College Students' Day-to-Day Maladaptive Drinking Responses to Stress Severity and Stressor-Related Guilt and Anger.

BACKGROUND: Stress is a common part of college students' daily lives that may influence their physical activity (PA) and alcohol use. Understanding features of daily stress processes that predict health behaviors could help identify targets for just-in-time interventions. PURPOSE: This study used intensive longitudinal data to examine whether prior day stress processes predict current day PA or alcohol use. METHODS: Participants (N=58, Mage=20.5, 59% women, 70% White) were 18-to-25-year-old students who engaged in binge drinking at least twice monthly and used cannabis or tobacco in the past year. They wore activity (activPAL4) and alcohol (Secure Continuous Remote Alcohol Monitor) monitors for 11 days to assess daily PA (e.g., step counts) and alcohol use (e.g., drinking day), and completed daily surveys about yesterday's stress, including number of stressors (i.e., frequency), stressor intensity (i.e., severity), and frequency of affective states (e.g., guilt). Multilevel models examined prior day stress predicting current day PA or alcohol use. RESULTS: Participants had higher odds of current day drinking (odds ratio=1.21) and greater area under the curve (B=0.08) when they experienced greater than usual stress severity the prior day. Participants had higher current day peak transdermal alcohol concentration (B=0.12) and area under the curve (B=0.11) when they more frequently experienced guilt due to stressors the prior day. CONCLUSIONS: College students' unhealthy response of increasing alcohol use due to stress could adversely impact health outcomes. There is a critical need for interventions addressing students' ability to effectively manage and respond to the stress-inducing, daily demands of student life.

College students experience stress regularly, which may influence their physical activity (PA) and drinking behaviors. Understanding how daily stress predicts health behaviors could be useful for stress-reduction interventions. This study examined whether prior day stress predicted current day PA or alcohol use. Participants (N = 58) were 18- to 25-year-old college students who binge drank at least twice per month and used cannabis or tobacco in the past year. They wore PA and alcohol sensors for 11 days to assess daily PA and alcohol use, and completed daily surveys about yesterday's stress, including the number of stressors experienced (i.e., frequency), stressor intensity (i.e., severity), and mood responses related to stress (anger, anxiety, guilt, sadness). Participants were 21% more likely to drink and drank at higher intensity when they experienced greater than usual stress severity the prior day. Participants had higher current day alcohol use intensity when they more frequently experienced guilt due to stressors the prior day. College students' unhealthy response of increasing alcohol use due to stress could negatively impact short- and long-term health outcomes. There is a critical need for interventions addressing students' ability to effectively manage and respond to the stress-inducing, daily demands of student life.

To Drink or Not to Drink: Is That the Question? Examining Correspondence and Predictive Validity of Morning Drinking Intentions for Young Adults' Drinking Behaviors and Consequences.

The Theory of Planned Behavior suggests that intentions are significant and proximal determinants of behavior. The purpose of this study was to test the predictive validity of drinking intentions for subsequent same-day drinking behaviors and negative consequences. Regularly drinking young adults (N = 222, 21-29 years, 84% undergraduates) completed an ecological momentary assessment (EMA) protocol and wore an alcohol monitor for five consecutive 24-h periods spanning 6 days (Wednesday-Monday). Each morning, participants reported their drinking intentions for the day and their previous day's alcohol consumption and the number of negative drinking consequences. Multilevel models showed that, at the within-person level, on days when people reported intending to drink, to get drunk, or to drink more than usual, they had higher odds of drinking, consumed more drinks, and had higher peak transdermal alcohol concentrations later that day. However, drinking occurred on 28% of days without drinking intentions, suggesting intentions were an imperfect signal for future drinking behavior. Morning drinking intentions also predicted experiencing more negative consequences, even after controlling for alcohol consumption. On average, young adults' morning-reported drinking-related intentions predicted increased odds of same-day drinking behavior and alcohol-related consequences. However, drinking frequently occurred on days participants did not intend to drink, suggesting that focusing only on drinking intention days will result in many missed prevention opportunities. Together, these results suggest the need for additional research to increase the predictive value of drinking intention assessments and for prevention interventions aimed at helping individuals follow through on their intentions not to drink.

