Negative body image is associated with routine dietary restraint and not compensatory
restraint

Yaqi Wang (Presenting author), Mandy Ho (Corresponding author), Pui Hing Chau, Daniel Yee Tak Fong

Purpose
Negative body image, including overestimation and dissatisfaction of body weight, is
related to increased attempts to restrain eating. This study examined the relationships
between negative body image and routine and compensatory restraints, respectively.

Methods
This study used a cross-sectional online survey design. A validated 13-item Chinese
version of the Weight-related Eating Questionnaire assessed routine and compensatory
restraints, emotional and external eating. Body weight perception was evaluated by
comparing self-rated weight status with calculated weight status from self-reported
weight and height. The attitude to current body weight was assessed by four options: (1)
weight satisfaction (2) weight dissatisfaction with the desire to lose weight (3) weight
dissatisfaction with the desire to gain weight (4) indifference to weight. Multinomial
logistic regression was conducted to analyze the association of routine and compensatory
restraints with weight perception and attitude to weight status with adjustments made
for sociodemographic factors, body weight, and emotional and external eating. Subgroup
analyses examined these associations across males, females, underweight, normal weight
and overweight/obese participants.

Results
In total, we included 949 participants (73.6% females, mean age=33 years, SD=14, 14.6%
underweight, 53.5% normal weight, 31.8% overweight/obese). Participants who
overestimated their body weight were more likely to report higher routine restraint levels
than those with accurate body weight perception (adjusted Odds Ratio (OR) = 1.315, 95%
Confidence Interval (CI) = 1.107, 1.563). Participants with weight dissatisfaction and the
desire to lose weight were more likely to have higher routine restraint levels than those
with weight satisfaction (adjusted OR=1.411, 95%CI=1.148, 1.734). However, there were
no significant relationships between compensatory restraint levels and overestimation
nor dissatisfaction of body weight. The subgroup analysis results indicate that the
association between routine restraint levels and body weight overestimation was
observed in males, females, and underweight and normal-weight participants, but not in
overweight/obese participants. Furthermore, the association between routine restraint
levels and body dissatisfaction with the desire to lose weight was only observed in females
and normal-weight participants.

Conclusions
Negative body image was related to higher routine restraint levels but not compensatory
restraint levels. Future studies are needed to assess the impact of routine and
compensatory restraints on weight management.

Purpose: A heart-healthy lifestyle requires optimization of multiple healthy behaviors, including a plant-rich diet, physical activity, sleep, avoiding tobacco and other substances, managing stress, and maintaining social connections. This study examined the feasibility, acceptability, and preliminary efficacy of a virtual, 8-week, group-based lifestyle medicine program (the HeartBeet Clinic) delivered through a partnership between a cardiology clinic and employee wellness program.

Methods: Participants were recruited by email advertisements from an employee wellness program. After confirming interest, participants were offered one group or individual visit with an advanced practice clinician. Vitals (weight and blood pressure), labs (cholesterol and blood glucose), and behavior (diet quality, physical activity, sleep quality, smoking status) and well-being (quality of life and perceived stress) surveys were obtained at the beginning and end of the program. The program was delivered virtually, with eight weekly group coaching sessions with a health coach via Microsoft Teams, a program workbook, online education videos, an online community for participant interaction and support, and bonus live sessions covering special topics and group exercise opportunities. Paired t-tests were used to compare pre-post changes in cardiovascular health (measured using Life’s Essential 8), behaviors, well-being, and labs.

Results: Participants (N=47) had an average age of 50.1 years (SD=9.4) and were primarily female (89%) and White (91%). Participants attended on average 4.6 of 8 coaching sessions (SD=2.6) and 33 (70%) completed the post-test survey. Participants were highly satisfied with the program (M=5.1/6.0) and 85% reported at least one positive change in their physical symptoms or well-being. Over the course of the program, there were significant improvements in cardiovascular health (p=.02, Cohen’s d=.43), diet quality (p=.004, d=.61), vigorous physical activity (p=.018, d=.44), sleep quality (p<.001, d=.68), perceived stress (p=.001, d=-.65), quality of life (p=.018, d=.43), weight (p=.03, d=-.41), and diastolic blood pressure (p=.01, d=-.53). Cholesterol and blood glucose did not significantly change.

