Title: A Causal Loop Diagram of factors that influence motor skills in school-aged children
Purpose:
Physically active children develop better motor skills. Children with good motor skills enjoy being physically activity more. When children enjoy being physically active, they will be physically active more frequently. And being physically active on a regular basis has a positive effect on their health, well-being and self-confidence. However, because of inequalities in family situation or neigbourhood were children grow up, not every child gets the opportunity to develop good motor skills. This inequality has only increased due to the corona pandemic resulting in closed schools and more time spent at home. Therefore, we want to gain insight into the complex interplay of personal and environmental factors that contribute to a healthy development of motor skills in children from a system dynamics perspective.
Methods:
Literature related to development of motor skills in children was reviewed from a multidisciplinary point of view. We extracted the main determinants from literature by expert meetings and integrated these determinants into a systems dynamics tool: a Causal Loop Diagram (CLD). The CLD provides a visual image of the determinants related to motor skills and the coherence between determinants. In addition, the effect size and strength of the evidence are included in the CLD.
Results:
We found key determinants for in different layers of the system, like challenge and variety of movement, parenting style and access to special services such as sportclubs. The CLD showed how these determinants were interrelated and the great coherence between different diciplines. In other words, the CLD shows a complex system around children which is only partially influenced to improve their motor skills.
Conclusion:
This causal loop diagram provides leverages points to positively influence development of motor skills in children. Further work is required to use this as a blueprint for specific neighourhoods and provide insight in the specific local system.  Subsequently, tailored intervention strategies can be developed in order to improve motor skills in children.

Purpose:

Most physical activity (PA) during school occurs at recess; however, recess PA may be influenced by children’s thermal comfort and interaction with nature. This cross-sectional study tests the reliability of adapting the validated System for Observing Play and Leisure Activity in Youth (SOPLAY) to include observations of shade and nature (SOPLAY-SN), and provides baseline results of PA, shade, and nature during recess.

Methods:

Interactions with shade and nature were measured using momentary time sampling within designated target areas in two playgrounds (primary=ages 5-8, upper-grade=ages 9-12) at one elementary school in Phoenix, AZ, USA. SOPLAY-SN reliability was initially tested using recess video footage (n=48 scans). Next, in-person observations were conducted over four warm days (primary=29-34°C, upper-grade=32-36°C) in May 2021 (n=179 scans). Pairs of observers conducted simultaneous independent observations to determine agreement. Intraclass correlation coefficients (ICC) using one-way average measures random effects models were used to calculate inter-rater reliability. PA, shade, and nature mean counts and frequencies were calculated.

Results:

Pilot reliability was acceptable (ICCs:0.60-0.92, average agreement=91% overall PA, 81% shade, 82% nature). In-person ICCs were good for sedentary (0.98, 95%CI:0.89-1.00), light (0.80, 95%CI:0.20-0.97) and vigorous (0.94, 95%CI:0.68-0.99) PA; shade (0.95, 95%CI 0.71-0.99); and nature (0.80, 95%CI:0.20-0.97). Inter-rater reliability and agreement were good (ICC 0.88, 95%CI:0.37-0.99 to 0.98, 95%CI:0.87-1.00; average agreement=86% overall PA, 88% shade, 90% nature). 

Most (60.1%) primary children were in the shade with 64.2% of those observations under a covered play structure where 46.7% of children were sedentary. Overall, 10.63% of primary students were observed interacting with nature, with 90.2% of those children in grassy fields with trees. Among upper-grade children, 23.1% were observed in the shade with 53.3% of those observations in large grassy fields where 48.2% of play was light. Few (6.9%) upper-grade children were observed interacting with nature, with most (75.6%) in a grassy field with trees. 

Conclusions:

Findings suggest SOPLAY-SN is a reliable tool for assessing simultaneous observations of children’s interactions with shade, nature, and PA. With most primary children observed under shade, yet few interacting with nature, elementary playgrounds may benefit from shade trees surrounding play equipment to encourage nature play.

 

 

Purpose. We sought to understand: the characteristics of online grocery shoppers, reasons for shopping online, barriers to shopping online, accessibility and availability of shopping online, types of food available in online grocery stores, and types of pricing, promotion, and placement strategies used to market foods and beverages in online grocery stores.

Methods. We searched PubMed, Scopus, Web of Science, Business Source Premiere, ACM Digital Library, Google Scholar, and USDA publications through June 2021. We included studies that collected empirical data on online grocery shopping and retailing. Two reviewers screened 787 titles and abstracts and 491 full texts, resulting in 121 relevant studies. Two reviewers then extracted information regarding online grocery retail use, availability, and equity.

Results/Findings. Preliminary results indicate that online grocery retail was of global interest for the last two decades across six continents, though most research was published after 2015. Availability of online grocery retail increased over our study time period, between 1999 and 2020, as internet access increased and more retailers developed online platforms. Longitudinal studies indicate that online grocery purchases greatly increased in 2020. Young and highly educated individuals are most likely to use online grocery retail, though older generations saw a greater uptick in use during the COVID-19 pandemic. Convenience/time savings, ease of use, the pandemic, and ability to compare products are common reasons for using online grocery retail. Some online retailers also offer more product options compared to brick-and-mortar stores. Barriers include delivery costs and delivery hours. Individuals may be less likely to purchase impulse items, particularly when shopping with children. Online retailers can change their product prices quickly to match competitors, often resulting in lower product prices. However, product price is also dependent on where consumers live and the business model the retailer follows.

Conclusions. Online grocery retail availability and use is increasing globally. Our review highlights that online grocery retail is convenient, time saving, possibly more affordable, but varies depending on where consumers are located. These findings indicate that online grocery retail may be a beneficial resource and that future efforts should work to increase availability and decrease barriers to ensure equity.

 

 

Purpose: Policy interventions may be effective for creating population-wide changes to nutrition and physical activity patterns if implemented and sustained. The aim of this review was to use the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE‐AIM) framework to examine food and physical activity policies implemented in community settings in the United States, that are accessible by all residents in the community with no restrictions focusing specifically on adoption, implementation, and maintenance.

Methods: The 2009 Preferred Reporting Items for Systematic Reviews and Meta-Analyses were used as a guide. PubMed, MEDLINE, PsycINFO, Agricola, and Google Scholar were searched using keywords informed by a library partner (e.g., ordinance, REAIM, food environment). Articles needed to focus on at least one AIM category. Two researchers completed the review of titles and abstracts and extracted data from each source, guided by RE-AIM. Meetings were used to gain consensus on discrepancies.

 Results: Thirty-three articles published since 2000 were included. Nineteen (57.5%) reported on both food and physical activity policies and none of the studies considered all dimensions of RE-AIM. The number of studies focusing on each RE-AIM dimension were reach, n=2 (6.1%); effectiveness, n = 9 (27.2%); adoption, n= 12 (36.3%); implementation n= 26 (78.7%); maintenance, n=2 (6.1%). The majority either focused on results related to policy adoption or implementation or both, n= 32 (96.9%), and found that enforcement, accountability, findings, and evaluation were some of the most important factors for the adoption and implementation of food and physical activity policies. These results do not rule out the influence of other factors, but many studies n=14 (42.3%) suggested the important role of factors related to key stakeholders as they highly influence policy adoption and implementation.

Conclusions: The findings indicate that the development of implementation strategies (e.g., Strict enforcement) could improve policy adoption, implementation, and maintenance. This systematic review underscores the need for a focus on maintenance of policies, as this dimension was under-reported, and informs potential barriers and facilitators for food and physical activity policies to impact public health. 

 

 

Purpose

Investing in cycling infrastructure provides numerous benefits for a community. However, to make a shift to active transport, low income residents need access to affordable bicycles and bike maintenance. Nonprofit, community bike shops sell refurbished bicycles and provide mechanical assistance or training at low cost or no cost, through sweat equity programs. The purpose of the study was to examine the demographics of nonprofit, community bike shop programs. These bike shops need to be included in transit designs, so all people within a community can access bicycling infrastructure and make the mode shift to active transport.

 

Methods

A thirty-three question survey was emailed to the 214 community bike shops in the United States. Eighty-eight completed surveys were returned (40.1%). Question categories consisted of Likert scales and qualitative data regarding bike shop goals, values, barriers, incentives, funding, programming and communities served.  Using zip codes and 2017 US Census Data, bike shop demographics – race, sex, education, median income, poverty rate, and transportation mode – were compared to national US averages and analyzed using a one-way t-test.

 

Results/findings

Bike shops reported either strongly agree or agree that their primary goals are to provide bicycles for active transport (81.8%) and empower people in the community (81.8%).  They serve diverse populations: low income/underemployed (98.9%), working adults (93.2%), homeless (89.8%), unemployed (89.8%), refugees (82%), veterans (84.1%), LGBTQ (88.6%), underserved teens/youth (86.4%), and individuals with disabilities (73.9%). Sweat equity opportunities are provided at 62.5% of the shops.  Eighty-four percent of shops are located within less than one mile from a bike lane. They serve a population significantly below the national averages for whites (p=0.001) and significantly above the averages for blacks (p=0.002). In addition, they serve in areas significantly below the national median income level (p<0.001) and significantly higher in poverty (p<0.001).

 

Conclusions:

Nonprofit, community bike shops help transform communities. To ensure equitable access to the active transport and its health benefits, community bike shops need to be part of the design of the built environment and supported by public policy. 

 

 

Informal cancer caregivers (ICC) require interventions to support their health. ICC have been shown to experience several physical, emotional, and social consequences leading to a reduced quality of life, an increased risk of all-cause mortality, and a reduced capacity to care for their loved ones. Exercise appears to be a potent intervention to improve the physical and emotional well-being of these caregivers but research in this area is lacking. The primary purposes of this study are to develop an understanding of the needs and preferences of adult ICC living in Nova Scotia and to better understand their views regarding participating in dyadic exercise programs with their care recipients to inform the design of exercise programs that will foster high uptake. ICC are generally interested in exercise programs, but their specific needs and preferences are not well understood. Very little is known about the PA behaviours of Nova Scotian ICC or about their specific preferences for exercise programs including frequency, intensity, time, type, mode, and interest in dyadic programs. In this mixed-methods study, a survey will be employed to assess ICC PA levels, caregiving demand and duration, quality of life, and exercise program preferences. Chi-squared analysis will explore relationships between these measures and whether PA levels, caregiving demand, quality of life, or program preferences differ for ICC who provide care to people with different types or stages of cancer. A follow-up semi-structured interview will seek to better understand ICC exercise behaviours and history, their knowledge of the benefits of exercise for ICC and people living with cancer, and their opinions about dyadic exercise programs. Interviews will be analyzed using interpretive description, which is a credible, transparent process for developing understanding and generating knowledge that can advance clinical practice. Data collection will take place from January-April 2022. The anticipated results of the study are a description of the characteristics of adult ICC living in Nova Scotia and an understanding of their needs, preferences, and views regarding exercise programs. This knowledge will be useful in designing exercise programs that will foster high uptake among adult ICC in Nova Scotia.

Purpose: Body dissatisfaction appears common among youth, with about 50% of young people reporting intentions to lose weight3. It is unclear however, how body image-related self-conscious emotions relate with intentions about weight throughout adolescence. The objective of this study is to assess the association between change in body-related self-conscious emotions and weight-related intentions during adolescence.

Methods: This secondary analysis is based on data from the MATCH study, an ongoing longitudinal study of 937 New Brunswick youth who answered a self-administered questionnaire 3 times per year for 8 years (from age 10 to 18 years). The measure of body-related emotions was administered once per year and captured self-conscious shame, guilt, envy, embarrassment, authentic pride and hubristic pride. Intentions about losing, gaining, or staying the same weight were measured at every cycle. Gender-stratified generalized estimating equations accounting for repeated measures were used to assess the association between changes in self-conscious emotions and weight-related intentions.

Results/findings: We found significant positive associations between all negative self-conscious emotions (shame (OR=2.84), guilt (OR=2.45), embarrassment (OR= 3.43), and envy (OR=2.21)) and weight loss intentions among girls (all, p < .001). Similar, but non-significant, positive associations were also found among boys. Inversely, a negative association was found between embarrassment (OR=0.66) and the intention to stay the same weight among girls. Authentic (OR=1.71) and hubristic pride (OR=1.83) were both associated positively with the intention to stay the same weight among girls. There was no significant association between self-conscious emotions and weight gain intentions.

Conclusions: Higher negative body-related self-conscious emotions were associated with higher weight loss intention in girls. Weight control interventions should focus more on body-related self-conscious emotions to improve the relation with weight control on adolescents.

Purpose

The purpose of this study was to assess whether the built food environment, measured by multiple indicators around home and in activity space, was associated with nutritional quality of food purchases.

Methods

This cross-sectional study included 462 households from a quota sampling survey conducted in the south of France (Montpellier metropolitan area). The revised Healthy Purchase Index was implemented in order to assess nutritional quality of food purchases. Food environment indicators (presence, number, relative density and proximity of food outlets) were calculated around home and in activity space (around home, work, other places of activity and along commuting journeys) using a geographical information system. Six different types of food outlets were studied: supermarkets, markets, greengrocers, bakeries, other specialized food stores (butcher's, fishmonger's and dairy stores) and small grocery stores. Associations between food environment and nutritional quality of food purchases were assessed using multilevel models, and geographically weighted regressions to account for spatial nonstationarity. Models were adjusted for households’ socioeconomic and demographic characteristics.

