions of personal control in disease prevention and health promotion of AIDS relative to other health problems. 4. Identify the role of social- environmental factors in children's knowledge and attitudes regarding these health problems. An interdisciplinary panel of experts will contribute to the development of the research instruments and techniques in conjunction with an instrument evaluation process using group and individual discussion of instruments with samples of 15 black and white elementary school children in each of grades 1, 3, nad 5. The final instruments are then administered to samples of 300 black elementary school children and 300 white elementary school children, each equally distributed across grades 1, 3, and 5, stratified by socioeconomic status and gender. Mothers of the children are interviewed by telephone to obtain demographic information and their knowledge and understanding about AIDS and AIDS education of their children. The research design is placed within a cognitive-developmental theory of health behaviors and of personal control in health promotion. Nine hypothesis are tested. The research team, which has considerable experience working with black and white elementary school children, consists of two developmental psychologists, three health educators, a medical sociologist, and a pediatrician.

The goal of the proposed project is to continue analysis of data from a longitudinal study of 246 urban Black preschool children and their families to identify the long-term effects of social and environmental influences on nutrition and activity and the consequences of these influences for the children's CVD risk status. This study contributes to understanding the development of patterns of eating and exercise, focusing on environmental influences that promote healthful life styles and prevent risk behaviors for CVD. This unusually rich data set exceeds that planned in the original proposal by including additional measures of activity and nutrition of the preschool child as well as measures of the activity of an older sibling and mother. The data set is not easily replicated because the data were gathered in the homes and schools of the children and include both self - report and direct measurement of activity and nutrition. Additional assessments of activity, lipid fractions and apoliproteins, and Type A Behavior Patterns (TABP) and Life Stress in the preschool child, i.e., Target Child (TC), an older sibling (OS) and the children's mother (M) have added considerably to the complexity and value of the data set permitting additional questions regarding the development of activity, the influences of siblings and parents on this development, and the relationship to CVD risk status and TABP. The proposed analyses will apply more powerful statistical models to this broader range of measures to expand on questions in the original proposal and to answer new questions. All data have been gathered, entered into data files, and cleaned. Hypotheses addressed include: 1. Activity levels and the activities selected show increasing stability with age in preschool and older black children. 2. The influence of parental prompts and family environment on activity increase asymptotically with age: The effects increase during early childhood; the effects do not increase significantly in older children. 3. OS's influence on TC's behavior increases with age. TC's CVD risk status becomes more like OS's with age. 4. Perceptions of recent Life Stress and ratings of TA.BP for TC, OS, and M are predisposing variables that are positively related to TC's activity. 5. Long-term patterns of physical activity are associated with HDL and apo A-1 in TC and OS; the effect is stronger for OS. Long-term patterns of TC's nutrient intake are associated with his/her lipid levels.

This project will continue to investigate the development of children's understanding, knowledge, and attitudes regarding health and illness, including colds, cuts, heart disease and HIV infection (AIDS), and to determine their influence on subsequent AIDS risk behaviors during the elementary and junior high school years. In the prior study, understanding of disease processes, knowledge about AIDS, health attitudes, and sources of information about AIDS were assessed in a sample of 307 black and 306 white elementary schoolchildren in grades 1, 3, and 5 and their parents. In this longitudinal follow-up to the prior study, understanding, knowledge, and attitudes about AIDS are reassessed in the same children and their parents and measures of risk behaviors are introduced with the older children. An interdisciplinary panel of experts will contribute to the development of the risk behavior assessment instrument in conjunction with an evaluation process using group and individual discussion with a sample of 60 children in grades 5 and 7. Risk behaviors assessed include health behaviors, use of abusable substances, and sexual behaviors. Confidential self-administered surveys are used for assessment of risk behaviors and individual interviews are continued for assessments of understanding, knowledge, and attitudes. The design permits examination of the potential influence of developmental, ethnic, familial, and socioeconomic factors on children's understanding and knowledge of AIDS and on children's AIDS risk behaviors.The goals of this longitudinal study are to investigate in black and white third, fifth, and seventh grade schoolchildren: 1. Development of understanding of AIDS and other health problems. 2. Development of AIDS knowledge and attitudes (perceived severity, vulnerability, health locus of control, self-efficacy, values, and risk taking) and changes in the relationship of understanding to knowledge and attitudes. 3. Relationship of prior and current perception of personal control to taking responsibility for prevention of health problems. 4. Cohort effects in understanding, knowledge and attitudes regarding health and illness, including cold, cuts, heart disease and AIDS. 5. Educationally appropriate terminology, process, content, and sources of information about AIDS. Additional goals are investigated in seventh grade schoolchildren and evaluated for appropriateness in fifth graders: 1. Development of health risk behaviors, particularly those related to risk for AIDS, i.e., use of abusable substances and unsafe sexual behaviors. 2. Perceived vulnerability to and severity of sexually transmitted diseases (STD). 3. Relationship of prior and current knowledge and understanding to health risk behaviors. 4. Relationship of prior and current health attitudes to health risk behaviors. 5. Educationally appropriate terminology, process, content, and sources of information about STDs. 12 specific hypotheses will be tested. The research team includes two developmental psychologists, two health educators, a medical sociologist, and a pediatrician.