Conclusions: The HeartBeet Clinic was highly acceptable to participants, feasible to deliver, and associated with positive changes across a variety of cardiovascular health, well-being and behavioral measures. Future iterations will include a randomized control group and will examine ways to increase engagement across the program.

Introduction:
Increased consumption of fast-food over the past several decades has led, at least in part, to a higher prevalence of obesity in Israel. The present study seeks to explore individual, psychosocial, and behavioral economic variables related to fast-food consumption among Jewish and Arab adults in Israel.

Method:
A cross-sectional sample of 3,379 adults enrolled in the Smoking and Lifestyle in Israel (SALI) study which was conducted in 2020. The study aimed to assess the lifestyle behaviors and policies affecting these practices among adults in Israel. The primary dependent variable was the frequency of purchasing fast-food: 0, 1, 2-3, 4-6, and 7-10 times per week. The following psychological and behavioral economic variables were examined: time preferences (temporal discounting and inconsistent preferences), grit, self-efficacy, and risk-taking. The association between the psychological variables and fast-food purchasing was assessed using an ordered logit regression model adjusting for age, gender, ethnicity, self-reported health, marital status, having children <18 years, college education, COVID-19 pandemic-related hardship, household size, and household income.

Results:
Participants’ mean age was 39.6 years (SD=13.8), 48.1% were women, and 46.9% were college-educated. Multivariable analysis revealed that higher grit scores were associated with a significantly lower likelihood of fast-food purchasing (Odds ratio (OR) = 0.861, 95% Confidence Interval (CI) 0.744-0.996). Conversely, more risk-taking was related to higher odds for increased fast-food purchasing (OR=1.034, 95% CI 1.003-1.065). Time preferences and self-efficacy were not associated with fast-food purchases. Moreover, no significant relationship was found between fast-food purchasing and the following covariates: sex, ethnicity, marital status, college education, pandemic-related hardship, and household income. Finally, whereas increased age was related to purchasing fast-food less frequently (OR=0.963, 95% CI 0.958-0.968), having children <18 years residing in the household was related to increased purchasing (OR=1.351, 95%CI 1.165- 1.566).

Conclusion:
Targeted interventions aimed at decreasing fast-food consumption in Israel should take into account participants’ degree of grit, risk preferences, age and children living in the household.

Aim: Cognitive functions may have an important role in the management of obesity by ensuring compliance towards lifestyle-related behaviours. This study aimed to identify the cognitive deficits among adults and study their association across different BMI categories in an Indian setting.
Methods: The indexed study is a cross-sectional survey of a sample attending a tertiary care hospital in northern India. The MoCA scale was administered in an interview schedule to assess participants' cognitive performance across eight domains. The responses were analysed to determine the association between BMI and total MoCA scores and domain-specific MoCA scores.
Results: Three hundred forty-nine participants with a mean age of 36.9 ± 10.9 years and BMI of 26.7 ± 4.6 kg/m2 were recruited. BMI was found to be significantly associated with total MoCA score, indicating a negative relationship (p<0.001). A significant negative association between six domain-specific scores, namely, visuospatial, attention, language, abstraction, delayed recall (p<0.001), orientation (p<0.05), and BMI, was also found.
Conclusion: A dose-effect association between BMI and cognitive functioning (overall and domain-specific) was observed. In these cases, visuospatial, attention, language, abstraction, delayed recall, and orientation were found to be impacted.

Purpose: Worksite wellness programs are popular employer offerings as of the last few decades. The COVID-19 pandemic caused major shifts in behavior since these programs have been implemented. The purpose of this study was to see how the pandemic affected various offerings within a university worksite wellness program.

Methods: This study is a secondary analysis of a university worksite wellness program, and it compares participation in the various offerings in response to the COVID-19 pandemic by evaluating 2019 participation (pre-pandemic) to 2020 participation (including onset of the pandemic and after). This worksite wellness program, which is available to employees at the University of Kentucky (Lexington, KY, USA) and individuals on the university-sponsored health insurance programs, included approximately 40,000 eligible individuals per year in 2019 and 2020. The main outcome measures include participation in the three arms (MoveWell, EatWell, and BeWell) of this university worksite wellness program.

