Background: The transition from the home to college is a phase in which emerging adults shift toward more unhealthy eating and physical activity patterns, higher body mass indices, thus increasing risk of overweight/obesity. Currently, little is understood about how changing friendship networks shape weight gain behaviors. This paper describes the recruitment, data collection, and data analytic protocols for the SPARC (Social impact of Physical Activity and nutRition in College) study, a longitudinal examination of the mechanisms by which friends and friendship networks influence nutrition and physical activity behaviors and weight gain in the transition to college life.

Methods: The SPARC study aims to follow 1450 university freshmen from a large university over an academic year, collecting data on multiple aspects of friends and friendship networks. Integrating multiple types of data related to student lives, ecological momentary assessments (EMAs) are administered via a cell phone application, devilSPARC. EMAs collected in four 1-week periods (a total of 4 EMA waves) are integrated with linked data from web-based surveys and anthropometric measurements conducted at four times points (for a total of eight data collection periods including EMAs, separated by ~1 month). University databases will provide student card data, allowing integration of both time-dated data on food purchasing, use of physical activity venues, and geographical information system (GIS) locations of these activities relative to other students in their social networks.

Discussion: Findings are intended to guide the development of more effective interventions to enhance behaviors among college students that protect against weight gain during college.

Background: College freshmen are exposed to a variety of environmental and social factors that can alter changes to health habits and encourage weight gain. Weight-related conversations had with friends may be related to self-perception of weight and alterations to health behaviors, but this association has yet to be assessed in the college population.

Objective: This study aims to examine the relationship between friend advice about weight management, self-perception of weight, and alterations to weight change intentions, physical activity, and eating habits in college freshmen over time.

Methods: College freshmen from ASU with complete data for three time points (n=321) were found to be predominantly female (72.2%) and non-white (53.2%) with a mean age of 17.5±41. Complete data included responses for items included in analysis which were related to friend encouragement about weigh management, self-perception of weight, physical activity, eating behaviors, and weight change intentions. A longitudinal multivariate mediation analysis using negative binomial regression adjusted for sociodemographics and clustering by dorm was used to assess the relationship between 1) friend encouragement about weight management at time 1 and behavioral outcomes at time 3, 2) friend encouragement about weight management at time 1 and self-perception of weight at time 2, and 3) self-perception of weight at time 2 and behavioral outcomes at time 3.

Results: A small proportion of population perceived friend encouragement about weight loss (18.3%) and weight gain (14.4%) at time 1. Half the population (50.9%) had the self-perception of overweight at time 2. At time 3, more than half (54.3%) of individuals performed at least 60 minutes of MVPA and consumed at least ½ a serving of sugar-sweetened beverages each day, while nearly half (48.6%) consumed at least 2 servings of fruits and vegetables each day. Males perceived more friend encouragement to gain weight (27.4%; p<0.01), but more females had the self-perception of overweight (54%; p=0.04) and were attempting to lose weight (59.3%; p<0.01). Individuals who perceived friend encouragement to lose weight at time 1 had a 14.8% greater prevalence (p<0.001) of overweight perception of time two, and a 9.6% and 6.9%; decreased prevalence (p<0.001) of weight change and weight loss intentions (p=0.023) at time three respectively. Individuals who perceived friend encouragement to gain weight had a 34.9% decreased prevalence of (p<0.001) of self-perception of overweight at time 1. In individuals with the self-perception of overweight at time 2, there was a 18.1% increased prevalence (p<0.001) of consuming at least ½ a serving of sugar-sweetened beverages/day and an increased prevalence of 22.8% and 24.0% for weight change intentions and weight loss intentions at time 3 (p<0.001).

Conclusion: These findings suggest that there was not a mediation effect of self-perception of overweight in the relationship between friend encouragement about weight management and behavioral outcomes in the current sample. However, the increased prevalence of overweight perception in individuals who perceived friend encouragement about weight management may inform future interventions to focus on how weight-related conversations with friends is related to overweight perception. More research about the relationship between weight-related conversations had with friends, self-perception of weight, and health behaviors is needed to confirm these findings.

