Interactive associations of physical activity, adiposity, and oral contraceptive use on C-reactive protein levels in young women.

Oral contraceptives (OCs) are the most frequently used type of birth control among young women. OC-users have higher C-reactive protein (CRP) values, an indicator of systemic inflammation, than do non-OC-users. In addition, adiposity (percent fat) is positively associated with CRP, and physical activity (PA) is inversely associated with CRP. The present study determined the interactive associations of PA, percent fat, and OC-use with CRP. Data were collected during 2012-2015 at the University of Georgia. Objective PA was measured via pedometers. Percent fat was measured via dual X-ray absorptiometry. The current OC-use was self-reported. High-sensitivity (hs) CRP was determined using venipuncture. Multivariate linear regression determined the interactive associations of percent fat, OC-use, and PA with hs-CRP. Participants (n = 247; mean age 18.9 ± 1.4 years, 60.7 percent white) accumulated a mean of 10,075.7 ± 3,593.4 steps/day. One-third of participants were categorized as overweight/obese by BMI (mean = 24.5 ± 4.8 kg/m2, mean percent fat = 35.2 ± 6.8). The current OC-use was reported by 26.2 percent of the sample (n = 61). A significant three-way interaction (ß = 0.01, p = .03) indicated that higher PA was associated with lower hs-CRP in non-OC-users with higher percent fat, but not among OC-users with higher percent fat. These results highlight the need to measure and account for the current OC-use in studies examining the relationship between PA and CRP.

Collective Efficacy, Physical Activity, and Health Outcomes Among Mothers.

Motherhood is associated with low rates of physical activity that increase disease risk. Most theory-based approaches to increasing physical activity focus on personal rather than social factors. The purpose of this study was to examine the associations among perceptions of community collective efficacy and objectively measured physical activity, self-efficacy, social support, and health. Mothers completed questionnaires and wore a pedometer for 7 days. There was a significant, positive association between physical activity and collective efficacy-social cohesion subscale. In the regression analysis, only age and social support were independent predictors of physical activity. Future studies should examine relationships among collective efficacy and social support and physical activity.

Development of a logic model for a physical activity-based employee wellness program for mass transit workers.

Transportation workers, who constitute a large sector of the workforce, have worksite factors that harm their health. Worksite wellness programs must target this at-risk population. Although physical activity is often a component of worksite wellness logic models, we consider it the cornerstone for improving the health of mass transit employees. Program theory was based on in-person interviews and focus groups of employees. We identified 4 short-term outcome categories, which provided a chain of responses based on the program activities that should lead to the desired end results. This logic model may have significant public health impact, because it can serve as a framework for other US mass transit districts and worksite populations that face similar barriers to wellness, including truck drivers, railroad employees, and pilots. The objective of this article is to discuss the development of a logic model for a physical activity-based mass-transit employee wellness program by describing the target population, program theory, the components of the logic model, and the process of its development.

Area-level socioeconomic status, adiposity, physical activity, and inflammation in young adults, 2013.

INTRODUCTION: We assessed the independent effects of socioeconomic status, sex, adiposity, and physical activity on C-reactive protein in young adults. METHODS: During the fall semester of their first year, college students (n = 177; mean age, 18.1 y; 66.7% female; 65.5% white) were assessed for adiposity via dual x-ray absorptiometry, physical activity via accelerometer, and serum C-reactive protein. Area-level socioeconomic status was based on self-reported home zip code. Hierarchical linear modeling was used to assess the relationship of sex, adiposity, and physical activity on the dependent variable of C-reactive protein, with participants nested within geographic regions of similar socioeconomic characteristics. RESULTS: C-reactive protein was positively associated with adiposity and inversely associated with socioeconomic status (both P < .05). Area-level socioeconomic status explained 28.2% of the variance in C-reactive protein. Adiposity was significantly associated with C-reactive protein in the full model (P = .006); physical activity was not associated with C-reactive protein (P = .48), and area-level socioeconomic status approached significance (P = .05) within the age range of our analysis after accounting for the variance explained by adiposity. CONCLUSION: The significant positive association between adiposity and C-reactive protein suggests that young adults with higher adiposity have higher C-reactive protein levels after accounting for area-level socioeconomic status, sex, and physical activity.

Effectiveness of an 8-week hatha yoga intervention to improve lower back pain in university office workers: A mixed-methods pilot exploratory study.