Results: Participation in the MoveWell and EatWell arms decreased after the onset of the pandemic in Kentucky (-33.6% and -32.1%, respectively), but participation in the BeWell arm increased (+41.8%). The most dramatic increase in participation that occurred was through BeWell’s health coaching, which increased by +76.1% when compared to the same time frame in 2020.

Conclusions: Although participation was reduced in the MoveWell and EatWell arms of this worksite wellness program, individuals were still participating in these programs, which is noteworthy during a pandemic. BeWell program participation increased during the pandemic and is a suggested point of focus for employers during pandemics.

Purpose: The purpose of this investigation was to determine how primary physical activity mode and frequency differed from before, during and after pregnancy (≤12 months since childbirth).
Methods: A survey for a larger study was disseminated electronically via a social media recruitment strategy to 282 individuals in the Spring of 2022. Individuals were eligible if they lived in a community with ≤50,000 people and had given birth to a child in the last year. The survey used previously validated questions to determine primary physical activity mode (1) Walking, cycling or other light exercise at least four hours a week (2) Sports or heavy gardening at least four hours a week (3) Hard exercise training or competitive sports regularly and several times a week (4) Reading, watching TV or other sedentary behavior. Participants were asked to reflect on their activity at 3 time points (1) before pregnancy (2) during pregnancy (3) at the time of survey completion. A one-way ANOVA was completed to compare physical activity mode between the 3 time points.
Results: The average participant was 30.8±4.4 years old and had given birth to a child 5.1±3.3 months before completing the survey (n=282). The majority of participants identified as White (47.2%), had a household income between $50,000-$99,999 (42.4%) and had an Undergraduate degree (39.7%). Mode of exercise varied significantly between the 3 time points (p<.001). Light exercise was the predominant form of activity across the 3 time points (T1: 50.4% vs T2: 58.2% vs T3: 52.5%). Sedentary behavior was highest in the postpartum period (T1:14.9% vs T2:28.7% vs T3:33.7%). Sports or heavy gardening (T1:18.1% vs T2:7.4% vs T3:6.7%). and heavy exercise training (T1: 13.1% vs T2: 3.5% vs T3: 3.5%) were most commonly reported in the pre-pregnancy period.
Conclusion: Women residing within rural areas self-report being predominantly sedentary or engage in light exercise activities such as walking. Engagement in higher intensity activities declined from pre-pregnancy through the perinatal period. These findings suggest rural women are not achieving moderate intensity physical activity recommendations which may be detrimental to their health during the perinatal period.

Background: Modern maternity care often lacks sufficient nurse support for mothers during labor, with nurses spending only 6-10% of their time on labor support despite new moms expecting 53% of their time. Given the comfort derived from having support during childbirth, doula-trained non-clinical birth workers have gained prevalence. This scoping review aims to examine and consolidate evidence on the impact of doulas throughout the entire pregnancy care continuum, including the prenatal phase, during pregnancy, and postpartum.

Methods: We searched PubMed, Scopus, EMBASE, CINAHL, Cochrane Review, and Cochrane Central to identify articles using the search words with the Boolean operator “doulas” AND “labor support” AND “birth outcomes” AND “pregnancy” AND “maternal health.” Peer-reviewed articles focusing on doulas and birth outcomes, written in English, and published between 2000 to 2022 were included to understand the current state of knowledge.

Result: Following the removal of duplicates, a review of 765 articles titles and abstracts yielded 115 articles for full-text review and 23 articles met the final inclusion criteria for a full review. Overall, the study found that doula supervision in pregnancy care was associated with better delivery outcomes, such as fewer cesarean sections, preterm deliveries, shorter labor durations, and reduced labor pain. Notably, doula help was also associated with breastfeeding initiation. However, one study indicated that doula support was associated with longer hospital stays. Furthermore, the emotional support provided by doulas has been linked to decreased stress and anxiety.

