Objective
While colleges have implemented brief, tailored interventions for health-risk areas such as alcohol prevention, theoretically-guided digital learning offerings for weight gain prevention ...have lagged behind in programming and implementation. Thus, the objective was to design and usability test a weight gain prevention digital learning platform for college students with modules targeting key nutrition and physical activity behaviors.
Methods
Development occurred in iterative phases: formative research, descriptive normative data collection, prototype development, and usability testing. Formative research consisted of background work and survey administration to incoming and current freshmen. Prototype development was guided by theories of behavior change and cognitive processing, and consisted of brief assessment and feedback using written text, graphs, and videos. Iterative usability testing was conducted.
Results
Current freshmen reported eating more quick order meals per week than incoming freshman, but fewer high-fat snacks and fewer sugary beverages. Current freshmen reported more sedentary time than incoming freshmen. Based on iterative testing results, eight behavioral targets were established: breakfast, high-fat snacks, fried foods, sugary beverages, fruit/vegetables, physical activity, pizza intake, and sedentary behavior. Initial usability testers indicated the modules were easy to understand, held their attention, and were somewhat novel. Analysis of qualitative feedback revealed themes related to content, layout, structure and suggested refinements to the modules.
Conclusions
A gap exists for evidence-based obesity prevention programs targeted to adolescents as they transition into adulthood. Brief, tailored digital learning interventions show promise towards addressing key behavioral nutrition and physical activity targets among students during the transition to college.
Background
The Beck Depression Inventory-II (BDI-II) is frequently used to evaluate bariatric patients in clinical and research settings; yet, there are limited data regarding the factor structure of ...the BDI-II with a bariatric surgery population.
Methods
Exploratory factor analysis (EFA) using principal axis factoring with oblimin rotation was employed with data from 1228 consecutive presurgical bariatric candidates. Independent
t
tests were used to examine potential differences between sexes. Confirmatory factor analysis (CFA) was conducted with the next 383 consecutive presurgical patients to evaluate the proposed model based on EFA results.
Results
EFA revealed three factors: negative perceptions, diminished vigor, and cognitive dysregulation, each with adequate internal consistency. Six BDI-II items did not load significantly on any of the three factors. CFA results largely supported the proposed model.
Conclusions
Results suggest that dimensions of depression for presurgical bariatric candidates vary from other populations and raise important caveats regarding the utility of the BDI-II in bariatric research.
Interventions to Increase Walking Behavior WILLIAMS, David M; MATTHEWS, Charles E; RUTT, Candace ...
Medicine and science in sports and exercise,
07/2008, Letnik:
40, Številka:
7
Conference Proceeding, Journal Article
Recenzirano
Odprti dostop
Walking is the most prevalent and preferred method of physical activity for both work and leisure purposes, thus making it a prime target for physical activity promotion interventions. We identified ...14 randomized controlled trials, which tested interventions specifically targeting and assessing walking behavior. Results show that among self-selected samples, intensive interventions can increase walking behavior relative to controls. Brief telephone prompts appear to be as effective as more substantial telephone counseling. Although more research is needed, individual studies support prescriptions to walk 5-7 versus 3-5 d.wk and at a moderate (vs vigorous) intensity pace, with no differences in total walking minutes when single or multiple daily walking bouts are prescribed. Mediated interventions delivering physical activity promotion materials through non-face-to-face channels may be ideal for delivering walking promotion interventions and have shown efficacy in promoting overall physical activity, especially when theory-based and individually tailored. Mass media campaigns targeting broader audiences, including those who may not intend to increase their physical activity, have been successful at increasing knowledge and awareness about physical activity but are often too diffuse to successfully impact individual behavior change. Incorporating individually tailored programs into broader mass media campaigns may be an important next step, and the Internet could be a useful vehicle.
Objective:
Using a multivariate extension of the
Baron and Kenny (1986)
mediation framework, we examined the simultaneous effect of variables hypothesized to mediate the relationship between a ...motivationally tailored physical activity intervention, and 6-month physical activity behavior in 239 healthy, underactive adults (
M
age = 47.5; 82% women).
Design:
Participants were randomly assigned to (a) print-based feedback; (b) telephone-based feedback; or (c) contact control.
Main Outcome Measures:
Psychosocial variables, including self-efficacy, decisional balance, and processes of change.