The combined effect of motivational interviewing and wearable fitness trackers on motivation and physical activity in inactive adults: A randomized controlled trial.

Despite overwhelming adoption of wearable fitness trackers (WFT), it is unclear if they affect physical activity (PA) engagement or PA motivation. We hypothesized that combining a WFT with an effective intervention, motivational interviewing (MI), would positively influence both motivation and PA. A 12-week randomized controlled trial was conducted in 40 adults who did not meet PA recommendations. The four conditions were: a PA education (Educational control, n = 10), a WFT (WFT, n = 10), bi-weekly MI sessions (MI, n = 10), or both interventions (WFT+, n = 10). Motivation and PA were measured through an online survey and actigraphy pre- and post-intervention. Both the WFT+ and MI groups improved autonomous forms and decreased controlled forms of motivation. They also had higher basic psychological needs scores when compared to the Education group post-intervention. We detected no changes in PA. High autonomous motivation at baseline predicted higher post-intervention PA in the WFT+ group but predicted lower post-intervention PA in the WFT group. Results suggests that MI alone or with a WFT can improve basic psychological needs and autonomous forms of motivation for PA, but not PA participation. Individual differences in motivation at baseline may moderate the effect of a WFT on PA. This study was registered at clinicaltrials.gov (NCT490014).

Examining the day-level impact of physical activity on affect during the early months of the COVID-19 pandemic: An ecological momentary assessment study.

Engaging in physical activity (PA) may be a promising approach to mitigate the effects of the COVID-19 pandemic and related restrictions on daily affect. The study used ecological momentary assessment (EMA) to examine the within-subject associations of day-level PA with same-day evening affect. Interactions between daily PA and overall stress related to COVID-19 predicting evening affect were also examined. Adults living in the U.S. (N = 157, M age = 31.7, 84.1% female) participated in a 28-day smartphone-based EMA study during the early months of the pandemic (April - June 2020). Evening EMA surveys assessed daily PA minutes, momentary positive activated and deactivated affect, and momentary negative activated and deactivated affect. An online questionnaire assessed demographics. Multi-level linear regression models assessed day-level associations between PA and evening affect, controlling for age, sex, income, body mass index, employment status, and morning affect. There were N = 2,409 person-days in the analysis. Baseline COVID-19 stress was not associated with daily PA minutes (p = .09) or positive-activated affect (p = .14), but was associated with lower positive-deactivated affect (p < .001) and greater negative-activated and negative-deactivated affect (ps < .001) in the evenings. On days when individuals reported more PA than usual, they reported greater positive-activated and positive-deactivated affect, and lower negative-activated and negative-deactivated affect in the evening (ps < .001). The interaction of day-level PA and COVID-19 stress predicting evening positive-activated, positive-deactivated, negative-activated, and negative-deactivated affect was not significant (ps > .05). During the early months of the pandemic, adults experienced improved evening affect on days when they engaged in more PA. However, data did not show that PA counteracts detrimental effects of the COVID-19 pandemic on evening affect. Public health efforts should strategically promote and address barriers to PA during the pandemic.

Autonomous motivation and action planning are longitudinally associated with physical activity during adolescence and early adulthood.

We examined the associations of autonomous motivation, controlled motivation, and physical activity (PA) planning with PA participation over six years across the adolescent-to-adult transition. Participants from the NEXT Generation Health Study, a nationally representative cohort study of U.S. 10th graders (N=2785), completed surveys yearly from 2010 to 2016 (four years post-high school). This study used data from Waves 2 (W2) through 7 (W7). Data were analyzed using growth models accounting for the complex survey design and controlling for sex, race/ethnicity, and body mass index. A piecewise growth model with two pieces (Piece 1: W2-W4; Piece 2: W4-W7) indicated that PA declined during late adolescence (W2-W4) (b=-0.31, ß=-0.22, p<.001), but did not decline after the transition into early adulthood (W4-W7) (b=-0.08, ß=-0.04, p=.052). Autonomous motivation was positively associated with PA at all waves (b=0.23-0.33, ß=1.90-4.37, p<.001). Controlled motivation was only positively associated with PA at W3 (12th grade) (b=0.13, ß=1.54, p=.011). PA planning varied significantly between individuals and significantly predicted PA (b=0.44, ß=0.21, p<.001). Although PA decreased significantly during late adolescence, PA did not decrease significantly after transitioning into early adulthood (one to four years post-high school). Elevated autonomous motivation and PA planning were consistently and significantly associated with higher PA, suggesting that these may be useful intervention targets during this adolescent-to-adult transition.

