Reducing LGBTQ+ Physical Activity Disparities Through Improved Measurement and Inclusion of Sexual Orientation in US National Data Sets.

Adequate participation in physical activity (PA) is effective in reducing negative health outcomes, including cardiovascular disease, stroke, type 2 diabetes, as well as stress, anxiety, and depression. However, 1 in 4 adults meet the PA guidelines, with lesbian, gay, bisexual, transgender, and queer (LGBTQ+) persons reporting increased rates of inactivity and higher rates of negative health outcomes. Limited research can be conducted on best methods to promote PA among LGBTQ+ adults as there is a lack of standardized measurements for both sexual orientation status and PA used in US national data set methodologies. A call to action is warranted to highlight the lack of uniform methodologies for collecting both sexual orientation and PA data in national data sets, with an overall goal of promoting inclusion and transparency of sexual orientation as a primary, secondary, and tertiary influence on PA. The current societal disconnect of national data sets collecting sexual orientation does not allow for proper extrapolation within the LGBTQ+ classifications. LGBTQ+ identities each report differing PA and health outcomes, promoting the need for proper sexual orientation measures. Without this inclusion, we will continue to see larger health disparities among LGBTQ+ persons due to outdated measurements in current US national data sets. This commentary provides sexual orientation status on health outcomes linked to physical inactivity, the need to include uniform sexual orientation measures in national data sets, and implications of the inclusion of this measure to conduct PA research as it relates to health outcomes.

Success and Challenges of Community Bicycle Advocacy Organizations in Reaching Underserved Populations.

INTRODUCTION: Bicycling, as forms of recreation and travel, offers many positive physical and mental health benefits, though there are still many disparities in bicycling rates among underserved populations in the United States. Community bicycling advocacy organizations/coalitions promote and advocate for increased bicycling; however, have been shown to have a lack of organizational capacity for equitable programming to diverse populations (racial/ethnic minorities, women, low-income, LGBTQ+ communities, youth). The purpose of this study was to understand the current practices for providing underserved populations bicycling programming among advocacy organizations and to find major barriers and helpful tools for equitable programming. METHODS: This was conducted in a volunteer sample of U.S. bicycle advocacy organizations. An interview (n = 23) assessed organizational function, successful programs, and barriers to reaching underserved populations. RESULTS: Several themes emerged from the interviews. Participants stated that the lack of organizational leadership and member diversity, along with a lack of trust with underserved communities, presented major barriers to providing equitable programming. Partnering with other community organizations that place an emphasis on serving diverse populations was noted to have potential for increasing successful programming by allocating resources and connections. CONCLUSION: Although barriers exist for bicycle advocacy organizations when attempting to reach underserved and diverse populations, groups should focus on creating successful and diverse partnerships to increase the capacity for providing equitable programming.

Gender and race/ethnicity differences in occupational activity among students.

Occupational physical activity (OPA) is related to positive health outcomes and meeting overall physical activity recommendations. OPA participation typically varies across racial/ethnic groups and by gender, though little research has examined differences in OPA among college students. A cross-sectional, online survey of college students examined demographics and OPA. Participants (n = 3739) were predominately Non-Hispanic White (77.1%) and female (57.8%) aged 20.97 ± 1.52. Employed students reported greater total PA compared with non-employed students. Males reported significantly greater vigorous OPA, overall OPA, and total PA compared with females. Among employed students, OPA contributed significantly to overall PA levels. Males reported significantly greater OPA compared with females and there were several significant differences by race/ethnicity. Academic performance was related to OPA. These findings provide some insight on the OPA levels of a population group that has not been thoroughly examined.

University bicycle programming capacity for underrepresented student populations: Pedaling toward equitable opportunities.

Purpose: Universities and colleges play a major role in facilitating the behaviors of students into adulthood. Active travel (AT; walking or bicycling for transportation) can provide substantial health benefits, though inequities among bicycling are shown in many underserved populations (racial/ethnic minorities, women, LGBTQ+, disabled, low-income). This study aimed to understand universities' capacity for underserved populations programming on campuses. Methods: Representatives from U.S. universities/colleges participated in an online survey which addressed basic information about university demographics/culture, common barriers and desired tools to reaching underserved students, priorities, and important outcomes. Results: University respondents (n = 51) indicated a lack of programming and implementation of strategies to reach underserved campus populations. Typically, universities ranked equity as a low priority and limited strategies for promoting bicycling reached/targeted underserved populations. Conclusion: There is a notable lack of programs and strategies to engage underserved populations on campus that should be addressed to better serve student health outcomes.

