Increasing Physical Activity using an Ecological Model

Increasing the proportion of adults in the United States (U.S.) who engage in physical activity is a national priority. Only 29% met the aerobic guideline, 3% met the muscle strengthening guideline only, and 21% met the guidelines for both aerobic and muscle-strengthening activity. Individually oriented physical activity interventions can be intensive and have large effects; however, changes may be temporary unless supportive environments and health-promoting policies are in place. A variety of strategies are required to get and keep people physically active

Fit Into College II: Physical Activity and Nutrition Behavior Effectiveness and Programming Recommendations

Purpose: To determine whether residency (living on campus versus off campus) was related to the effects of Fit into College on students’ health behaviors, and to understand interns’ perceptions of their roles in mentoring their trainees. Design: Pre-experimental, one-group, pretest-posttest design and a posttest focus group interview. Setting: University-offered health and internship courses. Subjects: Twenty-four students (trainees) participated in the intervention, nine of whom lived on campus. Five student-interns served as their mentors. Intervention: Fit into College was a 14-week intervention in which trainees teamed up with an intern to improve and/or maintain healthy nutrition and physical activity behaviors. Measures: Trainees’ nutrition and physical activity behaviors and perceptions were quantitatively assessed through surveys at preintervention and postintervention. Interns’ mentoring perceptions were qualitatively assessed through a focus group interview after the intervention. Analysis: Two-factor repeated measure ANOVAs and qualitative theme identification. Results: Regardless of their residency location, the trainees’ perceptions of the health benefits of eating fruits and vegetables improved during the intervention. However, for trainees living on campus, the intervention was not effective in increasing the number of fruits and vegetables consumed or the planning for food preparation. The interns perceived that they did not have adequate access to healthy foods, the knowledge or skills to prepare healthy foods, or the competency to teach food preparation strategies to their trainees. For trainees living on campus, the intervention was more effective in decreasing perceived exercise barriers than trainees living off campus. Conclusion: Future iterations of Fit into College may focus on 1) improving college students’ planning and preparation of healthy foods, 2) segmenting trainees into more homogeneous groups for the interns to tailor their areas of expertise (campus vs. off-campus and/or freshman vs. upperclass students), and 3) collaborating with university-partners to improve environmental conditions to promote physical activity and healthy nutrition

Parent perceptions of a child physical activity initiative in a rural community.

This study assessed the extent to which a community-based intervention developed for children impacted parent perceptions and behaviors toward physical activity in a rural community. Focus groups and individual interviews were conducted with parents of children who participated in physical activity programs. Analysis revealed an increased community awareness surrounding physical activity following program implementation. Parents and children encouraged each other to be physically active. Ecological barriers and enabling factors to adult physical activity were identified these findings indicate a bidirectional influence between parent and child physical activity and the need for community facilities where families can be active together

Integration of Consumer-Based Activity Monitors into Clinical Practice for Children with Type 1 Diabetes: A Feasibility Study

Current technology commonly utilized in diabetes care includes continuous glucose monitors (CGMs) and insulin pumps. One often overlooked critical component to the human glucose response is daily physical activity habits. Consumer-based activity monitors may be a valid way for clinics to collect physical activity data, but whether or not children with type 1 diabetes (T1D) would wear them or use the associated mobile application is unknown. Therefore, the purpose of this study was to test the feasibility of implementing a consumer-based accelerometer directly into ongoing care for adolescents managing T1D. Methods: Adolescents with T1D were invited to participate in this study and instructed to wear a mobile physical activity monitor while also completing a diet log for a minimum of 3 days. Clinical compliance was defined as the number of participants who were compliant with all measures while also having adequate glucose recordings using either a CGM, insulin pump, or on the diet log. Feasibility was defined as \u3e50% of the total sample reaching clinical compliance. Results: A total of 57 children and teenagers between the ages of 7 and 19 agreed to participate in this study and were included in the final analysis. Chi-square results indicated significant compliance for activity tracking (p \u3c 0.001), diet logs (p = 0.04), and overall clinical compliance (p = 0.04). Conclusion: More than half the children in this study were compliant for both activity monitoring and diet logs. This indicates that it is feasible for children with T1D to wear a consumer-based activity monitor while also recording their diet for a minimum of three days

Testing the Effects of Two Field-to-Fork Programs on the Nutritional Outcomes of Elementary School Students from Diverse and Lower-income Communities

The purpose of this quasi-experimental study was to evaluate the effects of two farm-to-school programs, specifically the Field-to-Fork Multi-visit Program (N  =  264) and the Field-to-Fork After-school Club (N  =  56), on nutritional outcomes of elementary school students (third to fifth grade) from urban, diverse, and lower-income communities. Data were collected via self-report surveys measuring: (a) knowledge of recommendations for daily fruit and vegetable intake; (b) fruit and vegetable consumption; (c) knowledge of cooking a healthy recipe using vegetables; and (d) desire for farm fresh foods at school. Statistical analyses included McNemar’s and Wilcoxon signed rank tests. The proportion of students knowing how to cook a vegetable rich recipe increased with both programs (Multi-visit Program p \u3c .001; After-school Club p  =  .002). Vegetable consumption increased with the After-school Club (p  =  .002). Farm-to-school programming can increase knowledge of cooking vegetable rich recipes and vegetable intake among elementary school students from diverse, urban, and lower-income communities