Conclusion: Doulas emerge as a significant resource for birthing women, encouraging discussion for increasing utilization. This study highlights the potential benefits of doulas for both the mother's and child's well-being. Future research and policy considerations should investigate ways to promote access to doula support, given its potential to improve mother and child health outcomes. Furthermore, there is a need to explore the impact of doulas on health behavior change during pregnancy. This will provide a more evidence-based foundation for maternal and child well-being decision-making.

Purpose: This study aims to explore the underlying mechanisms of self-rated health (SRH) as a predictor of mortality and overall health status by examining its association with health behaviors, specifically fruit and vegetable (FV) intake and physical activity.

Methods: We used a cross-sectional design to examine the relationship between FV intake, physical activity, and SRH using baseline data from 337 elementary school teachers participating in a parent experimental study in Houston, Texas. Linear models were used for the analysis, with SRH as a continuous outcome, and FV intake (in cup) and physical activity (seldom active, somewhat active, very active) as continuous exposures. SRH was assessed by asking the question “would you say that in general your health is?” and the response options were “poor”, “fair”, “good”, “very good”, “excellent”. The adjusted model controlled for age, gender, race, and food insecurity. Additionally, effect modifiers, including diagnosed diabetes, hypertension, obesity, anxiety, and depression, were considered.

Results: Among the participating teachers, 22 (6.67%) reportedly had diabetes, 68 (20.54%) had hypertension, 171 (50.75%) were obese. At baseline, 174 (53.05%) had mild to severe anxiety, and 148 (44.71%) had mild to severe depression. Mean FV intake was 2.14 (±0.56) cup, 198 (60.18%) were physically active, and 215 (64.18%) rated themselves with good to excellent health. Results of the regression analysis showed that each increase in cup equivalents of FV intake was associated with a 0.40 unit (95% CI: 0.20, 0.60) increase in SRH score. Similarly, higher level of physical activity was associated with 0.32 unit (95%CI: 0.17, 0.48) increase in SRH score. The association between FV intake and SRH was negatively influenced by the presence of diabetes, hypertension, obesity, anxiety, and depression. Similarly, the association between physical activity and SRH was negatively influenced by obesity, anxiety, and depression.

Conclusions: Elementary school teachers have a high prevalence of food insecurity, less than recommended FV intake, and poor cardiometabolic health. The findings demonstrate a positive association between self-related health and FV intake and physical activity. However, this relationship was influenced by the presence of physical and mental health conditions which warrants immediate attention in future research.

Purpose: The purpose of this study was to assess if a weight stigma intervention that successfully improved fat attitudes among university recreation center professionals had sustained effects after three months compared to a control group.

Methods: This study is a three-month follow-up to a randomized controlled trial where exercise professionals were randomly assigned to an intervention or control group. Participants were 46 exercise professionals employed at university recreation centers in the United States. The Fat Attitudes Assessment Toolkit (FAAT) measured participants’ attitudes towards fatness and fat people before completing a self-paced online intervention or control course, after course completion, and at a three-month follow-up. The intervention consisted of a two-hour, self-paced, interactive online course titled Weight Inclusive Thinking for Fitness Spaces (WIT FITS), informed by attribution theory, the socioecological model, and the Health at Every Size® (HAES®) paradigm. The intervention course aimed to change participants’ attributions toward fatness by presenting research on the complex relationship of behavior, social influences, health, and weight. The online course for the control group, titled Motivated2Move, was also a two-hour, self-paced online course addressing communication strategies to increase motivation for physical activity.

Results: At the three-month follow-up, participants in the intervention group showed significant improvement in total fat attitudes [F(2,88) = 7.94, p < .001, η2p = .15] and in fat acceptance [F(2,88) = 4.25, p = .017, η2p = .09]. The intervention course had a more robust effect on improving participants’ attitudes toward fatness, indicating that an intervention using HAES® principles mixed with attribution theory and the socioecological model is a more effective approach to decreasing weight stigma than other general professional development courses for exercise professionals.

