Methods: This study utilised data from the Physical Activity and Nutrition in Children (PANIC) Study, an ongoing longitudinal study in a population sample of 290 Finnish children (290 children (158 females) aged 9 to 11 years). Physical activity was assessed with Actiheart, a combined heart rate and movement sensor, and the uniaxial acceleration was used to calculate average-acceleration (a proxy metric for physical activity volume) and intensity-gradient (a metric of physical activity intensity distribution). Linear regression was used to examine the independent and interactive associations of physical activity volume and intensity with dual-energy X-ray absorptiometry assessed total-body-less-head bone mineral content, lean, and fat mass.

Results: In females, physical activity volume was positively associated with bone mineral content (unstandardised regression coefficient (ß) = 0.26, p = 0.035) but not with lean or fat mass. Physical activity intensity was not associated with any outcome in females. In males, physical activity volume was positively associated with bone mineral content (ß = 0.47, p = 0.002) and lean mass (ß = 7.33, p = 0.014), and negatively associated with fat mass (ß = -20.62, p = 0.013). Physical activity intensity was negatively associated with bone mineral content in males (ß = -0.13, p = 0.015), and was not associated with lean or fat mass. There was no interaction between physical activity volume and intensity in females or males for any outcome.

Conclusions: In conclusion, a greater volume of physical activity may be associated with improved bone mineral content in females and males, and with increased lean mass and reduced fat mass in males. The volume of physical activity may be crucial for the development of bone health in pre- and early-pubertal children.

Purpose: The purpose of this study was to gain an understanding of child (12-14 years) health behaviours prior to the COVID-19 pandemic, during strict pandemic restrictions (March – May 2020), and following the loosening of pandemic restrictions (June 2020) through qualitative interviews with children and their parents.

Methods: Interviews with 29 parent/child (mean age: 13.3, 51% female) dyads were conducted via Zoom in summer 2020. Interviews were transcribed and data were categorized into health behaviour (diet, screen time, physical activity), relevant family information (parenting practices, family context), social interactions, emotional state, and pandemic-specific information. Following the categorization of information, we used thematic analysis to identify commonalities.

Results: Thematic analysis revealed that strict pandemic restrictions negatively impacted physical activity and screen behaviours in most of our sample of children, but mixed results around eating behaviours. Six major themes were identified (1) shift to permissive parenting, (2) pandemic closure impact, (3) pandemic fear, (4) lack of schedule, (5) increased family time, and (6) an opportunity for autonomy. Parents described shifting to a more permissive parenting style, particularly around screen behaviours due to concerns around their children’s mental health or a lack of familial resources to manage screen use. Closures of schools and recreation facilities reduced physical activity, which parents supplemented with co-participation in family walks. Activity intensity (if not time) decreased for most children. During strict restrictions, there was an increase in home cooked meals, and reduced purchasing of meals and snacks due to fears around COVID-19. However, diet quality went down for some children because food was always available to them. When restrictions were loosened physical activity and screen behaviours improved for most children, but did not reach pre-pandemic norms. Purchasing of meals and snacks increased, but also did not reach pre-pandemic heights.

Conclusion: COVID-19 restrictions resulted in deterioration of health behaviours in most children, with greater impacts on physical activity and screen behaviours. Greater fear around the pandemic resulted in greater impacts in these health behaviours when parents restricted their children’s independent mobility. Families will need support in resuming and improving health behaviours as the pandemic evolves and eventually subsides.

 Purpose: The COVID-19 pandemic caused significant food supply chain and economic disruptions. As a result, there was an unprecedented and sustained increased demand for emergency food assistance program services (programs that provide food free of charge). Emergency food assistance programs (i.e. food banks, food pantries, and others) had to make significant adjustments to their previous food distribution models to assure client/staff/volunteer safety during COVID-19. However, little research has been done to document the breadth of innovative programming developed by these organizations. Therefore, the purpose of this research was to identify and describe a diverse sample of innovative emergency food assistance programs that operated during COVID-19 across the US.

Methods: A brief survey, developed in partnership with an expert advisory board, was sent out through multiple listservs (listservs for food banks, dietitians and nutrition professionals, school foodservice workers, social service providers and more). The survey collected the organization name and type, along with the population served, and a brief description of innovative emergency food assistance program(s) they operated during COVID-19. Descriptive statistics were used to summarize the survey results.

Results: 101 responses to the survey were collected. After data cleaning 81 unique responses remained. Of the respondents 29.6% were food banks/pantries, 13.5% were universities/school systems, 18.5% were food-based non-profits, 9.9% were social service agencies, and 28.5% were other organizations. Most organizations reported serving all populations (54.3%), others reported serving specific priority groups including children/families (19.7%) and the elderly (25.4%). Programs provided community members with food in various formats including prepared meals (25.9%), groceries (64.2%), and fresh produce (29.6%). Common COVID-19 related safety modifications included 38.3% of programs providing home food delivery, and 17.3% having contact-free curbside pick-up options. Other innovative but less widely implemented COVID safety options include online food package ordering, and outdoor mobile food markets or community gardens.

Conclusions: Emergency food assistance programs from a variety of organization types, serving diverse and vulnerable populations, created innovative programming to feed communities during the COVID-19 pandemic. By examining the response to COVID-19 improved strategies for daily operations as well as best practices for future crisis/disaster situations can be identified and expanded.

Purpose: Aromatase inhibitors (AI) are frequently used to treat hormone-receptor-positive breast cancer. AI has multiple adverse effects, resulting in premature therapy discontinuation or switch. Physical activity (PA) is safe and can attenuate these negative effects. However, most cancer survivors fail to perform/sustain adequate PA levels, especially in the long-term. This study aims to test the long-term effectiveness and cost-effectiveness of two 4-month group-based interventions on promoting sustained changes in PA, sedentary behavior, and quality of life, by implementing a randomized controlled trial (RCT). We will also study the impact of both interventions on secondary outcomes like AI therapy continuation, treatment adverse events, disease-free survival, body composition, tumoral biomarkers, limb perimeters, joint amplitudes, physical (eg, strength, aerobic capacity, physical function) and psychosocial indicators (eg, body image, depression). 

Methods: This is a 3-arm, 2-cohort, multi-centric, RCT, comprising a 4-month intervention and a 12-month follow-up. Group 1 – PAC – will have access to a brief group-based PA counseling (8 sessions, 90-minute each), provided in an autonomy-supportive way (based on Self-Determination Theory), and aimed at fostering self-regulation and sustained adherence to an active lifestyle. Group 2 – SEP – will receive a tailored structured exercise program encompassing aerobic, strength, and flexibility training, delivered in small groups. Patients allocated to the control group will receive the standard medical care plus a formatted informational packet containing general PA and health facts and will be offered the structured exercise program at the end of the study follow-up. We expect to enroll at least 100 (3:3:1 ratio) post-menopausal women (< 65 years), with hormone-receptor-positive breast cancer (stage I-III), on AI therapy for at least 1 month, and ECOG-Performance Status 0-1. Measures of objective and self-reported PA, quality of life, healthcare services, psychosocial, clinical and physical indicators, will be collected.

Results/Conclusions: Full study protocol and theoretical rationale, approved by the Ethics Committee, will be presented. Participant’s recruitment and baseline assessments are ongoing. Preliminary baseline data of this first of two cohorts will be presented. Results from this trial will help identifying cost-effective solutions that can be delivered by qualified exercise professionals and integrated in Health Care Systems.

Purpose:

Rural U.S. residents have higher chronic disease mortality rates compared to urban residents. Diverse policy approaches for chronic disease prevention have been implemented to address barriers to breastfeeding, healthy eating (HE), and physical activity (PA). Therefore, the purpose of this scoping review was to identify policy supports for breastfeeding, HE, and/or PA among rural Americans.

Methods:

A scoping review for policies was conducted March-June 2020 as part of a larger project about Policy, Systems, and Environment (PSE) Change approaches for breastfeeding, HE, and PA promotion in rural America. Search procedures were guided by the PRISMA-ScR, Arksey & O’Malley’s work (2007), and a science librarian. Medline, PubMed, Web of Science, and Agricola were used to identify peer-reviewed research.  ProQuest Dissertations and Theses A&I were used to identify dissertation research. Gray literature searches included Google, Google Scholar, government pages, and public health, federal nutrition assistance program, Cooperative Extension Services, and related webpages. Inclusion criteria included: (1) breastfeeding, HE, and/or PA focus; (2) about policy factors (for this presentation); (3) specific to U.S. rural populations/places; and (4) English language. Outcomes (study/source design, objective(s), methods/measurement, setting, population characteristics, behavioral focus, PSE-specific results) were extracted to a standardized Excel document.

Results/findings:

Breastfeeding policy results focused on hospitals (n=17) and workplaces (n=6), with Baby-Friendly Hospital initiatives most commonly reported. HE policy results focused on schools/childcare settings (n=35), food retail/local food producers (n=13), and charitable/food assistance programs (n=10). HE school recommendations included support for national school lunch programs, for rural schools to improve compliance with nutritional standards and implement mandated nutrition policies. PA policy results focused on initiatives in schools/childcare (n=41), streets (26), and parks/trails/recreation facilities (n=19). Rural communities overcame potential barriers to PA policy efforts by adapting policy approaches. For example, using remote drop-offs for Safe Routes to School allows children to congregate and walk from the drop-off to school. Other recommendations included joint/shared use agreements and including PA breaks policies throughout school days (e.g., recess, classroom PA sessions).

Conclusions:

Results from this scoping review compile and offer commentary on existing policy solutions to improve breastfeeding, HE, and/or PA in rural America.

Purpose: There is a growing body of research identifying environmental strategies that address low rates of breastfeeding, healthy eating (HE), and physical activity (PA) among rural U.S. residents. The purpose of this scoping review was to identify subjectively measured environmental factors that encourage breastfeeding, HE, and/or PA practices within rural U.S. communities.

Methods: A scoping review was conducted using the Policy, Systems and Environmental (PSE) Change framework. A scientific librarian guided the search strategy. Searches occurred February-July 2020. Gray literature searches spanned Google, Google Scholar, government pages, and public health, federal nutrition assistance program, Cooperative Extension Services, and related webpages. Four academic databases (Medline, PubMed, Web of Science, Agricola) were selected to identify peer-reviewed research, and ProQuest Dissertations & Theses A&I was used to identify dissertation research. Inclusion criteria included: (1) breastfeeding, HE, and/or PA focus; (2) about environmental factors; (3) specific to U.S. rural populations/contexts; and (4) English language. Outcomes were extracted using Excel and included study/source design and objective(s), methods/measurement, setting, population characteristics, behavioral focus, and PSE-specific results.

Results: Breastfeeding environment results focused on workplace settings (n=3). Breastfeeding environment initiatives/recommendations in workplaces included increasing compatibility for breastfeeding, by addressing environment (e.g., spaces for breastfeeding) and culture (e.g., acceptability by peers/superiors) barriers. HE environment results focused on initiatives in retail (n=65) and schools/childcare (n=33) settings. HE environment change initiatives/recommendations in retail settings included increasing the availability of fruits/vegetables in existing establishments (e.g., convenience stores) or prevalence of grocery stores and/or farmers markets. In schools, HE environmental initiatives/recommendations increased fruits/vegetables served and/or reduced unhealthy food access. PA environment results focused on initiatives in recreation (including parks, playgrounds, facilities; n=54), streets/sidewalks (n=44), or school (n=33) settings. PA environmental initiatives/recommendations in recreation settings included increasing transport/accessibility or addressing geographic disparities, in street/sidewalk settings included improving/installing walkability features, and in school settings included integrating PA into lessons or improving PA equipment/spaces.

Conclusions: Results from this scoping review were used to create recommendations to improve breastfeeding, HE, or PA environments in rural U.S. settings. Researchers and practitioners can use our recommendations to inform rural public health efforts, such as by identifying high-impact settings. 

Background: Adverse childhood experiences (ACEs) are stressful traumatic events experienced in childhood or adolescence. ACEs are associated with obesity risk and psychosocial conditions in childhood and subsequent adulthood. Less is known regarding how ACEs impact obesity-contributing behaviors (i.e., sleep and screen use). The purpose of this study was to examine the association between Parent-reported ACEs and their children’s obesogenic behaviors (sleep and screen time) in a representative sample of U.S. children and adolescents.

Methods: This study utilized data from the 2019-2020 National Survey of Children’s Health, with a sample of 70,553 aged 6-17 years. Separate multinomial logistic regressions were used to examine the odds of meeting screen-time and sleep guidelines given a reported total ACE score. A secondary analysis explored the exposure to individual ACE measures and each outcome of interest.

Results: Of the final analytic sample, 17,320 children (48% female, 38% non-White) experienced two or more ACEs, representing 24% of the final sample. Parents reported that covering basics such as food and housing was the most prevalent ACE (41%). Crude models show that children and adolescents with no ACEs are more likely to meet the sleep (OR 2.00 95%CI = 1.83, 2.19)  and screen-time (OR 2.92 95%CI = 2.63, 3.25) guidelines compared to children with two or more ACEs. After adjusting for race/ethnicity, sex of the child, highest education in the household, and child age, we found that children and adolescents with no ACEs are significantly more likely to meet the sleep (OR 1.70 95%CI = 1.54, 1.87)  and screen-time (OR 1.73 95%CI = 1.54, 1.96)  guidelines compared to children with two or more ACEs. Finally, when examining individual ACEs independently and each outcome (i.e., sleep, screen-time), we found that each of the nine ACEs captured was significantly associated with a 20-60% reduction in odds of meeting both screen and sleep guidelines.

Discussion: Parent-report of children and adolescents meeting recommended sleep and screen-time guidelines are associated with previous exposure to trauma. Screening for ACEs may better inform interventionists and practitioners when attempting to improve obesogenic behaviors among children and adolescents.

Purpose: To examine the comparability of sleep estimates when elementary school-age children’s raw accelerometry data were processed with and without a parent-reported sleep log.

Methods: Children (n=756, K-5^th grade, 51% female, 31% Black) wore an Actigraph GT9X accelerometer on their non-dominant wrist 24 hours/day for 14 days each during Fall 2020, Spring 2021, and/or Summer 2021. Parents completed nightly surveys indicating their child’s bedtime and waketime. Sleep outcomes of interest included sleep period (onset to offset), duration (minutes spent asleep), wake after sleep onset (WASO), and timing (midpoint). Only nights with a completed parent sleep log were included. Raw data were processed without a sleep log using the default HDCZA algorithm (no log condition) and separately with a parent-reported sleep log (sleep log condition) using the GGIR package (v2.6.0) in R. Mean/absolute bias and limits of agreement were calculated. Bland-Altman plots measured agreement between the sleep log and no log conditions. Mixed-effects logistic regression was used to examine weeknight/weekend as a predictor of agreement.