Although many studies have looked into the relationship between home food availability and dietary intake, few have assessed actual change in the home food environment as a result of an intervention program. This secondary data analysis of the Athletes for Life 3 (AFL3) program investigated the efficacy of a randomized controlled 12-week community-based, family-focused exercise and dietary behavior intervention program in improving the home food environment of families with children between the ages of 6 and 11 years old. A total of twenty-six adults from Phoenix, Arizona allowed research staff into their homes to assess variety of food availability, using a modified version of the Home Food Inventory and were randomized to either the AFL3 program or wait-list control group. The main outcomes of interest were change in availability of vegetables, fruits, sugar-sweetened beverages and desserts and WIC-approved breakfast cereal. There was a significant increase in the number of vegetable items (3.88 ± 0.85; p=0.006) and WIC-approved cereal items (1.16 ± 0.31; p=0.003) in the homes of the intervention participants, relative to the wait-list control group. Additionally, there was a significant decrease in the number of sugar-sweetened beverage items (1.18 ± 0.31; p=0.014) available in wait-list control participant homes. There were no other significant findings related to home food availability. Furthermore, dietary intake among adult participants did not significantly change as a result of change in home availability. In conclusion, the AFL3 intervention program was successful in eliciting small but significant changes at a household level related to vegetable and WIC-approved breakfast cereal availability.

The stadiometer is the gold standard human height measure, but recent studies have begun to question whether laser technology is a better tool to measure height. The purpose of this study was to investigate if the laser device has inter-rater reliability, how the laser-device measures supine height in comparison to standard methods, and if the laser device will be consistent in measuring human height shorter, as seen in previous studies. Two investigators measured a total of 80 adults independently. Measurements included knee height, arm span, demi span, supine height by laser, standing height by laser and standing height by stadiometer. There was a strong inter-rater reliability for the laser height measurement: excluding one outlier r=0.998. Supine height measures done with a laser were strongly correlated with arm span, but mean values were closest between supine height and knee height (171.3cm and 171.2cm). The laser measured standing height 0.5cm shorter, on average, than the stadiometer. It is concluded that the laser device is a reliable, validated tool to measure human height, standing or supine.

Low income, pregnant adolescents have an increased risk of adverse pregnancy outcomes, such as preterm birth, delivery of low birth weight babies and excessive gestational weight gain that increases the risk of postpartum overweight and obesity. Inadequate dietary intake is a modifiable risk factor that may differentially impact maternal health and fetal outcomes for pregnant adults and adolescents. To evaluate the effectiveness of a social media intervention on improving prenatal health knowledge and dietary intake, 22 racially diverse pregnant women (59% Black and 36% White) were recruited and adolescent (n=10) outcomes compared to those of adults (n=12) across the intervention. Pre- and post-intervention nutrition knowledge questionnaires and diet recalls were completed to assess nutrition knowledge and dietary intake. When assessing dietary change across the intervention, significant decreases in fat (pre vs. post, 97.9 ± 0.2 g vs. 90.2 ± 0.2 g, P=0.047) and folate intake (pre vs. post, 537.6 ± 0.3 μg vs. 531.2 ± 0.2 μg, P=0.041) were observed while significant increases in carbohydrate (pre vs. post, 318.9 ± 0.2 g vs. 335.9 ± 0.2 g, P<0.001), calcium (pre vs. post, 851.3 ± 0.3 mg vs. 893.5 ± 0.2 mg, P<0.001) and magnesium intakes (pre vs. post, 212.9 ± 0.2 mg vs. 227.8 ± 0.2 mg, P<0.001) occurred. These time effects occurred independent of group (adolescents vs. adults) as time*group interactions were not significant (p>0.05) with the exception of sugar intake. Increases in sugar intake across the intervention were greater among the adolescent group (adolescent vs. adult, 7.9 ± 0.2 g vs. 6.0 ± 0.2 g, P=0.023). Overall nutrition knowledge was limited and confusion regarding MyPlate recommendations persisted. The inadequate dietary behaviors observed suggest that future interventions should focus education on specific dietary nutrients such as added sugars and fiber to improve dietary intakes. The best way to actively engage pregnant adolescents is unknown: however, social media has the potential to reach teens and low-income women with education that may be key in allowing interventions to change dietary habits and behaviors.