Results

Nutritional quality of food purchases was positively associated with the number of greengrocers around home (1 vs 0: β=0.26, 95%CI= [0.01, 0.50]; >1 vs 0: β=0.28, 95%CI= [0.03, 0.52]), but negatively associated with the number of markets around home (1 vs 0: β=-0.20, 95%CI= [-0.40, 0.00]; >1 vs 0: β=-0.40, 95%CI= [-0.72, -0.08]), these associations varied across space in the studied area. For households with lower income, number of greengrocers in activity space was positively associated with nutritional quality of food purchases (1 vs 0: β=0.71, 95%CI= [0.13, 1.3]; >1 vs 0: β=0.67, 95%CI= [0.23, 1.1]). 

Conclusions     

Greengrocers might be an efficient food store type to promote healthier dietary behaviors. Further studies, in particular natural experiment studies designed to explore causality, should be conducted to assess the suggested effect of greengrocers on dietary behaviors. Consecutively such research may help guide public health policies to implement actions designed to improve the food environment, including actions that might contribute to decreased social inequalities in diet.

 

In the US, few children meet physical activity (PA) recommendations and rural youth disproportionately report inadequate PA levels. Different aspects of the environment, including micro- (e.g., home environment) and macro-level (e.g., built environment) factors, may be associated with rural children’s PA.

PURPOSE: To determine which environmental factors explain variation in average daily moderate-to-vigorous PA (MVPA), vigorous PA (VPA), and total PA among rural children at both the micro- and macro-level.

METHODS: Children (n=105; age=8.95±1.05 years; female=59%) who participated in the NU-HOME trial, a family-based childhood obesity prevention program implemented in rural Minnesota, provided objective PA data via accelerometry. Environmental variables were generated using parent report (survey data) and geospatial analysis (ArcGIS). Separate multiple regression models using block regression technique were used to determine the contribution of blocks to variation in MVPA, VPA, and total PA for micro- and macro-level models. Block 1 was comprised of sociodemographic factors (i.e., age, sex, and economic assistance). Block 2 represented physical components of the environment (micro models: indoor/outdoor PA equipment in the home; macro models: number of road intersections, sidewalk intersections, schools/parks/places of worship/recreation centers within a 1600m pedestrian network radius of the home). Block 3 included socioenvironmental variables (micro models: family PA, child PA support and self-efficacy; macro models: parent perceptions of neighborhood safety, access, and engagement).

RESULTS: At the micro-level, explained variation in MVPA was improved by sociodemographic (R²D=0.11; p=0.01) and physical (R²D=0.06; p=0.03) components of the environment. Also at the micro-level, sociodemographic variables added to explained variation in VPA (R²D=0.12, p=0.01), while the physical block of variables improved explained variation in total PA (R²D=0.09, p=0.01). At the macro-level, explained variation in MVPA was also improved by sociodemographic (R²D=0.14; p=<0.0001) and physical (R²D=0.12; p=0.04) blocks. Sociodemographic variables also added to explained variation in VPA in macro-level models (R²D=0.13, p=0.01); physical variables improved explained variation in total PA (R²D=0.17, p=0.01) at the macro-level.

CONCLUSION: Findings suggest that expanding access to home and outdoor PA equipment and improving the quality of PA physical infrastructure in the community may be important strategies to mitigate rural youth inactivity.

Purpose: Curbing childhood obesity is an increasing public health challenge underscoring the need for targeted nutrition initiatives. Jamaican school children’s consumption of beverages, fruits and vegetables (F&V) was assessed relative to WHO guidelines.

 

Method: A cross-sectional survey of Jamaican school children (aged 7-11 years) from 30 public and 6 private schools was conducted in 2019. Measurements included anthropometry and a single modified 24-hour dietary recall (to assess intakes of beverages, fruit and vegetable intakes relative to dietary guidelines). Regression analyses tested associations of intake with sex, body mass index for age z-score (BMIz), school type and sociodemographic characteristics.

 

Results: Of 742 children, (386 girls, 356 boys) with mean age 9.3 years (SD, 1.0), 17.5% and 12.9% were living with overweight and obesity, respectively, with mean BMIz of 0.3 (SD, 1.3). Overall, 81.8% of children consumed at least 1 sweetened beverage  (mean volume 642.9mL (SD, 400.6)), with 69.6% drinking unsweetened beverages (mean volume 459.5mL (SD, 425.6)). The latter was mainly water as only 5.5% children reported consuming milk or 100% juice. Beverages were consumed mostly as water 430.3mL (SD, 398.4), juice drinks 390.7mL (SD, 339.2), sweetened milks 46 mL (SD, 112.0) and sweetened homemade teas 56.9 mL (SD, 97.1). While 57.0% of children reported eating F&V at least once, only 4.7% of children ate recommended amounts with mean intake of 97.1g (SD, 129.7). Children derived 17.0 % (SD, 10.5) of total calories from beverage sugars (mean 72.2g (SD, 44.5)) with girls having significantly less (p<0.05). Most children (71.8%) exceeded the WHO recommended limit of 10% of total calories from free sugars. BMIz was associated with an increased consumption of non-sweetened drinks.

 

Conclusions: Jamaican school children are drinking excessive amounts of sweetened beverages, with sugars from beverages exceeding recommended sugar guidelines three-fold. Few children are drinking unsweetened options apart from water, and fruit and vegetable intakes are inadequate. Efforts are needed to educate parents, school personnel and manufacturers on healthy reduced sugar reformulations for both commercial and homemade beverages. Healthy food policies regulating children’s access and exposure to sweetened beverages at schools are strongly warranted.

 

Purpose: The COVID-19 pandemic limited opportunities for physical activity (PA), a key determinant of chronic disease, and the emergence of new variants necessitates identifying strategies for increasing/maintaining PA. We examined how changes in physical and mental health and the location of regular PA during the pandemic were associated with time spent in PA or sedentary (SED) among Texas college students.

Methods: Data are from the COVID-19 Texas College Student Experiences Survey (June-August 2020; n=608). Students were ≥18 years and enrolled in a Texas higher education institution. Students self-reported change in physical (PH) and mental health (MH) pre- and post-pandemic declaration (hereafter, pre- and post-pandemic). Location of regular PA (e.g., home, parks/trails) pre- and post-pandemic was coded as stopped use, no change, and new user. Post-pandemic weekly minutes in vigorous PA, moderate PA, walking, and sitting were assessed. Multiple linear regressions examined associations of time spent in PA and SED with changes in PH, MH, and location of PA. Analyses controlled for age, race/ethnicity, BMI, household income, and nativity. Standard errors were adjusted to account for clustering by institution.

Results: Adjusting for the covariates, improved self-reported PH post-pandemic was associated with more vigorous (B=9.31, p=.029) and moderate PA (B=9.62, p=.055) compared to those whose PH declined. New post-pandemic parks/trails users spent more time in vigorous PA (B=42.28, p=.039), moderate PA (B=28.46, p=.045), and walking (B=35.51, p=.027) than those reporting no change in their use. New online video users also spent more time in vigorous PA (B=24.03, p=.034) than those reporting no change in use of online videos. Students who stopped using online videos spent less time sitting than those who reported no change (B=-126.84, p=.029) but not necessarily more PA. Finally, those newly engaging in PA at home/ neighborhood spent less time walking (B=-19.97, p=.05) than students reporting no change in home/neighborhood usage. Home/neighborhood usage was not related to vigorous or moderate PA.

Conclusions: Findings of this study suggest higher education institutions could ameliorate the negative impact of COVID-19 social distancing policies on PA by directing resources to increase student access to outdoor facilities and virtual PA classes.

 

Purpose: College students exhibit poor physical activity, diet, sleep , stress management, and substance use behaviors. On-campus resources to improve college students’ health have been limited during the pandemic. The purpose of this study was to test a brief intervention to improve wellness behaviors and reduce substance use among college students.

Methods: This single-arm repeated measures intervention was conducted remotely over 12 weeks in spring and summer 2021, utilizing the Behavior Image Model. The model promotes positive goals and health-enhancing behaviors, while raising health-risk awareness. The intervention involved three components: a survey (baseline), a 25-minute consult with a peer health coach, and a 15-minute goal planning session. Follow-up measures were completed at 2-, 6-, and 12-weeks post session to assess changes in health behaviors. Linear mixed effects models for repeated measures were used to analyze associations between intervention on within-subject changes in physical activity, sedentary behavior, diet, sleep, general health, emotional wellness, and substance use.

Results: Of 121 participants who completed the baseline survey, 90 (74.4%) completed the health coach session (71.1% female, 76.7% White), and 83, 75, and 73 completed 2-, 6-, and 12-week follow-up surveys, respectively. At two weeks, significant increases were observed in vigorous physical activity days/week (coef.=0.5, 95% CI: 0.2,0.9), moderate physical activity (MPA) days/week (coef.=0.7, 95% CI: 0.2,1.1), general health (coef.=4.8, 95% CI: 2.1,7.5), and emotional wellness (coef.=8.6, 95% CI: 5.8,11.3). Significant decreases were observed in cannabis use (coef.= -2.3, 95% CI: -4.1,-0.5) and alcohol consumption (coef.= -2.5, 95% CI: -3.7,-1.3). At six weeks, significant increases were observed in MPA days/week (coef.=0.9, 95% CI: 0.4,1.4), weeknight sleep hours (coef.=0.4, 95% CI: 0.1,0.7), general health (coef.=7.4, 95% CI: 4.3,10.4), and emotional wellness (coef.=13.1, 95% CI: 10.0,16.2). Significant decreases were observed in sitting hours/day (coef.= -1.9, 95% CI: -2.9,-0.9), cannabis use (coef= -2.2, 95% CI: -4.3,-0.1), and alcohol consumption (coef= -1.6, 95% CI: -3.1,-0.1). Significant changes observed at six weeks were sustained at 12 weeks.

Conclusion: This brief wellness intervention shows promise to positively influence multiple health behaviors in college students and provides an example of how peer coaching can be utilized in an online setting.

 

This comprehensive review synthesizes research on eating behavior changes during the early months of the COVID-19 pandemic. Changes in amount, types, and healthfulness of foods consumed, rate and timing of consumption, reasons for eating (e.g., stress, hunger), and other specified eating behaviors (e.g., restrained eating, binging, emotional eating) are reviewed across 71 studies conducted in 2020 with participants from over 30 countries. Findings show eating behaviors changed little during the early pandemic, relative to before the pandemic, for most participants. Among those whose eating behaviors changed, increases in both intake and frequency of eating meals and snacks were more common than decreases. When changes occurred in type of food consumed, increases were more common for snacks, homemade pastries, white bread/pasta, legumes, and fruits/vegetables and decreases for meats, seafood/fish, frozen foods, fast food, dark breads/grains, and dark leafy green vegetables. Changes in depression, anxiety, boredom, and stress were related to changes in eating behaviors. Meal skipping, emotional eating, binge eating, and restrictive eating tended to increase during the pandemic. Despite the wealth of knowledge provided by these 71 studies, some questions remain (e.g., only 3 studies assessed changes in timing of eating). Thus, we include a critical discussion of researching eating behaviors under pandemic conditions and recommendations for further empirical inquiry

The present study aims to assess how the Covid-19 pandemic has affected food-related behaviors, such as shopping, eating, or cooking, and describe disparities across socioeconomic and demographic groups in the US. Likewise, it seeks to understand why people may have changed their food-related behaviors during and post-pandemic.

A mixed-methods design addresses the research questions.  Data was collected as part of an ongoing RCT of communities with mobile produce markets.  We used cross-sectional data from surveys collected between February and November 2021 with 399 adults in 28 communities across three US states.  Measures looked at perceptions of how COVID-19 affected fruit and vegetable (FV) access, consumption, cooking, and shopping.  We assessed differences by race, income, and governmental assistance participation using chi‐square tests. Semi-structured interviews are conducted with participants who reported changes to address the reasons behind them.  Qualitative data collection will be completed in February 2022 with guidance of the Retail Food Environment and Customer Interaction Model through an inductive and deductive approach.

The mean age of the participants is 51.1 years (SD=14.8); 51% identify as Black, and 40% White; 29% participate in at least one governmental assistance program; 18% have an annual household income <$10,000, and 18% >$60,000. Survey data revealed changes  in food frequency (28% consume more FV while 20% less), grocery online shopping (28% buy more often), and cooking at home (38% cook more often). We observed racial and income disparities in increased online-grocery-shopping between people who identified as White or not  (37% vs. 22%, p-value=0.01), and among income categories (17% <$10,000 vs. 41% >$60,000, p-value=0.0473). Users of governmental assistance eat fewer FV (23%) than non-users (12%)  (p-value=0.0367). Higher income participants cook at home more often (28% <$10,000 vs. 51% >$60,000, p-value=0.0397).

Changes in food-related behaviors have been described in the literature during the Covid-19 pandemic and are being examined in this study. Researchers and policymakers can capitalize on the results to encourage people to keep and improve positive post-pandemic food behavior changes using a health equity lens due to different motivations and barriers presented by different socioeconomic and demographic groups.