The apparent need for better communication between clinicians and patients regarding elevated blood pressure among United States emerging adults.

Objectives: To examine the discrepancy between 'told' and screened blood pressure (BP) category, and the association between body composition and told BP category. Methods: Between 08/2019-03/2020 college students (n = 1057) were asked what category they had previously been told their BP falls into prior to having their BP and body composition (waist circumference, body mass index (BMI), and body fat percentage) objectively assessed. Results: A disproportionate number (>80%) who were told that they had normal BP were categorized as having elevated BP. Men told they had borderline/high BP had less favorable body compositions than those told they had low/normal BP. Less favorable body composition was associated with increased likelihood of men being told that they had borderline/high BP. Conclusions: Better BP screening policies and procedures would ensure healthcare providers discuss elevated BP with emerging adults regardless of body composition and avoid missing opportunities to delivery of early and cost-effective interventions.

Factors contributing to gender inequities in physical activity and campus recreation facility use.

Examine college women's perceptions of factors contributing to gender inequities in physical activity and campus recreational facility use.Semi-structured interviews were conducted with female undergraduate students at a large university located in the Northeast of the United States. Qualitative data were analyzed using thematic analyses using the socio-ecological model as a conceptual framework.Women (N = 18; 6 non-Hispanic White, 5 Black, 7 Asian American; 20.6 ± 1.2 years old) cited intrapersonal, interpersonal, and environmental factors impacting their physical activity and campus recreation facility use due to their gender. Built environmental factors included facility proximity, facility layout and equipment, and crowdedness. Male peers impacted women by making them feel uncomfortable/intimidated and harassed. Intrapersonal factors included a perceived lack of skills/competence/knowledge, lack of confidence, and self-consciousness.Findings demonstrate the need for institutions to implement and enforce policies that achieve a cultural shift in the social environment to provide equitable physical activity participation opportunities.

College student aerobic and muscle-strengthening activity: the intersection of gender and race/ethnicity among United States students.

Objective: To adopt an intersectional approach to examine differences in aerobic and muscle-strengthening participation based on the intersection of gender and race/ethnicity among college students. Methods: Data from the American College Health Association (ACHA) National College Health Assessment collected between 2015 and 2018 were analyzed. Differences in the prevalence of meeting activity recommendations based on the intersection of gender and race/ethnicity were computed and displayed graphically. Odds of meeting activity recommendations were determined by calculating odds ratios controlling for age, year of enrollment, sexual orientation, and health status. Results: Aerobic and muscle-strengthening activity differed significantly between races within genders, and between genders within races. With minor exceptions, men were more likely to meet aerobic and muscle-strengthening activity recommendations than women of the same race/ethnicity. Disparities based on race varied considerably between genders. Conclusions: The intersection of gender and race/ethnicity should be considered when examining and addressing physical activity disparities.

College student aerobic and muscle-strengthening activity: Disparities between cis-gender and transgender students in the United States.

Objective: To examine aerobic and muscle-strengthening activity disparities among college cis-gender and transgender students adjusting for other socio-demographic characteristics (age, race/ethnicity, sexual orientation). Methods: National Collegiate Health Assessment (NCHA) data collected between Fall 2015 and Fall 2018 were analyzed using chi-square tests for independence and odds ratios. Results: Cis-gender women were significantly less likely to meet aerobic and muscle-strengthening activity recommendations compared to cisgender men. Transgender men and transgender women were less likely to meet aerobic and muscle-strengthening activity recommendations compared to cisgender peers. Differences were also revealed among transgender individuals, with transgender women more and less likely to meet aerobic and muscle-strengthening recommendations respectively compared to transgender men. Conclusions: Considerable aerobic and muscle-strengthening activity participation disparities exist between cisgender and transgender emerging adults. The unique constraints that transgender college students experience in relation to both aerobic and muscle-strengthening activity participation require further examination to ensure the provision of equitable opportunities to be physically active.

Effects of Desk Pedaling Work Rate on Concurrent Work Performance among Physically Inactive Adults: A Randomized Experiment.