While literature has examined the associations between emotions and overeating, rarely is the relationship between emotions and food choices included. The purpose of this secondary data analysis was to utilize mobile-based ecological momentary assessment (EMA) surveys to determine the associations among negative, positive, apathetic, and mixed emotions and a variety of food choices in college freshmen living in residence halls. A total of 2142 survey responses from 647 college freshmen were included in this analysis (70.3% female, 51.5% non-white). Mixed model logistic regression assessed the cross-sectional association between emotions and food choices adjusting for gender, race/ethnicity, Pell grant status, highest parental education, and the clustering of repeated measures within person and of students within residence hall. There were no significant associations between negative emotions and food choices. Positive emotions were significantly and inversely associated with eating pizza/fast food (OR=0.6; 95% CI=0.5, 0.8) and cereals (OR=0.6; 95% CI=0.4, 1.0), while apathetic emotions were significantly and positively associated with consuming salty snacks/fried foods (OR=1.6; 95% CI=1.1, 2.5) and inversely associated with consuming sandwiches/wraps (OR=0.5; 95% CI=0.3, 0.8) and meats/proteins (OR=0.6; 95% CI=0.4, 1.0). It was also found that there were several instances of surveys with mixed emotions, in which participants reported feeling two conflicting emotions at once (i.e. positive and negative). Mixed emotions were significantly associated with consuming sweets (OR=1.6; 95% CI=1.2, 2.1), meats/proteins (OR=1.6; 95% CI=1.2, 2.0), and cereals (OR=1.9; 95% CI=1.2, 2.9). Understanding the relationships between different types of emotions and food choices is helpful in understanding the motivation behind healthy versus unhealthy food choices. These findings can be used to develop interventions that encourage positive emotions in college freshmen to better promote healthy food choices and ultimately reduce the risk of weight gain and other health disparities. Future research should examine how college freshmen differ from other college students (i.e. upper classmen and graduate students), particularly related to their emotions and food choices, so that dietary interventions can be better suited to those who are vulnerable.

Background: Latinos have disproportionately high rates of obesity and type 2 diabetes. Family-based interventions may reduce chronic disease risk among Latinos across generations.

Purpose: To assess the efficacy of Athletes for Life (AFL), a 12-week community-and-family-based behavioral intervention, for improving diet, physical activity (PA), anthropometrics, fitness, and biochemical outcomes among mostly Latino parents.

Methods: Parents with at least one child 6-11 years of age were randomized to active AFL participation (n=14) or a wait-list control (n=14) group. AFL consisted of twice weekly 90 minute sessions (45 minutes of nutrition-focused lessons and 45 minutes of PA participation) designed to promote fruit and vegetable consumption, reduction of sugar intake, and increasing habitual PA. Data were collected prior to and immediately after the 12 week intervention.

Results: Participants (37.9±7.2y) were mostly Latino (93%), Spanish speaking (68%), and women (93%). Relative to participants in the control group, AFL participants had a significant reduction in body fat (-1.1±1.2% vs. 0.2±1.2%; p=0.014), resting (-7.6±10.2 bpm vs. +2.1±6.8 bpm; p<0.01), exercise (-8.4±8.7 bpm vs. +0.4±7.3 bpm; p<0.01), and recovery heart rate (-11.9±12.8 bpm vs. -0.3±11.4 bpm; p=0.01), and one mile run time (-1.5±1.0 min vs. -0.1±0.9 min; p<0.01), and a significant increase in estimated VO2 peak (+1.9±1.9 ml/kg/min vs. 0.0±1.8 ml/kg/min; p=0.01). AFL participants also reported an increase in the number of days/week accumulating 30 minutes of MVPA (+0.8±3.2 vs. -1.5±2.3; p=0.004) and daily servings of fruits (+1.3±1.4 vs. +0.3±1.4; p<0.05) and vegetables (+1.8±1.7 vs. +0.1±1.2; p<0.05), relative to control participants. There were no significant differences between groups in changes in diet assessed by 3-day food record, accelerometer-measured PA, weight, blood pressure, visceral fat, biomarkers for cardiovascular disease or nutritional biomarkers.

Conclusions: Despite the lack of effects on diet and PA behaviors, AFL shows promising preliminary efficacy for reducing body fat and improving fitness among adult participants. Future research aimed at improving fitness among Latino parents with family-based intervention is warranted.

Objectives

This cross-sectional study sought to assess the eating and physical activity behaviors among in-state and out-of-state college freshmen attending Arizona State University and to determine if social connectedness mediated the relationship between residency status and eating and physical activity behaviors.