Purpose: Little information is available on physical activity (PA) and other health outcomes among Chinese breast cancer survivors (BCS). This study investigated associations among Chinese BCS’s PA determinants, PA behavior, functional fitness, and biomarkers, as well as examined these outcome variables as a function of PA and BMI.

Methods: A total of 168 BCS (age = 44.81±7.94) were recruited from Guangdong, China. BCS self-reported demographic and clinical information (e.g., stage at diagnosis, menstrual status). Validated surveys discerned PA engagement and PA determinants (e.g., PA attitudes, PA strategies, self-efficacy, enjoyment, family support, friend support). BMI was defined as weight/height2. Other outcomes included lipid profile (i.e., total cholesterol, high-density lipoprotein, low-density lipoprotein, triglycerides), fasting serum glucose, breast cancer biomarkers (i.e., carcinoembryonic antigen [CEA] and cancer antigen 15-3[CA153]), and functional fitness (i.e., strength in arms and legs, endurance, balance, agility, and flexibility).

Results: Regression results suggested self-efficacy (β = 0.32), friend support (β = 0.20), lower body flexibility (β = 0.18), and upper body flexibility (β = -0.24) were significant predictors (p < 0.05) for participants’ PA levels. Participants’ triglyceride (β = 0.30), glucose (β = 0.23), and upper body strength (β = 0.45) significantly predicted their CEA; while glucose (β = -0.26) and upper body flexibility (β = 0.22) were significant predictors for CA153. Overall, the results yielded no significant differences on any outcomes between those met and not met the PA recommendations, Wilks' Lambda = 0.92; F (8,78) = 0.82, p = 0.59. Yet, participants’ outcomes differed significantly by BMI. Specifically, individuals with healthy BMI had higher HDL, F (1,90) = 3.43, p = 0.06, and lower glucose, F (1,90) = 8.12, p < 0.01, as compared with those overweight or obese individuals.

Conclusions: Findings indicated some, but not all of, PA determinants, fitness, and lipid profiles were predictors of participants’ PA and breast cancer biomarkers. Also, BCS with healthy BMI tend to have better lipid profile and glucose compared with overweight/obese BCS. Obesity prevention interventions targeting Chinese BCS need to be developed given that breast cancer risk factors may reduce because of decreased BMI. 

Based on observation of the market and the need for change the process of creating marketing innovations in service companies in Szczecin, the author adopted as the aim of the article the identification of new marketing solutions for the service market by way of an evaluation of the possibility of taking advantage of social media potential and social media activities carried out by local companies. In assessing the tools characteristic of new media and the attitude of companies towards these tools, an attempt was made to identify opportunities for companies to use social media. As part of the research, a questionnaire was used that was targeted at owners and managers of local companies from Szczecin. The study was expanded to include virtual ethnography, which involved observation of a company profile on social media. The article presents a proprietary classification of social media by social channels and their functions. The author has paid particular attention to breaking down social media not by the technology they use, but by their practical applications. Contemporary companies face a large challenge – functioning and competing in rapidly changing market conditions. Methods of building relationships with customers used to date are falling into oblivion and becoming forgotten. The products and services offered are continuously subjected to change to meet the needs of swiftly changing customer needs. The experiences of local companies prove that companies that offer products that are both innovative and meet customer expectations win against the competition. Researchers from around the world and business professionals agree that the most import role of contemporary local companies is continuous improvement of products and services. The literature on the subject highlights that innovations are changes whereby a company assimilates the knowledge it has acquired. As J. Wiśniewska claims, innovations are considered to be the main factor determining the development of modern companies (Wiśniewska, 2010, p. 31). Therefore, companies that want to be thought of as innovative should focus on acquiring information on how to improve their products, services and ways of communicating with customers.

Purpose: An essential component of a healthy lifestyle is diet, and problematic eating behavior can have negative physical and mental implications. Food addiction is a severe form of disordered eating that is understudied in the non-clinical population. Food addiction can place a significant emotional burden on an individual. College-attending young adults are at a stressful time period of life characterized by the development of unhealthy behaviors that can extend into their future lifestyle habits.  The purpose of this study is to further the understanding of food addiction and its associations with mental and emotional health in college-attending young adults.

Methods: Students currently enrolled at an Appalachian university in fall 2021 were invited to participate in an online survey via Qualtrics. Survey items used validated tools that measured food addiction using the Yale Food Addiction Scale Version 2.0, depression using the Patient Health Questionnaire-9 Item (PHQ-9), anxiety using the Generalized Anxiety Disorder-7 Item (GAD-7), stress using Cohen’s Perceived Stress Scale-10 Item (PSS-10), coping strategies using the Brief COPE, and emotion dysregulation using the Difficulties in Emotion Regulation-Short Form (DERS-SF). Descriptive statistics were computed for all variables. One-way ANOVA was used to examine significant differences in mean depression, anxiety, stress, coping, and emotion regulation scores among different levels of food addiction severity. 

Results/Findings: Respondents (n=1645) had a prevalence of food addiction of 21.9%, with 11.5% having severe, 4.7% having moderate, and 5.7% having mild food addiction. More severe food addiction showed significantly higher mean scores in depression (p<.0001), anxiety (p<.0001), and stress (p<.0001). More severe food addiction was associated with more difficulty with emotion regulation (p<.0001), non-acceptance of emotions (p<.0001), impulsivity (p<.0001), lower emotional awareness (p<.0001), and lower emotional clarity (p<.0001). Finally, more severe food addiction was associated with more frequent use of emotion-focused coping (p = .0007) and avoidant coping (p<.0001).

Conclusions: Results show that individuals with food addiction have difficulties with mental health disorders, emotional health, and negative coping strategies. These findings contribute to the understanding of the food addiction population and underlying mental and emotional problems that need to be address in interventions and treatments.

BACKGROUND: Studies on built environmental characteristics that drive overweight and obesity mostly focus on single exposures from the food or physical activity (PA) environments, whereas obesogenic environments are likely to consist of combined factors from both. This study aimed to compose and describe a comprehensive theory-based index to quantify obesogenicity for all administrative neighbourhoods in the Netherlands.

 

METHODS: The Dutch Obesogenic Built Environment CharacterisTics (OBCT) index consists of 15 components related to the food (including density and healthiness of food outlets) and PA environments (including following constructs: sports facilities, walkability, drivability, and bikeability). For each neighbourhood (n=12,821), componential data were collected for (or closest to) 2016 from public and commercial sources, processed in a geographic information system, and z-standardized. The initial OBCT index was calculated as an average of componential z-scores across the food and PA environments. The score was normalized to range from 0 to 100 where higher scores indicated more obesogenic neighbourhoods. Besides descriptive statistics and visualization of OBCT index using maps, we also computed Spearman correlations between the index and respective environmental scores; and assessed whether the index was sensitive to outliers by Winsorizing components.

 

RESULTS: The OBCT score for all neighbourhoods in 2016 in the Netherlands were right skewed with a median of 10.1 (IQR=2.76). The province of North Holland stood out, with Amsterdam having both the highest and the lowest scores. Obesogenicity was lower in more urban neighbourhoods, except for the highest urbanization degree (>2500 addresses/km2) where obesogenicity was highest. Obesogenic food environment tended to cluster around major cities while PA opportunities were depleted in rural areas. The overall OBCT index score was weakly correlated with the food environment (Spearman’s ρ= -0.26, p-value<0.05) and moderately with the PA environment (ρ=0.65, p-value<0.05). 99^th percentile Winsorization of the food component significantly reduced skewness and kurtosis of the index; resulting index has median of 38.01 (IQR=10.4).

 

CONCLUSIONS: The novel OBCT index and its comprehensive environmental scores are potentially useful tools to quantify obesogenicity of neighbourhoods. We plan to fine-tune the index using data-driven weights for the components before proceeding with further research with downstream outcomes and policy applications.

Purpose: Complete streets (CS) initiatives have the potential to create healthy, sustainable, and pedestrian-friendly communities. Smart Growth America defines these initiatives as a way to “prioritize safety, comfort, and access to destinations for all”. Although there is an emphasis to create CS for all, there are many disparities seen among underserved populations (communities of color, low-income, LGBTQ+, youth, women). Literature has suggested that policies which implement strategies targeting specific diverse populations to be the most successful. The purpose of these three studies were to understand how many CS initiatives implement explicit verbiage regarding diverse populations, and to spatially explore the demographics of cities which have CS initiatives.

 

Methods: A comprehensive dataset was retrieved from the Smart Growth America website which included all (n=1563) CS initiatives from April 2021. Initiatives were searched for explicit verbiage regarding equity, low-income, racial/ethnic minorities, LGBTQ+, youth, women, disabled/aged populations. If there was explicit verbiage, the specific quote was be extracted for secondary analysis. Chi-squared tests were completed using SPSS. A comprehensive dataset of housing, demographic, and transportation from the Census of all cities with more than 50,000 population (n=843) was linked to city-level CS initiatives. Cities were mapped with Arc GIS. Geographically weighted regression (GWR) models were used to understand how various variables predict cities having a CS initiative.

 

Results/Findings: Less than 7% of all CS initiatives mentioned equity, low-income populations, racial/ethnic minorities, LGBTQ+ communities, or women throughout their initiative’s literature, while youth and disabled populations were mentioned in >70%. GWR analyses suggested that lower percentages of black and Latino populations, higher levels of poverty, and median home value significantly (p<0.05) predicted a city to have a CS initiative.

 

Conclusions: CS initiatives have the potential to create livable and walkable communities for all, including underserved populations. In these studies, it was found that there was a lack of explicit verbiage throughout these initiatives. Various demographic and housing variables predicted a city having a CS initiative. With these initial studies regarding equitable CS practices, initiatives should attempt to introduce and advocate for targeting specific populations throughout their literature to increase their impact in these communities.

Purpose: The objective of this review is to systematically analyze cooking and/or gardening programs for elementary school-aged children for their effectiveness in improving eating patterns, specifically increase in fruits and vegetables.

 

Methods: Electronic databases such as Cumulative Index to Nursing and Allied Health (CINAHL), PubMed, Web of Science, Academic Search Complete, Google Scholar, Springer Link, Science Direct, MDPI, NIH, SAGE, and Mary Ann Liebert Inc. were searched to retrieve articles. Inclusion criteria were as follows: studies published in English, participants were in kindergarten through 5^th grade, study took place within a school setting, study included a cooking and/or gardening program, study was published from 2011-2021, and the study was peer-reviewed. Keywords used for literature search were identical across all databases and included “gardening”, “cooking”, and “elementary school”. PRISMA guidelines were used to conduct this systematic review. The quality of the studies was assessed by two researchers using the Quality Assessment Tool online forms from the National Institute of Health (NIH).

 

Results: In total, 69,595 articles were identified and screened. Finally, 34 articles met the inclusion criteria. 11/34 articles selected for review were exclusively gardening programs, 10/34 articles were exclusively cooking programs, and 13/34 articles were both cooking and gardening programs. The most prevalent study design was the quasi-experimental method with baseline and post intervention data collection. Third through fifth grade children were the most common age group in these studies. All interventions included hands-on experiences. Most studies ranged in duration from four months to one year. Two-thirds of the studies included additional components such as tasting sessions, physical activity, nutrition education, and parental engagement. Outcome measures in the studies included gardening/cooking enjoyment, gardening/cooking self-efficacy, preference for fruits and vegetables, access/availability/consumption of fruits and vegetables, willingness to try new foods, nutrition knowledge, BMI, and parental inclusion.

 

Conclusions: Positive results were seen for both gardening and cooking programs. However, combined cooking and gardening programs were more successful in significantly improving knowledge, exposure, availability, preference, and intake of fruits and vegetables. More research with larger study samples and follow up assessment is needed to confirm the findings from this review.

Purpose: Regular physical activity (PA) yields documented health benefits. The recommendation for MPA is 150 minutes/week and VPA is 75 minutes/week. However, 60% of U.S. adults do not engage in the recommended amount of PA; 25% of U.S. adults report no leisure time PA. Previous studies have examined exercise role identity (ERI) as a potential determinant of PA behavior. To investigate, this the present study sought to understand if exercise role identity would predict differences in moderate and vigorous physical activity (MVPA) over a 4-week period in a sample of college students.

Methods: Participants self-reported total bouts of MVPA, lasting 10 minutes or more, using a 7-day PA recall (correlation = .72, r = .58). ERI was measured using the Exercise Identity Scale. The Exercise Role instrument has been shown to be both valid and reliable in multiple populations (Cronbach’s alpha = .94, r = .93). ANOVA was used to compare group means. Linear regression was used to test ERI as a predictor of MVPA.

Results: A sample of 286 student volunteers were recruited to participate in a four-week PA study.  The original sample was 72% female and 28% male. Random sampling of female subjects was completed to balance the design (n = 155, 49.4% female, 50% male, M = 21 years). Mean ERI was 19.88 ± 5.89; mean MPA = 13.86 ± 11.21; mean VPA = 9.34 ± 9.83. The ANOVA model showed significant between group differences in ERI (p = .003). ERI was a significant predictor of both MPA (p = .006, R² = .06, β = .43) and VPA (p < .001, R² = .17, β = .70). 