Results: Children provided an average of 23±13 (median=24, IQR=12, 34) nights of valid data for a total sample size of 17,461 nights. Of those, 67% of nights showed perfect agreement in identifying sleep period (onset to offset) between the sleep log and no log conditions. Odds of perfect agreement for any given child were 1.97 times more likely on weeknights compared to weekends (95%CI=1.82, 2.14). At least one night with sleep period discrepancy was present in 88% of children. Compared to the sleep log condition, the no log condition produced longer estimates of the sleep period by 6.2 min (absolute mean bias, [AMB]= 58.9 min), longer estimates of sleep duration by 12.8 min (AMB=34.0 min), lower estimates of WASO by 18.9 min (AMB=29.1 min), and later estimates of midpoint by 16.9 min (AMB= 32.5 min).

Conclusions: Using a parent-reported sleep log did not alter sleep estimates on most nights in this large sample of elementary school-aged children. Increased odds of agreement on weeknights may be explained by more accurate parent-reported bed and wake times due to more consistent sleep routines.

Purpose. The COVID-19 pandemic would have contributed to increase adolescents’ leisure-based screen time (LBST). Excessive screen time would be associated with sleep problems, and inadequate sleep would be linked to physical and mental health issues among adolescents. The objective of this study was to verify if LBST was associated with sleep quality among adolescents during the COVID-19 pandemic.

Methods. Data collection took place in four high schools in one region of Quebec (Canada) from the end of April to mid-May, 2021. LBST was measured using the validated Screen-Time Based Sedentary Behavior Questionnaire. A question asking adolescents if they often use multiple screens simultaneously was added to verify if measuring time spent using different screens separately could overestimate LBST. Sleep quality was measured using the validated short version of the Adolescent Sleep Wake Scale. French versions translated by a certified translator of both questionnaires were used given our population was French-speaking. A linear regression analysis was computed to determine if LBST was associated with adolescents’ sleep quality.

Results. A total of 258 French-speaking adolescents answered the questionnaires on LBST and sleep quality. Adolescents (14-18 years; 66.3% girls) reported a mean of 5 hours and 52 minutes/day of LBST. Only 5.0% of participants mentioned never using multiple screens simultaneously and 4.7% respected the Canadian public health recommendation of a maximum of 2 hours/day of LBST. Sleep quality’s mean score was 4.03±0.87 on a maximum of 6, suggesting good sleep quality. LBST (β=-0.57; p<0.0001) and being a boy (β=0.47; p<0.0001) were significantly associated with sleep quality while age was not (p=0.3510), and this model explained 11% of the variance. Boys reported better sleep quality compared to girls (4.19±0.93 vs. 3.95±0.83, p=0.0364).

Conclusions. To our knowledge, this is the first study on the association between LBST and sleep quality in adolescents during the COVID-19 pandemic. LBST was high and it was negatively associated with adolescents’ sleep quality. Girls also seemed at higher risk for poorer sleep quality. Public health interventions during and after the COVID-19 pandemic could target LBST—and especially girls—to possibly improve sleep quality and promote optimal physical and mental health in adolescents.

Purpose: The aim of the study was to investigate the associations between perceived built environment features, self-reported physical activity (PA) and body mass index (BMI) of South African adolescents across socio-economic groups.

Methods: Adolescents (N=143, 13-18 years) in low or middle/high socioeconomic areas (SEAs) were conveniently recruited from three high schools located in low and middle/high SEAs in Cape Town. Anthropometry was measured using standardised methods. A demographics questionnaire, a validated adolescent PA questionnaire and the Neighbourhood Environment Walkability Scale (NEWS)-Africa were administered. PA behaviours were categorised as low (LPA), moderate (MPA) or vigorous (VPA) intensity. MVPA was assessed in different domains: informal (during school breaks or outside school); physical education (structured classes); school sports (school-related extracurricular activities); private club (sports outside school); active travel (walking/cycling to school) and household chores. Data on selected NEWS survey domains included: residential density, land use diversity, street connectivity, infrastructure and safety for walking and cycling, aesthetics, traffic safety, and safety from crime and personal safety. Data were analysed using descriptive analyses and multivariate linear regression.

Results: Two-thirds (65%) of the participants (median age 15 years) were female and 34.5% were overweight. Approximately half (48.3%) did not meet recommended adolescents MVPA levels regardless of residential SEAs. Compared to adolescents residing in low SEAs, those from middle/high SEAs had significantly higher walkability index values (p<0.001) in more than half of the NEWS domains indicating a PA-conducive environment. Regression analysis, adjusted for sex, home and school SEA, showed that land use diversity was significantly associated with private club MVPA (ß = 0.28 ;95% CI =0.66 to 3.64; p=0.05), street connectivity was significantly associated with school sports MVPA (ß = 0.17 ;95% CI =0.03 to 2.54; p=0.04) and personal safety with private club MVPA (ß = -0.22 ;95% CI = -3.18 to 0.19; p=0.03). BMI was not significantly associated with the NEWS variables and PA levels.

Conclusion: The findings, of varying associations between neighbourhood-built environment features and PA across socio-economic gradients highlight the need for evidence-based approaches to inform the design of adolescent-focused PA interventions, tailored to different socio-economic contexts within cities.

Purpose: This study examined associations between social contexts (screen use and social interactions), length of time eating and energy intake in young Australian Adults (18-30 years old) using wearable camera technology.

Methods: A subsample (n = 133) from a large cross-sectional study wore a camera that captured point of view images every 30 seconds over three consecutive days. Images (n = 487,912) were reviewed to identify length of time spent eating and social context (screen use and social interactions) of each eating episode. Energy (MJ) per meal was determined using the Automated Self-Administered 24-hour Dietary Assessment Tool. Socio-economic status (SES) was assigned using residential postcode. Body Mass Index (BMI) was calculated from self-reported weight and height. Mixed linear regression models were applied with eating time as the dependent variable and social interactions, screen usage, energy, SES, BMI and gender included  for all eating occasions and stratified by meal type.

Results/Findings: 1599 eating occasions were included in analysis (n = 235 excluded as meal length could not be determined and n = 6 excluded as meal components were unclear). The median time spent eating was 28.8 minutes per day (IQR: 18.0 – 42.0). Food consumption occasions with screen use were longer than those without screens for breakfast (β = 3.2, p < 0.001), lunch (β = 3.2, p = 0.007), dinner (β = 4.2, p = 0.001) and snacks (β = 2.9, p < 0.001). Food consumption occasions with social interactions were longer than those consumed alone for lunch (β = 5.0, p < 0.001), dinner (β = 4.2, p < 0.001) and snacks (β = 1.8, p < 0.001). As meal length increased energy intake for all eating occasions increased (β = 1.8, p < 0.001)

Conclusions: Among young adults social interactions and screen use increased meal length. Longer meals were associated with higher energy intake. Screen usage may act as a distraction during meals contributing to increased energy intake and could be targeted for behaviour change interventions. Social interactions led to longer lunches, dinners and snacks but its effects on the quality of meals should be investigated.

Purpose: The study’s aim is to understand case workers’ perceptions of how the COVID-19 pandemic shaped older adults’ access to food. Older adults disproportionately experience food insecurity and are understudied.  

Methods: From February to May 2021, in-depth interviews were conducted with 21 professionals from 13 public and private social service agencies across Oregon. Participants served in program coordination, case management, client services, outreach, and community health worker roles. A semi-structured protocol included questions about the pandemic’s impact on social service agencies and their clients, how the Supplemental Nutrition Assistance Program (SNAP) and other programs can be improved for older adults, and older adults’ food security and SNAP participation. Qualitative data were analyzed using thematic analysis. Two authors identified data relevant to the research question, coded to identify case workers’ perceptions of the specific ways in which older adults’ access to food and services changed during the pandemic, and organized the codes into themes.

Results: Participants reported changes for older adults’ food access during the pandemic, largely related to constraints resulting from social distancing. These reported changes occurred across three levels: 1) Personal capacities - Older adults faced new constraints concerning shopping, travel, or employment. Additionally, their access to and knowledge of technology became more important for accessing resources. 2) Social support and relationships - Older adults had more trouble accessing their social support networks and experienced isolation and loneliness. At the same time, these informal networks increased in importance as formal programs closed or suspended service. 3) Formal safety net programs - Many programs supporting older adults' access to food and related resources were discontinued or experienced interruptions; however, many programs were also expanded or innovated. Two program changes often cited by caseworkers as being of consequence to seniors’ food access were the acceptance of verbal signatures for the Department of Human Services and increased SNAP minimum benefit amounts. However, it is important to note that innovation and expansion of public programs only benefit those who can access them.

Conclusions: Findings inform our understanding of food insecurity among older adults and how programs can support food access and overall wellbeing.

Purpose

U.S. Hispanic/Latino households disproportionally experience food insecurity, a risk factor for poor diet and diet-related chronic diseases. Perceived food environments are associated with food security status and food purchasing behaviors in U.S. Hispanics/Latino households. However larger, heritage-diverse data are needed to inform generalizable strategies to promote food security, diet quality, and health. We sought to identify latent food security-environment-shopping classes among a sample of U.S. Hispanic/Latino households with youth (8-16y).

Methods

We used cross-sectional data from the multisite HCHS/SOL Youth Ancillary Study (n=1020 households). Caregivers responded to the 18-item Household Food Security Survey; we categorized each household as 1) high, 2) marginal, 3) low, or 4) very low food security. Caregivers also responded (from strongly disagree to strongly agree) to a 5-item questionnaire on perceived neighborhood availability, selection, and affordability of fresh produce and low-fat products. Caregivers reported typical shopping frequency (from never to always) at five store types: supermarkets, ethnic food stores, non-ethnic food stores, convenience stores, and farmers’ markets. We identified the best-fitting solution of latent classes by examining standard fit criteria in Mplus.

Results

We identified a 6-class solution: three classes of food-secure shoppers and three classes of shoppers at mixed food security levels. Class 1 (21.2%) were food-secure supermarket shoppers with perceived high-quality (availability and selection), affordable food environments. Class 2 (7.4%) were food-secure mixed food store shoppers (non-ethnic and ethnic food stores, convenience stores, and farmers’ markets) with perceived high-quality, expensive food environments. Class 3 (18.2%) were food-secure supermarket and ethnic food store shoppers with perceived medium-quality, somewhat affordable food environments. Class 4 (17.0%) were mixed food security supermarket shoppers with perceived high-quality, somewhat affordable food environments. Class 5 (21.1%) were mixed food security supermarket shoppers with perceived high-quality, expensive food environments. Class 6 (15.2%) were mixed food security convenience store shoppers with perceived low-quality, expensive food environments.

Conclusions

U.S. Hispanic/Latino households with youth 8-16y demonstrated distinct combinations of food security status, perceived neighborhood food environments, and food shopping behaviors. Future research should investigate these relationships to inform multi-level, targeted approaches to promoting food security, diet quality, and health equity among U.S. Hispanic/Latino families.

Purpose: Increased sedentary time is associated with negative health outcomes in breast cancer survivors (BCS). Previous research has demonstrated cancer survivors are more sedentary than the general population, thus accurate assessment of sedentary time is needed for health promotion efforts to reduce sedentary time. This secondary analysis aimed to compare the self-reported Domain-Specific Sitting Time questionnaire against objectively assessed sedentary time using inclinometers (activPAL™) in BCS and age-matched healthy controls.

Methods: Twenty BCS (M_age=55.3±9.8 years; mean months since diagnosis=77.9±42.7) and 20 age-matched healthy controls (M_age=53.8 ± 9.6 years) completed a modified version of the Domain-Specific Sitting Time questionnaire and wore an activPAL3™ micro inclinometer for 7 days during waking hours. The Domain-Specific Sitting Time questionnaire asks individuals to report the amount of time spent sitting (hours:minutes) on a typical weekday and weekend day in the following domains: transportation, occupation, television and home-based computer use, and leisure time. Spearman’s rank correlations examined the association between self-reported and objectively assessed sedentary time. Bland-Altman plots were used to assess bias and the limits of agreement between the measures for BCS and age-matched controls.

Results: The Spearman’s rank correlations between the modified Domain-Specific Sitting Time questionnaire and objectively measured sedentary time were marginally significant among BCS (ρ = 0.42, p = 0.06), but not among healthy controls (ρ = 0.37, p = 0.1). There was poor agreement between the measures among BCS (bias = -74.7 min/day) and healthy controls (bias = -87.7 min/day). The limits of agreement were wide for both BCS (95% CI = -387.6, 238.3; range = 625.9 min/day) and healthy controls (95% CI = -400.0, 224.6; range = 624.7 min/day).

Conclusion: The modified Domain-Specific Sitting Time questionnaire showed poor agreement with objectively assessed sedentary time. Both BCS and healthy controls appeared to underestimate their daily sedentary time. Self-reported sedentary time provides important information about the context of the behaviours, but the modified Domain-Specific Sitting Time questionnaire should not be used interchangeably with the activPAL™ inclinometers.

As compared to tracking multiple health indicators, weight is one metric that can be monitored. Repeated weight measurements over time represent the balance between intake (nutrition) and expenditure (physical activity). Daily self-weighing is recommended as a weight-monitoring strategy though concerns exist about vulnerable populations. The purpose of this study was to investigate the short- and long- term impacts of daily self-weighing in a sample at risk for both weight gain and disordered eating. Emerging adult women (ages 18 – 26) participated in a 3-month randomized controlled trial comparing daily self-weighing with an active control condition, daily temperature-taking. The Patient-Reported Outcomes Measurement (PROMIS) anxiety and depression scales were administered at baseline, two weeks (for comparison with published literature), and three months (end-of-treatment). Generalized linear mixed models were used to analyze data for within-participant changes in anxiety and depression T-scores and compare differences between groups using all available data. Controlling for baseline scores, at 2 weeks, the daily self-weighing group had significantly higher anxiety T-scores (but not depression T-scores) than the daily temperature-taking group (n  = 64; self-weighing: M = 58.2, SE = 1.2, n = 34; temperature-taking: M = 53.2, SE = 1.2, n = 30; β_group = 5.0, SE = 1.7, p = .003). Controlling for baseline scores, at 3 months, the daily self-weighing group had significantly higher depression T-scores (but not anxiety T-scores) than the daily temperature-taking group (self-weighing: M = 53.6, SE = 1.1; temperature-taking: M = 49.1, SE = 1.1; β_group = 4.5, SE = 1.5, p = .003). Results indicate that daily self-weighing may cause short-term elevations in mild anxiety and longer-term minor increases in depression scores in some populations. Thus, caution is advised when considering daily self-weighing as a weight management strategy.