BACKGROUND: Hatha yoga programs have been shown to be effective at improving low back pain among a variety of populations; however, methods to decrease low back pain of university office employees have not been studied. OBJECTIVE: To examine the impact of an 8-week hatha yoga intervention on measures of health among university office employees. METHOD: Seven participants completed the 8-week yoga intervention. All measures, including anthropometric measures and online questionnaires, were completed at baseline and post-intervention. RESULTS: Baseline pain intensity (6.6±3.1) and pain interference (15.6±4.7) reflected a moderate level of back pain and moderate to severe interference. Pain intensity showed a non-significant improvement with medium-to-large effect size [p = 0.07, (d = 0.7)]. There was a significant improvement with a large effect size [p = 0.002, (d = 2.4)] in pain interference. Baseline anxiety (7.4±3.6) reflected a borderline abnormal symptom level, but anxiety significantly reduced to normal levels at post-intervention with a medium effect size [p = 0.002 (d = 0.5)]. Focus group themes were improvements in health and development of a sense of community. CONCLUSIONS: Hatha yoga may be an effective mode of low-impact physical activity to decrease pain and improve mental health while facilitating a sense of community for office workers employed by a university. This study demonstrates promising results with large effect sizes; however, more research with larger sample size and randomized treatment and control groups are needed for future study efforts.

A comparison of undergraduate students' physical activity levels in a standard fitness walking class vs. a service-learning dog walking class.

Objective: To investigate the physical activity levels of students enrolled in a standard fitness walking class versus a service-learning dog walking class. Participants: College students (N = 65) from a university in the Southeastern United States (71% female; 85% White; 72% seniors). Methods: Students wore NL-1000 pedometers twice a week for 50 minutes for a full academic year. Service-learning students also completed reflection papers. Pedometer data was analyzed using SPSS and papers were analyzed through inductive coding. Results: Significant differences were found in each quantitative measure collected between classes. Students in the service-learning fitness walking class took more steps, walked further, and obtained more minutes of moderate to vigorous physical activity than the students in the standard fitness walking class. Results from student reflections provided insight into why these differences occurred as well as additional student experiences. Conclusions: Incorporating a service component into a physical activity course can be beneficial.

Logic model development for the exercise is medicine-on campus initiative.

One strategy to encourage college students to meet physical activity and public health guidelines is the Exercise is Medicine on Campus Initiative (EIM-OC), whose goal is to promote physical activity as a vital health sign within universities. To develop, implement, and evaluate the EIM-OC Initiative, it is critical to understand the mechanics of the program via a logic model. Objective: The objective is to present a conceptual logic model for EIM-OC Initiative implementation. Methods: Using an activities-approach framework, a logic model was developed using inputs, activities, outputs, and outcomes. Results: This logic model serves as a guide for the conceptual relationships within the EIM-OC Initiative. It was hypothesized that the EIM-OC Initiative would have an overarching outcome of improving physical activity levels in the university setting to promote overall community wellness and health. Conclusion: The authors anticipate this logic model will serve as a framework for other universities implementing EIM-OC.

Sex-specific correlates of metabolic syndrome risk in college-aged young adults.

Objective: To identify the sex-specific prevalence of metabolic syndrome (MetS) risk factors and their physiological, psychosocial, and behavioral correlates in a college-aged population. Participants and methods: Cross-sectional assessment of MetS risk factors and potential correlates occurred in 379 first-year students (aged 18.34 ± 0.49 years, 67.3% female). Multivariable linear regression assessed the relationships between potential correlates and continuous MetS risk scores, derived from principal component analysis. Results: MetS risk factors were present in 58.4% of females and 68.5% of males, with 2.4% and 3.2% having defined MetS. In females, percent body fat (ß = 0.46, p < 0.001), stress (ß = 0.12, p = 0.031), % kcal from sugar (ß = 0.18, p = 0.001), and moderate-to-vigorous physical activity (ß=-0.12, p = 0.036) were associated with risk score. Whereas, correlates in males included percent body fat (ß = 0.54, p < 0.001), C-reactive protein (ß = 0.15, p = 0.045), and AUDIT alcohol consumption score (ß = 0.15, p = 0.033). Conclusion: The sex-specific prevalence of MetS risk factors and correlates suggest that primary prevention strategies on college campuses should also follow a sex-specific approach.

Nurses' physical activity exploratory study: Caring for you so you can care for others.