Conclusions: This study showed the effectiveness of a 2-hour online intervention in improving fat attitudes among university recreation center professionals, and sustaining the majority of these improvements after three months, compared to a control group. More research is needed to assess the impact of WIT FITS across different samples, such as fitness professionals in commercial and non-profit fitness spaces and exercise students.

Purpose: Middle-aged women are at increased risks of cardiometabolic diseases partly due to adverse body composition changes associated with perimenopause and menopause. Adhering to a healthy diet may reduce this risk but little is known about the psychosocial factors influencing dietary patterns in middle-aged, multiethnic Asian women. This study aimed to examine the psychosocial factors associated with dietary patterns in middle-aged women from the Growing Up in Singapore Towards healthy Outcomes cohort.
Methods: 151 women aged 45-60 years completed a questionnaire based on selected constructs of the Social Cognitive Theory: outcome expectations (e.g., perceived benefits or barriers), behavioural capability (e.g., knowledge and skill), environmental (e.g., healthy foods accessibility), social support (family and friends) and self-efficacy related to meeting dietary guidelines. Dietary intake was measured using a food frequency questionnaire, and dietary patterns were determined using factor analysis. Linear regressions assessed associations between psychosocial factors and dietary patterns adjusted for socio-demographics.
Results: The first two principal factors identified dietary patterns resembling a “healthy” pattern (“Fruit, Vegetables and Fish (FVF)”, characterized by higher intakes of fruit and vegetables, fish and seafood, and dairy), and a “less-healthy” pattern (“Desserts, Fast food and Processed Meat (DFP)”, characterized by higher intakes of desserts, fast food, processed meat and fried snacks). Having the skills to prepare healthy meals [β 0.17, 95% CI (0.02, 0.31)] and liking the taste of healthy foods [0.18 (0.03, 0.34)] were associated with higher adherence to the FVF pattern. Limited accessibility to healthy foods [0.13 (0.01, 0.25)] and perceiving healthy foods as expensive [0.11 (-0.001, 0.21)] were associated with higher adherence to the DFP pattern, whilst following advice from health professionals [-0.14 (-0.27, -0.007)] and perceived risk of chronic diseases [-0.11 (-0.22, 0.001)] were associated with lower adherence to the DFP pattern.
Conclusions: Findings suggest that interventions to improve dietary patterns in middle-aged, multiethnic Asian women could incorporate strategies to improve skills in preparing healthy meals, change perceptions on taste and cost of healthy foods, improve access to healthier foods, and educate about the risks of chronic diseases of a “less-healthy” diet, whilst engaging health professionals to deliver lifestyle advice.

Purpose: The adolescent stage represents a critical developmental period for behavioral changes and the promotion of agency and empowerment, particularly concerning safe, healthy, and active lifestyles and environments. The objective of this study was to conduct ripple effects mapping (assessing intended and unintended impacts) to evaluate the influence of adolescent citizen scientists (non-professional researchers involved in conducting research) to promote a safe, healthy, and active environment in their schools.
Methods: This study constituted a sub-study of a larger project in which we recruited thirty-nine adolescents (Grade 9-11 learners) from 3 high schools in low-income communities in Cape Town, South Africa for an initial citizen science (CS) project using the “Our Voice” method to Discover, Discuss, Activate, and Change their local environments to foster healthy living. The adolescents identified factors impacting on physical activity, a healthy diet, hygiene, and safety in schools. They also proposed feasible solutions. In two of the schools, an environmental feature (i.e., a barrier) was selected for specific actions and implementation. Twenty of the citizen scientists (aged 13-18; 80% were girls) representing the 3 high schools participated in the ripple effects mapping (REM) at least a year after their initial CS project participation. REM, a qualitative participatory method, involved a 4-stage process: appreciative inquiry, mind mapping, facilitated discussion, and qualitative data analysis. In a facilitated workshop in the schools, citizen scientists were paired to interview each other using guided questions about the impacts of the CS project. In a group mapping session, citizen scientists reported on their interviews, discussed them further, and mapped the project ripple effects. The research team collated the data for thematic qualitative data analysis and mapping.
Results: The CS project resulted in multi-level intended and unintended positive impacts across a year that occurred within the citizen scientists' schools, their home environments, and their personal and social behaviors. These impacts included improved confidence, mental health, family togetherness, safety in school and sports participation, and healthy eating.
Conclusion: The study empowered the citizen scientists and led to behavior and lifestyle changes at the individual, family, and organizational levels that extended beyond the initial CS project.