Conclusions: ERI was low in the represented sample but was a significant predictor of PA. PA tends to decline beginning in adolescence and continues to decline through early adulthood. Thus, future research should develop interventions targeting ERI as a method to increase PA in college students.

Purpose: A recent change of political leadership in the City of Cape Town (South Africa) has opened the door for potentially progressive innovations in local food governance approaches and practices. These changes involve an attempt to coherently govern food systems and environments towards, in part, a healthier urban population. This research considers current barriers and facilitators to this process from the perspective of involved government officials.

Method: Semi-structured in-depth interviews were conducted online with purposefully sampled city- and provincial-level government officials (n=11). Interviews were recorded, transcribed, and thematically analysed to identify potential facilitators and barriers to effective food policy development and implementation. Anonymity of all interviewees was maintained by strict adherence to an approved ethics protocol.

Findings: Key barriers resulting from officials’ input included:

1) General government official misconduct - including officials working the system, often for personal gain – e.g., the hijacking of food aid and redirection towards selected beneficiaries for political currency.

2) Politics and entrenched power - including the deflection of responsibility/mandate to ‘save face’ and maintain political standing, decision-making based on the avoidance of risk, and the unwarranted holding of power and resources preventing innovation.

3) Siloed government structure and approaches - including hierarchical, bureaucratic systems based on narrow targets and progress indicators, stifling innovation and undermining competence.

Key facilitators centred around one theme, that of cross-departmental collaboration lead by visionary senior officials. This includes the cultivation of a ‘network culture’ to better facilitate collaborative interdepartmental relations and encourage participation in discursive food governance networks beyond the state; the inviting of neutral third parties to facilitate dialogue, thus allowing senior leaders to shift deeply entrenched mistrust and divisions; and the adoption of innovative reporting mechanisms that could support greater autonomy and transversal collaboration.

Conclusions: There is a real need for visionary leaders that forward a shift in organisational culture and conventions towards more collaborative attitudes and practices in Cape Town, as well as the cultivation of trust and the alleviation of tensions and divisions between City departments, if recent innovations in food governance are to effectively influence food policy development and implementation.

Purpose: Consuming a nutritious diet in early childhood is essential for growth, development, and future health, and dietary practices also have significant environmental impacts.  In developed countries, children aged 2-5 spend a significant amount of time in childcare where they are often provided with around 50% of their dietary intake during their day in this setting.  Due to the number of children catered for, childcare centres provide a promising space to cultivate environmentally sustainable food practices that can influence the health of children as well as the planet.

 

Methods:  This study is a descriptive exploratory study. A survey was sent out to all centres in the state of Victoria, Australia (concludes in December 2021).  The survey explored environmentally sustainable food practices such as local food purchasing, seasonal food on the menus,  regular vegetarian meals, the use of food from a vegetable garden for meals and previous food waste audits.  A subgroup was invited for a weighed food and waste audit which has been tested in a pilot centre. This protocol weighs all food served to children for 1 day as well as all food wasted at service and plate waste level.  Plans for food waste is also captured.

 

Results findings: Preliminary survey results found that 11% of centres had conducted a food waste audit in the past and 42% had a policy that included environmental sustainability.   Pilot results indicated that whilst the menu was compliant with guidelines, 54% of morning tea, 27% of lunch and 25% of afternoon tea was wasted and most of the waste was serving waste (what was left in the serving bowl).  Compost bins could not handle all the food waste which was therefore added to regular bins.  Data collection concludes February 2022,  and all findings will be analysed and presented at the conference. 

 

Conclusions: This research will be the first study to assess environmentally sustainable food practices and food waste in childcare centres and how these may relate to compliance with dietary guidelines. The findings will help identify areas for support and future research.

Background: Family Child-Care Homes (FCCHs) are a setting where providers care for children at their own residence. FCCHs face unique challenges and have less stringent regulations. Children may not always receive optimal nutrition and have higher risk of obesity compared to other programs. FCCHs have reported some common barriers to increasing nutritional quality of meals and serving more fruits, vegetables, and whole grains- concern about wasting food, children’s food preferences, and food costs. There is a lack of research on perception of barriers and meals quality in FCCHs. The objective of this study was to determine differences in meal quality between FCCHs who did/did not perceive these as barriers.

Methods: FCCHs (n=193) reported perceived barriers to serving healthy foods, the items to determine barriers were adopted from a previous study. To determine quality of food served, items related to foods and beverages served from the Nutrition and Physical Activity Self-Assessment for Child-Care (NAPSACC) were used with 1 (indicating lower quality) to 4 (indicating best practice). Means, standard deviations, and t-tests were conducted to determine differences in meal quality between FCCHs with and without reported perceived barriers. Adjusted alpha was 0.013 to reduce type 2 error risk.

Results: Concern about wasting food was the most prominent barrier (39%), followed by food preferences (35%), and food costs (28%). FCCHs perceiving food waste as a barrier had significantly lower scores for total food and beverage quality (p=0.006; d=0.42; 3.2 ± 0.3 vs 3.3 ± 0.3); served less fruits and vegetables (p=0.003; 3.1 ± 0.5 vs 3.3 ± 0.5). No statistically significant difference was found in meals quality among those providers with versus without perceived barrier of food preference or food costs.

Conclusion: Food waste is a significant barrier for FCCHs to serve healthy meals and snacks, especially fruits and vegetables. Meal quality did not differ for providers expressing barriers of children’s food preference and costs, although food preferences may have an indirect effect on wasting food. More research is needed to understand the differences between the perception of these barriers in FCCHs and the quality of the foods and beverages served to children.

Purpose: Childcare centres have the potential to promote health-enhancing physical activity (PA) in children. During the project “QueB 2 – developing quality with and through physical activity” an app-based quick assessment tool was developed to identify needs for action. It includes seven different categories, inter alia, based on the national recommendations for PA. The aim of the project is to sensitize prospective educators to the issue of PA promotion by using the tool.

Methods: Vocational schools for early childhood education in one model region in Germany were contacted and provided with information about the quick assessment tool. In meetings with principals and/or teachers of each school the scope of application by the students was identified and the integration of the tool into the curriculum was planned. Virtual meetings with the students were held to reflect upon their experience after testing the tool in childcare centres.

Results: Six out of seven vocational schools were interested in cooperating. However, due to the COVID-19 pandemic further implementation took place in only three schools. Around 105 students tested the quick assessment tool in course of their vocational training in childcare centers and took part in reflective talks. 67 students completed a short reflecting questionnaire. About 90% of the students perceived the tool as useful, appreciated its clear structure, and expressed an increased awareness of the factors contributing to physical activity in childcare centres. Nevertheless, they asked for deeper analysis as well as more support to implement PA promotion activities.

Conclusions: Early childhood education students perceived the app-based quick assessment tool as useful to analyse the PA potential in childcare centres. Given the training status and lacking work experience, students seem to have only limited possibilities to exert influence on sustainable changes in childcare centres towards more PA. A conceivable solution could be anchoring the quick assessment tool in the schools’ curricula to enhance acceptance and increase influence. To sustainably integrate the assessment tool, discussions with teachers and principals need to be held.

Purpose: To examine how the COVID-19 pandemic affected food assistance need in New Orleans, Louisiana, a city heavily hit by the pandemic-triggered economic downturn, with high rates of poverty, and whose demographic majority consists of historically marginalized populations.

Methods: We obtained information on the number of applications to the Supplemental Nutrition Assistance Program (SNAP), the largest safety net program in the United States to address food insecurity, at the zip code level for New Orleans and surrounding areas (n=X) at two time points: March-May 2020 (immediate aftermath of the COVID-19 lockdown) and March-May 2019 (baseline). Percent change in SNAP application density (number of SNAP applications/total number of households) at the zip code level between the two time points of interest was estimated and correlated to sociodemographic information (% families living <130% of the federal poverty line (FPL) and % Black individuals) of included zip codes.

Results/findings: An increase in SNAP application density was observed in all zip codes analyzed, ranging from 25% to 360%. We found a significant positive correlation between density of SNAP applications in March-May 2019 and % families living <130% FPL (0.809, p-value<.0001) and % Black (0.526, p-value=0.028), meaning that density of SNAP applications was highest in the most disadvantaged zip codes. We also found significant negative correlations between the percent change in density of SNAP applications from March-May 2019 to March-May 2020 and % families living <130% FPL (-0.719, p-value<.0001) and % Black (-0.553, p-value=0.0015), suggesting more disadvantaged zip codes observed less dramatic changes in SNAP applications across the time periods of interest.

 

Conclusions: This study identified a universal increase in SNAP applications in New Orleans, Louisiana in the immediate aftermath of the COVID-19 pandemic, with the most disadvantaged zip codes – which had very high food assistance need at baseline – experiencing a comparatively lower increase in SNAP applications. These results highlight the staggering need for food assistance resulting from the COVID-19 pandemic, including in areas with historically low demand. Planning for future emergencies should take into account the likely appearance of new pockets of need for food assistance and other vital services.

Background: Early childhood education professionals (ECEPs) possess risk factors for cardiovascular disease and high rates of stress which can lead to depression and/or burnout. Unfortunately, this may impact the quality of care they provide for children. Rural family childcare home (FCCHs) ECEPs typically have limited resources and access to physical and mental wellbeing trainings compared to their urban counterparts. Purpose: The purpose of this study is to explore the feasibility of the HERE For You For Them (HERE) program for rural FCCH ECEPs. Methods: HERE utilizes evidence-based mindfulness tools to improve the wellbeing of ECEPs and the children they care for. During this 16-week pilot the ECEPs attend monthly one-hour long trainings via Zoom. Online surveys were completed to measure their physical and mental wellbeing at baseline. ECEPs received a Fitbit to track their physical activity levels throughout the program. Feasibility of implementation is being assessed via bi-weekly surveys and end of program interview. Results: Our initial goal was to create two geographic based communities of practice (n=12 ECEPs/group). Due to challenges with recruitment of ECEPs and desire of the rural ECEP advisory board working with the research team to connect with more ECEPs across the state, eligibility was expanded to all rural areas in Nebraska. After additional recruitment strategies were utilized, recruitment goals were exceeded in 3 weeks (n=28). All participants are female and have been working in childcare for 17.4 (±6.5) years. Due to scheduling conflicts, a new trainer was recruited and trained to implement the program; however, some inconsistencies in implementation were noted and fidelity checklists were developed for the remaining trainings. Importantly, 95% of the ECEPs were satisfied with the topic of the first training and 85% were engaged by the presenter. Despite not being required, 13 participants joined the private Facebook group, 15 downloaded the HERE app. After the first week, the HERE website had 66 visits, and 11 activity pack downloads. Conclusion: There were multiple lessons learned during the recruitment process and launch of the HERE program. The program will continue to be assessed for feasibility and acceptability.

Purpose: The purpose of this study was to assess the one-year impact of a Healthy Food Access Intervention (Fresh for Less) utilizing a Mobile Market strategy designed to provide greater access to fresh fruits and vegetables (FV) on improving food security and fresh FV purchase and consumption among residents living in low-income, ethnically/racially diverse communities in central Texas.

Methods: 400 eligible individuals were recruited from low-income communities and categorized into 3 different groups: (1) the Confirmed Users group including participants recruited at one of the Fresh for Less (FfL) Mobile Market locations (n=130), (2) the Geographically Exposed group including participants living within .5 mile of a FfL Mobile Market location (n=185), and (3) the Comparison group including participants living in communities with no Mobile Market locations but were similar sociodemographically to the Geographically Exposed neighborhoods (n=85). Participants completed a quantitative survey during Baseline (October 2018-March 2019) and Year 2 (October 2019-Early March 2020 - pre-COVID-19). The survey included items measuring demographic variables and the 5 outcome variables: fresh FV purchase and consumption, food insecurity, awareness and usage of the Mobile Markets. Mixed regression modeling was used to examine changes in the outcome variables from Baseline (Year 1) to Year 2 by recruitment strategy (Confirmed User, Geographically Exposed, and Comparison group). Mixed regression models were run unadjusted for each outcome variable, and then adjusted for race/ethnicity and income. 

Results: Participants were mostly Hispanic and Black (54% and 10%, respectively). 23% had an income of less than $25,000 per year and 40% were classified as food insecure based on a validated food insecurity screener. 12% indicated using food banks/pantries.  Results indicate a significant increase in shopping at a FfL Mobile Market among the Confirmed Users group. Food insecurity decreased significantly in both the Confirmed Users and the Geographically Exposed groups. In addition, the Geographically Exposed group reported a significant increase in fruit consumption. 

Conclusions: Food access strategies such as the FfL Mobile Markets are effective in increasing healthy food purchasing and decreasing food insecurity in low-income communities. Polices that decrease barriers to implementation of such strategies need to be explored and implemented.

Purpose: The current study examined changes in weight, physical activity, and diet related to COVID-19 among school district employees who participated in Vibrant Lives (VL), a worksite weight loss program.

Methods: This study included a secondary analysisof data from the VL program (2017-2020). Among school district employees who participated in the 6-month VL weight loss program, we categorized participants into two groups based on school year of participation: 1) non-COVID (2017-2019 school years) and 2) COVID (2019-2020 school year). A questionnaire was added at follow-up in 2019-2020 to ask whether participants changed their behaviors due to the COVID-19 pandemic. Changes in weight, physical activity, and diet were compared between non-COVID and COVID years using repeated measure mixed model and logistic regression.

