Jonathan L Blitstein- PH.D.
- Medical Professional at RTI International
Jonathan L Blitstein
- PH.D.
- Medical Professional at RTI International
About
69
Publications
20,250
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Citations
Introduction
Dr. Jonathan L. Blitstein is a research psychologist at RTI international. His work focuses on design, execution, and analysis of program evaluation strategies that take place at the state, community, school, and worksite level. Dr. Blitstein's approach blends psychological and marketing theory to help elaborate the role of perceived costs and benefits associated with promoting uptake and maintenance of health-positive behavior.
Skills and Expertise
Current institution
Additional affiliations
September 2004 - present
Publications
Publications (69)
Despite growing evidence that warning labels reduce purchases of sugary drinks, less is known about warnings' impact on purchases of sugary snacks. This paper aimed to experimentally test whether a front-of-package label warning about high sugar content (“sugar warning label”) would reduce parents' likelihood of selecting a labeled snack versus a n...
Background
Consumption of sugar-sweetened beverages, including fruit drinks (i.e., fruit-flavored drinks containing added sugar), contributes to childhood obesity.
Objectives
We aimed to examine whether nutrition-related claims on fruit drinks influence purchasing among parents and lead to misperceptions of healthfulness.
Methods
We conducted an...
This article describes lessons from the feasibility testing of a parent-focused, life skills-based intervention to promote healthy weight in 58 low-income children aged 2 to 5 years. This intervention was feasible and acceptable, with a potential to impact child weight and diet (calories) and parental quality of life (QOL). The group delivery appro...
Background
Sugar-sweetened beverage (SSB) consumption among youth contributes to diet-related chronic disease including obesity, type 2 diabetes, and poor oral health.
Objective
Collect data to inform the development of a social marketing campaign aimed at reducing SSB consumption among youth age 11–17 in North Carolina (NC).
Study Design, Settin...
Purpose and objectives:
Effective community-based programs to manage arthritis exist, but many adults with arthritis are unaware that these programs are available in their communities. An electronic health record (EHR) referral intervention was designed to strengthen health care and community-based partnerships and increase participation in these...
Background
The Cooking Matters food skills education program equips low-income families with the skills and knowledge to shop for and cook healthy meals within budget and time constraints.
Aims
To explore whether participation in Cooking Matters is associated with healthier food choices using a 6-item scale, comprised of a variety of food categori...
Purpose
Examine a clinic-based approach to improve food security and glycemic control among patients with diabetes.
Design
One-group repeated-measures design.
Setting
Federally Qualified Health Centers in a large Midwest city.
Sample
Of the 933 patients with diabetes who consented at baseline, 398 (42.66%) returned during the follow-up period fo...
Objective
To examine the impact front-of-package nutrition labels (FOPLs) have on decision-making abilities among low-income parents in a virtual supermarket.
Design
A 4-by-2 experimental design with 3 FOPLs (summary, nutrient-specific, hybrid) and a no-FOPL comparison. Within the FOPL condition, participants either shopped with a time limit (10 m...
The growth in online grocery shopping has prompted research into why consumers are shifting food acquisition practices. Most research has relied on either confirmatory approaches (i.e., multiple choice surveys) that limit consumer input or ethnographic approaches that provide more in-depth understanding of consumer experience but are limited to a h...
This study's purpose was to qualitatively examine perceived advantages and disadvantages of online grocery shopping among participants (n = 7) in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Initial in-depth, qualitative interviews were conducted, after which participants completed an episode of online grocery...
Objectives
(i) To determine the current state of online grocery shopping, including individuals’ motivations for shopping for groceries online and types of foods purchased; and (ii) to identify the potential promise and pitfalls that online grocery shopping may offer in relation to food and beverage purchases.
Design
PubMed, ABI/INFORM and Google...
Objective:
To determine the interrater reliability of the Preschool Movement Assessment (PMA), a unique field-based assessment tool for use by early childhood professionals in preschool settings.
Methods:
A total of 123 preschool children, aged 3-5years, were assessed by 6 trained raters using the PMA tool in an intervention. Interrater agreemen...
Background:
The U.S. Centers for Disease Control and Prevention (CDC) develops tools to support implementation of evidence-based interventions for school health. To advance understanding of factors influencing the use of these implementation tools, we conducted an evaluation of state, school district, and local school staffs' use of four CDC tools...