PURPOSE: Under-desk pedaling devices could help reduce health risks associated with the global decline in work-related energy expenditure. However, the optimal pedaling work rate to facilitate concurrent work performance among physically inactive adults is unclear. We examined the effects of two light-intensity pedaling work rates on physically inactive adults' work performance. METHODS: We recruited equal numbers of older (45-65 yr) versus younger (20-44 yr), male versus female, and overweight/obese (body mass index [BMI], 25-35 kg·m -2 ) versus normal weight (BMI, 18.5-24.9 kg·m -2 ) participants. Using a Graeco-Latin square design, participants ( n = 96) completed a laboratory experiment to evaluate the effects of using an under-desk pedaling device at two seated light-intensity work rates (17 and 25 W), relative to a seated nonpedaling condition on objectively measured typing, reading, logical reasoning, and phone task performance. Ergonomic comfort under each pedaling work rate was also assessed. Equivalence tests were used to compare work performance under the pedaling versus nonpedaling conditions. RESULTS: Treatment fidelity to the 17- and 25-W pedaling work rates exceeded 95%. Mean work performance scores for each pedaling and nonpedaling condition were equivalent under alpha = 0.025. Age, sex, and BMI did not significantly moderate the effect of pedaling on work performance. Participants reported greater ergonomic comfort while completing work tasks at the 17-W relative to the 25-W work rate. CONCLUSIONS: Physically inactive adults obtained similar work performance scores under the 17- and 25-W pedaling and the nonpedaling conditions, suggesting that either pedaling work rate could help reduce health risks of sedentary work time. The 17-W work rate yielded greater ergonomic comfort and may be an appropriate starting point for introducing diverse inactive workers to under-desk pedaling.

Neighborhood Assessment of the Environment for Physical Activity: Engaging Adolescents Within an Under-resourced Community.

BACKGROUND: Physical activity (PA) participation has many benefits; however, rates of participation remain low, particularly among underserved populations which may face low PA participation due to having poorer quality of built environment factors which is a known influence on activity levels. OBJECTIVES: To train adolescents to conduct environmental neighborhood assessments and neighborhood resident surveys of with the end goal of encouraging advocacy for neighborhood improvements. METHODS: This mixed methods, prospective design study was focused in a low-income, under-resourced, predominately African American neighborhood in Pittsburgh. Adolescents (n = 14; 13-17 years) in a community partner's youth program were trained to conduct neighborhood environmental assessments and distributed neighborhood resident surveys. Results of these assessments were shared with community partners to create strategies for improvement. These adolescents participated in a focus group following the environmental assessments to reflect on their findings and the process. The neighborhood resident survey (n = 123) assessed demographics, perceptions of the neighborhood, PA participation and health outcomes. RESULTS: Neighborhood assessments noted and resident surveys noted many barriers to activity (i.e., poor sidewalks, unsafe areas). Results were informative for our community partner to advocate for neighborhood improvements. Focus group results indicated that the adolescents understood how their neighborhood environment could influence PA and how the findings could be utilized to make improvements in their neighborhood. CONCLUSIONS: Adolescents can be successfully trained/educated to follow a research protocol for assessing the built environment for PA using a variety of measurement tools, while additionally gaining insight towards neighborhood environment advocacy.

Physical Activity is Related to Mental Health and Sexual Orientation Among Women in College.

Non-heterosexual women tend to report lower physical activity and poorer mental health than their heterosexual counterparts. The purpose of this study was to examine differences in mental health (stress and depression) and physical activity among female college students by sexual orientation. Students self-reported socio-demographic characteristics, physical activity, perceived stress, and depressive symptoms via an online survey. Correlations, independent samples t-tests, and multiple regression analyses were used to examine relationships between perceived stress, depressive symptoms, physical activity, and sexual orientation. Most participants (n = 1072, 20.0 ± 1.5 years) identified as heterosexual (90.1%), non-Hispanic White (73%), and in their fourth semester or higher. Perceived stress and depressive symptoms differed significantly between heterosexual and non-heterosexual women, but physical activity participation did not. Higher participation in vigorous physical activity and strength training predicted both lower depressive symptoms and lower perceived stress while controlling for sexual orientation. For both heterosexual and non-heterosexual sexual women, depressive symptoms had a positive relationship with perceived stress, and a negative relationship to strength training. Depressive symptoms also had negative correlations with vigorous physical activity among heterosexual women. Findings indicate non-heterosexual women experience greater perceived stress and depressive symptoms, and these mental health issues can have multi-level implications. Greater vigorous physical activity and strength training were associated with lower perceived stress and depression regardless of sexual orientation. Administrators and health promoters should consider ways to promote these forms of physical activity among non-heterosexual women. Further research is needed on the potential barriers impacting engagement in physical activity.