Purpose: To estimate the prevalence of depression and to evaluate the relationship between depression screening status and loneliness among adult participants at a suicide prevention walk.

Methods: Annually, Walk for Hope is held as a fundraiser and community celebration for the Barb Smith Suicide Response and Response Network (SRRN).  As part of the Mental Health Research Advisory Council information table, participants volunteered to complete an anonymus survey that included the Patient Health Questionnaire (PHQ-2) for depression screening, the revised UCLA Loneliness Scale (ULS), and self-reported physical activity.  For each completed survey, US$2.00 was donated to SRRN.  Participants were classified as screening positive (PHQ-2= 3 to 6) or negative (PHQ-2= 0 to 2) for depression based on the sum of PHQ-2.  T-tests were performed to evaluate if the ULS total and item scores differed by depression screening status. 

Results: Approximately 1400 participants attended the Walk for Hope with donations estimated around $67,000.  Overall 133 adults completed the survey (males=29, females=103).  Ages ranged from 18 to 78 years.  The majority of participants lived with family and friends (87%) while 12% lived alone.  When compared to their peers, 44% were more active, 31% similarly active, and 21% less active.  Over the past month, 39% stated they had little to no activity, 46% stated they were moderately active, and 11% stated they were vigorously active.  13% of the participants had a positive screen for depression.  Loneliness was measured by the ULS was significantly greater for those who screened positive for depression (49+9) compared to those who screened negative (35+9)(p<0.0001). ULS and PHQ-2 were positively correlated (r=0.70, p<0.01).

Conclusion: As hypothesized, participants who screened positive for depression reported higher loneliness scores at the Walk for Hope. Our results suggest that loneliness may be a modifiable risk factor to target for adults at higher risk of depression and/or suicide at a community-based walk.

The purpose was to establish a healthy food environment provided by this laboratory-cafeteria in the Faculty of Medicine Mexicali (FMM) promoting a positive healthy change in the diet and lifestyle of its users.

We developed 30 healthy menus for lunch with a total of 600 calories using the ESHA software. We also developed Focus groups where nine participants, users of the laboratory-cafeteria, voluntarily debated about the food environment and service, modulated by the Author, data obtained awaiting analysis with the Nvivo software. And two questionnaires developed for voluntary users of the laboratory-cafeteria, the first one to evaluate food perception, quality, taste among others; and the second one to record the eating habits and physical activity. 

Stage one of the project, thirty healthy and balanced menus with a total of 600 calories created and provided in La Cafe 1600 prepared in the FMM dietetic laboratory. The questionnaires; the one for feedback regarding the menus, portion size, and taste, the results obtained were positive. The second questionnaire 30 participants provided information about their eating and exercise habits; the analysis of this data is in progress. In the focus group, participants debated the importance of having food available in a University and the importance of this food being nutrient dense, low in calories, high fiber and fruits and vegetables. Participants mentioned the convenience of having food available; most of them have limited free time between classes or during working hours. The stage one of the project is still ongoing; we are expecting to implement this officially in the school cafeteria, waiting for the university treasury department’s approval. For stage two of the project, a complete menu of 1600 kcal distributed between breakfast 400 kcal, two snacks 300 kcal each and dinner 600 kcal, based on the average consumption of 2000 kcal.

The purpose of this project is to promote a healthy food environment provided by La Cafe 1600 with balanced diverse and healthy menus. To evaluate the full extent of the impact that La Café 1600 could have in the Faculty´s community a second focus group and questionnaire is required for comparison.

Purpose: To develop a Nutrition Security Plan to improve equitable and sustainable access to

healthy foods among young adults in college. Prior research shows that college students struggle

with food insecurity and without an inclusive and holistic framework to address it long-term,

conditions such as the current health pandemic would continue to exacerbate both food and

nutrition security.

Methods: Using a community engaged participatory research approach, we employed a mixed

method design in the development of the nutrition security plan. University partners such as

university administration, students, food service contract staff, county health department nutrition

staff, the North Carolina Department of Health and Human services nutrition staff worked together

to develop a Nutrition Security Plan for our University. First, food purchasing behaviors and

barriers to nutrition security on campus were assessed. This included analysis of data generated

on student purchases and interviews with staff of Chartwells-the university’s food service

contractor. Second, existing nutrition supporting services on campus (e.g. food pantry, Swipe out

Hunger, student garden) were documented and reviewed. Third, nutrition support programs and

initiatives in operation at other universities were researched and considered for implementation.

Results/findings: We developed a 12-item nutrition security plan and carried out a process

evaluation of the implementation of the recommendations in the plan. To date, 3 of 12

recommendations have been implemented successfully. These are 1) a centralized resource center

for student nutrition needs was created and posted on the university student support website; 2)

the implementation of a university bus route that stops at a grocery store; and 3) a Supplemental

Nutrition Assistance Program (SNAP) Eligibility Screener for Students that was developed and

disseminated among student financial aid and student support services.

Conclusion: Providing equitable access to healthy foods for young adults has both short and long-

term benefits for public health and social outcomes. Implementing a Nutrition security plan on

university campuses is a step towards achieving this goal. Nutrition educators are encouraged to

collaborate with university partners to develop Nutrition Security Plans for their campus

community.

Aim: The study aimed to explore parental awareness of and opinions on six portion size guidance resources for feeding preschool children in the UK. The study also aimed to understand the portioning practices of first-time parents of one- to two-year-olds and the factors influencing these practices. 

Background: Consumption of large portions has been prospectively associated with excessive weight gain during the preschool years. However, little is known about how first-time parents decide the portions to serve their preschool children or whether they follow portion size recommendations.

Methodology: Online interviews with first-time parents of one- to two-year-olds were conducted in the UK. During the interviews, parents were shown images of six portion size guidance resources to facilitate discussion. Data was analysed in NVivo using Reflexive Thematic Analysis.

Results: 27 interviews with first-time parents were conducted (25 mothers, 2 fathers). Most first-time parents did not recognise the six portion size guidance resources. Parents liked when resources were short, concise, used bold colours and images of food portions, and were available in a range of accessible formats. However, most parents expressed they preferred to be child-led rather than follow the portion size recommendations within guidance resources. First-time parents used dishware and package size (physical indicators of portion size), as well as experience of previous feeding occasions to decide served portions, rather than following guidance recommendations. Parents used a number of practices along a spectrum from encouraging self-regulation of intake to restriction of foods. These practices were influenced by the food type, child appetite and hunger, and parental concerns about feeding.

Conclusions: Portion size guidance resources available online in the UK have not been effectively disseminated to reach parents and may not be the most effective strategy to promote age-appropriate portion sizes. Future research should focus on promoting age-appropriate portions and healthy weight gain through the use of dishware and packaging, which aligns with parents’ current portioning practices.

ABSTRACT

Cardiovascular disease (CVD) is a leading cause of mortality in the United States. Many of the primary risk factors for CVD, such as elevated circulating blood lipids, are modifiable with diet and lifestyle interventions. Therefore, the objective of this systematic review and meta-analysis was to evaluate the effectiveness of medical nutrition therapy (MNT) intervention provided by registered dietitian nutritionists (RDN) or international equivalent, compared to usual care or no MNT, on lipid profiles in adults with dyslipidemia. The databases MEDLINE, CINAHL, Cochrane CENTRAL, and Cochrane Database of Systematic Reviews were searched for randomized controlled trials (RCTs) published between January 2005 and July 2021. The revised risk of bias tool (ROB 2.0) and the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) method were used to assess risk of bias and determine the certainty of evidence, respectively. Meta-analyses were performed using a random-effects model. Overall, eight articles from seven RCTs were included. In a pooled analysis,  MNT interventions provided by RDNs improved plasma lipid levels : total cholesterol (total-C) [mean difference (95% CI): -20.84 mg/dL (-40.60, -1.07), P = 0.04]; low density lipoprotein cholesterol (LDL-C)  [-11.56 mg/dL (-21.10, -2.03), P = 0.02]; triglycerides (TG) [–32.55 mg/dL (-57.78, -7.32), P = 0.01]; and high density lipoprotein cholesterol (HDL-C) [1.75 mg/dl (-1.43, 4.92), P = 0.28]. Certainty of evidence was moderate for total-C, LDL-C and TG and low for HDL-C. In conclusion, in adults with dyslipidemia, MNT interventions provided by a RDN are effective for improving blood lipid levels.

Purpose: Responsive parenting (RP) interventions such as INSIGHT (Paul et al., 2014) reduce rapid infant weight gain, but their effect for underserved populations is largely unknown. The Sleep SAAF (Strong African American Families) study is a two-arm randomized clinical trial for primiparous African American mother-infant dyads that compares an adapted version of the INSIGHT RP intervention to a child safety control. Here we report on intervention effects on rapid infant weight gain during the first 16 weeks of life and trial implementation, including recruitment, retention, participant engagement, and intervention fidelity.

Methods: Families were recruited from a mother/baby nursery shortly after delivery. Community research associates (CRAs) conducted two intervention home visits at 3 and 8 weeks postpartum, and data collection home visits at 1, 8, and 16 weeks postpartum. Conditional weight gain (CWG), the primary outcome, and upward crossing of 2 or more weight-for-age major percentile lines were calculated.

Results/findings: Among the 212 mother-infant dyads randomized, 194 completed the trial (92% retention). Randomized mothers averaged 22.7 years, 10% were married, and 49% participated in the Supplemental Nutrition Assistance Program (SNAP). Adjusting for covariates, mean CWG was lower among RP infants (-0.10, 95% CI [-0.41, 0.20]) compared to the control group (0.14, 95% CI [-0.16, 0.45]), reflecting non-significantly slower weight gain (p=0.14, effect size d=.23). RP infants were also nearly half as likely to experience upward crossing of weight-for-age percentile lines (14.1%) compared to control infants (24.2%), p=0.09, odds ratio=1.94 (95% CI [0.91, 4.13]). Implementation data revealed that participating families were engaged in the intervention visits and CRAs demonstrated high levels of fidelity to intervention materials.

Conclusions: Findings show that RP interventions can be successfully implemented among African American families while suggesting the need for modifications (e.g., intervention content, dose, duration) to yield stronger effects on infant weight outcomes. Ongoing work from the Sleep SAAF trial examining group differences in sleep, soothing, and feeding outcomes will advance understanding of the RP intervention’s effects and inform future studies aimed at promoting healthy development and preventing obesity among African American children.

PURPOSE: Collecting data in rural communities presents unique challenges. With a strong plan and engaged community members, we illustrate how gathering a rural probability sample can be a strategic evaluation approach for health practitioners seeking community-based evidence to guide interventions.

METHODS: Using validated measures and scholarly and community input, the Rural Eastern Louisiana Food Accessibility and Active Transportation (RELFA) survey was developed to evaluate three rural counties participating in the Centers for Disease Control High Obesity Program (HOP) grant.  We used United States Postal Service (USPS) records and a free online random number generator to draw a probability sample (n=811). Survey responses were collected in person and via postcard using QR codes and website links. Members of each community were recruited to participate as data collectors, going door-to-door to collect surveys via offline iPADs, paper, or mail. A replacement scheme was utilized to address vacant or blighted properties.

RESULTS/FINDINGS: Postcards yielded thirty-two (5.99%) online survey responses, and fifty-one community data collectors collected 650 in-person surveys across three communities. There were ninety-two (11.34%) refusals, and 205 (25.28%) addresses were recorded as vacant or blighted. Respondents were 78.52% Black and 60.57% female. 37.6% of RELFA respondents rely on the Supplemental Nutrition Assistance Program (SNAP), and 26.47% reported using the charitable food system. 26.03% of respondents report walking at least weekly for transportation.

CONCLUSIONS: Lessons learned included the importance of community participation, local awareness, and flexibility to adapt protocols to fit local needs. RELFA provides evidence for grant priorities, including evidence of existing demand for active routes to everyday destinations, demonstrated by over a quarter of the sample reporting they walk for transportation at least weekly. Over a quarter of RELFA respondents reported relying on the charitable food system. Food pantry preference results have been shared with local food pantries where Extension staff are working alongside food pantry leadership to expand healthy options for pantry clients. Results have been shared with community members, stakeholders, and partners via community asset maps and data walks at community events. Gathering data from a true cross-section of rural communities is feasible with a plan and community involvement.

Purpose: Assess the sociodemographic, geographic, and health factors associated with increased physical activity (PA) and decreased PA during the pandemic in a sample of North Central Appalachian adults.

Methods: Surveys (n=1951) collected from a convenience sample of adults during Community Health Needs Assessments at two non-profit hospitals covering eight counties in West Virginia from January to March, 2021, were analyzed. The two dependent variables were based on response to a single, multi-select item in which respondents were asked “In the past six months, which of the following are things you have done in response to the coronavirus pandemic?” Among the list of 24 options were “spent more time doing physical activity” and “spent less time doing physical activity” from which the two, dichotomous dependent variables were created. Predictor variables included age, self-rated health, body mass index, sex, marital status, household income, education, children in the home, and county-level rurality (based on percentage of residents living in a rural area). Logistic regression analyses were performed using SAS 9.4©.

Results/findings: Roughly twice as many respondents indicated they spent less time doing PA during the pandemic (n=584, 29.9%) than more time doing PA (n=303, 15.5%). More time spent doing PA during the pandemic was positively associated with good/excellent self-rated health (AOR: 2.33), under/normal weight (AOR: 2.33) and overweight (AOR: 1.56), higher household income categories (AOR 1.56-2.50), and having earned a bachelor’s degree (AOR: 1.49). These same factors (with the exception of overweight, annual household income of $50,000-$74,999, and education level) were significantly negatively associated with less time spent doing PA during the pandemic (AORs 0.51-0.61). Noteworthy is the finding that living in a Mostly Urban county was positively associated with less time spent doing PA during the pandemic (AOR 1.57) when compared with Completely Rural county of residence.

Conclusions: Results highlight further PA reductions in a North Central Appalachia population already with low levels of PA prior to the pandemic. Understanding the impact of the pandemic on key health behaviors is critical in advancing our understanding of the long-term effects and where existing disparities have been exacerbated.