Results: A total of 380 participants were included in the analyses (non-COVID: n=237; COVID: n=143). After the program, we observed significant weight loss (non-COVID=-2.03 kg±0.32vs. COVID=-1.14 kg±0.42; B=-2.03, SE=0.32, p=<.001) and increases in moderate/vigorous physical activity minutes (non-COVID=47.8 min±10.6 vs. COVID=55.7 min±13.7; B=47.84, SE=10.64, p<.001), but no significant differences between the years. Participants in the COVID year decreased fast food consumption (2 or fewer times in the past week; OR=2.12, SE=0.61, p=.009) but increased sugar-sweetened beverage intake(did not drink in the past week; OR=0.20, SE=0.08, p<.001) more than non-COVID year participants after the program. More snacking frequency, baking sweets, and overeating during the COVID-19 pandemic were reported as barriers to a healthy diet.

Conclusion: The COVID-19 Pandemic was negatively associated with favorable dietary behaviors among the VL program participants, but the participants in the VL program showed efforts to retain healthy behaviors during the stay-at-home order. More research is required to understand the barriers to health behaviors related to COVID-19 pandemic.

Purpose: A balanced diet is instrumental in reducing the risk of developing obesity, with fruit and vegetables being important components of such a diet. An unhealthy dietary pattern lacking sufficient fruit and vegetable intake is more often observed among socioeconomically disadvantaged people. However, not all members of this population have an unhealthy diet. Identifying predictors that influence a healthy diet could steer intervention efforts. Therefore, the aim of this study is to examine the association between sufficient fruit and vegetable intake and individual characteristics among socioeconomically disadvantaged adults living in peri-urban municipalities in Flanders.

Methods: In total, 319 socioeconomically disadvantaged adults aged 25 to 65 years old (M_age= 48.47, SD=11.11, n=199 females, n= 115 males, n=3 gender unspecified) residing in two peri-urban Flemish municipalities completed a self-reported survey assessing demographics, dietary habits, physical activity, BMI, general health and perceived social and physical environmental characteristics between May and October 2021, as part of the CIVISANO project (“a mixed-methods project using community-based approaches to tackle disparities in health behaviours in the Flemish peri-urban environment”). Binary logistic regression was used to determine cross-sectional associations between sufficient (daily vs. non-daily) fruit and vegetable intake and individual characteristics.

Results/findings: Eating fruit at least once a day was reported by 60.69% of the sample and eating vegetables at least once a day by 54.72%. Positive subjective health (OR 2.14; CI 1.41, 3.24) was the most telling factor associated with sufficient fruit and vegetable intake. Higher educational qualifications (OR 1.74; CI 1.15, 2.61), less subjective financial hardship (OR 1.31; CI 1.03, 1.67), female sex (OR 2.04; CI 1.42,4.07) and higher age (OR 1.04; CI 1.01, 1.06) were also all positively associated with sufficient fruit and vegetable intake. While reduced mobility during the last month showed a negative association (OR 0.49; CI 0.29, 0.81) with consuming fruit and vegetables at least once a day.

Conclusions: The identification of individual characteristics that influence sufficient fruit and vegetable intake differ in socioeconomically disadvantaged adults, suggesting that population subgroups might benefit from targeted interventions to improve diet quality and prevent further healthy inequalities. 

 

 

Purpose: College food insecurity (FI) has garnered attention as rates are reported to be higher than the United States national average. To help alleviate this issue, many higher education institutions have implemented campus-based FI initiatives. However, literature on these initiatives is lacking, and little is known about program operations, funding mechanisms, and evaluation. The purpose of this study was to describe campus-based initiatives and to investigate the barriers and facilitators to sustained implementation on campus. 

Methods: Twelve nutrition and dietetic professionals from the Society of Nutrition Education and Behavior’s College FI Subcommittee developed an online survey based on previous literature. A convenience sample of higher education professionals with experience regarding campus FI initiatives completed the 23-item survey via Qualtrics. The survey included questions about campus FI  initiatives, including how they were funded, led, and evaluated, and if COVID-19 impacted implementation. Respondents were asked to describe what barriers they faced when implementing initiatives and what is needed for sustained implementation. Descriptive statistics were computed for quantitative data. Qualitative data were independently coded by two researchers, with any discrepancies resolved, and overarching themes were identified. 

Results/Findings: Ninety-five percent of respondents (n=108) reported having at least one campus  FI  initiative. A campus food pantry was the most common initiative (98%), and 75.3% of campuses reported changes in implementation due to COVID-19.  Respondents (69.7%) stated initiatives were evaluated for impact, but evaluation methods varied. Some institutions (38.9%)  provided an allocated budget for initiatives, but funding mechanisms varied. FI initiatives were most often managed through Student Life Offices. Barriers to implementation were funding and marketing/student awareness. Campus culture (such as institutional support), resources and operations (such as funding), and data collection (such as needs assessment) were themes derived as facilitators to sustaining initiatives. 

 

Conclusions: Campus-based FI initiatives are available, although the type, funding, and evaluation vary. The need for a campus culture that promotes sustainable funding and support is highlighted. Increased investment from administration and stakeholders is warranted. Awareness campaigns could be prioritized to increase student awareness of initiatives, especially as operations may continue to fluctuate due to COVID-19. 

Purpose: There are sound evidences associating high salt intake and greater risk of cardiovascular and non-cardiovascular diseases. A high salt intake has been observed in several populations worldwide, therefore the promotion of a healthier salt consumption has been encouraged as a low cost strategy to reduce this risk factor. However, these strategies need to be sound, built on theoretical and methodological bases and considering context of the target population. Considering these reasons this study aimed to develop a mobile phone App-based intervention to promote healthy salt intake among adults based on the steps of the Behavior Change Wheel (BCW). 

Methods: The three stages of the BCW guided the development of the intervention: (1) understanding the unhealthy salt intake according to Theoretical Domains Framework domains and the Capability, Opportunity, Motivation to Behaviour (COM-B) model; (2) identifying intervention options; and (3) identifying the content and implementation strategies. 

Results/findings: Three Theoretical Domains Framework domains were selected: Intentions, Beliefs about Capabilities and Behavioural Regulation and 2 components of the COM-B model: Reflective Motivation and Psychological Capability. After applying APEASE criteria (Affordability, Practicability, Effectiveness and cost-effectiveness, Acceptability, Side-effects and safety, and Equity) by five experts in the study area, firstly 6 intervention functions were selected: (1) education (increasing knowledge or understanding); (2) persuasion (using communication to induce positive or negative feelings or stimulate action); (3) incentivisation (creating an expectation of reward); (4) modelling (providing an example for people to aspire to or imitate); (5) enablement (increasing means/ reducing barriers to increase capability or opportunity; and (6) training (imparting skills).and after 16 behavior change techniques were retained: Goal setting (behavior); Problem solving; Goal setting (outcome); Action planning; Commitment; Feedback on behavior; Self-monitoring of behavior; Social support (unspecified); Social support (practical); Instruction on how to perform the behavior; Information about health consequences; Demonstration of the behavior; Prompt/cues; Behavioral practice/rehearsal; Credible source; Adding objects to the environment.

Conclusions: Results informed further development the next phases of the larger study, i.e., integration of the intervention strategies in the mobile phone App, its implementation and evaluation. 

Purpose: The migration effect on physical activity (PA) is understudied. In the European Union (EU), 72% of the citizens in Portugal vs. 30% in Sweden never or seldom exercise or play sports. Learning the factors influencing these differences may provide essential public health information. This study aimed to analyze the association between emigration from an “inactive country” (IC) to an “active country” (AC) and PA, and the quality of motivation (QM).   

Methods: In this cross-sectional study, 402 participants accessed an online survey. Of these, 83 met eligibility criteria: i) 18-65 years old; ii) have lived in an IC for at least 10 years; iii) migrated and now living in an AC for at least 6 months. An AC was defined as an EU country, where >8% “regularly” and <42% “never” exercise or play sport (EU averages, according to the Eurobarometer). A self-report assessed QM (BREQ-3) and PA (IPAQ-SF) in both contexts. Differences between contexts were examined through a paired sample t-test. Effect sizes (r) were calculated, with values of .1, .3, and .5 representing a small, medium, and large effect. Pearson correlations and regression analysis assessed the associations among the variables.   

Results: Emigrating from an IC to an AC increased all forms of PA (.55>r>.21). Autonomous motivation (AM) increased (r=.37), and controlled motivation also increased (r=.34; due mainly to introjected regulation). In the IC, AM was positively associated with all forms of PA. These associations were less frequent in the AC, where only higher AM was linked to higher vigorous PA and total PA MET-min. Interestingly, only integrated motivation (i.e., when one expresses that PA is part of their life) was associated with all PA forms in the AC. While living in the IC, it was mainly the intrinsic motivation associated with PA. The regression analysis did not produce any significant results.

Conclusions: In our sample, migrating from an IC to an AC increased the QM and PA. The correlations suggest that the AC facilitates an active lifestyle integration in their populations. Future studies should look into how their physical and psychosocial contexts may facilitate this.

Purpose: This abstract describes changes in the nutrition and physical activity (PA) environments of 119 family child care homes (FCCH) that participated in the Healthy Start/Comienzos Sanos randomized trial.

Methods: FCCH were randomized to an 8-month multi-component nutrition and PA intervention (I) vs. a literacy intervention (C). Both groups received tailored feedback, tip sheets, videos, motivational coaching and support groups. Observers recorded data using the Environment and Policy Assessment and Observation (EPAO) tool while children were in FCCH during two days at baseline and 8-months.They recorded types and frequency of foods and beverages available, feeding practices, nutrition environment, provider PA practices, time spent in PA and screen time, indoor and outdoor PA environments and captured detailed notes about the FCCH environment and provider’s behaviors. Nutrition scores included foods (12 items) and beverages (5) served, feeding environment (7) and practices (7). PA scores included PA time provided (3), indoor playtime (2), daily PA practices (3), PA education and professional development (2), sedentary time (3) and practices (2), outdoor play (2) and PA environment (4). Scores were calculated for baseline and 8-month first with each item for each day, then a total score was calculated for both days together. Items were then summed for each subscore and for the overall nutrition and PA scores at each timepoint. Changes in each subscore and overall score were calculated in linear models with the 8 month score regressed with the group (I v. C) as independent variables controlling for baseline values.

Results: FCCHs showed significantly better change than C FCCHs in all scores (foods provided (I: 0.12  v. C: -0.14, p=.001), food environment (0.24 v. 0.7, p=.014) and practices (0.05 v. -0.17, p=.007) except beverages; PA time provided (0.26 v. 0.16, p=.044), indoor playtime (0.58 v. -0.06, p=.006), daily PA practices (0.47 v. -0.32, p=.007) and a trend for PA education and professional development (0.44 v. 0.02, p=.068).

Conclusions: The Healthy Start intervention improved almost all aspects of FCCH nutrition and PA environments, indicating that FCCH environments can be feasibly measured as an objective research and changed by intervening with providers.

Background: The increase of physical inactivity across the world is costly to societies. A considerable number of Danish children and adolescents do not meet the national physical activity (PA) recommendations. In recent years, the concept of physical literacy (PL) has gained popularity worldwide and is considered as a proximal measure for lifelong PA. Few interventions, however, targeting PL exist on a global scale. In Denmark, the development of theoretically driven and evidence-based PL interventions that aim to increase children and adolescents’ PL are still in their infancy. Yet, a promising theory-based and internationally tested intervention, Youth-Physical Activity Towards Health (Y-PATH), has proven to be effective on children and adolescents’ PA levels, motor skills, and PL as a whole. Aim: This presentation introduces the Promoting Pupils’ Physical Literacy (3PL) project which aims to test the feasibility and acceptability of the Y-PATH intervention within the Danish context among pupils aged 9-11 years old. The goal being that a revised and adapted “3PL intervention” protocol that aims to increase pupils’ PL, will be ready for effectiveness testing by the end of this project. Methods: Two public schools will be recruited and randomly assigned to an intervention or control condition following a waitlist design. The feasibility of the practicality and the recruitment process will be assessed within a document log administered by trained research assistants. The acceptability, including demand and experiences, and the intervention implementation degree, will be evaluated using short bimonthly questionnaires with teachers, along with interviews for pupils, teachers, parents, and school managers. The preliminary effectiveness will be tested by comparing changes in pupils’ PL over time assessed with the validated Danish Assessment of Physical Literacy (DAPL) tool. Discussion: A revised PL intervention, a Template for Intervention Description and Replication (TIDieR) checklist, and a protocol that offers a solid empirical and theoretical foundation for a future upscaled effectiveness study will be developed and implemented. The development of such a protocol and checklist provides a national, as well as an international, opportunity for researchers to use and compare the effectiveness of the intervention across countries taking into account educational, cultural and societal differences.

Purpose: Parental knowledge on physical activity (PA) and screen viewing time (SVT) recommendations for infants, toddlers and preschoolers have been less explored. We aimed to examine parental knowledge of existing PA and SVT guideline recommendations, and its association to proxy-reported child’s PA and SVT in Singapore.

