Cohort profile: Life-course experiences and pregnancy (LEAP)-A retrospective pregnancy cohort for life-course reproductive health research.

BACKGROUND: Life course factors may be associated with pre-pregnancy body mass index and gestational weight gain; however, collecting information on pre-pregnancy exposures and pregnancy health in the same cohort is challenging. OBJECTIVES: The Life-course Experiences And Pregnancy (LEAP) study aims to identify adolescent and young adult risk factors for pre-pregnancy weight and gestational weight gain (GWG). We built upon an existing cohort study to overcome challenges inherent to studying life course determinants of pregnancy health. POPULATION: Participants in an ongoing prospective cohort study of weight-related health who identified as women. DESIGN: Retrospective cohort study. METHODS: In 2019-2020, 1,252 women participating since adolescence in a cohort study of weight-related health were invited to complete an online reproductive history survey. Participants who reported a live birth were invited to release their prenatal, delivery, and postpartum medical records for validation of survey reports. Descriptive analyses were conducted to assess the characteristics of the overall cohort and the medical record validation subsample, and to describe adolescent and young adult characteristics of those with high (>80th percentile), moderate (20th-80th percentile), and low (<20th percentile) GWG z-score for gestational age and pre-pregnancy weight status. PRELIMINARY RESULTS: Nine hundred seventy-seven women (78%) completed the LEAP survey and 656 reported a live birth. Of these, 379 (58%) agreed to release medical records, and 250 records were abstracted (66% of the 379). Of the 977 survey respondents 769 (79%) reported attempting a pregnancy, and 656 (67%) reported at least one live birth. The validation subsample was similar to the overall cohort. Women with a high GWG had a higher adolescent BMI percentile and prevalence of unhealthy weight control behaviors than those with moderate or low GWG. CONCLUSIONS: LEAP offers a valuable resource for identifying life course factors that may influence the health of pregnant people and their offspring.

Emerging adult college students' descriptions of exposure to childhood emotional abuse and associated factors: A qualitative exploration.

BACKGROUND: Growing evidence on the long-term deleterious impacts of emotional abuse highlights the need to further understand childhood emotional abuse and its context to strengthen prevention efforts. OBJECTIVE: To describe emerging adults' experiences of emotional abuse in their childhoods and the household context surrounding that abuse. PARTICIPANTS AND SETTING: Fifty-eight interviews were conducted with emerging adults, ages 18-25, recruited from four 2- and 4-year institutions of higher education. METHODS: Thematic analysis was conducted to identify and describe patterns in the data. A cyclical approach to codebook development and data analysis was followed by a team of four coders. RESULTS: Themes related to participants' experiences of emotional abuse included: inability to meet parent expectations; parent attacks on the child's character; parent negative comparisons to siblings and others; parent invalidation of the child's emotions and mental health needs; and evolution over time in the parent-child relationship. Aspects of childhood family environments contemporaneous with the childhood emotional abuse included: financial stress; parent mental illness; parent divorce, separation, or volatile relationship; parent adversity or trauma; physical abuse; and young parent age. Many participants identified these aspects of their family environment, most of which could potentially be improved with sufficient support, as playing causal roles in the emotional abuse they experienced. CONCLUSION: This descriptive qualitative study provides additional insight into child emotional abuse and its associated factors, providing invaluable insights that can enhance current measurement and intervention approaches.

Portion size effects on weight gain in a free living setting.

OBJECTIVE: Examine the effect of weekday exposure over 6 months to different lunch sizes on energy intake and body weight in a free-living sample of working adults. METHODS: Adults (n = 233) were randomly assigned to one of three lunch size groups (400 kcal, 800 kcal, and 1,600 kcal) or to a no-free lunch control group for 6 months. Weight and energy intake were measured at baseline, and months 1, 3, and 6. RESULTS: Lunch energy was significantly higher in the 800 and 1,600 kcal groups compared with the 400 kcal group (P < 0.0001). Total energy was significantly higher for the 1,600 kcal group compared with the 400 and 800 kcal groups (P = 0.02). Body weight change at 6 months did not significantly differ at the 5% level by experimental group (1,600 kcal group: +1.1 kg (SD = 0.44); 800 kcal group: -0.1 kg (SD = 0.42); 400 kcal group: -0.1 kg (SD = 0.43); control group: 1.1 (SD = 0.42); P = 0.07). Weight gain over time was significant in the 1,600 kcal box lunch group (P < 0.05). CONCLUSIONS: Weekday exposure for 6 months to a 1,600 kcal lunch caused significant increases in total energy intake and weight gain.

Household obesity prevention: Take Action--a group-randomized trial.

The purpose of the present study was to evaluate an intervention to prevent weight gain among households (HHs) in the community. Ninety HHs were randomized to intervention or control group for 1 year. Intervention consisted of six face-to-face group sessions, placement of a television (TV) locking device on all home TVs, and home-based intervention activities. Measures were collected in person at baseline and 1 year. Weight, height, eating behaviors, physical activity (PA), and TV viewing were measured among HH members ages ≥ 12 years. Follow-up rate at 1 year was 96%. No significant intervention effects were observed for change in HH BMI-z score. Intervention HHs significantly reduced TV viewing, snacks/sweets intake, and dollars per person spent eating out, and increased (adults only) PA and self-weighing frequency compared with control HHs. A 1 year obesity prevention intervention targeting entire HHs was effective in reducing TV viewing, snack/sweets intake and eating out purchases. Innovative methods are needed to strengthen the home food environment intervention component. Longer intervention durations also need to be evaluated.

Pricing and availability intervention in vending machines at four bus garages.