BACKGROUND: Nurses report the greatest stress of all health care workers. Although physical activity (PA) is associated with health benefits among other populations, nurses have stressors that other occupations do not typically encounter. It is important for nurses to identify techniques for stress management since stressors negatively impact their health and patient care. OBJECTIVE: We aimed to examine the relationship between PA levels and physical, mental, and occupational health among nurses. METHODS: Nurses (N = 62) completed measures of anthropometrics, demographics, and domains of physical, mental, and occupational health. Pearson correlations determined the relationship between PA and measures health along with the relationship between PA and health among active versus inactive nurses. RESULTS: Fatigue was significantly correlated with moderate-to-vigorous PA (r = -0.27, p < 0.05). Relationships were found between mental health and light and moderate intensity PA (r = 0.40, p < 0.001; r = 0.30, p < 0.05). CONCLUSIONS: Stress is prevalent among nurses and negatively impacts a nurse's health along with patient care. Findings suggest health benefits associated with PA among nurses. PA interventions among nurses may be needed to fully see the effects of PA on physical, mental, and occupational health, and ultimately patient health and safety.

Undergraduate students' physical activity levels and experiences in a service-learning dog walking class: an exploratory pilot study.

OBJECTIVE: To investigate the physical activity levels and experiences of students enrolled in a service-learning dog walking class. Participants: College students (N = 10) from a rural university in the Eastern United States (age = 20.8 years ±1.2; 80% female; 90% White). Method: Students wore NL-1000 pedometers twice a week for 50 minutes for ten weeks. They also completed reflection papers at the end of the class. Pedometer data was analyzed using Microsoft Excel and the papers were analyzed through inductive coding. Results: Students obtained approximately 40% of their recommended daily physical activity requirements during class time. Reflection papers revealed that student beliefs about shelter dogs were challenged and that their primary motivations for attending class involved the physical activity needs of the dogs. Conclusions: Incorporating a service component into a physical activity course whereby the physical activity needs of others are the focus can be beneficial for all involved.

Impact of a standard versus collective-efficacy enhanced intervention to increase physical activity among mothers.

Objective: Mothers have lower moderate-to-vigorous physical activity than non-mothers and this negatively impacts health. Group dynamics interventions have been successful for increasing physical activity, yet studies using these strategies among mothers are limited and rely on self-reported physical activity. The goal of this study was to examine the effectiveness of a collective-efficacy enhanced physical activity intervention that used group dynamics principles compared to a standard group-based intervention. Design: Mothers (N = 86) were randomly assigned to a 6-week intervention (collective-efficacy enhanced) or standard health education/walking group. Main outcome measures: participants wore pedometers for 1-week and completed a self-efficacy questionnaire at pre-intervention, post-intervention, and 3-month follow-up. Results: There were statistically significant increases in activity minutes (p = 0.05) and step counts (p = 0.049) and no changes in self-efficacy (p = 0.74) from pre- to post-intervention. There were no group by time interactions for changes in physical activity or self-efficacy. None of the changes in physical activity were maintained at follow-up. Conclusions: There is a continued need to understand how to use social factors to promote sustained physical activity among mothers.

Development and implementation of a logic model: Occupational stress, physical activity, and sedentary behavior in the workplace.

BACKGROUND: An increasing level of occupational stress is a major problem in the workplace that requires innovative approaches and strategies. An understudied research area pertains to the effects that physical activity performed during the workday have on occupational stress. OBJECTIVE: To determine if and how an intervention that increases physical activity and reduces sedentary behavior affects workplace stress. The population of interest are employees at a large university medical center including supportive staff, healthcare professionals, physicians, and faculty members; the study design is longitudinal; the approach is the implementation of an innovative workplace program (i.e., the Booster Break). METHODS: We present a logic model promoting physical activity and reducing sitting time during the workday as a feasible and practical strategy to cope with occupational stress. RESULTS: The logic model approach emphasizes that funding, partnerships, and incentives are inputs to implementing program activities such as Booster Break sessions, weekly meetings, social support, and personal self-monitoring. Short-term outcomes were categorized as psychosocial, goal setting, organizational, and social; intermediate outcomes were behavioral and psychosocial; and long-term outcomes were health status and physiological status. CONCLUSIONS: This study is the first known effort to outline a comprehensive intervention based on changing physical activity and sedentary behavior during the workday and the concomitant effects on occupational stress. The findings of this study can be used to develop and implement interventions at workplaces to target increases in physical activity, decreases in sedentary time, and improvements in overall employee health.

Development of a logic model for a service learning, dog walking course for college students.

Despite overwhelming evidence of the importance of physical activity, only 20% of US adults meet physical activity recommendations. A subsector of the population vulnerable to inactivity is college students. There is a disconnect between evidence-based physical activity programming and dissemination into college communities, which may be overcome through logic model development and evaluation. The purpose of this paper is to discuss logic model development for a service-learning, dog walking program for undergraduates. Participants were undergraduates (18-25 years). Process evaluations and observational data were used in a content analysis to determine major themes to create the logic model. A set of resources were needed to complete program activities, which led to short- and long-term outcomes. The overarching goal of the program is to improve the overall health status of college students and companion animals. This logic model may have significant public health impact as it can serve as a framework for universities wanting to develop, implement, and evaluate a service-learning, dog walking program for students.