Acceptability and validity of using the BACtrack skyn wrist-worn transdermal alcohol concentration sensor to capture alcohol use across 28 days under naturalistic conditions - A pilot study.

Wrist-worn transdermal alcohol concentration (TAC) sensors have the potential to provide detailed information about day-level features of alcohol use but have rarely been used in field-based research or in early adulthood (i.e., 26-40 years) alcohol users. This pilot study assessed the acceptability, user burden, and validity of using the BACtrack Skyn across 28 days in individuals' natural settings. Adults aged 26-37 (N = 11, Mage = 31.2, 55% female, 73% non-Hispanic white) participated in a study including retrospective surveys, a 28-day field protocol wearing Skyn and SCRAM sensors and completing ecological momentary assessments (EMA) of alcohol use and duration (daily morning reports and participant-initiated start/stop drinking EMAs), and follow-up interviews. Day-level features of alcohol use extracted from self-reports and/or sensors included drinks consumed, estimated Blood Alcohol Concentration (eBAC), drinking duration, peak TAC, area under the curve (AUC), rise rate, and fall rate. Repeated-measures correlations (rrm) tested within-person associations between day-level features of alcohol use from the Skyn versus self-report or the SCRAM. Participants preferred wearing the Skyn over the SCRAM [t (10) = -6.79, p < .001, d = 2.74]. Skyn data were available for 5614 (74.2%) out of 7566 h, with 20.7% of data lost due to syncing/charging issues and 5.1% lost due to device removal. Skyn agreement for detecting drinking days was 55.5% and 70.3% when compared to self-report and the SCRAM, respectively. Correlations for drinking intensity between self-report and the Skyn were 0.35 for peak TAC, 0.52 for AUC, and 0.30 for eBAC, which were smaller than correlations between self-report and SCRAM, at 0.78 for peak TAC, 0.79 for AUC, and 0.61 for eBAC. Correlations for drinking duration were larger when comparing self-report to the Skyn (rrm = 0.36) versus comparing self-report to the SCRAM (rrm = 0.31). The Skyn showed moderate-to-large, significant correlations with the SCRAM for peak TAC (rrm = 0.54), AUC (rrm = 0.80), and drinking duration (rrm = 0.63). Our findings support the acceptability and validity of using the Skyn for assessing alcohol use across an extended time frame (i.e., 28 days) in individuals' natural settings, and for providing useful information about day-level features of alcohol use.

Motivational Profile as a Predictor of Physical Activity Among US Adults During the Early Months of the COVID-19 Pandemic: A Daily Diary Study.

This study used a daily diary approach to examine associations between day-level physical activity (PA) behavior, PA-specific motivational profile, and days since the COVID-19 national emergency declaration during the early months (April-June 2020) of the pandemic. A total of 468 US adults (Mage = 34.8 y, 79% female) participated in a 28-day smartphone-based daily diary study assessing PA. A baseline survey assessed PA and motivation for PA using the Behavioral Regulation in Exercise Questionnaire. Multilevel linear regression models examined the main effects and interactions of motivational profile and time (days since the US March 13, 2020, COVID-19 national emergency declaration) on daily PA minutes. Latent profile analysis identified 4 distinct motivational profiles for PA among this sample: profile 1: high amotivation (n = 100, 21%); profile 2: low controlled motivation (n = 55, 12%); profile 3: high external regulation (n = 47, 10%); and profile 4: moderate autonomous motivation (n = 266, 57%). After controlling for baseline PA, there were significant interactions between profile and time on daily PA (-0.21, P < .01). Profile 2 showed greater decreases in daily PA minutes over time than profile 1 (b = -0.29, P < .01). Profiles 3 and 4 did not indicate significant decreases in PA compared with profile 1 (b = 0.14, P = .31 and b = -0.16, P = .05, respectively). Contrary to previous research, individuals with lower controlled or moderate autonomous motivation demonstrated the largest decreases in PA over time, whereas individuals with higher amotivation or external regulation demonstrated smaller decreases over time. These findings suggest that external motivation may have provided short-term protection against declines in PA observed during early months of the COVID-19 pandemic.