Title: Mental Health, Sleep Quality, and Psychological Well-Being During the Month of Ramadan

Authors: Danny Jandali¹, Abdullah Alwaleedi², Amine Sheikh¹,², Malak Elayyan², Sarah Liener², and Weiyun Chen²*
¹Presenting author, ²Corresponding author, *Principle Investigator

Purpose: This study aimed to explore the relationship between mental health factors (depression, anxiety, and stress), sleep quality, and psychological well-being (subjective happiness and life satisfaction) during the month of Ramadan among participants and by gender.

Methods: The study enlisted 163 participants (74% female, 25.7% male), with an average age of 36.8 years (SD = 13.1), mostly of Middle Eastern descent. Recruitment was conducted via flyers at local community mosques, social media, and outreach through local religious leaders. Data collection took place in the last three weeks of Ramadan, utilizing a Qualtrics survey that included the Depression Anxiety and Stress Scale (DASS-21), the Subjective Happiness Scale (SHS), Satisfaction with Life Scale (SWLS), and the Pittsburgh Sleep Quality Index (PSQI). Data were analyzed by means of descriptive statistics and multiple linear regression models using SPSS version 28.

Results: The study indicates that while mental health and psychological well-being remained within normal levels during Ramadan, sleep scores indicated a significant sleep disturbance among participants (5-21). Multiple linear regression models revealed that subjective happiness, sleep duration, and global PSQI score were significant predictors of stress for the total sample (F=9.816, p=.001). Life satisfaction was the only significant predictor of anxiety (F=7.258, p=.001 ), and it, alongside subjective happiness, significantly predicted depression (F=12.317, p=.001). For men, subjective happiness alone predicted stress, while life satisfaction was a predictor for both anxiety and depression (F=4.637 , p=.001). In women, sleep latency and medication usage were linked to stress, but not anxiety. Life satisfaction and subjective happiness were, however, predictors of depression (F=6.380, p=.001).

Conclusion: Fostering positive affective states can serve as a protective mechanism against the potential psychological distress associated with altered sleep patterns and lifestyle changes that accompany Ramadan. The study highlights the need for strategies to accommodate sleep and well-being needs during Ramadan, especially in non-Muslim majority contexts like the USA, to safeguard against potential psychological distress. Further research using longitudinal and objective methodologies is recommended to explore these findings across different cultures and religions.

Purpose: As temporally dense device-based assessments of physical activity (PA) become increasingly available, two key knowledge gaps have emerged: the day-to-day temporal dynamics of PA, and idiographic (i.e., individual-level) approaches to statistical analysis. The purpose of this study was to demonstrate how an idiographic approach can be implemented using person-specific day-to-day PA data to identify and describe sudden gains and losses of daily steps over a four-week period.
Methods: A total of 134 college students (Mean age = 19 ± 2 years; 77% female) who wore an Apple Watch on a daily basis completed a baseline demographic survey and provided access to four weeks (28 days) of step count data from their Apple Health accounts. Using a regression tree-based recursive partitioning algorithm developed by Chevance et al., (2021), we characterized sudden gains and losses of steps/day for each participant, defined as stable (i.e., lasting seven days) 30% deviations from their median steps/day.
Results: Heterogeneity in patterns of step fluctuations were observed across participants. Almost two-thirds (61.2%; n = 82) of the sample had at least one significant sudden change in their daily step count of the course of the study: one significant gain was experienced by 10.1% (n = 27) of participants, 26.1% (n = 35) experienced one significant loss, 2.2% (n = 3) experienced two significant losses, and 12.7% (n = 17) experienced one gain and one loss. In contrast, 38.8% (n = 52) of participants maintained consistent step counts across the observation period (no sudden gains or losses). Males had 70% lower odds of being maintainers compared to females (OR = 0.30, 95% CI: 0.10, 0.74).
Conclusions: Findings revealed college students – males in particular – commonly experience significant changes in their day-to-day PA levels, which would otherwise be obfuscated by common analytical practices in the field of PA research (e.g., group-level analysis of steps averaged over the assessment window). Given the growing ubiquity of commercial wearables that track behavioral metrics, there is an opportunity to refine current theorizing and behavior change approaches through considering unique information about the dynamic nature of PA behavior at the individual-level.