Type 2 diabetes as a familial illness: Findings from a focus group study.

INTRODUCTION: Type 2 diabetes mellitus (T2DM) is a prevalent illness with high societal and personal costs. Whereas there is some systemic research, there are still many pieces yet unknown about T2DM and families. The purpose of the current study is to understand the transgenerational health experiences related to T2DM for both patients and caregivers. METHOD: Focus groups were the primary methodology. Interviews were recorded, transcribed, and coded for themes. Participants were recruited via community fliers and e-mail listservs. The primary inclusion criterion was having a (a) family history of T2DM or (b) personal history of T2DM. Participants also needed to be at least 18 years old and be able to read and speak English. RESULTS: In 4 focus groups, 32 people were interviewed. The sample was entirely rural yet reasonably diverse. Five dominant themes emerged from the data: physical health comorbidities, T2DM is a lifestyle illness affecting the whole family, mental health stresses and comorbidities, personal and family relationship with T2DM, and sharing knowledge. DISCUSSION: Participants indicated that their families had been influenced by T2DM and that the illness had both physical and mental health comorbidities-both of which caused considerable stressors. Participants also reported that they valued the sharing of knowledge related to T2DM with each other and people in their lives. Limitations to the study include lack of generalizability because of small sample size and the majority of recruitment being done via technology. Future research should include larger, more diverse samples and quantitative data collection. Implications are also discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Evaluating the effectiveness of implementation intentions in a pedometer worksite intervention.

BACKGROUND: Pedometer-based worksite interventions have been found to be successful in increasing physical activity (PA) but adherence is challenging. OBJECTIVE: To examine the use of Implementation Intentions (II), a self-regulatory skill, with self-monitoring with a pedometer to initiate behavior change as well as post-intervention adherence in a worksite wellness intervention. METHODS: University employees (N = 54) participated in an 8-week pedometer-based intervention. A 2-arm randomized trial was used to compare the effectiveness of 1) only pedometers (PED) (n = 28) and 2) pedometers and II (PED+II) (n = 26) on PA. RESULTS: Significant differences were observed between time points (p < .0001) but not between groups. Post-hoc pairwise comparisons between the time points revealed difference between Baseline and Week 4 (mean difference: 2446.9 steps/ day; p < 0.001), Week 4 and 12 (mean difference: 2956.3 steps/ day; p < 0.001), and Week 8 and 12 (mean difference: 2228.8 steps/ day; p = 0.005). CONCLUSION: The PED+II group had higher step increases during the intervention indicating that the behavioral strategy was effective. However, participants in both groups had a significant decrease in steps from the end of the intervention to the delayed-post assessment highlighting the challenge to maintain behavioral changes post-intervention.

Self-Concept in the Context of Diabetes Prevention: Development of the Lifestyle Health-Related Self-Concept Questionnaire.

PURPOSE: Understanding psychosocial factors in the context of lifestyle change is important to recognize distinctions in type 2 diabetes prevention behaviors. A relatively stable psychosocial feature, such as health-related self-concept (HRSC), may indicate factors that promote or repress positive health behaviors. The present study created a questionnaire specific to lifestyle change activities by modifying the Generalized Health-Related Self-Concept Questionnaire (G-HRSC). DESIGN: A modified lifestyle health-related self-concept (Lifestyle-HRSC) questionnaire was developed through creation of new items, context expert review of new items, and small and large sample test of new items. PARTICIPANTS: 101 college students completed the Lifestyle-HRSC. ANALYSIS: Kaiser-Meyer-Olkin (0.64) and Bartlett sphericity tests (χ2 = 6350.7 [ df = 3081], P < .01) indicated the sample met criteria for factor analysis. Principle component factor analysis was performed using varimax rotation with Kaiser normalization. RESULTS: Six factors were revealed: nutrition, social support, avoiding diabetes, physical activity, problem solving, and challenges related to being healthy. Item analysis was conducted to remove correlated and conceptually redundant items and to create the 31-item final questionnaire. CONCLUSION: The Lifestyle-HRSC provides additional knowledge regarding the relationship between self-concept and health as well as insights into the role of psychosocial factors in the context of diabetes prevention.

Organizational Culture and Implications for Workplace Interventions to Reduce Sitting Time Among Office-Based Workers: A Systematic Review.