Developing and evaluating a peer-based mental health literacy intervention with adolescent athletes.

Widespread adolescent involvement in organized sport means that sport contexts are well-suited to 'actively' integrate prevention programs that may promote population-level change. This mixed methods study aimed to evaluate the feasibility and acceptability of a peer-based mental health literacy intervention. The intervention (i.e., Team Talk) was presented to eleven adolescent sport teams in the United States, with a total of 174 participants. Athlete participants completed surveys immediately before and after the intervention-including measures of workshop acceptability, social identity, and help-seeking behaviors. Semi-structured interviews were also conducted with a subset of five athletes, nine parents, and two coaches. With respect to recruitment as an indicator of feasibility, club-level adoption of the intervention was low, with difficulty recruiting clubs for intervention delivery. This signals that feasibility of the intervention-as it is currently designed and implemented by the research team-is low when considering similar competitive adolescent sport clubs and delivered as team-level workshops. Meanwhile, participants reported high acceptability of the intervention, and acceptability levels across participants was predicted by contextual factors related to implementation such as session duration. Regarding limited efficacy testing with measures completed before and after the intervention session: (a) social identity scores increased following the intervention, and (b) significant differences were not identified regarding efficacy to recognize symptoms of mental disorders. Athlete, coach, and parent interview responses also described potential adaptations to mental health programs. This research demonstrates the potential utility of peer-based mental health literacy interventions, while also revealing that further implementation research is necessary to adapt mental health literacy interventions to suit diverse adolescent sport contexts.

United States' universities are forgetting about equitable bicycle programming on campus.

PURPOSE: Regular participation in bicycling offers many health benefits. Universities throughout the U.S. have a large proportion of underrepresented populations among students/employees (e.g., racial/ethnic minorities, LGBTQ+, disabled) who participate in cycling at lower rates. The purpose of this study was to understand the current practices of universities for implementing equitable bicycling programming to their students/faculty/staff. METHODS: A volunteer sample of U.S. university bicycle representatives (n = 19) were interviewed to analyze current practices, barriers, motivators, and future tools for equitable programming. RESULTS: Multiple themes emerged from the interview, including barriers to programming such as lack of personnel and finances, as well as motivators such as partnering with off-campus organizations and connecting community/university infrastructures. CONCLUSIONS: Although various barriers exist for universities which may present decreased equitable programming, university bicycle/alternative transportation departments should consider partnering with on and off-campus organizations rooted into underrepresented populations to better provide equitable programming to these populations.

Participation in Higher Intensity Physical Activity Predicts Lower Depressive Symptom Incidence in College Students.

The prevalence of depression and insufficient physical activity (PA) continue to rise in the United States, particularly among college students. PA is typically associated with decreased levels of depressive symptoms; however, the association between different intensities of PA and depressive symptoms is unclear among college students. The aim of this study was to examine how well weekly moderate PA (MPA), vigorous PA (VPA) and strength training (ST) volumes predicted depressive symptoms in college students. Students self-reported weekly MPA, VPA, ST, depressive symptoms (CESD-7), restful nights of sleep, grade point average (GPA) and socio-demographic characteristics. Four individual linear regression models were performed to examine how MPA, VPA, and ST predicted depressive symptoms. Covariates controlled for socio-demographic characteristics (gender, race/ethnicity, and sexual orientation) and other variables (GPA and sleep) that could influence depressive symptoms. Data suggested that higher volumes of VPA (ß = -0.11; R2 = 0.157) and higher days of ST (ß = -0.11; R 2 = 0.157) significantly predicted (p < 0.001) lower depressive symptoms. While MPA volume (ß = -0.01; R 2 = 0.147) did not significantly predict depressive symptoms. Higher volumes of VPA and more days of ST participation predicts lower depressive symptoms in college students. High intensity exercise programs should be promoted at universities and throughout the young adult population. Exercise prescription may be useful and successful for students at risk of depression. Emphasis placed on these intensities will attempt to decrease depressive symptoms in students.

Differences in United States college student physical activity and exercise self-efficacy based on gender and race/ethnicity.