Results:
All mediation criteria were satisfied for both intervention arms. A moderate indirect effect of print (0.39, 95% CI = 0.21, 0.57) was found due to increases in behavioral processes (0.54, 95% CI = 0.29, 0.80) being attenuated by decreases due to cognitive processes (−0.17, 95%CI = −0.31,-.03). A moderate indirect effect was observed for telephone (0.47, 95% CI = 0.28, 0.66), with increases due to behavioral processes (0.61, 95% CI = 0.34, 0.87) attenuated by decreases due to cognitive processes (0.15, 95% CI = −0.27, −0.02); self-efficacy and decisional balance mediational paths did not attain statistical significance.
Conclusions:
These findings highlight the importance of studies that deconstruct the theoretical components of interventions to determine which combination produces the greatest behavior changes at the lowest cost.
Objective: An automated telehealth counseling system, aimed at inactive midlife and older adults, was shown previously to achieve 12-month physical activity levels similar to those attained by human ...advisors. This investigation evaluated the sustained 18-month impacts of the automated advisor compared with human advisors. Methods: Following the end of the 12-month randomized, controlled trial, participants who had been randomized to either the human advisor (n = 73) or automated advisor (n = 75) arms were followed for an additional 6 months. During that period, human or automated advisor-initiated telephone contacts ceased and participants were encouraged to initiate contact with their advisor as deemed relevant. The primary outcome was moderate-to-vigorous physical activity (MVPA), measured using the Stanford Physical Activity Recall and validated during the major trial via accelerometry. Results: The two arms did not differ significantly in 18-month MVPA or the percentage of participants meeting national physical activity guidelines (ps >.50). No significant within-arm MVPA differences emerged between 12 and 18 months. Evaluation of the trajectory of physical activity change across the 18-month study period indicated that, for both arms, the greatest physical activity increases occurred during the first 6 months of intervention, followed by a relatively steady amount of physical activity across the remaining months. Conclusions: The results provide evidence that an automated telehealth advice system can maintain physical activity increases at a level similar to that achieved by human advisors through 18 months. Given the accelerated use of mobile phones in developing countries, as well as industrialized nations, automated telehealth systems merit further evaluation.
This study examined self‐reported physical activity (PA) barriers, and their effects on PA behavior change at 3 and 12 months among 280 previously inactive women enrolled in a PA promotion trial. ...Effect modification of baseline barriers by baseline weight status on PA behavior change was also examined. At baseline and month 12, obese women reported significantly greater PA barriers compared with normal and overweight women (P < 0.05). Individual barriers that were more likely to be elevated for obese vs. normal and overweight participants at baseline were feeling too overweight, feeling self‐conscious, reporting minor aches and pains, and lack of self‐discipline. Also, weight status moderated the effect of PA barriers on PA behavior change from baseline to month 3 (P < 0.05), but not to month 12 (P = 0.637), with obese participants reporting high barriers achieving 70 min/week fewer than those with low barriers (P < 0.05). Finally, the interaction between barriers (high vs. low) and weight status (obese vs. normal), shows PA barriers had a detrimental PA effect among obese participants that was 122.5 min/week (95% confidence interval (CI) = 15.7, 229.4; P < 0.05) lower than their effect on normal‐weight participants. These results suggest that for obese women, PA barriers have quantifiable effects on PA behavior change. This study has implications for the design of future weight loss and PA interventions, suggesting that a comprehensive assessment of PA barriers is a prerequisite for appropriate tailoring of behavioral PA interventions.
Bariatric surgery may increase the risk of substance use. The purpose of this study was to prospectively assess smoking and alcohol use before and after bariatric surgery, identify characteristics ...associated with alcohol use and smoking, and examine substance use and weight loss. Participants (N=155, mean=50.1±11.3 y and 45.7±7.0kg/m2) were Roux-en-Y gastric bypass (RYGB) patients that completed surveys on substance use preoperatively and postoperatively. Alcohol use decreased significantly from the preoperative (72.3%) to the postoperative (63.2%) period. As preoperative alcohol quantity rose, the odds of consuming any alcohol postoperatively increased six-fold. Higher BMI increased the odds of high alcohol consumption. Older age decreased the odds of alcohol use and smoking. Smoking status did not differ pre- (19.4%) to post- (14.8%) surgery. Alcohol use and smoking were not associated with weight loss. After weight-loss surgery, alcohol use declined but smoking rates did not significantly change. Younger patients were more likely to use alcohol and smoke postoperatively. Patients with a higher BMI or a history of substance use may be more likely to use alcohol postoperatively.