Methods

College freshmen from two dormitories were recruited for participation from Arizona State University’s Tempe campus. A 128-item survey assessing demographics, college life, eating and physical activity behaviors, and social connectedness was administered. In addition, participants completed up to three days of dietary recall. Multivariate linear regression models, adjusting for age, gender, race, ethnicity, highest parental education, dormitory, Pell grant status, number of dietary recalls, and availability of a weekend day of dietary recall were used to assess the relationships between residency status, social connectedness, and eating and physical activity behaviors.

Results

No associations were observed between residency status and calories, grams and percentage of calories from fat, and added sugar. There was a statistically significant association between residency status and moderate-to-vigorous physical activity (MVPA). In-state students reported 21 minutes less per day of MVPA than out-of-state students did (β=-20.85; 95% CI=-30.68, -11.02; p<0.001). There was no relationship between residency status and social connectedness. Social connectedness and eating and physical activity behaviors were not associated. Social connectedness did not mediate the relationship between residency status and eating and physical activity behaviors.

Conclusions

In-state and out-of-state students differed in their MVPA; however, this relationship was not mediated by social connectedness. Further studies are needed to confirm the relationship between MVPA and residency status. In addition, more studies are needed to assess the relationship between social connectedness and MVPA.

Salad bars are promoted as a means to increase fruit and vegetable consumption among school-age children; however, no study has assessed barriers to having salad bars. Further, it is not known if barriers differ across school level. This cross-sectional study investigated the barriers to having salad bars across school level among schools without salad bars in Arizona (n=177). Multivariate binominal regression models were used to determine differences between the barriers and school level, adjusting for years at current job, enrollment of school, free-reduced eligibility rate and district level clustering. The top five barriers were not enough staff (51.4%), lack of space for salad bars (49.7%), food waste concerns (37.9%), sanitation/food safety concerns (31.3%), and time to get through the lines (28.3%) Adjusted analyses indicated two significant differences between barriers across school level: time to get through lines (p=0.040) and outside caterer/vendor (p=0.018) with time to get through lines reported more often by elementary and middle school nutrition managers and outside caterer/vendor reported most often by high school nutrition managers. There were several key barriers reported and results indicate that having an outside vendor/caterer for their meal programs and time to get through the service lines varied across school level. High schools report a higher percent of the barrier outside caterer/vendors and elementary and middle schools report a higher percent of the barrier time to get through the lines. Results indicate that research determining the approximate time it takes students to get through salad bar lines will need to be considered. More research is needed to determine if the barrier time to get through the service lines is due to selection of food items or if it is due to the enrollment size of the lunch period. Future research interventions may consider investigating food safety and sanitation concerns of middle school nutrition managers. Findings may be used to guide ways to decrease barriers in schools without salad bars.

Individuals in urban low-income areas often do not have easy access to large grocery stores and supermarkets, and regularly shop at nearby small/corner stores. These stores stock an abundance of processed, energy-dense, nutrient poor foods, combined with few nutrient-dense products. A high concentration of small/corner stores is associated with poor diets by nearby residents. Interventions that target small food stores for increasing the availability and sale of healthy foods have been launched in many communities, and validated survey instruments have been developed to evaluate the effectiveness of the interventions. However, in-store surveys can take up to thirty minutes to conduct and require individual visits from investigators. Many projects assess the food environment in a large number of stores spread across broad geographical areas, making in-person evaluations infeasible and resource-prohibitive. The purpose of this study was to develop a valid and feasible short survey that could be used in-store or over the phone to capture the healthfulness of corner stores. An adapted version of the Nutrition Environment Measures Survey for Corner Stores (NEMS-CS) was used to conduct store audits of 230 corner stores in four New Jersey cities. Audit results were used in exploratory factor analysis and item response theory to develop a seven-item survey. The short survey was highly correlated with the full survey (r=0.79), and the short survey's classification of stores as healthy (top 20% of scores) versus unhealthy (bottom 80% of stores) matched NEMS-CS categorizations in 88% of cases. A second round of audits was conducted in 100 corner stores to confirm the validity of the seven-item survey and to test its feasibility as a phone audit tool. Complete phone responses were obtained from 86% of stores. Response matches indicated that store owners did not distinguish between 2% and low-fat milk, and tended to round up the fruit and vegetable count to five if they had fewer varieties. The seven-item short survey discriminates between healthy and unhealthy stores and is feasible for use as a phone audit tool.