Background: Time spent in sedentary behaviors is an independent risk factor for several chronic diseases (e.g., cardiometabolic diseases, obesity, type 2 diabetes, and hypertension). Recently, interventions to reduce sitting time at work (a prominent sedentary behavior) have been developed and tested. Organizational culture plays a critical role in the success of workplace interventions. However, there are a limited number of studies that have examined the role of organizational culture in reducing sitting time in the workplace. Objectives: Therefore, in this systematic review, we summarized the empirical literature investigating organizational culture and sedentary behavior in the workplace and identify gaps in the knowledge base. Methods: We described the procedures of our systematic review and included two study flow diagrams that detailed the step by step process. Combinations of several search terms were used; the databases searched were PubMed, Medline, Academic Search Complete, and Google Scholar. We started with thousands of citations. After applying the inclusion and exclusion criteria, eight relevant articles were identified. Results: For each identified article, the data extracted included citation, sample, objective, intervention, assessment of organizational culture and workplace sitting, findings, and implications. Each article was rated for risk of bias by population, intervention, comparator, outcomes, and study design (PICOS) analysis. The classification for each study was either: high-, moderate-, or low-quality evidence. Given the paucity of data, no definitive conclusions were presented; however, positive trends were highlighted. Conclusions: Work place interventions to reduce sitting time at work may benefit from considering elements of organizational culture; however, the evidence to date is sparse and more high-quality studies in this area are needed. To advance the field of workplace health promotion, organizational culture, and interventions to reduce sitting at work, we present 11 recommendations.

Review of Physical Activity Benefits and Potential Considerations for Individuals with Surgical Fusion of Spine for Scoliosis.

Evidence-based recommendations for physical activity following spinal fusion surgeries for idiopathic scoliosis are limited, specifically in the adolescent population. Individuals with scoliosis treated operatively or non-operatively have been reported to participate in less than 1-3 days/week of even mildly strenuous physical exercises. Over 40% of individuals with scoliosis returned to sports at a level lower than pre-operative participation levels or did not return at all post spinal fusion. It is particularly important for human movement specialists, such as physical therapists, occupational therapists, athletic trainers and kinesiologists to assist these individuals effectively transition to and maintain engagement in physical activity. This review provides a snapshot of common considerations and potential factors influencing individuals with spinal-fusion for scoliosis to participate in safe physical activity.

Barriers to Physical Activity in a Mass Transit Population: A Qualitative Study.

BACKGROUND: The physical inactivity epidemic continues be one of the greatest public health challenges in contemporary society in the United States. The transportation industry is at greater risk of physical inactivity, compared with individuals in other sectors of the workforce. The aim of this study was to use the Nominal Group Technique, a focus group technique, to examine mass transit employees' perceptions of the barriers to physical activity at their worksite. METHODS: Three focus groups (n = 31) were conducted to examine mass transit employees' perceptions of barriers to physical activity at the worksite. RESULTS: Salient barriers included (1) changing work schedules, (2) poor weather conditions, and (3) lack of scheduled and timely breaks. CONCLUSIONS: Findings were consistent with previous research demonstrating shift work, poor weather, and lack of breaks can negatively impact mass transit employees' ability to be physically active. Although physical activity barriers for this population have been consistent for the last 20 years, public health practice and policy have not changed to address these barriers. Future studies should include conducing focus groups stratified by job classification (eg, operators, maintenance, and clerical) along with implementing and evaluating worksite-based physical activity interventions and policy changes.

Cost and culture: Factors influencing worksite physical activity across three universities.

BACKGROUND: Physical inactivity is a leading cause of morbidity and mortality. Worksites provide an ideal environment for physical activity (PA) interventions. Colleges and universities are a unique work venue, with institutions of higher education of varying scope within every state of the United States and worldwide. OBJECTIVE: To explore the institutional influences on worksite PA across multiple universities. PARTICIPANTS: Employees from two large, universities (Midwestern and Southern) and a mid-size, university (Midwestern) participated in exploratory research in March/April 2010 and 2013. METHODS: The Nominal Group Technique (NGT) methodology and the Health Belief Model (HBM) were used to assess perceived influences on employees' engagement in worksite PA. RESULTS: The findings demonstrate that university employees experienced similar factors that influence PA as employees across the different institutions. Specifically, there was an interesting relationship between opportunities for PA and lack of a supportive work culture to promote it. CONCLUSIONS: Emphasis on immediate perceived threats to PA inactivity may improve the utility of the HBM for interventions within this context. Further, campus worksite interventions for employees should address barriers such as cost of campus recreation centers and administrative support for engaging in worksite PA as possible cues to action.