Method: Three hundred and forty caregivers of children ages 0-6 participated in a survey, and were assessed for awareness and self-reported knowledge of existing PA and SVT guideline recommendations for their child’s specific age groups (infants, toddlers and preschoolers). Caregivers proxy reported their child’s total PA which included light and energetic PA, and total SVT. Knowledge of guideline recommendations were assessed by questions, and based on their answers, parents were categorized into three groups for physical activity: accurate, underestimate, overestimate, and two groups for SVT: accurate and inaccurate. A Kruskal-Wallis H test, and a Mann-Whitney U test was used to determine statistically significant differences between the groups of parents and child’s proxy reported PA and SVT.

Results/Findings: Amongst parents who reported awareness of children’s PA and SVT recommendations, <50% correctly estimated these recommendations for each respective age group. The level of agreement between perceived awareness and actual knowledge was overall low, with Cohen’s kappa values between 0.01-0.1. When assessed for knowledge, 28% of all parents accurately estimated recommendations for PA in infants, however, only 9% and 7% accurately estimated recommendations for toddlers and preschoolers, respectively. Overall, children of parents who underestimated their PA needs had the lowest levels of PA (p<0.05), compared to children of parents who were accurate or overestimated the recommendations. For SVT, 33% and 42% of parents accurately estimated SVT recommendations for infants and preschoolers, respectively, but only 14% accurately estimated recommendations for toddlers. Overall, children of parents who inaccurately estimated SVT allowance, had more SVT (p<0.05) compared to those whose parents who accurately estimated the recommendations.

Conclusion: Improving parents’ knowledge of existing PA and SVT guidelines recommendations may lead to higher PA involvement and reduced SVT. This indicates a need for effective communication strategies to educate and inform parents, as important influencer of children’s health behaviours. 

Purpose: Disruptions to health behaviors during pandemic stay-at-home measures have been well-documented. Less well-known is how behavior changes as restrictions ease. The aim of this study was to investigate changes in health behaviors following the easing of pandemic restrictions.

Methods: University staff (n=154) who participated in a 2021 vaccination study and its pilot study the prior year. The 2020 recruitment occurred ~7 weeks into strict stay-at-home orders while 2021 participation occurred ~2.5 months after blended on-campus/online teaching had begun and ~11 months after other on-campus working was permitted. Participants self-reported health behaviors, including the number of hours sleep on a weeknight; sleep quality; the number of days in the past week they had done ≥30 minutes physical activity which was enough to raise breathing rate; servings/day of fruit and vegetables; alcohol intake frequency; and emotional health (DASS-21). Proportion and means testing were conducted to compare between years and correlations were conducted on change variables; α=0.05. (Ethics Approval: 2019/711)

Results: Respondents were mostly female (62%) with mean age of 44±11.6 years. Physical activity, BMI, fruit and vegetable intake, alcohol consumption, sleep quality rating, and overall emotional health indicators remained stable. Sleep duration decreased by 12 minutes on average (95%CI 0.01- 0.39), a significant change. Change in sleep duration was correlated with age (r=0.16, p=0.04) such that younger people reported more sleep loss. Change in sleep was noticeable among females, with a 13% drop in the proportion who achieved the recommended duration (p=.03), and was negligible among males (5% decrease in proportion).

Conclusion: Following the release from lockdown, staff experienced a small but significant reduction in sleep duration. This may indicate an increased sleep duration during lockdown, consistent with the literature, with an ensuing return to normalcy. The health implications from the sleep reduction appear minimal in this well-educated and higher socioeconomic population as the reduction was small and most adults achieved age-appropriate sleep duration, but whether this is also true in marginalized communities is unknown. Further, the sustained failure to achieve recommended physical activity and dietary indicate a continued need for public health interventions and policies.

Purpose: Although the beneficial health effects of well-balanced plant-based dietary patterns are evident, it is not clear if population-wide dietary patterns are shifting in a more plant-based direction. This study evaluated secular trends in dietary patterns among Flemish adults over a 10-year period. Second, differences in socio-demographic characteristics between different dietary pattern groups were explored.

Methods: A time series design, during which five different representative samples (2011, 2013, 2016, 2018 and 2020; N = 4859) were surveyed through an online questionnaire, was used to evaluate secular trends in dietary patterns.

Results: Across the 10-year time period, the vast majority of Flemish participants were omnivorous and only a very small proportion reported to be vegetarian or vegan. Compared to baseline (2011), the relative number of Flemish flexitarians, i.e., eating no meat or fish for minimally 3 days per week, increased from 5.3 to 10.0% (~ 88.7% increase) in 2016 and from 5.3 to 9.2% (~ 73.6% increase) in 2020, whereas the relative number of Flemish omnivores decreased from 89.0 to 84.6% (~ 4.9% decrease) in 2016 and from 89.0 to 72.7% (~ 18.3% decrease) in 2020. No secular trends were found for vegan, vegetarian, almost vegetarian and pesco-vegetarian patterns in Flemish adults. The vegan/vegetarian group differed from the omnivorous group in sex (67.1 vs. 47.0% of females), age (42.9 vs. 23.9% of 18-34-year olds), education (44.3 vs. 30.0% reporting higher education) and geographical distribution (54.3 vs. 42.0% living in urban areas).

Conclusions: While the proportion of vegetarians and vegans remained stable over the past decennium, a modest shift from the omnivorous towards the flexitarian dietary pattern was observed in the Flemish adult population. Despite this shift, the share of flexitarians remained relatively low (nearly 10%) and plateaued after 2016. The observed plateau effect may suggest that previous campaigns mostly triggered the more receptive and open-minded people. Finally, eating more plant-based was associated with female sex, younger age, higher education and living in urban areas. So, besides focusing on those being less open-minded on the topic, campaigns might benefit from targeting older and lower educated males living in rural areas.

Purpose: Despite the well-known health benefits of Physical Activity (PA), young still do not engage in sufficient PA. While most studies on the young population, who are largely represented among university undergraduate students, are focused on their barriers to PA, little or no information exists on what they need to be physically active. Therefore, this study aimed to assess the PA levels and barriers, as well as PA needs of undergraduate students in a Nigerian University.

Methodology: This study used a mixed-method that involved a cross-sectional design (n=402) and a focus group discussion (FGD) [n=9] using a grounded theory approach. Participants were randomly selected from a pool of undergraduate students in the University of Benin, Benin-City, Nigeria.  The PA needs, levels, and barriers of respondents were assessed using an assessment of PA needs checklist, International Physical Activity Questionnaire, and Perceived Barrier to Physical Activity Questionnaire, respectively.

Results: The results showed 40.3% of the sample were not physically active, while 41.3% and 18.4% had moderate and high PA levels, respectively. Safety (53.7%) and provision of PA equipment at the sports complex (50.3%) were the most reported needs in the cross-sectional analysis. In addition, the most reported barriers to PA were time limitation due to school work and other recreational activities (35.8%), and the high cost of gym membership (33.1%). Three major subthemes: barriers, facilitators and levels of PA emerged from the FGD.

Conclusion: The level of physical inactivity among this sample of Nigerian undergraduate students was high. Provision of security and PA equipment were the major PA needs of the students. Addressing these needs along with the barriers identified in this study may be needed to promote PA among the young population in Nigeria and help reduce the burden of non-communicable diseases in the long term.

Purpose: Covid-19 survival rate in Dhaka city is higher compared to other densely populated cities in the world. However, different post-Covid-19 symptoms were reported by many survivors. The aim of this study was to investigate the post-Covid-19 manifestations along with the changes in lifestyle behaviors among the survivors which were the major determinants of health consequences during the covid-19 outbreak.

Methods: A cross-sectional study was carried out among 391 Covid-19 survivors in Dhaka city. The study was conducted between the 15^th November to 30^th November 2021. A semi-structured questionnaire was used for the data collection process. The scope of the study included various socio-economic factors, dietary patterns and post-Covid-19 symptoms that were reported by each participant after their recovery from Covid-19. Physical exercise and sleep duration were also included in the study. Data was analyzed by SPSS software and response surface plots were produced to explore the relationships between several variables.

Results: In this study, 86.7% of survivors reported post-Covid-19 manifestations with a wide range of symptoms even after more than two months into their survival from Covid-19. The mild symptoms (headache, fatigue, sore throat) were most commonly reported (73.5%), moderate to severe symptoms (stroke, renal failure, respiratory problems) were reported by smaller percentages (13.2%). This study showed that the severity of post-Covid-19 manifestations was largely dependent on the presence of other comorbidities. Food consumption habits indicated that increased skipping of breakfast correlated to a higher late-night meal among the Covid-19 survivors. It was also observed that the consumption of body-building and protective foods were significantly increased after Covid-19 survival. Moreover, consumption of freshly home-made food was increased while showing a significant decrease (p<0.05) in consumption of various processed foods.  A significant increase in physical activity was reported by the survivors compared to their pre-Covid lifestyle. Moreover, a notable increase was detected in day-time sleep and a decrease in night-time sleep among the participants.

Conclusions: The large group of post-Covid-19 survivors reported mild manifestations, changes in food consumption habits and changes in lifestyle behaviors. Thus, all subjects recovered from Covid-19 are recommended to undergo long-term monitoring with nutrition education programs. 

Purpose: The Canadian Cancer Registry does not currently report its findings based on ethnicity/race. However, data from the United States shows that cancer survivors of African, Black, and Caribbean (ABC) descent have the lowest survival rate of any racial or ethnic group for most cancers. A strong and growing body of evidence has demonstrated that regular physical activity (PA) and exercise is associated with lower risk of cancer recurrence, cancer-related death, all-cause mortality, and decreased adverse effects associated with treatments. Nova Scotia (NS) Canada is home to the oldest and largest indigenous Black community in Canada. To date however, no study has explored exercise participation among ABC cancer survivors in NS. Knowing the benefits of exercise for cancer survivors and the higher advanced disease diagnoses and death rates among those of ABC descent, the primary objective of this study will be to examine: 1) the trends of exercise participation of cancer survivors of ABC descent; and 2) their perceived preference, barriers, and facilitators to exercise participation while living with a cancer diagnosis.

Methods: This study will use an explanatory sequential mixed-methods design (two-phase). ABC cancer survivors will first complete an anonymous online survey that will include self-reported quality of life using the Functional Assessment of Cancer Therapy – General (FACT-G) and self-reported leisure time using the modified Godin Leisure Time Exercise Questionnaire (GLTEQ). Participants will also be asked about their beliefs, barriers and facilitators, and preferences to exercise and physical activity. Semi-structured interviews will also take place to find emerging themes and add depth to survey answers. Descriptive statistics will be used to describe survey responses and an inductive thematic approach will be used to analyze interviews and focus groups.

Results: The survey will be open for 2 months. Since November 8th, there have been 12 completed surveys. We hope to receive 50 completed surveys and 8 interviews. Preliminary results will be updated and discussed by conference date.

Conclusion: Identifying barriers and preferences to regular PA among ABC cancer survivors is needed for improving survival outcomes, quality of life and minimizing disparities in conducting, developing, and implementing tailored exercise interventions. 

Young adults are at a time period of increased independence with a stressful, fast-paced lifestyle and the emergence of mental health disorders. The development of unhealthy behaviors is prevalent in college, despite the need to learn to practice healthy behaviors, such as budgeting skills and cooking, which play a significant role in future financial and physical wellness. The aim of this study was to investigate how stress, mental health, and alcohol use are associated with college life skills and cooking self-efficacy. 

Students attending an Appalachian university in spring 2019 completed an online survey that measured their stress using Cohen’s Perceived Stress Scale-10 Item (PSS-10), depression using the Patient Health Questionnaire-9 Item (PHQ-9), anxiety using the Generalized Anxiety Disorder-7 Item (GAD-7), alcohol use using the Alcohol Use Disorder Identification Test (AUDIT-C), life skills (such as financial and time management), and cooking self-efficacy. Multiple linear regression was used to determine influence of stress, depression, anxiety, and alcohol use on life skills and cooking self-efficacy. All data was analyzed using JMP Pro Version 14.0.

The mean life skills score was 10.67 + 2.88 out of a possible 24 and the mean cooking self-efficacy score was 16.51 + 3.45 out of a possible 20. Students were least confident in their ability to budget money for food, managing time while preparing food, and their understanding of personal finance. Stress and depression were negatively associated with life skills scores (β = -.05, p<.0001 and β -.08, p<.0001, respectively) and cooking self-efficacy scores (β = -.08, p<.0001 and β = -.08, p<.0001, respectively). Anxiety was positively associated with life skills scores and cooking self-efficacy scores (β = .06, p<.0001 and β = .05, p = .0025, respectively. Alcohol use was positively associated with cooking self-efficacy scores (β = 0.11, p<.0001). 

Findings show that education for college students on budgeting and life skills is needed in order to increase their confidence in how to budget for foods and manage time while preparing them. Further, mental health disorders negatively impact college student life and cooking skills and improving the mental health of college students can positively influence these behaviors.

Purpose: The COVID-19 pandemic caused widespread business closures and changes in business practices, altering purchasing behaviors throughout the United States. However, little is known about the impact on food consumption from restaurants (including drive-thru, takeout, and delivery), particularly among socioeconomically disadvantaged adults. This study examined restaurant dining behaviors from fast-food and non-fast-food (i.e., fast casual and full-service [‘other’]) restaurants and their association with diet quality among low-income adults (incomes <250% of the Federal Poverty Level) during the early months of the COVID-19 pandemic.