Purpose: Interventions that promote responsive feeding in early childhood have been shown to reduce obesity risk. However, interventions mostly target parent-child dyads without considering the complexities of feeding multiple children within a family unit. This study extends existing knowledge on feeding relationships by exploring how mealtimes are enacted in families with more than one child.

Methods: This mixed-methods study was undertaken in South East Queensland, Australia. Preliminary data were collected from n=15 families, comprising of mealtime observations, semi-structured interviews, field notes, and memos. Data were analysed using constructivist grounded theory methods of open and focused coding, and constant comparison.

Results: The sample included two-parent households with siblings aged 12 to 67 months (mean age difference=24 months). A model was generated to explain transactional feeding processes in the sibling context. Parents may adapt their feeding practices in response to the individual characteristics of siblings, and mediate dynamics between them to facilitate or limit their food intake. Within a family unit, how parents feed each sibling is also interdependent, operating through processes such as resource dilution and learnt experience, and eliciting certain spill-over effects.

Conclusions: The findings elucidate the complexities of feeding that give shape to the overall family food environment. The theoretical model emerging from the data highlights intricate processes that may explain how parents coordinate mealtimes and manage feeding in the context of siblings. This model has the potential to inform the design of family-based feeding interventions that aim to nurture the development of healthy eating behaviours during early childhood.  

Purpose: Caribbean territories are currently undergoing a nutrition transition, but little is known about how migration could influence the adherence to specific dietary patterns in Caribbean migrants. We specifically aimed to identify dietary patterns and their association with migration status and sociodemographic factors in a context of nutrition transition, in a cross-sectional observational study.

Methods: The study sample was composed by 1,094 participants from the NutriNet-Santé e-cohort, categorized in 4 subsamples: born and living in the French West Indies (West Indies/West Indies; n=172); born in the West Indies and living in mainland France (West Indies/Mainland, n=317); born in mainland France and living in the French West Indies (Mainland/West Indies, n=288) and those born and living in mainland France (Mainland/Mainland, n=317). From dietary intake provided by 24h records, we conducted a comparison between the four subsamples on nutritional quality of the diet, dietary patterns and sociodemographic, lifestyle and anthropometric characteristics.

Results/findings: The West Indies/West Indies group had the highest contribution of unprocessed food to their diet (40% of total energy intake vs. 30% for Mainland/ Mainland), with higher intake of traditional West indies tubers, rice, fish, chicken but also sugary drinks (p<0.05). The West Indies/Mainland group had consumption reflecting an intermediate nutritional quality between the West Indies/West Indies and the Mainland/Mainland group which exhibited higher consumption of plant-based foods. The Mainland/Mainland group were more likely to adhere to a mainland-France traditional dietary pattern, rich in animal-based foods, whereas the West Indies/West Indies group, and to a lesser extent the West Indies/Mainland group, were more likely to adhere to a West Indies dietary pattern and to a convenient pattern, rich in ultra-processed foods.

Conclusions: Migration has effects on nutritional quality of the diet suggesting that food environment may play a role in the current nutrition transition in the West Indies

Purpose

         The COVID-19 pandemic impacted life for many households, disrupting access to adequate food and increasing economic stressors. These impacts may have downstream effects on food choice and perceived stress, especially for parents; yet existing evidence is limited. Restaurant eating behavior, in particular, is associated with poor diet quality and chronic disease risk. This study sought to determine associations between food insecurity, parental stress, and restaurant eating behaviors during the COVID-19 pandemic.

Methods

         A cross-sectional survey among low-income parents of 2-11 year-olds who frequently ate food from restaurants prior to the pandemic was administered through the participant sourcing platform, CloudResearch, from November 2020 through February 2021 (n=1480). Participants reported how often they went out to eat in the last week and what their child ordered at the “most recent” restaurant they visited. Child orders were classified as healthy vs unhealthy for entrees, sides, and beverages. The validated Hunger Vital Signs screener measured food insecurity and the validated perceived stress scale measured stress. Chi2 tests were conducted to compare differences in perceived stress by food insecurity status. Negative binomial regressions tested associations between food insecurity and frequency eating food from restaurants, adjusting for stress, sociodemographics, and reasons for eating from restaurants. Child ordering behaviors were analyzed through logistic regression.

Results

         About 82% of respondents reported food insecurity. Preliminary findings demonstrate that parental stress levels were significantly higher among food insecure individuals compared to food secure individuals (p=0.0000). Food insecure individuals also reported increased frequency eating food from restaurants when adjusted for covariates (IRR=1.129, p<0.05). Food insecurity was not significantly associated with child food orders.

Conclusions

         Outreach services targeting food insecure families should consider higher levels of stress these families experience and higher rates of eating food from restaurants compared to food secure families. Given that food insecurity and stress are associated with reduced diet quality as well, higher rates of eating food from restaurants may further increase risk of weight gain and related chronic diseases for both parents and children. Efforts to improve diet quality in this population should consider restaurant eating behaviors.

Purpose: To determine the feasibility and acceptability of a food-based diabetes self-management and education (DSME) intervention for food insecure individuals.

Methods: A single arm (pre-post) intervention study was conducted in partnership with a food bank and federally qualified health center (FQHC). Twenty-one food insecure FQHC patients with type 2 diabetes (T2DM) participated in the 3-month intervention: six bimonthly food boxes, recipes, DSME resources, and two, 30-minute virtual dietitian consults. Food security, diabetes self-efficacy, sociodemographic characteristics, and dietary intake (two, 24-hour dietary recall interviews) were assessed during phone interviews; diet quality scores were calculated (Healthy Eating Index (HEI)-2015). Hemoglobin A1c (HbA1c), height, and weight were obtained (FQHC electronic medical record). Wilcoxon signed-rank and Stuart-Maxwell tests evaluated pre-post intervention differences. Participants completed one in-depth interview at follow-up; data were coded to assess feasibility criteria using structured thematic analysis.

Results: 247 patients with T2DM and food insecurity were recruited, 71 expressed interest, 25 consented, and 21 completed the study. Participants were median (IQR) 48.0 (38.0-63.0) years, 71% female, 62% Hispanic, and 38% White. Fifteen participants (71%) received all home food deliveries and > 1 dietitian visit. At baseline, (n=15, 71%) participants reported low/very low food security; median (IQR) diabetes self-efficacy score (0-10) was 6.4 (5.9-7.0); HEI-2015 score (0-100) was 55.9 (51.8-63.9); 90% were overweight or obese; HbA1c was 10.4 (7.6-11.0). There were no significant differences in food security, diabetes self-efficacy, diet quality or biometric data (HbA1c, body mass index) between baseline and follow-up. The intervention was feasible - participants were satisfied with resources and reported using most/all foods received. Reported benefits included offsetting food costs, increased consumption of healthy foods, and help with T2DM meal planning. Challenges included time to cook some food items, family support, and securing dietitian appointments. Participants provided suggestions for improvement - more recipes, greater food diversity, T2DM management tools, and tailoring food amount to household size.

Conclusions: The intervention was feasible and acceptable, and participants gave specific suggestions for improvement. Most participants reported moderate diabetes self-efficacy, and low diet quality and food security, suggesting unmet needs. Next steps include a randomized clinical trial to establish intervention efficacy.

Purpose: Belgium has one of the highest prevalence rates of grandparents among people aged ≥50 years compared to other European countries. This rate will rise due to the increasing life expectancy and aging society. In general, the aging population is prone to not meeting physical activity (PA) and sedentary behaviour (SB) recommendations. As grandchild care comprises physical tasks and playful activities, this study investigated PA and SB levels as well as body composition in caregiving grandparents as compared to non-caregiving grandparents and non-grandparents.

Methods: In this case-control study, data collection was performed through home visits. Actigraphs GT3X(+) were used to objectively measure participants’ PA and SB over a one-week period. Anthropometrics (i.e. height, weight, waist and hip circumference) and body composition (i.e. fat%, TANITA MC-780) were determined. ANOVA analyses were conducted to establish differences between the three subgroups in all outcome measures, while controlling for participants’ age, sex and socio-economic status (SES).

Results: Two-hundred fifty-three participants were included in the analyses of which 98 were caregiving grandparents, 64 non-caregiving grandparents and 91 non-grandparents. The total sample (65.6 ± 5.8 years, 64.6% females) had a mean body mass index (BMI) of 25.7 ± 4.1 kg/m². Concerning PA, a significantly higher amount of light intensity PA was found between caregiving (1808.6 ± 413.8 min/week) and non-caregiving grandparents (1642.9 ± 528.4 min/week) (p=0.004) as well as between caregiving grandparents and non-grandparents (1670.4 ± 430.6 min/week) (p=0.015), whereas no differences were observed between non-caregiving grandparents and non-grandparents (p=0.509). No subgroup differences were found in MVPA (p=0.275), total counts (p=0.638), SB (p=0.311), BMI (p=0.119), waist-to-hip ratio (p=0.169) or fat% (p=0.329).

Conclusion: Caring for grandchildren on a regular basis might have a beneficial effect on levels of light intensity PA. Despite this beneficial outcome, no differences were found for MVPA, nor for SB or any body composition measures. Future research should examine whether caregiving grandparents obtained these higher amounts of light intensity PA in presence or in absence of the grandchildren.

Purpose: Despite its contribution to a healthy lifestyle, undergraduate students often do not engage in recommended levels of exercise. Research suggests college students’ health, including exercise and mental health outcomes, are impacted by their social support networks. This study examined how exercise participation potentially impacts the health and wellness support undergraduate students receive through their personal networks. 

Methods: An egocentric network analysis was conducted on a sample of undergraduate students (n=465) and their social support networks defined as people they felt closest to at their institution (n=1,925). Participants reported their personal leisure-time exercise (LTE) habits, campus group exercise (GX) involvement, and mental health scores. Participants also reported perception of their social connections’ LTE habits and GX involvement as well as the degree of health/wellness support each network connection provided. Multilevel modeling assessed factors related to students receiving health and wellness support through their social connections.

 Results: Students who reported lower stress levels (β=-0.01, p=.01), and more engagement in LTE (β=0.13, p>.01), received more health and wellness support through their social ties. Social connections who were female (β=0.12, p>;.01) and who exercised more often (β=0.45, p>.01), were perceived as more supportive. While the main effects of GX membership (either by the individual (β=0.03,p=.59) or their connection (β=0.09, p=.13)) connections were not significant, results showed significantly more support was perceived when both the participant and their connection were involved in the campus GX program (β=0.18, p=.04).

 Conclusions: This study suggests the importance of exercise, at the individual and dyadic level, in making undergraduate students feel supported in their health and wellness. Additionally, this study adds to existing evidence that exercise and social support are both independently associated with wellbeing and suggests social support within personal networks can contribute to increased exercise habits. Findings support campus GX programs as a potentially ideal environment to create reciprocal supportive ties for college students. Increased GX participation enhances individual LTE and allows for additional support through expanded networks. Future research could further explore the ways exercise and social support, particularly in group settings, affect health and wellbeing.

Purpose: The aim of this systematic review was to examine the impact of behavioral-based interventions on cardiometabolic outcomes (weight status, glucose, HbA1c, blood pressure, cholesterol) among youth at risk for diabetes.

Methods: This systematic review was guided by the Preferred Reported Items for Systematic Reviews and Meta-analyses and managed using Covidence, a systematic review workflow platform. Searches across four online databases in October 2021 using key terms including: type 2 diabetes mellitus, cardiometabolic outcomes, behavioral intervention, diet, and child were conducted. Eligible studies were published between September 2011 through September 2021, included youth 6-12 years-old at-risk for diabetes, implemented a behavioral-based intervention, had a randomized study design, and included 1 cardiometabolic outcome. If reported, dietary quality data were extracted, but did not impact inclusion criteria. Two reviewers independently screened, reviewed, and extracted data. Any disagreements were solved by a third reviewer. Risk of bias was assessed using the revised Cochrane risk-of-bias tool for randomized trials.

Results: Of the 2,386 records identified, 8 met inclusion criteria. Studies ranged from 10 weeks to 24 months in length with sample sizes ranging from 53-247 for participants who engaged in the intervention. All studies included measures of weight status with only three finding significant between group differences. Five studies assessed fasting glucose and three assessed HbA1c, none found significant changes within or between groups. Of the four studies reporting blood pressure outcomes, one found significant between group difference for systolic blood pressure. Two studies reported cholesterol and found no changes. No studies included measures of dietary quality. Five of the eight studies had ‘some concerns’ in terms of bias and three had ‘high’ risk of bias.

Conclusions: These findings suggest that behavioral-based interventions can change weight status in youth at-risk for diabetes; however, evidence of further health effects such as cardiometabolic outcomes remains limited. Examining more intermediate outcomes such as diet quality may help elucidate the lack of cardiometabolic outcomes.  

Purpose: Modifiable health behaviors place many older African American (AA) adults at increased risk for chronic diseases.  AA women face even greater health disparities.  The COVID-19 pandemic has exacerbated health disparities but few studies have documented this impact in AAs.  This study investigated changes in older AAs physical activity, eating, and sleep behaviors during the COVID-19 pandemic.

Methods: A nationwide sample of AAs aged 65 to 85 (N = 624) participated in an online health behavior survey in which participants reported  health behavior changes from before the pandemic to the beginning of 2021. Outcome measures included moderate-to-vigorous physical activity (MVPA), eating, and sleep behaviors, and predictors were gender, COVID-19 history, and their interaction. Ordinal logistical regressions examined predictors of change while controlling for covariates including age, socioeconomic status, marital status, employment status, and education level.

Results: Most AA participants reported no change in their MVPA (59%), eating (64%), or sleeping (71%) behaviors. Participants experiencing change were more likely to report decreases in MVPA and sleep and increases in eating. AA females reported increases in eating (odds ratio [OR] = 1.67, p< 0.01) and decreases in sleep (OR = 0.67, p< 0.05) compared to AA males. Contracting COVID-19 predicted decreases in eating (OR = 0.48, p< 0.01) for AA males and females. There were no significant predictors of MVPA, and no interactions.

Conclusions: About two-thirds of older AAs reported no change in their health behaviors. However, for the one-third experiencing changes, they were more likely to be maladaptive. Consistent with previous findings assessing COVID-19 effects on health behaviors (Maness et al., 2021), we found that AA women had greater odds of increased eating and decreased sleeping behaviors. Covariates did not provide insights about subgroups of AA men or women at greatest risk. Our findings suggest that in order to offset the effects of the COVID-19 pandemic, systematic efforts should be made to promote health behaviors for older AAs, particularly AA women. 

