Stress, Health Risk Behaviors, and Weight Status Among Community College Students

The objective of this study was to describe the relationship between stress, weight-related health risk behaviors (e.g., eating behaviors, physical activity, sedentary behavior, sleep, cigarette smoking and binge drinking), and weight status using cross-sectional data on 2-year community college students enrolled in a randomized controlled weight gain prevention trial. Modified Poisson regression and linear regression were used to examine crude and adjusted cross-sectional associations. Higher stress was associated with higher prevalence of overweight/obesity (crude PR=1.05 [95% CI 1.01, 1.09]), though the relationship was no longer statistically significant after controlling for a wide range of weight-related health risk behaviors (adjusted PR=1.04 [95% CI 1.00, 1.08]). Stress levels were significantly associated with meal skipping and being a current smoker. Future research should investigate the mechanisms through which stress is related to obesity risk and examine the causes of stress among this understudied population to inform the design of appropriate interventions

Adolescent physical activity and screen time: associations with the physical home environment

<p>Abstract</p> <p>Background</p> <p>Previous research on the environment and physical activity has mostly focused on macro-scale environments, such as the neighborhood environment. There has been a paucity of research on the role of micro-scale and proximal environments, such as that of the home which may be particularly relevant for younger adolescents who have more limited independence and mobility. The purpose of this study was to describe associations between the home environment and adolescent physical activity, sedentary time, and screen time.</p> <p>Methods</p> <p>A total of 613 parent-adolescent dyads were included in these analyses from two ongoing cohort studies. Parents completed a Physical Activity and Media Inventory (PAMI) of their home environment. Adolescent participants (49% male, 14.5 ± 1.8 years) self-reported their participation in screen time behaviors and wore an ActiGraph accelerometer for one week to assess active and sedentary time.</p> <p>Results</p> <p>After adjusting for possible confounders, physical activity equipment density in the home was positively associated with accelerometer-measured physical activity (p < 0.01) among both males and females. Most of the PAMI-derived measures of screen media equipment in the home were positively associated with adolescent female's screen time behavior (p ≤ 0.03). In addition, the ratio of activity to media equipment was positively associated with physical activity (p = 0.04) in both males and females and negatively associated with screen time behavior for females (p < 0.01).</p> <p>Conclusions</p> <p>The home environment was associated with physical activity and screen time behavior in adolescents and differential environmental effects for males and females were observed. Additional research is warranted to more comprehensively assess the home environment and to identify obesogenic typologies of families so that early identification of at-risk families can lead to more informed, targeted intervention efforts.</p

Recruiting and retaining young adults in a weight gain prevention trial: Lessons learned from the CHOICES study

Young adults are at risk for weight gain but little is known about designing effective weight control trials for young adults or how to recruit and retain participants in these programs. The Choosing Healthy Options in College Environments and Settings (CHOICES) study evaluated the effectiveness of a weight gain prevention intervention for 2-year college students. We describe the methods used to recruit and retain the colleges and their students, describe the sample and discuss recommendations for future studies

Results of a 2-year randomized, controlled obesity prevention trial: Effects on diet, activity and sleep behaviors in an at-risk young adult population

Excess weight gain tends to occur in young adulthood. However, research examining effective weight-related interventions for this age group has been limited. As one of seven trials in the EARLY Trials consortium (Early Adult Reduction of weight through LifestYle intervention), the CHOICES Study (Choosing Healthy Options in College Environments and Settings) tested effects of a technology-integrated, young adult weight gain prevention intervention. It was a randomized controlled trial with assessments at baseline (2011) and 4-, 12- and 24-months post-intervention initiation and included 441 participants (ages 18-35) who were students at three Minnesota community colleges. The 24-month intervention included a 1-credit academic course and social networking and support online intervention. This analysis examined effects on 12 secondary behavioral outcomes across three domains: diet (fast food, sugary beverages, breakfast, at-home meal preparation), physical activity/screen time (minutes and energy expenditure in leisure time physical activity, television viewing, leisure time computer use) and sleep (hours of sleep, time required to fall asleep, days not getting enough rest, difficulty staying awake). The intervention resulted in significant reductions in fast food (p=0.007) but increases in difficulty staying awake (p=0.015). There was limited evidence of other behavior changes at 4 months (0.05<p<0.1) in the expected direction but differences by treatment condition dissipated over time. Analyses examining summary treatment effects (i.e., modeling effects on all behavioral outcomes simultaneously) indicated significant overall effects (p=0.014), largely driven by 4-month results (p=0.005). Additional research is needed to understand effective obesity prevention among young adults, particularly when addressing multiple weight-related outcomes

How we eat what we eat: identifying meal routines and practices most strongly associated with healthy and unhealthy dietary factors among young adults