Methods: Using a cross-sectional design, participants completed an online survey using CloudResearch (formerlyTurkPrime) asking about restaurant dining behaviors in the past week during the COVID-19 pandemic (June 2020) and during a typical week pre-pandemic. Diet quality was measured using the Prime Diet Quality Score (PDQS). Surveys from 1,756 adults were analyzed using chi-squared tests to examine demographic characteristic associated with consuming foods from restaurant during the pandemic, as well as to examine differences in dining frequency compared with prior to COVID-19.  Negative binomial regressions were used to examine mean restaurant dining frequency, adjusted for socio-demographic characteristics.

Results: During the COVID-19 pandemic, participants who dined at restaurants reported consuming foods from both fast-food and other restaurants on average twice per week. Greater consumption of fast-food was observed among those who were Hispanic, non-Hispanic Black, or with lower educational attainment. Despite the overall high levels of ordering from restaurants, compared with prior to the pandemic, the majority of participants reported that both fast-food and other restaurant ordering occurred less frequently. During the pandemic, greater fast-food consumption was consistently associated with poorer diet quality; participants who ate fast-food 3+/week had a PDQS score of 51.3 compared with a PDQS Score of 55.9 among those who did not eat fast food (p< 0.001).

Conclusions: While fast-food consumption was less frequent during the pandemic, the overall high levels observed among socioeconomically disadvantaged adults remains concerning, highlighting the continued need for initiatives and policies to encourage greater access to and purchasing of affordable and healthier food choices.

Purpose: Young adults in college are at risk of developing unhealthy eating styles during this stressful transitional stage of life. The role of personality in health is an important area of research in order to understand underlying determinants of lifestyle behaviors. The purpose of this study was to determine the relationships between personality types and eating styles in college-attending young adults.

Methods: Young adults enrolled at an Appalachian university during fall 2021 were invited to participate in an online survey via Qualtrics. Survey measures included the Ten Item Personality Inventory (TIPI) which measures the Big 5 Personality types: extraversion, agreeableness, openness to experiences, emotional stability, and conscientiousness; and the Three Factor Eating Questionnaire (TFEQ) that measures three eating styles: cognitive restraint, uncontrolled eating, and emotional eating. Descriptive statistics were computed for all variables. Bivariate analysis examined the relationships between personality types and eating styles. All analysis occurred using JMP Pro Version 16.0.

Results/Findings: The mean extraversion score was 7.96 + 3.41, the mean agreeableness score was 9.67 + 2.46, the mean conscientiousness score was 10.38 + 2.77, the mean emotional stability score was 7.82 + 3.09, and the mean openness to experiences score was 10.28 + 2.34. The mean cognitive restraint score was 14.39 + 4.32, the mean uncontrolled eating score was 19.21 + 6.27, and the mean emotional eating score was 6.43 + 2.75. Lower cognitive restraint was significantly associated with higher emotional stability (p<.0001) and higher openness to experiences (p=.0169). Lower uncontrolled eating was significantly associated with higher emotional stability (p<.0001), higher openness to experiences (p=.0017), higher agreeableness (p=.0014), and higher conscientiousness (p<.0001). Lower emotional eating was associated with higher emotional stability (p<.0001), higher openness to experiences (p<.0001), higher agreeableness (p=.0023), and higher conscientiousness (p<.0001).

Problems resulting from the ageing of societies are discussed in many different areas, and are considered to be one of the stronger trends affecting economic policy. In recent decades, the intensity of this phenomenon has increased significantly, particularly in more-developed countries, which – with a simultaneous decrease in the birth rate in these countries – means that the percentage of older people in society is growing rapidly. It's the result of life extension, civilisational progress and the improvement of the quality of life. It's not the fact that the older population is increasing in numbers that's worrying, but that the share of the youngest age groups in the demographic structure of society is decreasing. According to the European Commission, the percentage of people aged 65 and over will exceed one-third of the European population by 2030, while the working age population will decrease by 15% (European Commission data). Various types of programmes and initiatives have been run in Poland for many years, promoting better use of the potential of older people not only on the labour market, but also in social work, for example, volunteering. Activities related to the education of older people, including in digital competence, are also supported. The goal of all programmes and initiatives is to create conditions for a healthy, safe, independent and dignified long life. Research on the characteristics of elderly people's behaviours and way of life is clearly different to that from decades ago. Above all, the attitude of seniors towards themselves has changed. They are more likely to try new consumption habits, which determine a new lifestyle that is often targeted particularly at young people. Moving to retirement at a time when a senior is in good physical and intellectual fitness makes them more willing to spend their free time actively, travel or go on frequent cultural and entertainment outings. In addition, the feminisation of old age (women live longer than men) and the singularisation of old age (being single in old age) result in the need for the elderly to have more access to information thanks to the spread of ICT.

Purpose: Food environment interventions are recently expanding in high income countries (HICs), defined by the World Bank Data; however, it is important to understand if implementing environmental strategies will promote purchasing behaviors. The aim of this review was to characterize the stocking and marketing practices used to sell candy and confectionery products in HICs food stores and identify effective ways to promote healthier food environments

Methods: The Preferred Reported items for Systematic Reviews and Meta-analysis guidelines (PRISMA) was used. Key words were informed by a research librarian and used to locate peer reviewed and original research (quantitative or qualitative) published since 1975 in 4 databases. The Marketing Mix and Choice Architecture (MMCA) framework was used to guide data extraction (e.g., place, profile, portion, pricing, promotion, priming or prompting, and proximity).

Results: Forty-one articles were included in the review. Studies were based in (some in multiple countries) New Zealand (n=4), Spain (n=1), USA (n=13), Denmark (n=2), Peru (n=1), Cosa Rica (n=1), Australia (n=10), Canada (n=2), Netherlands (n=3), Sweden (n=1), UK (n=7), Columbia (n=1), Brazil (n=1), Taiwan (n=1), and Italy (n=1). MMCA strategies were most used for sweet snacks and varied by store type (e.g., lower prices of candy and confectionary in grocery stores and greater promotions in convenience stores). Most studies used store assessments to measure nutritional quality/ profile (n=9), pricing (n=12), and promotional activities (n=23) in stores. A few used interviews/ surveys to assess consumers (n=5) or stores owners’ perceptions and/ or interactions (n=4) with the marketed products. 

Conclusion: Future research is needed to inform healthy retail interventions in HICs to promote food stores’ environments using the MMCA framework and influence consumers’ decisions to purchase healthier options. 

Background: Physical activity (PA) after a colorectal cancer (CRC) diagnosis can improve health outcomes and is associated with lower mortality. Unfortunately, CRC survivors report some of the lowest levels of PA of any survivor group, necessitating interventions which utilize behavior change techniques (BCT’s). BCTs drawn from social cognitive theory (e.g., goal setting, graded tasks, self-monitoring), and group-dynamics (e.g., group environment, structure, processes) have demonstrated success in face-to-face PA interventions but have yet to be tested in a virtual format. Herein, we describe the study protocol of an ongoing group-based videoconference-delivered PA intervention for CRC survivors.

Methods: Participants must be ≥40 years old, diagnosed with stage II-IV CRC, completed chemo and/or radiation therapy ≤5 years, and have access to a computer or phone with internet and camera. Exclusion criteria are evidence of metastatic disease, ≥150 minutes of PA per week, and presence of known contraindications for exercise. Participants are randomized 1:1 to the intervention or a PA education control group. The intervention consists of instructor led group-based exercise sessions 2x week for 12-weeks, and 5 PA discussion sessions, all delivered in real-time via Zoom videoconferencing software. Outcomes are assessed at baseline and post-intervention, and include PA, quality of life, body composition, and physical fitness. Additional questionnaires will assess hypothesized mediators of PA behavior change, including exercise self-efficacy, outcome expectations, social support, group cohesion, and neighborhood PA resources.  

Results: To date, N=16 have enrolled in the study (Mage=58±13 years, 62.5% female, MBMI=29.0±5.8 kg/m²), N=8 allocated to intervention. A total of N=9 have completed the post-intervention study visit, N=3 withdrawal/dropout, and N=4 currently on study. Adherence to exercise and discussion sessions is 65.6% and 90%, respectively. At baseline, accelerometer measured MVPA was M=15.5±16.6 mins/day, and sedentary time was M=12.94±2.25 hrs/day.

Conclusions: Accrual is ongoing through July 2023. Results from this study can inform the use of videoconferencing software to enhance the reach and accessibility of PA interventions and programs for CRC survivors.

Cancer survivors (CS) can significantly benefit from physical activity (PA), as regular engagement can reduce symptoms of fatigue and medication side-effects, improve function and quality of life, and decrease cancer recurrence. Concerningly, evidence shows that 34% of adult CS report engaging in no leisure time PA. The COVID-19 pandemic is believed to have additionally affected this populations’ PA engagement, given their higher-risk status and desire to reduce possible exposure.

Purpose: Since many in-person PA opportunities became inaccessible and unsafe for CS, the purpose of this pilot study was to examine the feasibility of recruiting CS for a fully-remote home-based PA promotion program during the COVID-19 pandemic.

Methods: Study recruitment took place from July-September of 2021. Recruitment efforts were restricted to 150 miles of the research lab. We specifically targeted cancer support groups, survivor-orientated and community social media pages, and contacted participants from existing databases.

Results: 33 CS contacted the lab expressing interest. Of these individuals, 16 (48%) were ineligible primarily for being too active, or having recent cancer treatment (< 1month). Overall, n=16 participants are currently enrolled, producing an overall enrollment rate of 48%. N = 15 CS with an average age of 58.73 (±10.24) years were successfully recruited and are currently participating a fully-remote PA promotion program. 100% of participants are female Caucasians with an average time since cancer diagnosis of 111(±95.7) months. The most common cancer type is breast cancer (N=10) followed by ductal carcinoma (N=2). A majority of the participants were diagnosed with stage 1 (N=7), or stage 2 cancer (N=4).

Conclusion: Over 3 months, it was feasible to recruit and enroll 15 CS for a fully remote PA program. While our recruitment and enrollment rates are comparable to past studies, strong clinical connections (oncologists, clinicians) could help improve rates. Virtual programming seems to be of interest for this population, however, supplementing the recruitment efforts with in-person events may allow for an effective recruitment strategy as it lends itself to making a personal connection between the research team and participants prior to commencement of a fully remote PA promotion program.

Purpose: Funded by the New Mexico Human Services Department as a Supplemental Nutrition Assistance Program Education (SNAP-Ed) program, the University of New Mexico Prevention Research Center implements the Child Health Initiative for Lifelong Eating and Exercise (CHILE) Plus obesity prevention in Head Start centers, as a statewide initiative. The key component includes the implementation of nutrition and physical activity classroom curriculum that provides repeated opportunities to try new foods and to increase physical activity. Yong children’s health behaviors at school might have changed since the COVID-19 physical restrictions have been implemented. This study investigated the impact of COVID-19 on (1) implementation of CHILE Plus and (2) preschool children’s physical activity and eating behaviors throughout the school day.

Methods: All implementing agencies were required to report the progress on REDCap. We looked at (A) “number of enrolled children/class” (question1) and changes on children’s health behaviors (question 2), including (B) “proportion of kids tasting during the nutrition lesson/day” and (C) “average number of minutes of structured physical activity/day”. The COVID-19 timelines in New Mexico were broken down into: March 27th 2019 - March 27th 2020 (before outbreak), March 28th 2020 - April 5th 2021 (during: between school closed and schools given green-light to start hybrid model), and April 6th 2021 - December 1st 2021 (after: between back to school full time and time the abstract drafted). Descriptive statistics were used to describe the basic features.

Results/findings: A total of 43 Head Start centers (> 1000 preschool children) implemented CHILE Plus between March 27^th 2019 and December 1^st 2021. Before COVID-19, A was 14.69±0.12, B was 0.8353±0.09, and C was 54.53±1.06. During COVID-19, A was 7.11±0.34, B was 0.7658±0.06, and C was 53.36±0.87. After COVID-19, A was 10.10±0.77, B was 0.7921±0.03, and C was 62.88±1.21, respectively.

Conclusions: COVID-19 remarkably affects the implementation of CHILE Plus. Enrollment dropped in Head Starts and children demonstrated decreased physical activity and eating behaviors at school during the pandemic. Despite the promising trend (i.e., increased enrollment and health behaviors) after school reopen, innovative and safe implementing actions are still needed for this statewide initiative in the post-pandemic. 

Purpose: Mass media campaigns have been studied regarding their potential to raise awareness, change social norms, and improve population physical activity (PA). This review of reviews aims to summarize the evidence from published reviews on the effectiveness of mass media campaigns to promote PA, or PA-related determinants, and to identify policy-relevant recommendations related to successful PA campaigns. This will serve to inform the PA environment policy index (PA-EPI), a tool for monitoring and benchmarking government progress in implementing public policies.

Methods: An extensive literature search was performed on March 1^st, 2021, including the databases Medline, Embase, Cinahl, SportDiscus, Web of Science, Scopus, and Cochrane. Reviews that evaluated the impact of campaigns on distal (e.g., PA) and/or proximal outcomes of PA(awareness, knowledge etc.) and that targeted the general population or subsets (socioeconomic subgroups or children) were included, those targeted at clinical populations were excluded. Quality of reviews was assessed using the AMSTAR-2 tool. Policy-relevant recommendations were systematically derived and synthesized,  and formulated as good practice statements. A protocol was registered beforehand (ID: CRD42021249184).