OBJECTIVE: To evaluate the effects of lowering prices and increasing availability on sales of healthy foods and beverages from 33 vending machines in 4 bus garages as part of a multicomponent worksite obesity prevention intervention. METHODS: Availability of healthy items was increased to 50% and prices were lowered at least 10% in the vending machines in two metropolitan bus garages for an 18-month period. Two control garages offered vending choices at usual availability and prices. Sales data were collected monthly from each of the vending machines at the four garages. RESULTS: Increases in availability to 50% and price reductions of an average of 31% resulted in 10% to 42% higher sales of the healthy items. Employees were mostly price responsive for snack purchases. CONCLUSIONS: Greater availability and lower prices on targeted food and beverage items from vending machines was associated with greater purchases of these items over an 18-month period. Efforts to promote healthful food purchases in worksite settings should incorporate these two strategies.

Worksite environment intervention to prevent obesity among metropolitan transit workers.

OBJECTIVE: The results of an 18-month worksite intervention to prevent obesity among metropolitan transit workers are reported. METHODS: Four garages in a major metropolitan area were randomized to intervention or control groups. Data were collected during the fall of 2005 prior to the start of the intervention and during the fall of 2007, after the intervention ended. Intervention program components at the garage included enhancement of the physical activity facilities, increased availability of and lower prices on healthy vending machine choices, and group behavioral programs. Mixed model estimates from cross-sectional and cohort samples were pooled with weights inverse to the variance of their respective estimates of the intervention effects. RESULTS: Measurement participation rates were 78% at baseline and 74% at follow-up. The intervention effect on garage mean BMI change was not significant (-0.14 kg/m(2)). Energy intake decreased significantly, and fruit and vegetable intake increased significantly in intervention garages compared to control garages. Physical activity change was not significant. CONCLUSION: Worksite environmental interventions for nutrition and physical activity behavior change may have limited impact on BMI among transit workers who spend most of their workday outside the worksite.

Capturing the spectrum of household food and beverage purchasing behavior: a review.

The household setting may be the most important level at which to understand the food choices of individuals and how healthful food choices can be promoted. However, there are few available measures of the food purchase behaviors of households and little consensus on the best way to measure it. This review explores the currently available measures of household food purchasing behavior. Three main measures are described, evaluated, and compared: home food inventories, food and beverage purchase records and receipts, and Universal Product Code bar code scanning. The development of coding, aggregation, and analytical methods for these measures of household food purchasing behavior is described. Currently, annotated receipts and records are the most comprehensive, detailed measure of household food purchasing behavior, and are feasible for population-based samples. Universal Product Code scanning is not recommended due to its cost and complexity. Research directions to improve household food purchasing behavior measures are discussed.

Worksite environment physical activity and healthy food choices: measurement of the worksite food and physical activity environment at four metropolitan bus garages.

BACKGROUND: The present research describes a measure of the worksite environment for food, physical activity and weight management. The worksite environment measure (WEM instrument) was developed for the Route H Study, a worksite environmental intervention for weight gain prevention in four metro transit bus garages in Minneapolis-St. Paul. METHODS: Two trained raters visited each of the four bus garages and independently completed the WEM. Food, physical activity and weight management-related items were observed and recorded on a structured form. Inter-rater reliability was computed at the item level using a simple percentage agreement. RESULTS: The WEM showed high inter-rater reliability for the number and presence of food-related items. All garages had vending machines, microwaves and refrigerators. Assessment of the physical activity environment yielded similar reliability for the number and presence/absence of fitness items. Each garage had a fitness room (average of 4.3 items of fitness equipment). All garages had at least one stationary bike and treadmill. Three garages had at least one weighing scale available. There were no designated walking areas inside or outside. There were on average < 1 food stores or restaurants within sight of each garage. Few vending machine food and beverage items met criteria for healthful choices (15% of the vending machine foods; 26% of the vending machine beverages). The garage environment was perceived to be not supportive of healthy food choices, physical activity and weight management; 52% reported that it was hard to get fruits and vegetables in the garages, and 62% agreed that it was hard to be physically active in the garages. CONCLUSION: The WEM is a reliable measure of the worksite nutrition, physical activity, and weight management environment that can be used to assess changes in the work environment.

Use of a Web-based component of a nutrition and physical activity behavioral intervention with Girl Scouts.

This study describes the development and usage of a Web-based component of a nutrition and physical activity behavioral intervention to promote bone health among preadolescent girls. Thirty Girl Scout troops were randomized to either an intervention or control group for a 2-year period. Girls in the intervention troops (aged 10 to 12 years, N=194) were exposed to grade-specific Web sites that were developed to reinforce the content of the broader, face-to-face intervention. In 5th grade, 82% of the girls logged on once and 48% logged on more than once, compared to 56% and 23% of 6th graders, respectively. Results suggest that although Web-site usage decreased over time, a Web-site program may be useful as a component of a face-to-face, multicomponent intervention. More research is needed to determine ways to enhance and maintain Web-site use over time among youth in health-behavior intervention programs.

Food environment in secondary schools: a la carte, vending machines, and food policies and practices.

OBJECTIVES: This study described the food environment in 20 Minnesota secondary schools. METHODS: Data were collected on school food policies and the availability and nutritional content of foods in school à la carte (ALC) areas and vending machines (VMs). RESULTS: Approximately 36% and 35% of foods in ALC areas and in VMs, respectively, met the lower-fat criterion (< or = 5.5 fat grams/serving). The chips/crackers category constituted the largest share of ALC foods (11.5%). The median number of VMs per school was 12 (4 soft drink, 2 snack, 5 other). Few school food policies were reported. CONCLUSIONS: The availability of healthful foods and beverages in schools as well as school food policies that foster healthful food choices among students needs greater attention.