Motivational Message Framing Effects on Physical Activity Dynamics in a Digital Messaging Intervention: Secondary Analysis.

BACKGROUND: Digital smartphone messaging can be used to promote physical activity to large populations with limited cost. It is not clear which psychological constructs should be targeted by digital messages to promote physical activity. This gap presents a challenge for developing optimal content for digital messaging interventions. OBJECTIVE: The aim of this study is to compare affectively framed and social cognitively framed messages on subsequent changes in physical activity using dynamical modeling techniques. METHODS: We conducted a secondary analysis of data collected from a digital messaging intervention in insufficiently active young adults (18-29 years) recruited between April 2019 and July 2020 who wore a Fitbit smartwatch for 6 months. Participants received 0 to 6 messages at random per day across the intervention period. Messages were drawn from 3 content libraries: affectively framed, social cognitively framed, or inspirational quotes. Person-specific dynamical models were identified, and model features of impulse response and cumulative step response were extracted for comparison. Two-way repeated-measures ANOVAs evaluated the main effects and interaction of message type and day type on model features. This early-phase work with novel dynamic features may have been underpowered to detect differences between message types so results were interpreted descriptively. RESULTS: Messages (n=20,689) were paired with valid physical activity monitoring data from 45 participants for analysis. Received messages were distributed as 40% affective (8299/20,689 messages), 39% social-cognitive (8187/20,689 messages), and 20% inspirational quotes (4219/20,689 messages). There were no statistically significant main effects for message type when evaluating the steady state of step responses. Participants demonstrated heterogeneity in intervention response: some had their strongest responses to affectively framed messages, some had their strongest responses to social cognitively framed messages, and some had their strongest responses to the inspirational quote messages. CONCLUSIONS: No single type of digital message content universally promotes physical activity. Future work should evaluate the effects of multiple message types so that content can be continuously tuned based on person-specific responses to each message type.

Effects of a community gardening intervention on diet, physical activity, and anthropometry outcomes in the USA (CAPS): an observer-blind, randomised controlled trial.

BACKGROUND: Unhealthy diet, physical inactivity, and social disconnection are important modifiable risk factors for non-communicable and other chronic diseases, which might be alleviated through nature-based community interventions. We tested whether a community gardening intervention could reduce these common health risks in an adult population that is diverse in terms of age, ethnicity, and socioeconomic status. METHODS: In this observer-blind, randomised, controlled trial, we recruited individuals who were on Denver Urban Garden waiting lists for community gardens in Denver and Aurora (CO, USA), aged 18 years or older, and had not gardened in the past 2 years. Participants were randomly assigned (1:1), using a randomised block design in block sizes of two, four, or six, to receive a community garden plot (intervention group) or remain on a waiting list and not garden (control group). Researchers were masked to group allocation. Primary outcomes were diet, physical activity, and anthropometry; secondary outcomes were perceived stress and anxiety. During spring (April to early June, before randomisation; timepoint 1 [T1]), autumn (late August to October; timepoint 2 [T2]), and winter (January to March, after the intervention; timepoint 3 [T3]), participants completed three diet recalls, 7-day accelerometry, surveys, and anthropometry. Analyses were done using the intention-to-treat principle (ie, including all participants randomly assigned to groups, and assessed as randomised). We used mixed models to test time-by-intervention hypotheses at an α level of 0·04, with T2 and T3 intervention effects at an α level of 0·005 (99·5% CI). Due to potential effects of the COVID-19 pandemic on outcomes, we excluded all participant data collected after Feb 1, 2020. This study is registered with ClinicalTrials.gov, NCT03089177, and data collection is now complete. FINDINGS: Between Jan 1, 2017, and June 15, 2019, 493 adults were screened and 291 completed baseline measures and were randomly assigned to the intervention (n=145) or control (n=146) groups. Mean age was 41·5 years (SD 13·5), 238 (82%) of 291 participants were female, 52 (18%) were male, 99 (34%) identified as Hispanic, and 191 (66%) identified as non-Hispanic. 237 (81%) completed measurements before the beginning of the COVID-19 pandemic. One (<1%) participant in the intervention group had an adverse allergic event in the garden. Significant time-by-intervention effects were observed for fibre intake (p=0·034), with mean between-group difference (intervention minus control) at T2 of 1·41 g per day (99·5% CI -2·09 to 4·92), and for moderate-to-vigorous physical activity (p=0·012), with mean between-group difference of 5·80 min per day (99·5% CI -4·44 to 16·05). We found no significant time-by-intervention interactions for combined fruit and vegetable intake, Healthy Eating Index (measured using Healthy Eating Index-2010), sedentary time, BMI, and waist circumference (all p>0·04). Difference score models showed greater reductions between T1 and T2 in perceived stress and anxiety among participants in the intervention group than among those in the control group. INTERPRETATION: Community gardening can provide a nature-based solution, accessible to a diverse population including new gardeners, to improve wellbeing and important behavioural risk factors for non-communicable and chronic diseases. FUNDING: American Cancer Society, University of Colorado Cancer Centre, University of Colorado Boulder, National Institutes of Health, US Department of Agriculture National Institute of Food and Agriculture, Michigan AgBioResearch Hatch projects.