Abstract Objective (i) To examine associations between young adults’ meal routines and practices (e.g. food preparation, meal skipping, eating on the run) and key dietary indicators (fruit/vegetable, fast-food and sugar-sweetened beverage intakes) and (ii) to develop indices of protective and risky meal practices most strongly associated with diet. Design Cross-sectional survey. Setting Minneapolis/St. Paul metropolitan area, Minnesota (USA). Subjects A diverse sample of community college and public university students ( n 1013). Results Meal routines and practices most strongly associated with healthy dietary patterns were related to home food preparation (i.e. preparing meals at home, preparing meals with vegetables) and meal regularity (i.e. routine consumption of evening meals and breakfast). In contrast, factors most strongly associated with poor dietary patterns included eating on the run, using media while eating and purchasing foods/beverages on campus. A Protective Factors Index, summing selected protective meal routines and practices, was positively associated with fruit/vegetable consumption and negatively associated with fast-food and sugar-sweetened beverage consumption ( P &lt;0·001). A Risky Factors Index yielded significant, positive associations with fast-food and sugar-sweetened beverage consumption ( P &lt;0·001). The probability test for the association between the Risky Factors Index and fruit/vegetable intake was P= 0·05. Conclusions Meal routines and practices were significantly associated with young adults’ dietary patterns, suggesting that ways in which individuals structure mealtimes and contextual characteristics of eating likely influence food choice. Thus, in addition to considering specific food choices, it also may be important to consider the context of mealtimes in developing dietary messaging and guidelines

Weight-Gain Reduction Among 2-Year College Students: The CHOICES RCT

The young adult years have been recognized as an influential period for excess weight gain. Non-traditional students and those attending 2-year community colleges are at particularly high risk for a range of adverse weight-related outcomes

One-Year Follow-Up Examination of the Impact of the North Carolina Healthy Food Small Retailer Program on Healthy Food Availability, Purchases, and Consumption

We examined the short-term impact of the North Carolina Healthy Food Small Retailer Program (HFSRP), a legislatively appropriated bill providing funding up to $25,000 to small food retailers for equipment to stock and promote healthier foods, on store-level availability and purchase of healthy foods and beverages, as well as customer dietary patterns, one year post-policy implementation. We evaluated healthy food availability using a validated audit tool, purchases using customer bag-checks, and diet using self-reported questionnaires and skin carotenoid levels, assessed via Veggie Meter™, a non-invasive tool to objectively measure fruit and vegetable consumption. Difference-in-difference analyses were used to examine changes in HFSRP stores versus control stores after 1 year. There were statistically significant improvements in healthy food supply scores (availability), with the Healthy Food Supply HFS score being −0.44 points lower in control stores and 3.13 points higher in HFSRP stores pre/post HFSRP (p = 0.04). However, there were no statistically significant changes in purchases or self-reported consumption or skin carotenoids among customers in HFSRP versus control stores. Additional time or other supports for retailers (e.g., marketing and promotional materials) may be needed for HFSRP implementation to influence purchase and consumption

A School-Based, Peer Leadership Physical Activity Intervention for 6th Graders: Feasibility and Results of a Pilot Study

Background: The aim of this study was to promote physical activity in 6th graders by developing and testing the feasibility of an enhanced Presidential Active Lifestyle Award (PALA) program comprised of a peer leadership component and innovative exercise resource toolkit including DVDs. Methods: A racially/ethnically diverse sample of students received the standard PALA program (2 control schools, n = 61) or enhanced PALA+Peers program (2 intervention schools, n = 87) during 2006-2007 academic year. Results: Compared with the control condition, the intervention was successful in increasing moderate physical activity in all students (P = .02) and moderate and hard physical activity among girls (P = .03 and P = .04, respectively). Teachers and students reported a high level of satisfaction and receptivity with the intervention. All teachers thought the DVDs were well-received, and 87% of students reported that they would recommend the enhanced program to peers. Conclusion: Coupling peer leadership with DVDs that promote physical activity may be an effective way to increase youth physical activity

Translating a health behavior change intervention for delivery to 2-year college students: the importance of formative research

Young adults are at risk for weight gain in the transition to independent adulthood; 2-year college students are at greater risk and understudied relative to 4-year students. This project conducted formative research for a randomized controlled weight gain prevention trial among 2-year college students, to ensure appropriateness of content and delivery of a curriculum originally developed for 4-year college students. Data were collected from community college students, faculty, and staff from October 2009 to August 2011. Work included focus groups and key informant interviews, curriculum pilot testing, and social network and support website beta testing. Based on focus groups and interviews, program content, course delivery modes, and communication channels were adjusted to meet population interests and preferences. The course was delivered successfully in pilot testing, and the website was received well by beta testers. Formative work successfully guided program adaptations to address population needs