Objectively measured physical activity of USA adults by sex, age, and racial/ethnic groups: a cross-sectional study

<p>Abstract</p> <p>Background</p> <p>Accelerometers were incorporated in the 2003–2004 National Health and Nutritional Examination Survey (NHANES) study cycle for objective assessment of physical activity. This is the first time that objective physical activity data are available on a nationally representative sample of U.S. residents. The use of accelerometers allows researchers to measure total physical activity, including light intensity and unstructured activities, which may be a better predictor of health outcomes than structured activity alone. The aim of this study was to examine objectively determined physical activity levels by sex, age and racial/ethnic groups in a national sample of U.S. adults.</p> <p>Methods</p> <p>Data were obtained from the 2003–2004 NHANES, a cross-sectional study of a complex, multistage probability sample of the U.S. population. Physical activity was assessed with the Actigraph AM-7164 accelerometer for seven days following an examination. 2,688 U.S. adults with valid accelerometer data (i.e. at least four days with at least 10 hours of wear-time) were included in the analysis. Mean daily total physical activity counts, as well as counts accumulated in minutes of light, and moderate-vigorous intensity physical activity are presented by sex across age and racial/ethnic groups. Generalized linear modeling using the log link function was performed to compare physical activity in sex and racial/ethnic groups adjusting for age.</p> <p>Results</p> <p>Physical activity decreases with age for both men and women across all racial/ethnic groups with men being more active than women, with the exception of Hispanic women. Hispanic women are more active at middle age (40–59 years) compared to younger or older age and not significantly less active than men in middle or older age groups (i.e. age 40–59 or age 60 and older). Hispanic men accumulate more total and light intensity physical activity counts than their white and black counterparts for all age groups.</p> <p>Conclusion</p> <p>Physical activity levels measured objectively by accelerometer demonstrated that Hispanic men are, in general, more active than their white and black counterparts. This appears to be in contrast to self-reported physical activity previously reported in the literature and identifies the need to use objective measures in situations where the contribution of light intensity and/or unstructured physical activity cannot be assumed homogenous across the populations of interest.</p

Community-Led Response to Address Economic Vulnerability due to COVID-19 with, for, and by Transgender Women of Color: A Qualitative Pilot Evaluation

PURPOSE: Intersectional stigma fuels inequities among transgender women of color, which have been exacerbated by coronavirus disease 2019 (COVID-19). This study evaluated a community-led emergency assistance program for transgender women of color. METHODS: We conducted a pilot program evaluation (n=8). RESULTS: Retention was 87.5% over the follow-up. Funds were primarily used for bills, food, and housing. Requesting and receiving funds was described as somewhat to extremely easy. Participants identified the need for economic empowerment components in future programming, specifically gender affirmation, skill-building for education and employment, and entrepreneurial opportunities. CONCLUSION: Findings highlight the need to invest in community-led strategies to address inequities experienced by transgender women of color

Exercise and global well-being in community-dwelling adults with fibromyalgia: a systematic review with meta-analysis

<p>Abstract</p> <p>Background</p> <p>Exercise has been recommended for improving global-well being in adults with fibromyalgia. However, no meta-analysis has determined the effects of exercise on global well-being using a single instrument and when analyzed separately according to intention-to-treat and per-protocol analyses. The purpose of this study was to fill that gap.</p> <p>Methods</p> <p>Studies were derived from six electronic sources, cross-referencing from retrieved studies and expert review. Dual selection of randomized controlled exercise training studies published between January 1, 1980 and January 1, 2008 and in which global well-being was assessed using the Fibromyalgia Impact Questionnaire (FIQ) were included. Dual abstraction of data for study, subject and exercise program characteristics as well as assessment of changes in global well-being using the total score from the FIQ was conducted. Risk of bias was assessed using the Cochrane bias assessment tool. Random-effects models and Hedge's standardized effect size (<it>g</it>) were used to pool results according to per-protocol and intention-to-treat analyses.</p> <p>Results</p> <p>Of 1,025 studies screened, 7 representing 5 per-protocol and 5 intention-to-treat outcomes in 473 (280 exercise, 193 control) primarily female (99%) participants 18-73 years of age were included. Small, statistically significant improvements in global well-being were observed for per-protocol (<it>g </it>and 95% confidence interval, -0.39, -0.69 to -0.08) and intention-to-treat (-0.34, -0.53 to -0.14) analyses. No statistically significant within-group heterogeneity was found (per-protocol, Q_w= 6.04, <it>p </it>= 0.20, <it>I</it>²= 33.8%; intention-to-treat, Q_w= 3.19, <it>p </it>= 0.53, <it>I</it>²= 0%) and no between-group differences for per-protocol and intention-to-treat outcomes were observed (Q_b= 0.07, <it>p </it>= 0.80). Changes were equivalent to improvements of 8.2% for per-protocol analyses and 7.3% for intention-to-treat analyses.</p> <p>Conclusions</p> <p>The results of this study suggest that exercise improves global well-being in community-dwelling women with fibromyalgia. However, additional research on this topic is needed, including research in men as well as optimal exercise programs for improving global well-being in adults.</p