OBJECTIVE: Disparities in physical activity (PA) and PA antecedents, such as exercise self-efficacy, based on the intersection of gender and race/ethnicity among college students are poorly understood. This study aimed to examine differences in PA and exercise self-efficacy based on the intersection of gender and race/ethnicity. METHODS: An online survey collected data on demographics (age, gender, race/ethnicity), PA, and exercise self-efficacy from students (n = 5341) enrolled in general health and wellness at a large Northeastern U.S. University. Differences in PA and exercise self-efficacy based on gender and race/ethnicity were examined using two-way ANOVAs. RESULTS: Analyses revealed significant differences in overall PA and exercise self-efficacy based on gender and race/ethnicity. A significant interaction between gender and race/ethnicity was found in relation to PA, but not exercise self-efficacy. CONCLUSION: Findings demonstrate the need for universities to tailor PA promotion efforts, and to consider how gender and race/ethnicity may intersect to influence PA participation.

The association between vaping and health behaviors among undergraduate college students in the United States.

Objective: To examine the association between vaping and health behaviors (physical activity, fruit and vegetable consumption, sleep, cigarette use, alcohol consumption) and mental health among college students. Methods: Socio-demographic characteristics, vaping, health behaviors, perceived stress, and depressive symptoms of undergraduates enrolled at a large university located in the Northeast of the United States were assessed via an online survey. Results: Of all participants (n = 1775), less than a fifth (n = 314, 17.7%) reported any vaping in the past month. More men reported vaping than women (23.2% vs. 14.5%). Those who vaped reported fewer nights of restful sleep and greater alcohol consumption. Those who smoked and binge drank were more likely to report vaping. Perceived stress was greater among women who vaped, and depressive symptoms were greater among those who vaped regardless of gender. Conclusions: Vaping was associated with smoking, alcohol consumption, and poorer mental health among young adults.

Power 5 conference institutions' summer transition program physical activity promotion efforts: A review.

Objective: To review the physical activity promotion efforts of Power 5 conference institutions' summer transition programs. Methods: The websites of Power 5 Conference and affiliate member institutions (N = 78) were systematically reviewed and information on summer transition programs pertaining to health were extracted. Results: Most (n = 45, 57.7%) institutions had a summer transition program of some kind. Among those who had summer transition programs, 14 (31.1%) had a nonphysical activity health course (i.e. health and/or nutrition), while courses that incorporated a physical activity component were uncommon (n = 6, 13.3%). Only two institutions covered physical activity, nutrition, and health in at least one offered course. Conclusions: There is an opportunity for tertiary institution-level summer transitional programs to expand coverage to address a currently unmet need for physical activity promotion while avoiding perpetuation of existing inequities.

Gender differences in college student physical activity, and campus recreational facility use, and comfort.

Objective: To examine disparities in physical activity, campus recreation facility (CRF) use, and CRF comfort of college students. Methods: Students (n = 319) responded to an online survey that assessed their demographics, physical activity behaviors, CRF use, comfort using CRFs, as well as reasons for discomfort, and strategies used to feel comfortable. Results: Women reported less muscle-strengthening activity, lower frequency of weight use and informal sport participation, and higher frequency of cardio and group exercise participation. Women also reported lower comfort using CRFs, particularly weights areas. The presence of men, a perceived lack of skill (competence), and self-consciousness/judgement emerged as dominant themes explaining women's discomfort. Disassociation using music, going with friends for social support, knowledge acquisition regarding equipment, and clothing selection emerged as strategies used to increase comfort. Conclusions: Meaningful differences in physical activity behaviors, facility use, and comfort using facilities emerged. Administrators should consider changing environments and/or policies to provide equitable physical activity opportunities.

Assessing the stress-buffering effects of social support for exercise on physical activity, sitting time, and blood lipid profiles.

OBJECTIVE: This study tested the hypothesized stress-buffering effects of social support on physical activity, sitting time, and blood lipid profiles. PARTICIPANTS: 537 college students. METHODS: College students volunteered to self-report stress, social support for exercise, physical activity and sitting time, and provided blood samples to assess lipid profiles in this cross-sectional study. RESULTS: Lower stress was associated with higher vigorous physical activity (ß = -0.1, t = -2.9, p = .004). Higher social support was associated with higher moderate (ß = 0.2, t = 2.0, p = .042), vigorous (ß = 0.5, t = 5.4, p < .001), and total (ß = 0.1, t = 3.2, p = .001) physical activity, and lower sitting time on weekdays (ß = -0.1, t = -3.3, p = .001) and weekends (ß = -0.2, t = -3.6, p < .001). Social support moderated the association between stress and sitting time on weekdays. CONCLUSIONS: Stress reduction and fostering social support may be important strategies for promoting physical activity and reducing sedentary behaviors in college students. Additional strategies are needed to buffer the deleterious effects of stress.