Purpose

Moderate-to vigorous physical activity (MVPA) and diet may play a role in the prevention of depression. Previous observational research has shown limited associations, but benefits may become more apparent later in adolescence or when the combination of both behaviours are considered synergistically. This study aimed to investigate the independent and joint prospective associations of diet quality and MVPA in adolescence with mental health into early adulthood. 

Method

Data collected in 2005-2007 were from ROOTS, a longitudinal cohort study of adolescents (n=1238; 14.5 years at recruitment; 45.6% male) in England. Four-day diet diaries collected at baseline were used to derive the 9-point Mediterranean Diet Score (MDS) and ActiHeart monitors worn over four days measured MVPA (min/day) at baseline. The MDS index is created by scoring individuals on their dietary intake of nine key aspects that characterise a high-quality diet (e.g., vegetable intake). Mental health was measured using the self-reported 33-item Mood and Feelings questionnaire (MFQ) at age 14.5, 16, 17.5 and 25 years. Prospective associations of MVPA and MDS with MFQ were examined using two-level mixed effects multi-level regression, adjusted for baseline covariates. Multiple imputation by chained equation (MICE) was applied to handle missing data up until age 17 (n=1170). Separate analyses were repeated in a subset of participants with MFQ at age 25 (n=133).

Results

There were significant negative association of time with average MFQ in all models, (MDS β=-0.69; p<.01). MDS (β=-.18; p=.27) and MVPA (β=-.01; p=.84), were not independently associated with MFQ, nor when both behaviours were jointly modelled. There was no interaction between MDS and MVPA (β=-.01; p=.40). Analyses in those with MFQ at age 25 revealed similar patterns of null associations.  

Conclusion

 This study showed that MVPA and diet quality in early adolescence, alone or synergistically, were not associated with mental health into later adolescence and early adulthood. The potential role of diet and MVPA in the prevention of mental health problems in adolescence remains a key research priority. 

Purpose: Both individual characteristics and country-level macro-environmental factors have been associated with self-reported physical activity. In old age, most physical activity comes from light daily activities that are better captured by accelerometers. This study aimed to investigate country-level differences in accelerometer-based physical activity within European countries. The association of both individual factors (i.e., personality traits and quality of life) and country-level macro-environmental factors (i.e., GDP and health expenditure) with physical activity were investigated.

Methods: The data from the Survey of Health and Retirement in Europe (SHARE) collected in 2019–2020 were used. Tri-axial accelerometers captured physical activity from a subsample in ten countries (n=855). Outcomes were overall physical activity level (average acceleration over a measurement period) and intensity distribution (intensity gradient from the log-log regression line between time and intensity, more negative gradient indicates less distribution). Personality traits were assessed with BFI-10 and quality of life with CASP-19. Country-level indicators (GDP per capita and health expenditure) were collected from World bank. Mixed-model regressions with two levels (individuals nested within country) were used for analyses. All analyses were controlled for age, gender, and education.

Results/findings: Average acceleration was lowest in Czech Republic (mean=23.38, standard deviation=1.67) and highest in Denmark (M=32.31, SD=1.63). Intensity gradient was lowest in Poland (M=-2.50, SD=0.14) and highest in Sweden (M=-2.34, SD=0.17). Mixed models indicated statistically significant variability (likelihood ratio tests p<0.01) in average acceleration (the intraclass correlation coefficient=0.035) and intensity gradient (ICC=0.019) between countries. None of the individual or country-level variables was associated with average acceleration. Higher quality of life (B=0.01, p=0.004) and GDP (B=0.001, p=0.035) were associated with higher intensity distribution.

Conclusions: Both accelerometer-based overall physical activity level and intensity distribution among older adults varied between European countries. Accelerometer-based measures of physical activity were unrelated to personality traits. Individuals with higher quality of life had higher intensity distribution. In addition, GDP was associated with higher intensity distribution. 

Purpose: Cancer, heart disease, Chronic obstructive pulmonary disease, depression, diabetes, stroke, and hypertension are among leading causes of death and disability in US. Physical activity (PA) has proven to be a mechanism for both prevention and management of chronic conditions. Although there is a strong association of PA and reduced risk and severity of chronic conditions, PA statistics and barriers among individuals with chronic conditions are unknown. The purpose of this study was to determine the differences in knowledge of physical activity recommendations (KPA), PA levels and perceived barriers to PA in healthy individuals (HI) and those with one or more of the above-mentioned chronic conditions (CI).

Methods: As a part of a larger ongoing-RCT, 116 older adults (mean age-63.76) completed self-reported measures of KPA and Perceived PA Barriers scale and wore an accelerometer to assess PA levels. Participants who self-reported having at least one of the chronic conditions were categorized as CI.

Results: N=44 HI, N=72 CI were analyzed. No significant differences regarding age, BMI and KPA were observed between the groups. Independent T-test showed a significant difference in accelerometer-measured moderate-vigorous intensity PA levels (MVPA), (p=.015) with the HI groups reporting 21.7 mins/day as compared to the CI group reporting 13.7 mins/day. Common barriers reported in both groups were procrastination, lack of self-discipline, exercise not a priority, lack of interest, exercise is boring, not in routine and fatigue. The prevalence of these barriers were significantly different across groups, with higher percentage of CI reporting frequent encounter with these barriers. Overall 64% of CI reported procrastination, 58% lack of self-discipline and 26% fatigue, compared to only 27%, 32% and 4.5% HI respectively.

Conclusion: Results demonstrated that, although CI’s report similar knowledge to PA guidelines as HI’s, they engage in significantly lower levels of MVPA. They also reported more barriers related to time, motivation, and energy levels which could be a function of their chronic condition. Future interventions targeting CIs should incorporate an educational component to promote strategies for overcoming these barriers, such as encouraging light PA, frequent breaks in sedentary-time, and shorter bouts of MVPA throughout the day.

Purpose: The majority of parent-based interventions address maternal practices and behaviors, excluding fathers and their role within the family. Failure to assess fathers’ parenting practices leaves a critical gap in understanding the etiology of childhood obesity. Additionally, there is little to no research examining how fathers’ stress may contribute to obesogenic behaviors in children. The purpose of this pilot project is to evaluate the effects of Latino fathers’ stress and parenting behaviors on their child’s dietary, physical activity, and sedentary behavior over the course of a single-wave, 7-day ecological momentary assessment (EMA) study.

Methods: Latino father-child participants (n= 50 dyads, children ages 8-12 years) will be recruited using snowball sampling methods, including church services, men’s faith groups, social media, and email fliers shared through elementary and middle schools. Study participants will complete a 7-day, single-wave EMA study that includes additional measures of salivary cortisol, anthropometric measures, 24-hr dietary recalls, measures of parental support of child healthy eating and physical activity, accelerometry, and paper surveys. The EMA protocol will include up to 4 prompts per day on weekdays in the afterschool hours (3 PM- 9 PM) and up to 8 prompts per day on weekend days (8 AM- 9 PM). 

Results: Multi-level modeling through random-effect regression models will be used to test the within-day effects of father’s stress on children’s obesogenic behaviors within any given day, taking into account clustering of observations within persons. Outcomes will be children’s dietary behaviors and time spent sedentary and in physical activity (measured through EMA, accelerometry, and 24-hour diet recalls) in specified time windows (+120 min., +180 min., +240 min.) after fathers’ EMA survey or saliva collection. Between-subject and within-subject predictors will allow distinction of time-varying predictors and the ability to examine temporal effects.

Conclusions: The results of this study will inform future R01 observational studies utilizing EMA to explore triadic relationships amongst parents and their children. Future work could qualitatively examine how to identify challenges related to parenting and supporting child healthy behaviors, stress and its impact on parenting, and best practices for recruitment and retention of Latino fathers in child health studies.

Background: Meeting 24-hour movement guidelines (24hr-MGs, MVPA >1 hour, Sleep duration 9-11hrs, Screen time duration<2 hours) is associated with positive health outcomes among children(5-17 years). Recent literature shows reduced structure may impact changes in children’s movement behaviors between the school year and summer. This observational study estimated changes in the prevalence of meeting 24hr-MGs among elementary-age children at three, structurally different timepoints (Fall 2020 [remote learning-pandemic], Spring [in-person school-pandemic] and Summer of 2021) during the COVID-19 pandemic. Due to school closures, the effect of neighborhood environment on 24hr-MG adherence was explored.

Methods: Children’s (n=841, mean age=8.4(1.7), 50% female, 33% Black) physical activity and sleep patterns were estimated using Actigraph GT9X for 14-days at each timepoint. Parents completed daily time diaries via SMS-text message for 14-days to report child’s total recreational screen time (ST). Children were classified as meeting each guideline if the daily guideline was met on >75% of measured days at each timepoint. Area Deprivation Index (ADI) was used to group (i.e., 1-3 Low-ADI; 4-7 Mid-ADI; 8-10 High-ADI) GIS-mapped census blocks by socioeconomic disadvantage. The prevalence of meeting combinations of guidelines (e.g. at least 3, 2, or 1) are reported by ADI at each timepoint.

Results: On measured days (mean=11.5[3.7]), few children met all three 24hr-MGs (Fall=2%, Spring=5%, Summer=2%). Across timepoints, a greater proportion of children living in Low-ADI neighborhoods met at least two 24hr-MGs than children in Mid/High-ADI neighborhoods (Fall: Low-ADI[22%], Mid-ADI[7%], High-ADI[13%]) (Spring: Low-ADI[29%], Mid-ADI[14%], High-ADI[12%]), (Summer: Low-ADI[21%], Mid-ADI[13%], High-ADI[15%]). Marginal differences in meeting at least one 24hr-MG were observed  (Fall: Low-ADI(37%), Mid-ADI[34%], High-ADI[28%]) (Spring: Low-ADI(36%), Mid-ADI[36%], High-ADI[34%]), (Summer: Low-ADI(37%), Mid-ADI[35%], High-ADI[34%]).

Conclusion: Consistent with previous literature, few children met all three 24hr-MGs. Notably, the prevalence of children who met at least two 24hr-MGs was considerably impacted by neighborhood socioeconomic disadvantage and disruptions in school schedules. These findings suggest that transformative community-level interventions are needed to promote children's adherence to 24hr-MGs throughout the year.

Introduction: At present, very little is understood about how best to deliver nutrition information and support to Irish cancer survivors. Ascertaining cancer survivors’ specific needs and preferences regarding nutrition information delivery is an important step in the development and design of future health interventions in oncology. Therefore, the aim of this study was to explore the nutrition information needs of Irish cancer survivors and their preferences regarding intervention delivery.

Methods: This was a mixed methods study. An online survey was circulated to and promoted by cancer support groups and centres as well on social media. Focus groups were conducted with twenty individuals. 

Results:  The majority of individuals who completed the survey were female (n=50, 89.3%) breast cancer survivors (n=42, 75%). Eleven (19.6%) had received nutrition advice with 7 of these reporting that advice came from a dietitian. The majority have an interest in receiving nutrition advice (n=52, 92.9%), however there was variability in how this should be delivered. The most popular additional resource desired was recipes (n=26, 46.4%). In addition to nutrition there was an interest in information on improving sleep quality (n=35, 62.5%), how to make positive lifestyle changes (n=28, 50%) and access to cancer specific physical activity classes (n=27, 48.2%). The best time to deliver information was throughout the cancer journey (n=31, 55.4%).  Time and motivation (both n=15,26.8%) were deemed to be the main barriers to taking part with the main facilitators being keeping healthy (n=42, 75%), and weight maintenance (n=31, 55.4%). Four themes emerged from the qualitative data; lack of nutrition guidance, abundance of misinformation, one size does not fit all and dietitians as preferred source of advice.  

Conclusion: There was a keen interest in receiving nutrition advice regularly throughout the cancer journey. There was also an interest in additional information to support improvements in sleep and physical activity. It is clear however that one size does not fit all in terms of how this information should be delivered. Understanding the barriers and facilitators to accessing this information will ensure the development of useful and desired resources.

Background: The current study aims to systematically review a comprehensive sample of websites in the English language that provide information on nutrition after a cancer diagnosis.

Methods: In consultation with cancer survivors and experts we developed search strings for an internet search (google incognito mode) to be completed in six English speaking countries (Ireland, UK, Australia, New Zealand, Canada, United States using the google specific search engine for each and the first 10 results for each page). Websites/pages were included if the links related to sites/content that provided information on health post diagnosis, in English and aimed at adults (aged 18+). To assess the quality of the websites the International Patient Decision Aids Standards (IPDAS) and JAMA were used. Flesch– Kincaid Reading Ease Score (FRES) and the Flesch–Kincaid Grade Level Score (FGLS) were determined using online software (www. readabilityformulas.com). useability was assessed using the Health Communication and Health Information Technology tool.

Results: In total, 720 links were found in the initial search with 159 of these eligible for inclusion.  The majority of web-links eligible for review were Charity/Support/NGO type web-links (49.1%), originated from the USA (42.8%) and did not specify a particular cancer type (65.4%).  Only one third (n=59, 37.1%) contained nutrition guidance however there was a lack of practical strategies for implementation. The majority of the websites/pages were not HON certified and were lacking in overall quality with a mean IPDAS score of 20.4/40 and JAMA score of 1/4. Readability also failed to meet ideal levels. In terms of usability, only 31% were usable for those with disabilities, 45% minimized vertical scrolling and 45% visually grouped related topics.

Conclusion: Cancer survivors seeking nutrition information online may find it difficult to locate advice, and where they do it is unlikely to contain guidance on how to implement the guidance into day-to-day life. This is a concerning finding, given the important role nutrition can play in cancer survivorship.

Given the unique challenges imposed by COVID-19 on previously marginalized communities, researchers are called to action to understand and respond to the evolving needs of residents in medically underserved areas (MUA’s). Ongoing pandemic-related challenges highlight a need for mindful and effective interventions to enhance access to resources supporting food access (FA) and physical activity (PA) resources and presents a new opportunity to incorporate community-informed strategies into interventions which reflect residents’ lived experiences. PURPOSE: To explore pandemic-related changes in resident-identified strategies to improve FA and PA resources in an Appalachian community’s MUA’s. METHODS: Surveys were collected from households in MUA-qualified census tracts in 2019 (n = 169) and 2021 (n = 82). Inductive content analysis was applied to open-ended survey questions to classify resident-identified resource needs related to FA and PA. Emergent themes from 2019 and 2021 were compared to understand thematic changes surrounding the pandemic. RESULTS: Prior to the pandemic (2019), emergent themes related to FA enhancement included access to healthier food options (healthier restaurant options, less fast and convenience foods; 17% of respondents), and neighborhood-level infrastructure (grocery stores, farmer’s markets, mobile markets; 11.1%); infrastructure upgrades (sidewalks, new parks, road maintenance; 61%), enhanced safety (greater police presence, less crime; 21%), and traffic calming measures (8%) emerged as strategies to enhance PA. In 2021, a higher proportion of residents described the need for neighborhood-level infrastructure to enhance food access (52%) and a desire for resources in close proximity to the home emerged (17%). Safety enhancements remained a prominent strategy to enhance PA in 2021 (43%), and COVID-related themes emerged (increased park sanitization, restrictions;1%).  CONCLUSIONS: As a result of the COVID-19 pandemic, resident-identified strategies to enhance FA and PA resources in Roanoke city’s MUA describe a shift toward supporting more proximal community needs. 