Testing affect regulation models of drinking prior to and after drinking initiation using ecological momentary assessment.

OBJECTIVE: Affect regulation models of drinking state that affect motivates and reinforces drinking. Few studies have been able to elucidate the timing of these associations in natural settings. We tested positive affect (PA) and negative affect (NA) as predictors of drinking behavior, both prior to and during drinking episodes, and whether drinking predicted changes in affect during episodes. METHOD: Two hundred twenty-two regularly drinking young adults (21-29 years, 84% undergraduates), completed an ecological momentary assessment (EMA) protocol for five consecutive 24-hr periods stretching across 6 days (Wednesday-Monday). Participants provided PA and NA reports three times daily and every half hour during drinking episodes. Alcohol consumption reports were provided each morning and every half hour during drinking episodes. RESULTS: Multi-level models showed that greater pre-drinking PA predicted higher odds of drinking, but not number of drinks consumed. Pre-drinking NA did not predict same day odds of drinking or drinks consumed. Episode-level results revealed different associations for PA and NA with drinking. Current PA did not predict drinks consumed over the next half hour; however, increased drinking was associated with greater increases in PA over the next half hour. Higher NA predicted fewer drinks consumed in the next half hour and higher odds of the end of a drinking episode; however, increased drinking was not associated with changes in NA. CONCLUSIONS: PA increased following drinking during episodes. Our results suggest that a focus on PA prior to episodes and a focus on NA during episodes may interrupt processes leading to heavy drinking, and may therefore aid prevention efforts. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Using a daily diary approach to examine the early effects of COVID-19 on daily physical activity bouts and contexts among residents of Colorado and California.

COVID-19 restrictions may prevent adults from achieving sufficient physical activity (PA) and may affect PA context. This study examined the early effects of COVID-19 on daily PA bouts and contexts during April-June 2020 using a daily diary approach. Adults (N = 390) completed daily diary surveys for 28 days assessing number of PA bouts and social (e.g., alone), locational (i.e., home, neighborhood, recreational space), and technology (e.g., using streaming videos) contexts of PA. Mixed-effects models examined the effects of days since the pandemic started (on 3/13/2020), state residence, and demographics on number of daily PA bouts. Models examined demographic and temporal effects on PA context. Participants were 18-77 years, 15% Hispanic/Latino, and 80% female. PA bouts per day decreased significantly over time among Californians versus Coloradans (bsimple = -0.01, p < .001) and Hispanics/Latinos (vs. non-Hispanic Latinos) did fewer PA bouts per day (b = -0.17, p = .04). Most PA bouts occurred while alone (56.7%), at home (43.4%), or in any neighborhood (40.5%). Older (60+ years) versus younger (<40 years) adults were less likely to do PA with others (odds ratio [OR] = 0.40, 95% confidence interval [CI]: 0.18-0.90). PA bouts in recreational spaces were more common on weekends versus weekdays (OR = 1.59, 95% CI: 1.32-1.92) and were less common among California versus Colorado residents (OR = 0.23, 95% CI: 0.12-0.42). PA bouts decreased from April to June 2020, and these changes disparately affected subgroups. Resources are needed to counteract the negative effects of COVID-19 restrictions intended to slow disease spread on PA.