Results: A total of 1,915 studies were identified, of which 22 reviews were included. Results indicate that the most consistent evidence was found for the effectiveness  of mass media campaigns on proximal outcomes, while the evidence for distal outcomes was mixed. Interventions that were combined with other population initiatives were most effective. Some good practice statements could be derived with regards to mass media: 1) to achieve behaviour change, mass media is an important component of larger, multilevel, and multicomponent strategies, 2) mass media strategies should be coordinated and aligned at local and national level, and should be sustained, monitored and resourced at these levels, 3) media should be targeted and tailored to reduce socioeconomic inequalities.

Conclusions: Mass media can play an important role in the promotion of PA. In general, the more distal the outcomes under study, the smaller and more inconsistent the evidence base for effectiveness. The policy-relevant recommendations identified were to combine mass media with other health initiatives, to coordinate, resource, sustain and monitor at local and national level, and to tailor strategies.

Purpose: As electronic screens are progressively integrated into every facet of modern life, there is increasing public and scientific concern over the potential effects of high screen time. Previous studies have largely analyzed behavioral associations, with limited understanding of molecular mechanisms. Herein, we present the first molecular investigation of high screen time using a systems biology approach.

 

Methods: We explored the fecal microbiome and metabolome of a diverse group of 60 college students classified by high (≥75 min/day; n = 46) or low (0-75 min/day; n = 14) self-reported screen time using 16S amplicon sequencing, liquid chromatography-tandem mass spectrometry (MS/MS), and gas chromatography-MS.

 

Results/findings: General linear modelling showed differential abundance in microbiome and metabolome profiles between groups. PICRUSt analysis predicted differential functional changes in more than 50 biologically relevant enzymes (1.39e-4 ≤ q ≤ 0.049); enzyme enrichment analysis of metabolomic data predicted dysfunction in 22 enzymes (0.003 ≤ p ≤ 0.045). Taxon set enrichment analysis showed subjects in the high screen time group had significantly (q) more taxon sets related to Crohn’s disease (0.001), type I diabetes (0.003), having an overweight/obese mother (0.003), and myocardial infarction (0.008); high screen time users also had significantly more taxa related to consumption of red wine (0.007) and coffee (0.025). Conversely, the low screen time group had significant increases in taxa related to liver cirrhosis (0.001), autism (0.006), as well as high-fat diet exposure (0.047). Furthermore, fecal metabolites associated with eight disease signatures were significantly (p) higher in the high screen time group: celiac disease (0.001), inflammatory bowel disease (0.001), treated celiac disease (0.008), obesity (0.016), asymptomatic diverticulitis (0.031), diverticular disease (0.031), symptomatic uncomplicated diverticular disease (0.031), and chronic fatigue syndrome (0.043). Neural network analysis revealed a subset of microbial consortia had high probability of co-occurrence with isoleucine, L-alloisoleucine/leucine/norleucine, valine, proline, and phenylalanine.

 

Conclusions: Integration of findings suggests that mitochondrial dysfunction and aberrant amino acid metabolism associate with elevated screen time. Understanding the effects of high screen time at the molecular level may assist in framing formal guidance on screen use in adults. Future research may use mechanistic techniques to corroborate these findings.

Purpose: The Texas Research-to-Policy (TX RPC) Collaboration Project is a non-partisan network that aims to accelerate the adoption of data-driven health policy through partnerships between policymakers and health researchers. Nutrition-related data and information are needed for policies related to food insecurity, including administration of the Supplemental Nutrition Assistance Program (SNAP) at the state level.  This presentation details the process of developing nutrition-related resources for policymakers, and presents data from utilization of these policy tools.

Methods:  The TX RPC Health Policy Resource reports were generated based on requests by Texas Legislators and their staff for the state legislative session in 2021.  Reports were developed using an iterative approach that included drafting the main points, and review by content experts, community and advocacy advisory committee members, and university governmental relations staff. Use of the reports was determined by clicks on links sent through newsletters and webpage analytics

Results/Findings: Of the 21 legislators enrolled in TX RPC, 17 requested information related to food access, insecurity, and SNAP. Six Health Policy Resource reports were developed on the following topics: food insecurity during COVID-19, Double-Up Food Bucks, SNAP work requirements, SNAP vehicle value limits, SNAP utilization and eligibility in Texas by legislative district, and the interactive food access map by Texas legislative district. Findings from the food access map shows that among lower-income residents, access to grocery stores varied from 3.0%-23.3% across all Texas Senate Districts and ranged from 0.2%-34.6% among all Texas House Districts.  These reports were imbedded into the TX RPC newsletters, with the interactive food access map having the highest newsletter link clicks among legislators and staff (14), compared to the SNAP utilization and eligibility report (2), and food insecurity (1). The highest webpage and unique page views (120) of the resources page (105) occurred in March 2021.

Conclusions: Providing timely information to state-level legislators is important to inform evidence-based policy; researchers can serve an important role in this process. Partnerships between researchers and advocacy groups can also help to frame data for better usage. Characterizing data by congressional district can highlight disparities that can potentially lead to legislative action.

Research suggests that intrinsic motivation—doing an activity because it is inherently enjoyable or interesting—supports sustained exercise engagement. Intrinsic motivation is posited to increase when one feels they have autonomy over their behaviors and choices (see self-determination theory; Deci & Ryan, 2008). However, changes brought about in the early stages of the COVID-19 pandemic heavily restricted how people could engage in exercise. Thus, this study aims to examine how these restrictions impacted people’s affective experiences with exercise, especially for those who were previously highly intrinsically motivated to exercise, and if changes to these experiences are associated with declines in exercise engagement.

A sample of US adults who were highly physically active prior to the pandemic (>150 weekly PA minutes; N=373) were recruited from MTurk in April/May 2020, and completed a survey assessing engagement in moderate-vigorous PA (MVPA) pre- and during COVID-19, disruption to one’s exercise routine, intrinsic motivation for exercise, and perceived changes in affective experiences during one’s exercise sessions (i.e., how one most often feels during workouts during the pandemic, as compared to before).

We first tested if the association between disruption and MVPA declines were mediated by positive/negative affect. Findings revealed a partial mediation, such that greater disruption was associated with less positive/more negative affect during workouts, which were associated with larger declines in MVPA. Second, we tested if intrinsic motivation moderated the pathways between disruption and affect using moderated mediation (with parallel mediators). Findings indicated that positive and negative affect were predicted by an interaction between intrinsic motivation and disruption, such that those with high intrinsic motivation had the highest positive and lowest negative affect if they experienced less disruption, but had the highest negative affect if they experienced more disruption.

Findings suggest that there might be affective repercussions when autonomy is constrained for people who have high intrinsic motivation for exercise. More negative affective experiences during physical activity may undermine exercise engagement, especially for those who were previously motivated to exercise for intrinsic reasons (i.e., positive affect). Future work using experimental and longitudinal methods is needed to strengthen inferences about causality.

This study examined the relationship between categories of stakeholders who are responsible for evaluating implementation of Texas school districts’ local wellness policies (LWPs) and the number/types of wellness goals. School districts (n=111) in a Texas Public Health Service region were coded using a state-level LWP template and analyzed in STATA. LWP were coded based on their inclusion of template goals for nutrition promotion (n=4), nutrition education (n=5), physical activity (n=7), and other school-based activities (n=3) (such as promoting wellness for students and their families). Descriptive statistics and effect sizes were calculated, and number of selected goals within each category was investigated by the primary stakeholder responsible for evaluating implementation. Most LWP implementation evaluators were academic leaders (n=70, 63.0%); of those, 17 mentioned an additional designee evaluator. Other implementation stakeholders were health leaders (n=8, 7.20%), nutrition leaders (n=6, 5.40%), physical activity leaders (n=7, 6.31%), and non-leadership stakeholders (e.g., school health advisory council; n=4, 3.60%). Eleven LWPs had implementation evaluators in more than one category. Across all LWPs, the mean ± standard deviation number of goals were 2.16±0.72 for nutrition promotion, 2.41±0.95 for nutrition education, 4.1±1.93 for physical activity, and 2.54±0.86 for other school-based activities. When physical activity leadership was responsible for evaluating implementation, LWPs contained more goals for nutrition promotion (2.29±0.59 vs. 2.15±0.74; d=0.2), nutrition education (3.29±1.25 vs. 2.34±0.90; d=1.02), physical activity (5.86±1.25 vs. 3.97±1.90; d=1.01), and other school-based activities (3.14±0.69 vs. 2.49±0.86; d=0.77), compared to all other stakeholders. LWPs reported more goals when multiple stakeholders were responsible for implementation, but 25% of these districts included physical activity leadership. When a designee was listed with academic leadership, there were also more goals for nutrition promotion (2.36±0.50 vs. 2.13±0.77; d=0.32), nutrition education (2.64±1.03 vs. 2.30±0.91; d=0.36), physical activity (4.91±1.92 vs. 3.89±1.88; d=0.54), and other school-based activities (2.91±0.83 vs. 2.44±0.86; d=0.54), compared to those without a designee. Implementation evaluation teams that have more members and include context experts, particularly physical activity staff, have more goals across all LWP content areas. School should consider engaging multiple staff in the LWP evaluation process.

PURPOSE: This study aimed at identifying the determinants of the parents to offer 2 portions of fruits per day to their children aged 2 to 5 years old, based on the Behavior Change Wheel (BCW) approach. This research was motivated by the fact of the low consumption of fruits by children aged 2 to 5 years in Brazil and by the lack of interventions with this focus, based on a solid methodological framework.

METHODS: The BCW guide was followed for this qualitative study. The interview questions were developed using the Theoretical Domains Framework (TDF). The interviews were conducted by telephone and transcribed. Transcripts were deductively analysed by two independent researchers by means of content analysis. Written informed consent was obtained from all subjects by google forms.

RESULTS/FINDINGS: We interviewed 16 parents, defined by saturation criteria. Qualitative analysis using COM-B identified that participants felt that, regarding Capability, they don’t have enough knowledge about the number of portions that they should offer to their children and how to plan the meals, including fruits in the routine. Oportunity was identified as very important once the participants have financial problems or don’t have easy access to buy fruits. Many of them believed that they can’t offer fruits regularly because of lack of time or they don't believe the children would accept. Motivation represents a relevant determinant because often the parents don't believe that the lack of adequate fruit intake brings consequences for the child and they don’t have an objective view of what they would like to achieve.

 

CONCLUSIONS: This study shows the importance of recognizing and better understanding the role of parents in offering fruit to their children. Parental factors such as knowledge, habits, environment, resources can determine the behaviour of offering fruit to children and, therefore, bring future consequences. Tools to assist parents are strategies needed to amplify and help form habits that are potentially important to parents' self-efficacy in performing and determining the child's fruit intake.

Purpose: We explored associations of objectively-measured worksite neighborhood walkability (WNW) with self-reported and accelerometer-measured moderate-to-vigorous physical activity (MVPA) to address two aims. Aim 1: To determine the variance in MVPA explained by WNW. Aim 2: To examine potential moderators (e.g., age, sex) of the relationship between WNW and MVPA.

Methods: Healthy, inactive adults (N=512, mean 44 years, 59% female, 30% Non-White and/or Hispanic) employed outside of the home participated in the baseline phase of the WalkIT Arizona intervention in the Phoenix, Arizona, USA region. Six self-report measures of weekly PA minutes were collected: IPAQ Total Walking, NPAQ Total Walking, NPAQ Walking Inside Home Neighborhood, NPAQ Walking Outside Home Neighborhood, NPAQ Total Biking, and IPAQ Transportation Biking. Objective weekly MVPA minutes were obtained via participants’ (n=472) use of a wrist-worn ActiGraph GT9X. Worksite (500-meter street-network buffers) and home (block-group level) neighborhood walkability indices were calculated using GIS-measured net residential density, intersection density, transit density, and land-use mix. Mixed effects negative binomial regression models were used to examine associations of WNW with MVPA, adjusting for home walkability and demographic covariates. Changes in Bayesian information criterion (BIC) and likelihood ratio tests were used to evaluate model fit and explained variance. Negative binomial models also included interaction terms to capture potential moderation of relationships between WNW and MVPA outcomes.

Results/findings: Aim 1: Results indicated that WNW was not directly related to any self-reported or accelerometer-measured PA outcomes after adjusting for covariates. Home neighborhood walkability improved fit in models predicting IPAQ (p=0.001) and NPAQ Total Walking (p=0.015). Aim 2: Sex (p=0.04) and the number of children in the household (p=0.006) independently moderated the relationship between WNW and accelerometer-measured MVPA. For women and individuals without children, worksite walkability was positively associated with accelerometer-measured MVPA, while it was unrelated for men (p=0.67) and individuals with one (p=0.29) or two (p=0.18) children in the home.  

Conclusions: PA levels of certain subgroups were associated with WNW, notably women and individuals without children. Nuanced research into the worksite neighborhood and social characteristics offered insights into factors that may influence PA and how urban environments can be designed to promote PA.