Objective: Learning high-quality domain word embeddings is critical for obtaining good performances in Machine Learning (ML) tasks. Typically, word embeddings are pre-trained on massive general-purpose data. However, for domain-specific applications, general-purpose embeddings learned are frequently inadequate. Although domain-specific tasks rarely have extensive in-domain corpora to train high-quality embeddings, embeddings trained on domain-specific corpora outperform those trained on general-purpose corpora. Hence, we provide a pre-trained corpus of domain specific embeddings of food concepts and recipes (by fusing food concept embeddings, with a heuristic defined using domain knowledge).

Methods: The data was accumulated from heterogenous publicly available recipe datasets. As these datasets came in different formats, data harmonization was necessary – defining a data format and transforming the datasets to fit that format. For the food concepts we obtain embeddings in two ways: applying word embedding algorithms on each word and merging the vectors; and applying paragraph embedding algorithms on the whole food concept. The recipe embeddings were obtained by fusing the food concept embeddings with a heuristic incorporating the quantities.

Results: For the food concept embeddings, the ingredients were needed, and for the recipe embeddings quantities and measurement units – all extracted using Natural Language Processing techniques on unstructured text. From the 2589277 ingredients contained in all datasets, after pre-processing, and lemmatization, 338824 unique ingredients were extracted, and food concept embeddings were learned on them. With embedding fusion on the food concept embeddings 230980 recipe embeddings were obtained. As one of the most important data information for ML tasks on food data is nutritional information, we enrich the data with nutrient values by mapping it to a nutrition database (FoodData).

Conclusion: As most recent work in ML takes advantage of textual representation using data mining and predictive techniques, we provide a predefined corpus of representations for food concept and recipes. With the captured semantic information in the embeddings the performance for domain-specific prediction tasks can be improved. Having such corpus reduces the development time of a ML pipeline for food predication tasks, by skipping the process of representation learning, and transferring the learned embeddings as input data in the modelling process.

Purpose: Identify variations in prevalence of US adults meeting the aerobic, muscle-strengthening, and combined aerobic and muscle-strengthening physical activity (PA) guidelines by rurality and region.

Methods: National Health Interview Survey (NHIS) 2020 public-use data were analyzed. Rurality was determined using a four-category version of the Urban-Rural Classification Scheme for Counties from the National Center for Health Statistics. Region was determined using the four-category US Census household region for each respondent. Self-reported frequency and duration of moderate, vigorous, and muscle-strengthening PA was used to categorize respondents as meeting or not meeting the 2018 PA guidelines for aerobic PA (≥150 minutes/week of MVPA), muscle-strengthening activity (≥2 days per week), and the combined PA guidelines. Multivariate logistic regression analyses were used to model predicted population probabilities of the three PA variables by rurality and region for adults 18-84 years old controlling for sex, age, race/ethnicity, education, and income-to-poverty ratio. Least-squares means estimates were produced to calculate predicted population margins for all categories of rurality and region. Analyses were performed with SAS 9.4© with parameters adjusted for population weights, clusters, and stratification.

Results/findings: Adults in the most rural county classification (Nonmetropolitan) were less likely to meet aerobic, muscle-strengthening, and combined PA guidelines compared to adults in the three other county classifications (AORs 0.67 – 0.88). Adults in the Medium and Small Metropolitan county classification were more likely than adults in the Nonmetropolitan counties to meet the PA guidelines but were less likely to meet PA guidelines than adults in the two most urban county classifications (i.e., Large Central Metro, Large Fringe Metro; AORs 0.85 – 0.88). Adults in the Northeast, Midwest, and South were all less likely to meet each of the PA guidelines when compared to adults in the West region (AORs 0.74 – 0.82).

Conclusions: These analyses are the first to identify with this level of rural-urban specificity where disparities exist in US adults meeting each of the three PA guidelines. Developing, testing, and implementing effective population-level interventions are desperately needed to increase PA in rural populations experiencing pernicious and pervasive PA and health disparities.

Purpose: The LSU AgCenter SNAP-Ed program implements a variety of policy, systems, and environmental (PSE) changes according to needs identified by local community members and partners. One PSE change that is often made to promote physical activity in parks and playgrounds lacking other equipment is stenciling of concrete spaces using designs that prompt active play, demonstrate yoga poses, and promote other forms of activity. Stencils are a low-resource way to promote physical activity, but little prior work has evaluated their acceptability and effectiveness. This cross sectional, mixed methods evaluation sought to identify how these stencils are being used, preferred types of stencils, the reach of stencil projects, and the general perception of stencil projects.

Methods: SNAP-Ed staff distributed surveys to teachers and administrators at locations where stencils had been placed in the past year. Surveys asked respondents to report observed changes in student activity after stencil placement, the number of students at the school, and the types of stencils that were most used and preferred by students. Open ended questions asked respondents to describe how stencils were used, how students’ physical activity changed, and suggestions for improvement and additional comments.

Results/Findings: Surveys were completed by respondents at 20 locations where stencils were placed, with an estimated reach of 5236 students. Half (n=10) of respondents reported that students’ activity levels stayed the same, and nine respondents (45%) reported an increase in activity levels. The most frequently observed exercises at stencil sites were jumping (n=16, 80%), walking (n=11, 55%), and muscle strengthening exercises (n=10, 50%). A majority of respondents stated students were primarily interested in hopscotch stencils (n=12, 60%). Qualitative themes included the importance of making physical activity spaces inviting and attractive and the importance of stencils during the pandemic.

Conclusions: Despite the limitations of the cross-sectional survey design, our results indicate that stencils may be a low-resource PSE change that can support active play for a large number of school children.

Purpose:

Eating later in the day (dinner and evening snacks) may have a role in the development of obesity. However, most studies are cross-sectional and rarely focus on children in Eastern countries. Therefore, we investigated associations between dinner/evening snacks intake and later obesity in a nationally representative Chinese sample.

Methods:

A total of 1292 children participating in the ongoing open cohort (CHNS) from 1997 to 2011, with complete 24-hour dietary recall for three consecutive days at 7-8 years and anthropometric data over 2-4 years of follow-up, were included. Dietary recalls recorded food names and size (grams) for each meal or snack consumed. Chinese food composition tables were used to capture energy intake (kcal). “Dinner/evening snack size” was the percentage of total energy intake (%TEI) for dinner or evening snack. “Dinner/evening snack frequency” was the total number of dinners or evening snack over 3 days (0-3 dinners, 0-3 evening snacks). Outcomes (body mass index (BMI); overweight/obesity) were assessed at 10.5 years. Multiple linear and logistic regression was used for estimating the association between later eating and each outcome. Interaction analysis was used to assess gender differences. Adjustment was made for age, gender, residency, parental education, maternal age, physical activity, maternal BMI, snack frequency, TEI and baseline BMI. 

Results:

Children had 36.0% (SD 9.4%) and 2.1% (SD 5.8%) of TEI for dinner and evening snacks respectively. Average dinner frequency was 3.0 (SD 0.2) times over 3 days, and 98% of children ate dinner every day; average evening snack frequency was 0.3 (SD 0.8) times over 3 days, only 6% of children ate evening snacks on all 3 days, 10% ate them once or twice, and 84% did not have any. Having evening snacks was associated with higher outcomes (BMI: b (95%CI) =0.50 (0.18 0.83) kg/m² per time/3 days; overweight/obesity: OR (95%CI) =1.74 (1.19 2.55) per time/3 days). No other associations or interactions were found.

Conclusions:

We observed that consuming evening snacks, but not dinner, were prospectively associated with obesity. Therefore, it is worth considering later eating behaviours in preventing obesity in children in Eastern countries.

Purpose:

Later eating rhythm (LER), termed night eating in adult studies, refers to a later timing, greater energy intake (EI), and higher meal frequency in children in the evening. The role of eating later in obesity development is emerging, but most evidence is cross-sectional, considers just one feature of LER and is rarely studied in children. Therefore, we investigated associations of LER at age 7 with adiposity over 2 years of follow-up.

Methods:

A total of 4029 children aged 7 years with complete 3-day food diaries from the ongoing UK birth cohort (ALSPAC) were included. Diaries recorded the exact time of, and energy consumed in each eating occasion (EO). An individual EO was separated by the unique time of food intake. Bedtime was parent-reported via questionnaire. “Last mealtime” was the time of the last reported EO; “Eating before bedtime” was the percentage of total energy intake (%TEI) consumed within 2 hours before bedtime; “Eating frequency” was the counts of EOs for 5pm-12am; all variables were averaged over 3 days. Outcomes (body mass index (BMI); overweight/obesity) were assessed at 9 years. Multiple linear and logistic regression was used for estimating the association between LER and each outcome. Interaction analysis was used to assess gender differences. Adjustment was made for age, gender, ethnicity, parental education, maternal age, TV watching and parental late eating.  

Results:

Average last mealtime was 7.10pm (SD 56mins), boys ate 6.0 mins (SE 1.8 mins) later than girls (p=0.001). Children consumed 17.2% (SD 11.9%) of TEI before bedtime with no gender differences (p=0.858). Average eating frequency was 2.3 (SD 0.9) EOs, 2.4 in boys vs. 2.2 in girls (p<0.001). Last mealtime was positively associated with BMI (b(95% CI) =0.12(0.01, 0.23) kg/m2 per hour later). Eating more before bedtime was associated with lower outcomes (BMI: b(95% CI) =-0.10(-0.19, -0.01) kg/m2 per 10%TEI; overweight/obesity: OR(95% CI)=0.91(0.83,0.99) per 10%TEI). No other associations or strong gender interactions were found.

Conclusions:

We observed that the timing and EI, but not frequency, of later eating occasions was prospectively associated with obesity in children. Therefore, LER should be considered when developing dietary guidelines in children.   

Purpose: Despite the potential of public transit use to increase transportation-related physical activity through walking or biking to and from transit stops, public transit ridership in many areas within the United States remains low. To increase public transit use, multiple influences of behavior associated with public transit use must be identified. The purpose of this study was to determine the associations between psychosocial constructs and public transit use among a racially and ethnically diverse sample of adults living in Houston, Texas, USA.

Methods: This cross-sectional analysis was conducted using baseline data from Houston Travel-Related Activity in Neighborhoods (TRAIN), a natural experiment involving more that 800 participants on the effect of new light-rail transit on transit use and physical activity (2013-2018). All variables were self-reported by participants using a questionnaire. Independent variables were psychosocial constructs guided by the Social-Ecological Model (SEM), which included subjective norm, perceived behavior control, attitude, self-efficacy, and decisional balance pros/cons. The dependent variable of interest was reported public transit use for transportation in their lifetime, dichotomized into user vs. non-user. A multivariable logistic regression model was used to test the hypothesis that SEM psychosocial constructs variables were associated with public transit-use, while adjusting for socio-demographics.

Results: The 388 adults (M=48.9 years) in the analytic sample were diverse (38.5% White, 28.9% Black, 25.8% Hispanic or Latino), primarily female (60.1%), and living at or above the federal poverty level (92.8%). Most participants (83.2%) reported that they had used public transit for transportation in their lifetime. In general, adults with higher subjective norm scores (OR = 2.75, 95% CI [1.43, 5.41]) and attitude scores (OR = 2.30, 95% CI [1.24, 4.37]) had a greater odds of reporting public transit use for transportation in their lifetime.

Conclusion: Results suggest that to encourage public transit ridership, and perhaps the physical activity associated with transit use, efforts to improve attitudes (perceptions of pleasantness and usefulness) and subjective norms (supported by others) towards public transit use may be an effective public health strategy.

Purpose: Numerous barriers exist that prevent many Latinos from engaging in research studies including acculturation status, language proficiency, time, trust, and cultural values. Multiple recruitment and retention strategies are used to increase Latino participation in health research, including person-to-person recruitment, culturally tailoring interventions for the sample population, and trust-building. Understanding the recruitment, retention, and engagement practices of Latino parents is critical to improve intervention effectiveness in studies that address Latino children’s weight-related behaviors. Thus, the purpose of this study is to summarize the current literature regarding recruitment and retention in Hispanic/Latino child weight-related interventions.

Methods: Literature searches were conducted from six databases: CINAHL, Cochrane, ERIC, PubMed (MEDLINE), PsychInfo, and SocIndex.  Two reviewers independently screened titles/abstracts and full texts for inclusion; any disagreements were resolved by a trained third reviewer.  Of the 1,692 articles pulled from the databases, 19 were included in the final analysis.   

Results: Recruitment duration ranged from 8 to 36 months, with an average enrollment of 5% for Latino fathers. Recruitment locations included local hospitals/health clinics (40%), schools (20%), community organizations (20%), schools (20%), social media (4%), and WIC/SNAP offices (16%).  Recruitment strategies were consolidated into three categories: Direct-Personal, Direct-Not Personal, Indirect. Direct-personal recruitment strategies included promotoras, word-of-mouth, telephone calls, and community events. Direct-not personal recruitment strategies incorporated targeted messages to a specific audience directly, but did not include any personal contact (e.g., email, letters). Indirect recruitment strategies incorporated broad-reaching, untailored messaging techniques that did not include personal contact (e.g., flyers/brochures, newspaper advertisements, posters, websites, radio commercials). Indirect recruitment was most frequently used. Retention at the end of the intervention was reported by all 19 studies (average retention rate of 79%) and three studies reported retention rates at the end of the study follow-up (76% retention).

Conclusions: Latino fathers are not equally represented in child weight-related studies, which negatively influence our understanding of the true etiology of child obesity.  Future research needs to address barriers and facilitators for Latino fathers to increase effective intervention delivery. This may include recruitment at locations that Latino fathers frequent, along with strategies that specifically target men, including personal contact at recruitment locations.

