Title: Characteristics of Dietary Behaviors and Cardiometabolic Health in East African Immigrants living in the San Diego Area: Preliminary Insights from the HAWAASH2 Study

Amy E. Atun¹ (presenting), Nicole N. Karongo¹, Sahra Abdi², Tsigealem Birhane², Jabir Mohamed², Meshate Mengistu², Xochitl Aguinaga¹, Cheryl A.M. Anderson¹

¹ Herbert Wertheim School of Public Health and Longevity Science, University of California, San Diego
² United Women of East Africa and East African Cultural Center, San Diego, CA, USA

Purpose: To characterize dietary behaviors and cardiometabolic health status among East African immigrants residing in the San Diego area.

Methods: In partnership with the United Women of East Africa and East African Cultural Center, we recruited a sample of 46 individuals who are refugees or immigrants living in San Diego. Data were collected between May and November 2023 through personal mobile phones, computer tablets and/or laptops using the REDCap survey platform. Participants responded to the survey in English, and standardized assistance with interpretation was provided, if needed.

Results:
The sample was 63% female, with a median age of 38.5 years (IQR: 22, 53.75). Fifty nine percent of participants were born outside the United States, and within this group there were 65% born in Somalia, 10% born in Ethiopia, 6% born in Kenya, and 3% in Sudan. Ninety eight percent of the sample observe the Muslim religion. Seventy two percent of participants achieved a high school degree or higher. Eighty three percent of participants earned a household income under the median household income in San Diego ($98,657). Twenty seven percent of participants reported having a hypertension or pre-hypertension diagnosis and 50% reported a family history of hypertension. Thirty percent of participants reported having been diagnosed with diabetes. Among individuals not born in the United States, 42% reported a perceived decline in overall health post-migration. Fifty five percent of the overall sample reported consistently cooking meals at home, and 33% reported making a conscious effort to integrate cultural traditions when choosing healthier foods. Fifty eight percent obtained household foods from wholesale clubs like Sam’s Club and Costco.

Conclusion: Our findings of consistent home cooking practices and the incorporation of cultural traditions into food choices underscore the importance of tailoring dietary interventions for immigrant populations and promoting access and availability of culturally significant foods. The prevalence of cardiometabolic conditions in the sample suggest a need for effective integration of cardiovascular health promotion and disease prevention into dietary interventions.

Purpose: Hispanic adolescents are disproportionately burdened by type 2 diabetes. Digital health interventions are promising for reaching and engaging high-risk youth in disease prevention opportunities, yet few digital interventions have been developed and tested among Hispanic adolescents. The purpose of this study was to examine the feasibility and acceptability of Fit24, a 12-week intervention that uses a Fitbit and theoretically grounded text-messages to promote physical activity and sleep among Hispanic adolescents (14-16 years) with obesity. Methods: A randomized waitlist-controlled trial with a process evaluation was conducted to assess feasibility (NCT04953442). Youth randomized to the intervention (n=22) received a Fitbit, guidance on setting adaptive activity and sleep goals, and daily text messages (n=125) grounded in Self Determination Theory to support goal attainment. Youth randomized to the waitlist control (n=21) received a Fitbit only. A priori feasibility criteria were to: (1) recruit 48 Hispanic adolescents with obesity; (2) retain ≥85% of participants for pre- and post-assessments; (3) record Fitbit wear time ≥5 days/week throughout the intervention; (4) achieve an 80% response rate of text messages when prompted; (5) ≤10% technical issues with Fitbit and text messages; and (6) have ≥80% of youth report ‘agree’ – ‘strongly agree’ that they were satisfied with the program. Results: We enrolled 90% (n=43) of the goal and retained 93% (n=40) of participants for post-assessment. 68% of participants wore their Fitbit ≥5 days/week and 60% responded to text messages when prompted. Some youth reported charging issues (n=2) with the Fitbit or that the watchband irritated their skin (n=4). For intervention youth, almost half (45.5%, n=10) experienced Fitbit sync issues at least once throughout the intervention. We achieved 87% “agree/strongly agree’ satisfaction ratings. Conclusions: Fit24 is a promising approach for reaching and engaging Hispanic youth in a diabetes prevention program. Given that sync issues experienced with the Fitbit hindered our ability to set adaptive goals and provide accurate feedback on goal attainment, strategies are needed to address technical issues experienced prior to conducting a larger randomized trial to assess effectiveness. Findings from this feasibility study will inform future digital diabetes prevention strategies focused on high-risk pediatric populations.