Objective:
Determine the impact of Cooking Matters for Adults (CM) on food resource management (FRM) skills and self-confidence 6 months after course completion.
Design:
Quasi-experimental design with nonequivalent comparison group and 6-month follow-up.
Setting:
Cooking Matters for Adults programs in CA, CO, ME, MA, MI, and OR.
Participants:...
Background
Little is known about public health practitioners’ capacity to change policies, systems, or environments (PSEs), in part due to the absence of measures. To address this need, we partnered with the Alliance for a Healthier Generation (Alliance) to develop and test a theory-derived measure of the capacity of out-of-school time program prov...
Background:
Evidence supports the use of social marketing campaigns to improve nutrition knowledge and reinforce the effects of nutrition education programs. However, the additional effects of parent-focused social marketing with nutrition education have received little attention.
Objective:
Our aim was to assess the impact of the Iowa Nutrition...
This study evaluated the impact of a four-session interactive nutrition education program-Eat Smart, Live Strong (ESLS)-on the consumption of fruit and vegetables by low-income older adults. A pre-post quasi-experimental design study was conducted with a longitudinal sample of 614 low-income Supplemental Nutrition Assistance Program (SNAP) particip...
This study reviews the current literature on behavioral and environmental food safety interventions conducted in commercial and institutional food service settings. A systematic search of the published literature yielded 268 candidate articles, from which a set of 23 articles reporting intervention outcomes was retained for evaluation. A categoriza...
To examine behavioural intention to reduce soda consumption after exposure to the Choose Health LA 'Sugar Pack' campaign in Los Angeles County, California, USA.
A cross-sectional street-intercept survey was conducted to assess knowledge, attitudes, health behaviours and behavioural intentions after exposure to the 'Sugar Pack' campaign. A multivari...
Background
San Diego received federal funding to expand the use of Electronic Health Records (EHR) for surveillance by leveraging existing infrastructure, the San Diego Immunization Registry (SDIR), as a mechanism to collect Body Mass Index (BMI) data. By the project’s conclusion, BMI data transfer was in place for 12 sites including six communit...
Brands are marketing tools that create mental representations in the minds of consumers about products, services, and organizations. Brands create schema that help consumers decide whether to initiate or continue use of a product or service. Health branding determines behavioral choice by building consumer relationships and identification with heal...
Objective:
This study evaluated whether a nutrition-education program in child-care centers improved children's at-home daily consumption of fruits and vegetables, at-home use of low-fat/fat-free milk, and other at-home dietary behaviors.
Materials and methods:
Twenty-four child-care centers serving low-income families were matched by region, ty...
Introduction: Lack of access to healthy food contributes to inadequate consumption of fresh fruits and vegetables (FFV) and increased odds for obesity. The literature documents the disparity in access to healthy food, particularly in rural, low-income, and minority neighborhoods. Healthy corner store intervention (HCSI) is a strategy for increasing...
The executive summary presents the background, methods, and key findings of the final report produced for the U.S. Department of Agriculture (USDA) Food and Nutrition Service (FNS) SNAP Education and Evaluation Study, Wave II. This study evaluated three Supplemental Nutrition Assistance Program Education (SNAP-Ed) demonstration projects. The findin...
This executive summary presents the background, methods, and key findings of the final report produced for the U.S. Department of Agriculture (USDA) Food and Nutrition Service (FNS) study entitled Models of SNAP Education and Evaluation, Wave I. This study evaluated four Supplemental Nutrition Assistance Program-Education (SNAP-Ed) demonstration pr...
Introduction: During 2012, the Choose Health LA (CHLA) Sugar Pack counter-advertising campaign was broadly launched across multiple public transit channels in Los Angeles County (LAC) to raise public awareness about sugary drinks' contribution to excess calories and obesity. Few studies to date have examined the contributory effects of counter-adve...
Low‐income women are faced with high risk of stress, poor dietary behaviors, and obesity. The impact of these factors on dietary quality in this population is not well characterized. We conducted a cross‐sectional study among 101 non‐pregnant women with a child enrolled in the Cumberland County (NC) WIC Program. We measured dietary intake by 24‐hr...
Background:
This article revisits an article published in Evaluation Review in 2005 on sample size estimation and power analysis for group-randomized trials. With help from a careful reader, we learned of an important error in the spreadsheet used to perform the calculations and generate the results presented in that article. As we studied the spr...