Purpose: Play Streets have demonstrated feasibility and physical activity benefit in rural U.S. areas, yet information is needed to identify implementation characteristics that promote sustainability. This study examined rural Play Streets implementation characteristics that can impact sustainability from local partners’ perspectives.

Methods: Play Streets are community-led environmental initiatives where public spaces/streets are temporarily closed to create safe, low-cost physical activity opportunities.

This study explored perceptions of 16 local partners who implemented Play Streets in rural U.S. communities (rural-urban commuting area code ≥4.0) in the summers of 2017 and 2018. Participating communities were in Maryland, North Carolina, Oklahoma, and Texas. Eligible interview participants included Play Streets implementation team members. Semi-structured in-person individual (n=4) and group (n=5; 2-3 participants each) interviews were conducted in the fall of 2018. Interviews were recorded and transcribed verbatim. A coding protocol was developed collaboratively by two researchers. Transcripts were coded using iterative inductive and deductive approaches based on the Public Health Program Capacity for Sustainability Framework (NVivo). The coding process included peer review for maximum quality.

Results/findings: Characteristics perceived as facilitating Play Streets implementation aligned with the Public Health Program Capacity for Sustainability Framework: funding stability, political support, partnerships, organizational capacity, program adaption, and communication. In addition to capacity characteristics, results revealed that public health impacts (e.g., social, physical benefits) were both positive outcomes of Play Streets and factors that could influence future implementation and sustainability. For instance, partners identified community connectedness/engagement and availability of public spaces (e.g., recreational facilities, parks) as key to implementation. Participants noted community connectedness/engagement as reciprocally impactful, since it was noted as an impact of Play Streets implementation and also a motivator/facilitator for future efforts: “For me, it was more community. I mean, this year's overall thing was about community and what each individual community, the resources they had within their community and that was kind of just a difference.”

Conclusions: Play Streets implementation characteristics noted by community partners align with capacity factors known to impact sustainability. In addition to considering capacity characteristics, future research should examine the reciprocal role of public health impacts: as both outcomes and factors influencing sustainability.

Purpose: This study examined the relationship between school demographics and satellite-measured temperature. While significant deviations in temperature have been identified between neighborhoods throughout the world, research on schools is limited. Schools, as centers of activity and exposure for children and families, represent focal points of community life and key exposure locales. Exposure to chronic high temperatures has been shown to negatively affect school performance, sleep, and engagement in physical activity. We hypothesized that schools with higher proportion of Black, Hispanic, or non-White students would have high afternoon temperatures relative to regional means.

Methods: We processed land surface temperatures derived from NASA’s Aqua satellite for the continental United States for each cloudless day in September for the years 2013-2016 to create a single average afternoon temperature at 1kmX1km resolution which we aggregated to school point (e.g., 9 sq km surrounding school location) and catchment area (e.g., geographic area in which resident students are assigned to the school). Our analysis included 47,061 elementary, 31,729 middle, and 16,303 high schools nested inside 12,145 districts. We used OLS regression with fixed effects to control for local conditions, then used interaction terms to investigate city- and district-specific associations between student demographics and temperature in the biggest cities and districts.

Results: Controlling for local conditions at state, city, and distance-buffer levels, we found that student demographics are predictive of school temperature deviations. Nationwide, a 10% increase in the student population of Black, Hispanic, or non-White students was associated with 0.44-0.64 degrees higher temperature when controlling for state, 0.38-0.46 degrees when controlling for city, and 0.19-0.25 degrees when controlling for a 25-mile buffer, relative to the area mean. Large differences in associations were identified by city and district. Amongst the 8 largest cities (16.1% of schools; 19.6% of students), city-specific associations between an increase in 10% of the students ranged from -0.27 degrees (Black, high school, Los Angeles) to 0.77 degrees (Hispanic, high school, Philadelphia).

Conclusions: Schools are the workplace for the job of learning, but different populations are faced with different conditions. Racially-patterned disparities can be addressed through appropriate school, district, and city-level interventions.

Purpose: As hypothesized in the social ecological model, one’s built and social environments play an important role in physical activity (PA) behavior. Further, these environments have critical overlap and influence one another. A thorough review of studies assessing these influences is needed to identify similarities as and gaps in the literature to leverage future change. This review aims to examine articles that simultaneously assessed influential aspects of the built and social environments on PA.

Methods: A comprehensive search of the literature was performed using PsycINFO, MEDLINE, PubMed, and Web of Science databases. To be included in the final sample, articles needed to: 1) include a measure of PA either self-reported or objectively measured, 2) include a measure of the built environment such as walkability or accessibility to parks, 3) include a measure of the social environment such as social networks, social support, or social norms, and 4) conduct an analysis between built environment, social environment, and physical activity. An initial search of 4,358 articles resulted in 87 articles which met inclusion criteria.

Results: Several populations were present within the sample including various age groups and countries. As previously established, the built environment and social environment were consistently associated with PA; however, mediating factors and associations between these two layers were less clear. Additionally, while measurement of PA was relatively homogenous, the constructs and methods of measurement for built and social environments were less consistent. Further, there was a lack of longitudinal and causal methodologies as well as examination of these associations across groups with noted health disparities.

Conclusions: Results here call for more longitudinal and causal designs with more validated and granular social and built environment measures. Examining these associations in correspondence with related health disparities would promote greater understanding of policies and environments which may exacerbate these disparities. As communities recover from the COVID-19 pandemic, a thorough understanding of how built environment factors enhance or detract from social connectedness and how this reciprocal relationship impacts PA behavior is needed for future policy, environment, and systematic change.

Background: African American (AA) women report the lowest levels of physical activity (PA) compared to any other racial/ethnic and gender group and are more likely to be sedentary. This is significant given the pattern of health outcomes observed in AA women. AA women are disproportionately impacted by cardiometabolic diseases when compared to women of other racial/ethnic groups. Given the relationship between inactivity and disease risk, health educators must consider effective PA interventions in an effort to improve health outcomes in AA women and achieve health equity. Social Cognitive Theory (SCT) has been successfully used to explain the process of behavior change across several health behaviors, including PA behavior. This analysis addresses two specific research questions: 1) Do PA interventions targeting AA women influence SCT psychosocial variables; 2) Are increases in SCT psychosocial variables followed by PA increases in interventions for AA women?

Methods: A literature search of three databases was conducted using the following search terms – Social Cognitive Theory, Physical Activity, African American Women, Black Women – to identify behavioral interventions targeting PA in AA women.

Results: Our search returned 43 articles; 14 studies met search criteria and were included in this systematic review. The most frequently targeted SCT psychosocial varaibles were social support, self-efficacy, and outcome expectations. Social support and self-regulation/goal setting were the varaibles most frequently associated with increases in PA behavior.

Conclusions: Our systematic review revealed that social support and self-regulation were associated with positive changes in PA behavior. Future research should further explore the relationship between SCT psychosocial variables and PA in AA women. Culturally-tailored programming was incorporated into three of the studies we reviewed. Further investigation is needed to better understand the utility of culturally-tailored programs to promote PA in AA women. Given the relatively small sample sizes and short-duration of studies included in this review, larger and more long-term studies will be needed to better understand correlates of adoption and adherence of PA in AA women. 

Background/purpose: Physical activity behaviors are socioeconomically patterned. Understanding if, and how, the built environment contributes to socioeconomic inequalities in physical activity among children and adolescents and for whom built environments are most important, can lead to the identification of intervention entry points to reduce inequalities in physical activity. Therefore, this systematic review aims to summarize the existing evidence among children and adolescents on a) whether the built environment mediates the association between socioeconomic position (SEP) and physical activity and b) whether SEP moderates the association between the built environment and physical activity.  

Methods: PubMed, Embase, PsycINFO and Web of Science were searched from inception to the 4^th of August 2021. Two independent reviewers screened articles for eligibility and extracted information from the included studies. The Quality Assessment Tool for Observational Cohort and Cross-Sectional studies was used for risk of bias assessment. We performed a narrative evidence synthesis considering the totality of the evidence and by study characteristics such as geographic region, age-group, and exposure-outcome assessment methodology.

Results/findings: The search yielded 28 papers eligible for the review. Based on three studies, there was no evidence to support the built environment functions as a mediator in the relationship between SEP and physical activity. Conflicting evidence was found for SEP as a moderator in the association between the built environment and physical activity. Five studies reported stronger associations between built environment and physical activity behaviors among high SEP youths, while seven studies reported stronger associations among low SEP youth. Fourteen studies found no difference in the associations. We observed different moderation patterns across geographical regions (Europe vs US), but not across younger vs older children or exposure-outcome assessment methodology. The evidence base consists of cross-sectional studies with insufficient control for putative confounding sources.

Conclusions: Current evidence does not support a strong interplay between built environment and SEP on physical activity in youth, however, given the quality of the evidence, firm conclusions cannot be made, and additional high-quality research is likely to have a substantial impact.

Purpose: Physical activity (PA) participation changes across the life span and tends to decrease with age. Due to the positive relationship between sport participation and PA, younger adolescents may obtain higher levels of PA than older adolescents because they are more likely to be enrolled in organized sport. The purpose of this study was to compare middle school, high school and college sport participation (percentage and number of sports played) between college athletes and non-athletes enrolled in a private Division III, US college. A secondary aim was to compare self-reported PA levels, fruit and vegetable intake, BMI, happiness, sleep duration and stress between college athletes and non-athletes.

Methods: 156 college students (71 athletes (31 male: 40 female) and 85 non-athletes (60 male: 25 female), mean age of 20.8±2.4 years) completed a survey that asked about sports participation in middle school [grades 6-8], high school [grades 9-12], and college. Also, current PA levels, fruit and vegetable intake, BMI, happiness, sleep duration and stress were collected. Mann Whitney U tests compared responses between college athletes and non-athletes. 

Results: Overall sports participation declined with age (80.8% in middle, 78.8% in high school, and 45.9% in college). College athletes were more likely to play sports in middle (97.2% verses 67.1%) and high school (100% verses 61.2%), participate in more sports in middle (1.73±1.1 verses 1.0±1.2) and high school (1.9±1.2 verses 1.1±1.3), and report greater minutes per week of moderate (288±251 versus 144±190) and vigorous PA (478±259 versus 191±212) compared to non-athletes (all p<0.05). College athletes also reported greater happiness (8.8±1.5 versus 8.0±2.0), longer sleep duration (6.8±0.9 versus 6.3±1.3), and less stress (23.3±8.6 versus 27.3±7.4) compared to non-athletes (all p<0.05). There were no differences in BMI (mean=26.3±5.5), or fruit and vegetable intake (mean=3.4±2.9). 

Conclusions: This study supports a decline in PA from middle school through college. Due their current involvement in sport, compared to non-athletes, college athletes may spend more time in moderate and vigorous PA and may be more likely to score favorably on numerous wellness indicators including PA levels, happiness, sleep duration and stress that could comprise a wellness report card.  

Purpose: Motor skills are important for the physical, social and cognitive development of young children. The development of these motor skills is stimulated by physical activity. However, due to the Covid-19 pandemic, primary schools were closed and organized sports were cancelled. Hereby possibilities for guided physical activities (PhysicalEducation and organized sports) were diminished. In Amsterdam sport participation (4 times per month or more) for children aged 5-12 years was 49% instead of the expected 81%. In contrast, the group of children who did not participate in sports increased from the expected 10% to the actual 42%. Possibly, this could result in a decreased development of motor skills in young children. Therefore, the aim of this study is to investigate the effects of the first Dutch lockdown on the motor skills of Dutch primary school children.

Methods: We compared data on the motor skill development from 6 years old (6,59 ± 0,43) to 7 years old (7,54 ± 0,40) for three groups: 2017 to 2018 (control group 1 (CG1), n=293), 2018 to 2019 (control group 2 (CG2), n=259) and 2019 to 2020 (lockdown group (LG), n=239). Motor skills were measured using the 4 Skills Test and led to a score of Motor Age which was used to determine the Motor Lead (ML)  (Motor Age  ̶  Calender Age).  A 3x2 RM-ANOVA-analysis was carried out to compare the 3 groups over time.

Results: Preliminary results show that the change in ML between ages 6 and 7 years is dependent on the group (change ML: 0,01 years, 0,14 years, and -0,09 years for CG1, CG2, and LG, respectively (p=0,019). The LG showed less progress in ML than CG2 (p=0,016), but not than CG1 (P>0,05).

Conclusions: The results indicate that the imposed lockdown restrictions might have had a negative effect on children’s motor skills development. Further analysis is needed because there is considerable variation in the change in ML between years, which could mean that the observed difference between CG2 and LG is within the standard variation in ML-change. Therefore, we will extend our analyses to both extra control groups and a second lockdown group.

It is well known that physical activity (PA) decreases dramatically during adolescence, thus indicating that maturation has an effect on adolescents’ PA. However, only a few studies focused on the differences between early and late maturing girls’ and boys’ PA over a longitudinal period.

The aim of the study was to investigate the influence of early- and late-maturation on adolescent boys’ and girls' PA during the mid-adolescence over a 3-year longitudinal period.

One hundred and thirty (58 girls and 72 boys) learners with a mean age of 13.08±3.40 years (girls) and 13.60±4.01 years (boys) at baseline, from one Quintile 5 High School were selected to participate in the 3-year longitudinal study. Gender groups were divided into early-, average- and late-maturing groups based on their maturation status (maturity offset score), classified by maturation differences of more than 6 months above or below the mean maturity offset score. Anthropometric measurements (ISAK protocol) and PA levels (PAQ-C Questionnaire) were used to collect the data. Basic statistics, independent t-testing (p<0.05), effect size (Cohan’s d-value), breakdown and one-way ANOVA with a Tuckey adjustment was used to analyse the data.

Early developing girls and boys were taller, heavier, had longer sitting height, arm span and a higher BMI during baseline measurements. Early maturing groups in girls and boys were found to be more physically active, especially at a younger age. In Grade 8 (13 years of age), small to medium practically significance was found between early and late maturation groups’ PA, although these findings were statistically insignificant (p>0.05), these differences decreased (p>0.05) in both girls and boys during Grade 10 (15-16 years of age). Late developing groups also surpassed the early developing groups in certain aspects of PA with increased age (p>0.05, d>0.5). 