Nakagata Takashi*, Yamada Yosuke, Taniguchi Masashi, Nanri Hinako, Kimura Misaka, Miyachi Motohiko, Ono Rei

This study aimed to compare step-count outcomes between older and younger adults using seven different activity trackers, addressing a gap in existing research which often overlooks variations in walking patterns and gait speeds between these age groups.

Abstract
Purpose
Previous studies have compared activity trackers, including pedometers and accelerometers, in various scenarios; however, older adults frequently display distinct walking patterns and gait speeds compared to younger adults. This study aimed to compare the step-count outcomes between older and younger adults using seven different activity trackers.

Methods
This study included 35 younger adults (21–43 yrs) and 57 older adults (65–91 yrs). All the participants were equipped with one pedometer and the following six activity trackers: ActiGraph GT3X+ Wrist and Hip, Actimarker, Omron, TANITA, Yamasa, and Yamasa AS-200. We examined the correlation of step-count as measured by all activity trackers, employing standardized major axis analysis.

Results
Wrist-worn ActiGraph GT3X devices consistently recorded step counts consistently over 4,000 steps higher than waist-worn activity trackers in free-living experiments involving both young and older adults. When ranking the six waist-worn devices by step count, the Actimarker consistently scored highest overall, recording an average of 8,569 ± 4,881 steps (mean ± SD). Furthermore, this device ranked highest among younger adults, with an average of 9,624 ± 5,177 steps, and among older adults, with an average of 7,890 ± 4,562 steps. In contrast, the Yamasa AS-200 pedometer recorded the lowest step count among all devices, averaging 6,442 ± 4,249 steps overall. In the younger adult group, it ranked second to last, registering an average step count of 7,517 ± 4,388, whereas in the older adult group, it recorded the lowest average at 5,750 ± 4,015 steps. The correlation among all devices demonstrated a very high consistency, with the exception of the ActiGraph worn on the wrist.

Conclusion
Step counts recorded from four activity trackers and one pedometer showed a variation of approximately 2200–2600 steps for both groups, yet maintained a high correlation with each other, except for the wrist-worn ActiGraph.

Authors: Emma E. Saving (presenting author, corresponding author), Christopher D. Pfledderer, Derek W. Craig, Kempson Onadeko, Timothy J. Walker

Topics: child physical activity, education, sedentary behavior

Background: Brain boosts and physically active learning are evidence-based approaches to improve students’ physical activity by integrating movement into the classroom. However, less is known about student learning preferences regarding engagement in movement-based approaches in the classroom. The purpose of this study was to: 1) examine student participation in classroom-based physical activity and 2) compare student preferences for learning while moving versus sitting.

Methods: We used baseline data from a parent study that developed and tested an implementation strategy to support classroom-based physical activity. During late fall 2023, we administered a paper-based questionnaire to 3rd-5th grade students at two elementary schools in Texas, USA. The questionnaire included six questions about student learning preferences and their teacher’s use of classroom-based physical activity approaches. Outcomes for this study utilized data from the following questions: 1) how much do you like to learn while sitting? (5-point scale); 2) how much do you like to learn while moving? (5-point scale); 3) did you do any moving around in your classroom this week, like dancing, running, jumping, stretching, skipping, or anything else that made you move? (yes/no/don’t know). We used linear mixed models to compare learning preferences while controlling for gender, race/ethnicity, grade, and free and reduced lunch status (school partners shared demographic data for control variables).

Results: A total of 135 3rd-5th grade students (51% female, 69.6% Hispanic, 92.6% free or reduced lunch qualified) completed the questionnaire. Seventy-three percent of students (n=127) reported participating in classroom-based physical activity at least once within the past week. Students reported significantly higher scores for liking to learn while moving (m=4.23, sd=1.17) compared to while sitting (m=3.59, sd=1.26) (p<0.001.).

Conclusions: Results suggest that elementary-aged students prefer to learn through movement compared to sedentary approaches. These findings were consistent across grade levels, gender, race/ethnicity, and free/reduced lunch status. In addition to supporting physical activity and health, movement-based approaches may also help to better engage students in learning.