Purpose: There is no denying the benefits of physical activity, yet more than 75% of children ages 6-17 do not participate in the recommended 60 minutes of physical activity per day. Marathon Kids is a national running program designed to motivate youth and introduce them to the joy of physical activity. In 2018, Marathon Kids became an approved evidence-based Nebraska Extension curriculum to promote physical activity and reduce childhood obesity. The purpose of this presentation is to provide an observational overview of the implementation of Marathon Kids by Nebraska Extension.

Methods: Nebraska Extension has implemented Marathon Kids in before and after school settings, physical education classes, recesses, and summer camps with a target audience of Pre-K-12th grade youth of all genders. As the demand for the program increased across the state, the Nebraska Extension team developed in-person and virtual Nebraska Extension Marathon Kids (NEMK) Coach trainings to enhance growth, maintain fidelity, and support the sustainability of the program. Self-paced online modules were also created to train coaches on demand. The goal of these trainings is to empower passionate after school directors, teachers, and community members to implement Marathon Kids in their own communities.
A pre/post evaluation was developed with the help of a University of Nebraska-Omaha associate professor and the national Marathon Kids team. Some constructs assessed were participants’ enjoyment of physical activity, confidence, and ability to set and reach goals. These surveys were administered to participants in 3rd grade or above.

Results: In 2023, the NEMK Team of 16 coaches, delivered 40 Marathon Kids programs in 16 counties to 1,563 Pre-K-12th grade youth. These participants logged a total of 59,537 miles (over 2,272 marathons). Statewide impact data showed that post-program, youth participants reported positive increases in physical activity and goal-setting participation, enjoyment, and self-efficacy. As a result of programming, 71% said physical activity is “definitely important” to them.

Conclusions: The train-the-coach model allows Nebraska Extension to extend its reach while maintaining program fidelity. Improving goal-setting skills and self-efficacy in Nebraska’s young people can help support future confidence and physical activity patterns as they become adults.

Purpose:
This quasi-experimental study aimed to observe changes and differences in dietary behavior, anthropometrics, and blood pressure between a control group and an intervention group, who participated in a 4-week intervention focused on plant-based eating.
Methods:
This study was a mixed-methods quasi-experimental study design. Participants were recruited through advertisements sent to university employees and then were randomized into an intervention and a control group. Those receiving the intervention were asked to attend weekly nutrition education sessions focused on plant-based eating and establishing behavioral changes and a healthy relationship with food. Each session included a topic related to plant-based eating, a cooking demonstration, and a discussion about both psychological and environmental barriers. At the end of each session, participants were given the ingredients for the recipe that was demonstrated and were asked to try it at home within one week. For those in the intervention group, weight, waist circumference, and blood pressure were measured pre- and post-intervention. The control group received weekly emails with handouts and recipes related to the topics and self-reported weight and height. Both groups were also asked to reflect on changes in dietary behaviors made each week that related to the previous session through a short open-ended survey. T-tests were utilized to determine significant differences pre- and post-intervention.
Results/Findings:
24 participants completed the study, 13 in the intervention, and 11 in the control. Participants were primarily female (71%) and ranged from 29 to 76 years old. Results showed a significant improvement between pre- and post-measures with a 15 mmHg +/- 7.605 decrease in systolic blood pressure (p<0.001), 3.1 inch +/- 1.897 decrease in abdominal circumference (p<0.001), and 2.85 pound+/- 1.6 decrease in weight (p<0.001). Through responses to open-ended surveys, participants also showed increases in confidence, enjoyment of eating, cooking skills, and family support.
Conclusion:
Findings suggest that receiving weekly nutrition education, support, and resources to incorporate plant-based eating is a behavioral change that can decrease blood pressure, weight, and abdominal circumference in 4 weeks. Working with a health practitioner and group support eased personal and social barriers to help patients achieve their goals.