Maturational differences do have an influence on girls’ and boys’ PA respectively. Although early maturation initially is beneficial to PA, it seems that late maturation has a better lasting effect on higher PA levels in boys and girls at a later age. As a result, boys’, and girls’ PA respectively, can only be adequately compared after having reached puberty

Purpose. Adolescents would consume large amounts of sugar-sweetened beverages (SSB), which would expose them to health issues. It is important to have questionnaires to measure adolescents’ consumption of SSB and healthier beverage options that are short and easy to complete. To our knowledge, only one questionnaire measures frequency and quantity of beverages (BEVQ), and this tool was validated among English-speaking adolescents in the United States. The objective of this study was to adapt and validate a French version of this questionnaire among French-speaking adolescents.

Methods. The BEVQ was translated in French and only the items on SSB, 100% pure fruit juice and water were retained. The French version of the BEVQ was reviewed by seven experts from different domains (public health, nutrition and behavioral sciences) and pretested among five French-speaking adolescents to verify if its items were easy to understand. Finally, 60 French-speaking adolescents (14-17 years) from two regions in Quebec (Canada) completed the French version of the BEVQ twice at a two-week interval and two Web-based 24-hour dietary recalls (R24W). The temporal stability of the French version of the BEVQ was evaluated with intra-class coefficients (ICC) and its validity using Spearman correlations (r_s) between reported intakes from the BEVQ and from the two R24W.

Results. The mean age of participants was 15.3±1.1 years and 55.6% of the sample were girls. The French version of the BEVQ had acceptable temporal stability for the quantity of SSB (ICC: 0.68; 95% confidence interval [CI]: 0.46; 0.81), 100% pure fruit juice (ICC: 0.54; 95% CI: 0.23; 0.72) and water (ICC: 0.66; 95% CI: 0.38; 0.81) consumed by adolescents. The quantities of SSB (r_s=0.49; p<0.0001), 100% pure fruit juice (r_s=0.38; p=0.0024) and water (r_s=0.37; p=0.0034) reported in the French version of the BEVQ were significantly correlated to those of the two R24W.

Conclusions. The French version of the BEVQ has adequate psychometric properties to measure SSB, 100% pure fruit juice and water consumption among adolescents. It could be an interesting tool to evaluate French-speaking adolescents’ consumption of SSB, including for public health interventions aimed at promoting healthier beverage options among this high-risk population.

Purpose: Walkable communities benefit individuals and society and enhance social capital. Perceived walkable destinations have been shown to benefit social capital, but little is known about how community type (urban, suburban, or rural) may impact this relationship.  

Methods: This study uses the Survey of the Health of Wisconsin, a probability sample (N = 1957) with measures including four social capital scales (community participation, sense of belonging, leadership competence, and policy control), perceived walkable destinations within a 10-minute walk (additive scale of 18 possible destination categories), and moderation analysis by urban, suburban, or rural community. Moderation analyses tested main hypotheses using Process (model 2). A multiple linear regression model for each social capital scale was tested using perceived walkable destinations as the main predictor variable, with two binary variables indicating rural and suburban residence as moderators, while covariates included sex, race/ethnicity, household income, neighborhood safety, and education.

Results: Destinations within a 10-minute walk from home support social capital in all community types. Urban and suburban residents benefited in 4 social capital scales; rural residents were associated with higher social capital for 3 scales (no benefit for community participation). For sense of belonging, leadership competence, and policy control, participants in urban, suburban, and rural communities report a .02 higher social capital per category of walkable destination within 10 minutes. This effect is additive. For community participation, only urban and suburban participants saw a .02 benefit per category of perceived walkable destinations.

Conclusions: Living within a 10-minute walk of different types of destinations relates to higher reports of social capital in the forms of community participation, sense of community, leadership competence, and policy control. Findings revealed that the relationship between 10-minue walkable destinations and community participation was conditional on the type of community participants lived in. For participants living in urban and suburban communities, increases in 10-minute walkable destinations was associated with increases in community participation. However, this was not the case for individuals living in rural communities where community participation was stable, regardless of perceived walkable destinations. These findings indicate walkable destinations bolster social capital, moderated by rurality for community participation.

Purpose. Over 40% of adults in the United States have obesity. Obesity is associated with leading causes of preventable death, including heart disease, and psychosocial challenges, including lower quality of life (QOL). Weight loss of 5-10% of body weight significantly improves health and quality of life, though these findings are primarily derived from studies conducted in centers of excellence. It is unclear if similar improvements in quality of life are achieved during pragmatic trials that treat underserved patients. The present analysis tested the hypothesis that, compared to a usual care (UC) control group, qualify of life would significantly improve among underserved patients who received an intensive lifestyle intervention (ILI) for weight loss.

Methods. Data from a 24-month pragmatic cluster-randomized trial were evaluated. Of 18 clinics enrolled, 9 were randomly assigned to provide patients with UC and 9 to deliver an ILI for weight loss (N=803). Assessments occurred at baseline and months 6, 12, and 24. Weight-related QOL was assessed with the Impact of Weight on Qualify of Life – Lite (IWQOL) and health-related QOL was assessed with the PROMIS-29. Using an intent-to-treat approach, change on the outcome variables was examined with a linear mixed effects multi-level model, with intervention group, clinic, assessment time, and their interactions included in the model.

Results. The sample was predominantly Black (67.3%) and female (84.4%). Mean+SD age and body mass index were 49.4+13.1 years and 37.2+4.7 kg/m², respectively. Weight loss at month 24 was significantly greater in the ILI (-4.99%) vs. the UC (-0.48%) group. Compared to UC, the ILI group experienced significant improvements in weight-related QOL, measured with the IWQOL’s Total score and Physical Function scale, at months 6, 12, and 24. Self-esteem, measured with the IWQOL, increased significantly in the ILI vs. UC group at months 6 and 12. With one exception at month 6 (Social Functioning), change in PROMIS scores did not differ by group.

Conclusions. Weight loss induced by an ILI improved weight-related QOL among underserved patients in a pragmatic trial, extending findings from previous clinical trials. Improvements in health-related QOL were modest, possibly due to poor sensitivity of the PROMIS. 

Purpose: Louisiana has some of the lowest rates of physical activity in the United States (ranking 46 out of 50, with an inactivity rate of 30.8%) and these rates are even lower for women.  Understanding what motivates women to engage in physical activity can help researchers and public health practitioners address inactivity in this population.  The purpose of this study is to describe walking group behaviors, facilitators and barriers for women who live small towns (less than 5,000) and consistently exercise with a partner. 

Methods: Women were recruited through local Extension SNAP-Ed agents in 4 counties with high adult obesity rates (35-42%). Inclusion criteria included being at least 18 years old, and walking with a partner at least once a week for a minimum of 2 months. Due to COVID-19, women were given the option to complete the interview over Zoom, outdoors, or distanced with masks indoors. Seven interviews were completed, with a total of 14 participants, as well as a demographic intake form and informed consent.  Interview recordings were transcribed and coded for like themes.

Results: Participants ranged in age from 33-77 years old, with a mean age of 54.2. Eleven participants were Black, 3 were White (all non-Hispanic). Three women reported participating in food assistance programs. Accountability and encouragement from their walking partner emerged as a primary theme in each interview. Themes also included lack of sidewalks and fear for safety from traffic as a barriers and parks with walking trails and personal concerns about chronic diseases as facilitators.

Conclusions: Social support is critical for maintaining physical activity habits among women in small towns. A walking partner was viewed as essential for maintaining consistency and remaining motivated. Promoting ways to meet other women to walk together through community partnerships, local libraries, or faith communities could be a low cost-way to increase physical activity levels in women living in small towns.

Purpose: Adolescents living in low- and middle-income countries (LMICs) may be affected by various socioecological factors affecting their food and built environments and thereby influencing dietary intake and physical activity. We explored how adolescents’ food and built environments influenced nutrition knowledge and practices and self-reported physical activity.

Methods: A cross sectional study of 528 adolescents (10-18 years old) from 3 urban communities in LMICs (Yaoundé (n=227), Kingston (n=158) and Cape Town (n=143)) was conducted. The environmental socio-economic exposure (ESE) for each participant was determined using neighbourhood and school characteristics and adolescents grouped into 3 ESE categories (low-low (LL), low-high (LH) and high-high (HH)). Dietary behaviours (frequency of consumption of country-specific healthy and unhealthy foods, breakfast consumption and snacking) and nutrition knowledge was determined by questionnaire. The physical activity questionnaire (adapted from South Africa) captured information on the frequency and intensity of informal, school-related and extra-curricular physical activities and travel activity. Anthropometric measurements were obtained by trained researchers. Site-specific ordinal and binary regression analyses were used to explore the associations of ESE with dietary behaviours (low, moderate and high scores) and total moderate to vigorous physical activity (MVPA) behaviours (low engagement and high engagement) respectively.

Results: Of the 528 adolescents, 69.3% were female and 55.9% were over 15 years old. Over two-thirds of the adolescents (68.0%) resided in low-income neighbourhoods, and 63.3% attended schools in high income settings. Country effects were not significant. Overall, higher ESE was associated with better dietary behaviours (p=0.041) and nutrition knowledge (p=0.001) but after adjusting for age and BMI-for-age, only the adolescents residing in high-income settings attending schools in high-income settings (HH) showed significantly higher nutrition knowledge (OR=1.90, 95% CI 1.29-2.79, p=0.001). Overall, only travel-related physical activity was associated with ESE (p=0.002) but after adjusting for sex, age, BMI-for-age, and engagement in each PA domain, only the adolescents residing in low-income settings attending schools in high-income settings (LH) showed significantly lower odds of highly engaging in MVPA (OR=0.45, 95% CI 0.27-0.75, p=0.002).

Conclusion: ESE specific interventions are needed to address issues of adolescent obesity risk focused on dietary behaviours and physical inactivity in LMICs.

Purpose

In recent years, research on the combination of physical activity, sedentary behavior, and sleep has grown. Interestingly, these behaviors affect more than just physical outcomes. Therefore, the objective of the systematic review is to evaluate different combinations of physical activity, sedentary behavior, and sleep duration and their associations with health and non-health outcomes in children and adolescents. 

Methods

MEDLINE, CINAHL, PsychINFO, SPORTDiscus, PubMed, EMBASE, and ERIC were searched in June 2020. Studies needed to quantitatively analyse the association of two or more movement behaviors (i.e., physical activity, sedentary behavior, sleep) with an outcome, the average age of participants needed to be between 5-17 years old, and include an abstract published in English. 

Results 

We identified 141 studies that met the inclusion criteria. Most studies included the combination of physical activity and sedentary behavior in their analyses. Sleep was studied less frequently. High physical activity and low sedentary behavior was associated with the best physical health, psychological health, and education-related outcomes. When sleep was analysed it was often the most important factor associated with favorable outcomes. The role of sedentary behavior had a stronger influence in adolescents than children and tended to be associated more negatively with outcomes when it was defined as screen time compared with overall time spent being sedentary.

Conclusion 

Researchers are recognizing the importance of studying movement behaviors in combination as opposed to in isolation. Sleep has been understudied, but consistently showed a positive association across many outcomes. More initiatives and guidelines combining all three movement behaviors will benefit adiposity, cardiometabolic risk factors, cardiorespiratory fitness, muscular physical fitness, well-being, health-related quality of life, mental health, academic performance, and cognitive/executive function.

Purpose: To apply a dietary index based on the recommendations of the EAT-Lancet Commission on Food, Planet, Health in a nationally-representative sample of US adults and examine how different data specifications affect derivation of the index. A secondary objective is to explore the association between this index and cardiometabolic risk factors.

Methods: 24-hour recall data from 4,923 adults in the 2017-2018 cycle of the National Health and Nutrition Examination Survey (NHANES) were coded in three ways: single-day recall; mean of two-day recalls (mean); and usual intake estimated by two-part modeling (twopm). Fourteen food groups were used to derive the Planetary Health Diet Index (PHDI) in accordance with the recommendations of the EAT-Lancet Commission, with values ranging from 0 to 10 for each food group. Participants were classified into quintiles of each PHDI (i.e., index from single-day, mean, or twopm input data). ANOVA and χ2 were used to test for differences in sociodemographic characteristics across quintiles. Multivariable logistic regression was used to estimate the association of each PHDI with obesity and hypertension.

Results: PHDI values ranged from 22-115.5 (single-day), 23-114 (mean), and 36.5-107.5 (twopm) out of a maximum of 140. The distributions of all indices were approximately normal, and the PHDI derived with twopm had a smaller variation relative to that of single-day or mean of two-day recalls. Participants in the highest quintile of each PHDI were more likely to be female, have a college degree, have higher income, be never smokers, and had lower mean total energy intake compared to their counterparts in the lowest quintile. Quintile of PHDI was inversely associated with obesity, regardless of data specification (p_trend<0.01 for all PHDI).  Quintile of PHDI derived from single-day intake was not associated with hypertension, but an inverse relationship was observed for PHDI from mean intake (p_trend=0.04) and for PHDI from twopm (p_trend<0.01).

Conclusions: The PHDI is a flexible dietary tool that performs well in a nationally-representative sample of US adults and is correlated with cardiometabolic risk factors. Two-part models should be used to derive the index when two or more days of recall are available.

Purpose: Childhood maltreatment is highly associated with physical health problems throughout the lifespan. Young adulthood represents a unique timeframe in life where physical activity tends to decline and eating behaviors may change. The current study explored the role that physical activity and binge eating may have in the trajectory of childhood maltreatment and poor adult health.

Methods: Emerging adults (N=100, 73 females) were recruited from a college sample and completed two separate lab visits 10-14 days apart. Participants completed a physical health assessment (including measures of heart rate, blood pressure, blood sugar, BMI, and waist circumference), wore a Fitbit for 10-14 days, and self-reported measures of health (symptoms of illness, perceived health), binge eating behavior, and childhood maltreatment. Group differences were explored between the maltreatment and non-maltreatment groups in physical activity levels and binge eating score. Moderation analyses were then conducted to examine physical activity and binge eating scores as separate moderators between maltreatment and physical health.

Results: Physical activity, specifically low-intensity movement, moderated the pathway between maltreatment history and both resting heart rate and symptoms of illness while binge-eating behavior moderated the pathway between maltreatment and symptoms of illness.

Conclusions: Results support the importance of learning more regarding the trajectory of childhood maltreatment to chronic disease as health risk indicators are present in emerging adults. Furthermore, results provide examples of health behaviors that may alter the effects of childhood maltreatment on current health. This study provides examples of health behaviors that may alter the effects of childhood maltreatment on current physical health. These include sedentary behavior and binge eating behavior exacerbating poor health symptoms, low-intensity physical activity improving health symptoms, and higher levels of overall physical activity protecting impacts on resting heart rate.