•Gastric bypass patients completed surveys on substance use.•Alcohol use decreased after weight-loss surgery.•Smoking rates did not significantly change after weight-loss surgery.•Older age decreased the odds of alcohol use and smoking after weight-loss surgery.•Alcohol use and smoking were not associated with post-operative weight loss.
Abstract Objectives The relationship between enhanced physical activity and decreased menopause symptoms is equivocal. In this study we sought to better understand this relationship by examining the ...association of physical activity to different symptom domains and by examining mediating and moderating variables. Study design Women participating in a randomized control trial on physical activity were given a menopause symptom measure (MENQOL) at follow-up. Of the 280 women participating, 113 (mean age = 52) reported having symptoms they attributed to menopause. Regression analyses were run to examine if change in physical activity predicted fewer symptoms. Exercise self-efficacy was examined as a mediator and depressive symptoms as a moderator. Results An increase in physical activity from baseline was found to be related to reporting fewer total menopause symptoms ( β = −0.22, p = .02). When the total menopause symptoms score was examined by domain, increased physical activity was found to be related to reporting fewer general symptoms attributed to menopause (psychosocial ( β = −0.18, p = .05) and physical ( β = −0.23, p = .01)), but had no effect on specific symptoms of menopause (vasomotor and sexual). Exercise self-efficacy was found to mediate the relationship between increased physical activity and total, physical and psychosocial menopause symptoms. Finally, for individuals with high depressive symptoms, those who increased physical activity the most reported fewer sexual symptoms of menopause. Conclusion This study suggests that physical activity participation is associated with lower general symptom reporting as opposed to specifically impacting menopause symptoms. Further, exercise self-efficacy mediates the relationship between physical activity and general menopause symptoms, suggesting a psychological pathway.
Examining behavioral and psychological factors relating to weight stability over a 1-year period is of public health importance. We conducted a physical activity (PA) intervention trial for women ...(N=247; mean age=47.5±10.7; mean BMI=28.6±5.3) in which participants were assigned to one of three groups (two PA and one contact-control). By Month 12, participants achieved 140.4±14.82 min of PA/week, with no group differences. Weight status change from baseline to Month 12 was categorized: no change (N=154; 62.4%); increase (N=34; 13.8%); decrease (N=59; 23.9%). Discriminant function analyses indentified two statistically significant dimensions associated with weight change. Dimension 1 was positively weighted by mood (0.73) and self-efficacy (0.79); dimension 2 was positively weighted to change in physical activity (0.58) and fat consumption (0.55). Results provide further evidence for the importance of behavior in long-term weight maintenance, particularly physical activity and dietary fat. These findings also provide evidence for the importance of addressing psychosocial variables, in particular depressed mood and self-efficacy.
Smoking is often used as a maladaptive weight control strategy among female smokers. Many of the perceived benefits accrued from smoking, including enhanced mood, reduced anxiety, and weight control, ...can also be achieved through physical activity. The purpose of this study was to examine the effects of a novel behavioral task (body-image exposure) that was designed to elicit body image and weight concerns on urge to smoke among 18-24 year old female smokers who vary in levels of physical activity. Using a cue-reactivity paradigm, 16 sedentary (SE) and 21 physically active (PA) female smokers (≥5 cigarettes/day for past 6 months) were exposed to a pilot tested body-image exposure session. Self-reported urge and latency to first puff were obtained before and after exposure session. Paired sample t tests showed significant increases in self-reported urge (p < .01) and quicker latency to first puff (p < .01) at posttest for the entire sample compared with pretest. Results of partial correlation (controlling for body mass index BMI, nicotine dependence, withdrawal, and depressive symptoms) showed that increased time engaging in vigorous intensity physical activity was associated with lower self-reported urge to smoke at post (r = −0.44; p = .01) but not with latency to first puff (r = −.10; p = .62). These results suggest that among weight-concerned female smokers, physical activity may attenuate smoking urges in a context where weight concerns are increased. Future research should continue to explore effects of physical activity on reactivity to body image and smoking cues and variability in smoking cue-reactivity related to physical activity.
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