Purpose: Annually 1.1 million people are diagnosed with a stroke in Europe. Due to improved acute care, the vast majority returns home after stroke. However, 25% will have another major adverse cardiovascular event (i.e. recurrent stroke, transient ischemic attack (TIA), acute coronary events or cardiovascular death, MACE) within one year. A disturbed balance in 24-hour movement behaviour (24h MB), including high amounts of sedentary behaviour, low levels of physical activity and reduced sleep quality, increases the risk for a new cardiovascular event. However, 78% of people after a stroke have a sedentary and inactive movement behaviour pattern. Therefore, we recently developed and successfully tested the RISE intervention: a blended behaviour change intervention to improve 24h MB. The current study aims to investigate the preventive effect and cost-effectiveness of the RISE intervention on reducing MACE.
Methods: This study is an assessor-blinded, multicenter randomized controlled trial in which 934 people with first-ever stroke will be enrolled within 6 months post-stroke. At baseline, 24h MB will be assessed. Sedentary and inactive participants will be selected and randomly assigned to the experimental group (RISE intervention + usual care) and control (usual care) group. The RISE intervention is a 15-week blended care intervention in which primary care physiotherapists coach people to improve their 24h MB in their home setting using behaviour change techniques and the RISE eCoaching system. This consists of 1) an activity monitor, 2) a smartphone application that provides real-time feedback and contains e-learning modules, and 3) a monitoring dashboard for the physiotherapist. Participants receive participatory support from someone from their social network throughout the intervention.
Results/findings: After one year follow-up, MACE, 24h MB, and cost-effectiveness will be assessed. MACE will be analyzed using survival analysis comparing intervention and control group. Cost-effectiveness will be assessed for MACE and quality adjusted life years. Compositional data analysis will assess changes in 24h MB over time.
Conclusions: We hope to demonstrate that the RISE intervention, a blended primary care preventive program aiming to improve 24h MB for people returning home after stroke, reduces the risk for new MACE and is cost-effective.

BACKGROUND: A leading cause of chronic disease worldwide is a sedentary lifestyle. Some workplace physical activity interventions (PAIs) have been developed to combat sedentary workplace environments. Improvements in employee well-being and productivity increase the value of a PAI for the employer and employee; however, few PAI studies measure these outcomes. This systematic review aims to identify PAIs that measure employee well-being and productivity and evaluate their effects on employees. METHOD: A search following PRISMA guidelines included ten electronic databases. Any US-based PAI study published between 2012 and 2023 measuring employee well-being and/or productivity was included. The intervention type (i.e., educational and/or exercise equipment), physical activity (PA), productivity, and well-being outcomes were extracted and examined for effectiveness. Two experts in the field confirmed article criteria, eligibility, and categorization. RESULTS/FINDINGS: Of the 3,526 records identified, eight studies met the inclusion criteria. Intervention type varied (educational n = 2, equipment n = 2, both n = 4). Intervention location also varied (within workplace n = 5, hybrid: in-person and over email n = 1, exclusively online n = 1, education provided at local fitness facility n = 1). Common measurements of employee well-being included employee energy, health-related absenteeism, fatigue, pain, social functioning, and non-work satisfaction. Productivity measures included task planning efficiency, concentration, and absenteeism. Five studies reported reduced sedentary time, while three articles had various results including increases in PA but not sedentary time, improvements in both PA and sedentary time, and no PA improvements. Employee well-being and productivity improvements were reported in six and seven studies, respectively. Concentration was the most common reported productivity outcome (n = 3) and health-related absenteeism was the most common wellbeing outcome (n = 3). CONCLUSION: PAIs can enhance employee well-being and productivity, making employers and employees more likely to implement them. Future research should optimize PAIs to improve well-being and productivity, thus leading to increased adherence and implementation in workplaces. Specifically, within the U.S. there appears to be lacking research on workplace PAIs that improve wellbeing and productivity. Adapting PAIs from other countries may face unique challenges related to differences in U.S. workplace culture.