Purpose
To examine changes in parent-child communication related to sexual behavior after exposure to public health messages.
Design
Randomized, controlled trial that was part of precampaign message testing.
Setting
Exposure occurred online or through DVDs mailed to participants and viewed on their personal computers. Data collection occurred via...
Objective:
The present study examined whether characteristics such as quality, selection and convenience are associated with dietary intake of fruits and vegetables independent of perceived costs in an inner-city, low-income population.
Design:
Secondary analysis of baseline data from a social marketing intervention designed to change household...
To test a social cognitive behavior change model and identify mediators of the effects of the Parents Speak Up National Campaign (PSUNC) on parent-child sexual communication.
Investigators used 5 waves of data from an online randomized controlled trial. Latent variables were developed based on item response theory and confirmatory factor analysis....
Prior research supports the notion that parents have the ability to influence their children's decisions regarding sexual behavior. Yet parent-based approaches to curbing teen pregnancy and STDs have been relatively unexplored. The Parents Speak Up National Campaign (PSUNC) is a multimedia campaign that attempts to fill this void by targeting paren...
We conducted an online randomized experiment to evaluate the efficacy of messages from the Parents Speak Up National Campaign (PSUNC) to promote parent-child communication about sex.
We randomly assigned a national sample of 1,969 mothers and fathers to treatment (PSUNC exposure) and control (no exposure) conditions. Mothers were further randomized...
To determine the effectiveness of a sanitation campaign that combines 'shaming' (i.e. emotional motivators) with subsidies for poor households in rural Orissa, an Indian state with a disproportionately high share of India's child mortality.
Using a cluster-randomized design, we selected 20 treatment and 20 control villages in the coastal district o...
OBJECTIVE: To determine the effectiveness of a sanitation campaign that combines "shaming" (i.e. emotional motivators) with subsidies for poor households in rural Orissa, an Indian state with a disproportionately high share of India's child mortality. METHODS: Using a cluster-randomized design, we selected 20 treatment and 20 control villages in th...
Obesity and childhood overweight is a worldwide epidemic that has significant long-term public health implications both in developed and developing countries. South Africa, which has a well-documented burden of HIV/AIDS, tuberculosis, and other infectious diseases, now also has an increasing burden of obesity and noncommunicable diseases (NCD) such...
Brands build relationships between consumers and products, services, or lifestyles by providing beneficial exchanges and adding value to their objects. Brands can be measured through associations that consumers hold for products and services. Public health brands are the associations that individuals hold for health behaviors, or lifestyles that em...
Over a decade ago an editorial in the journal Tobacco Control posed the question: ‘What is the best known word in the world: Sex? Life? Death? Jesus? ....’ ‘No’, the answer came, ‘It's Coca Cola’. This impressive tribute to the power of branding suggested that any attempts to tackle youth smoking would need to take on tobacco brands. Brands build r...
Branding can be viewed by public health practitioners as a tool that will allow them to influence the perceived costs of engaging in health promoting behaviours. Branded campaigns promote a consumer orientation that emphasizes the nature of the exchange by appealing to the individual's self-interest. This approach will become increasingly important...
Previous reviews have identified problems in the design and analysis of group-randomized trials in a number of areas. Similar problems may exist in cancer research, but there have been no comprehensive reviews.
We searched Medline and PubMed for group-randomized trials focused on cancer prevention and control that were published between 2002 and 20...
Inadequate water and sanitation infrastructure is a major problem in India and throughout the developing world, contributing to severe health problems that limit human and economic development. In order to effectively address these problems, policy makers need a better understanding of what works to improve sanitation and health outcomes. This pape...
Health marketing mass media campaigns have been shown to be effective in changing health behavior and behavioral mediators. Tobacco countermarketing mass media campaigns have been effective in reducing smoking initiation and progression to established smoking. Targeted message strategies used by countermarketing campaigns influence specific attitud...
Group-randomized trials often involve repeat observations on the same participants. When there are no more than two observations from each participant, standard mixed-model regression methods for a pretest-posttest design can be used. When there are more than two observations from each participant, random coefficients models may be useful. This pap...
To identify sociodemographic variables and beliefs about the causes of obesity associated with reported use of Nutrition Facts panel (NFP) information.