The goal of the proposed project is to continue analysis of data from a longitudinal study of 246 urban Black preschool children and their families to identify the long-term effects of social and environmental influences on nutrition and activity and the consequences of these influences for the children's CVD risk status. This study contributes to understanding the development of patterns of eating and exercise, focusing on environmental influences that promote healthful life styles and prevent risk behaviors for CVD. This unusually rich data set exceeds that planned in the original proposal by including additional measures of activity and nutrition of the preschool child as well as measures of the activity of an older sibling and mother. The data set is not easily replicated because the data were gathered in the homes and schools of the children and include both self - report and direct measurement of activity and nutrition. Additional assessments of activity, lipid fractions and apoliproteins, and Type A Behavior Patterns (TABP) and Life Stress in the preschool child, i.e., Target Child (TC), an older sibling (OS) and the children's mother (M) have added considerably to the complexity and value of the data set permitting additional questions regarding the development of activity, the influences of siblings and parents on this development, and the relationship to CVD risk status and TABP. The proposed analyses will apply more powerful statistical models to this broader range of measures to expand on questions in the original proposal and to answer new questions. All data have been gathered, entered into data files, and cleaned. Hypotheses addressed include: 1. Activity levels and the activities selected show increasing stability with age in preschool and older black children. 2. The influence of parental prompts and family environment on activity increase asymptotically with age: The effects increase during early childhood; the effects do not increase significantly in older children. 3. OS's influence on TC's behavior increases with age. TC's CVD risk status becomes more like OS's with age. 4. Perceptions of recent Life Stress and ratings of TA.BP for TC, OS, and M are predisposing variables that are positively related to TC's activity. 5. Long-term patterns of physical activity are associated with HDL and apo A-1 in TC and OS; the effect is stronger for OS. Long-term patterns of TC's nutrient intake are associated with his/her lipid levels.

This project will continue to investigate the development of children's understanding, knowledge, and attitudes regarding health and illness, including colds, cuts, heart disease and HIV infection (AIDS), and to determine their influence on subsequent AIDS risk behaviors during the elementary and junior high school years. In the prior study, understanding of disease processes, knowledge about AIDS, health attitudes, and sources of information about AIDS were assessed in a sample of 307 black and 306 white elementary schoolchildren in grades 1, 3, and 5 and their parents. In this longitudinal follow-up to the prior study, understanding, knowledge, and attitudes about AIDS are reassessed in the same children and their parents and measures of risk behaviors are introduced with the older children. An interdisciplinary panel of experts will contribute to the development of the risk behavior assessment instrument in conjunction with an evaluation process using group and individual discussion with a sample of 60 children in grades 5 and 7. Risk behaviors assessed include health behaviors, use of abusable substances, and sexual behaviors. Confidential self-administered surveys are used for assessment of risk behaviors and individual interviews are continued for assessments of understanding, knowledge, and attitudes. The design permits examination of the potential influence of developmental, ethnic, familial, and socioeconomic factors on children's understanding and knowledge of AIDS and on children's AIDS risk behaviors.The goals of this longitudinal study are to investigate in black and white third, fifth, and seventh grade schoolchildren: 1. Development of understanding of AIDS and other health problems. 2. Development of AIDS knowledge and attitudes (perceived severity, vulnerability, health locus of control, self-efficacy, values, and risk taking) and changes in the relationship of understanding to knowledge and attitudes. 3. Relationship of prior and current perception of personal control to taking responsibility for prevention of health problems. 4. Cohort effects in understanding, knowledge and attitudes regarding health and illness, including cold, cuts, heart disease and AIDS. 5. Educationally appropriate terminology, process, content, and sources of information about AIDS. Additional goals are investigated in seventh grade schoolchildren and evaluated for appropriateness in fifth graders: 1. Development of health risk behaviors, particularly those related to risk for AIDS, i.e., use of abusable substances and unsafe sexual behaviors. 2. Perceived vulnerability to and severity of sexually transmitted diseases (STD). 3. Relationship of prior and current knowledge and understanding to health risk behaviors. 4. Relationship of prior and current health attitudes to health risk behaviors. 5. Educationally appropriate terminology, process, content, and sources of information about STDs. 12 specific hypotheses will be tested. The research team includes two developmental psychologists, two health educators, a medical sociologist, and a pediatrician.