Nationally representative, cross-sectional survey of 1139 adults. Data collection employed a single-stage, equal-probability sampling design with random-digit dialing across 50 states and the Distri...
The present study sought to determine whether risk factors for cigarette smoking onset have a stronger influence on Black versus White children, and whether those patterns differ for nonsmokers versus experimental smokers. As part of a larger study, 5,213 seventh graders were surveyed annually for 5 years. The survey instrument assessed cigarette s...
Our first purpose was to determine whether, in the context of a group-randomized trial (GRT) with Gaussian errors, permutation or mixed-model regression methods fare better in the presence of measurable confounding in terms of their Monte Carlo type I error rates and power. Our results indicate that given a proper randomization, the type I error ra...
The study by Dr Gould and colleagues addressed whether asking high school students about suicidal ideation or behaviors was harmful. We are concerned about aspects of the study methods. The study describes a group-randomized trial design in which 181 classrooms, containing 2342 students enrolled at 6 purposely selected New York State high schools,...
This study describes a method for incorporating external estimates of intraclass correlation to improve the precision for the analysis of an existing group-randomized trial. The authors use a random-effects meta-analytic approach to pool the information across studies, which takes into account any interstudy heterogeneity that may exist. This appro...
This article builds on the previous article by Blitstein et al. (2005), which showed how external estimates of intraclass correlation can be used to improve the precision for the analysis of an existing group randomized trial. The authors extend that work to sample size estimation and power analysis for future group-randomized trials. Often this ap...
The authors assessed a cohort of 2,335 students from the Minneapolis, Minnesota, area to identify predictors of violent behavior and to determine whether the predictors varied by gender. The sample was 76% White; boys and girls were equally represented. The majority lived with two parents. A measure of violent behavior collected at the end of the e...
This article compares four mixed-model analyses valid for group-randomized trials (GRTs) involving a nested cohort design with a single pretest and posttest. This study makes estimates of intraclass correlations (ICCs) available to investigators planning GRTs addressing dietary outcomes. It also provides formulae demonstrating the potential benefit...
This article compares four mixed-model analyses valid for group-randomized trials (GRTs) involving a nested cohort design with a single pretest and a single posttest, the most common design used in GRTs. This study makes estimates of intraclass correlations (ICCs) available to investigators planning GRTs with alcohol, tobacco, and other drug measur...
We reviewed group-randomized trials (GRTs) published in the American Journal of Public Health and Preventive Medicine from 1998 through 2002 and estimated the proportion of GRTs that employ appropriate methods for design and analysis.
Of 60 articles, 9 (15.0%) reported evidence of using appropriate methods for sample size estimation. Of 59 articles...
We review recent developments in the design and analysis of group-randomized trials (GRTs). Regarding design, we summarize developments in estimates of intraclass correlation, power analysis, matched designs, designs involving one group per condition, and designs in which individuals are randomized to receive treatments in groups. Regarding analysi...
A sample of 372 adolescents completed annual surveys regarding their initial reactions to smoking (IRTS) and their current smoking status. Each annual survey asked participants if they had the following five reactions the first time they smoked a cigarette: coughing, or feeling dizzy, sick, high, or relaxed. Time 1 IRTS data were collected within 1...
While the correlates and predictors associated with transition through the stages of smoking acquisition have received substantial attention, the identification of factors associated with the time course of progression remain generally unexplored.
We identified adolescents escalating from nonsmoking to regular smoking in 1 year as rapid progressors...
Active suppression of a thought can lead to preoccupation with that thought. Thisrebound effectcan be conceptualized as an increase in cognitive accessibility. If so, then the effects of suppression-induced accessibility should be moderated by variables (such as cognitive load) that moderate the effects of accessibility produced by other priming pr...
Questions
Question (1)
I'm looking for advice on how to handle informative missing information in a study with multiple dependent variables.
Participants were assigned to one of 4 labeling condition and exposed to 3 packages. Eye-tracking data was used to determine how much attention they paid to the label. The yields 3 dependent variables (mean fixation time) for each participant and one independent variable (condition). My first thought was MANOVA but some participants may not fixate on some labels leading to intermittent missing information which will cause case-wise deletion. I don't think recoding is an option because in this case, missingness is informative.
Does anyone have thoughts on a modeling approach that will handle this data?
thank you