The COVID-19 pandemic has resulted in closure of spaces for engaging in physical activity, including gyms, parks, and recreation centers. Closure of these spaces likely had a negative impact on activity. We used daily, phone-based surveys to study the effects of COVID-19 on the number of activity bouts individuals did each day, and the context of activity, between April and June 2020. Our study included 390 adults living in California or Colorado who were 18­77 years old, 80% female, and 15% Hispanic/Latino. Californians significantly decreased the number of daily bouts over time, but Coloradans showed no change in daily bouts. Hispanic/Latinos did fewer daily bouts than non-Hispanic/Latinos. Most bouts occurred when people were alone (56.7%), at home (43.4%), or in a neighborhood (40.5%). Adults 60+ years were more likely to do activity alone than with others. Bouts in recreational spaces were more common on weekends versus weekdays, and Californians were less likely to do bouts in recreational spaces than Coloradans. Additional resources are needed to counteract the negative effects of COVID-19 restrictions that intended to slow disease on activity levels, particularly in places with greater restrictions for accessing physical activity spaces.

Alcohol Use as a Function of Physical Activity and Golfing Motives in a National Sample of United States Golfers.

Alcohol and physical inactivity are risk factors for a variety of cancer types. However, alcohol use often co-occurs with physical activity (PA), which could mitigate the cancer-prevention benefits of PA. Alcohol is integrated into the culture of one of the most popular physical activities for adults in the United States (U.S.), golf. This study examined how alcohol use was associated with total PA, golf-specific PA, and motives for golfing in a national sample of golfers in the U.S. Adult golfers (n = 338; 51% male, 81% White, 46 ± 14.4 years) self-reported alcohol use, golfing behavior and motives, and PA. Most (84%) golfers consumed alcohol, averaging 7.91 servings/week. Golf participation, including days/week, holes/week, and practice hours/week, was not associated with alcohol use. Golfers with stronger social motives were 60% more likely to consume alcohol. Weekly walking (incident risk ratio (IRR) = 7.30), moderate-to-vigorous PA (MVPA; IRR = 5.04), and total PA (IRR = 4.14) were associated with more alcohol servings/week. Golfers' alcohol use may be higher than the general adult population in the U.S. and contributes 775 extra kilocalories/week, a surplus that may offset PA-related energy expenditure and cancer-protective effects. Alcohol use interventions targeting golfers may facilitate weight loss and reduce cancer risk, especially for golfers motivated by social status.

Associations of mental health with driving while impaired and risky driving in emerging adults.

OBJECTIVE: Examined cross-sectional associations of driving while impaired (DWI) and risky driving with mental and psychosomatic health among U.S. emerging adults. METHODS: Data were from years 1-4 after high school (waves 4-7) of the NEXT Generation Health Study, a nationally representative study starting with 10th grade (2009-2010). Outcome variables were DWI (dichotomous variable: ≥ 1 day vs. 0 days in the last 30 days) and risky driving Checkpoints Self-Reported Risky Driving Scale (C-RDS). Independent variables included depressive symptoms and psychosomatic symptoms. Multivariate logistic and linear regressions were conducted with complex survey features considered. RESULTS: Higher depressive and psychosomatic symptoms were associated with modestly higher likelihood of DWI (Adjusted odds ratio [AOR] ranged from 1.02 to 1.03 and from 1.04 to 1.05, respectively) and higher C-RDS scores (b ranged from 0.06 to 0.12 and from 0.08 to 0.23, respectively) in years 1-4 after high school. CONCLUSIONS: Depressive and psychosomatic symptoms were associated with greater DWI and risky driving in all 4 years after high school. Negative mental and psychosomatic health should be targeted components of DWI and risky driving prevention to lower fatal motor vehicle crashes among emerging adults.

Golfers' Interest in Multilevel Sun-Protection Strategies.

Active adults accumulate more ultraviolet (UV) radiation exposure and are at greater risk of skin cancer than inactive adults. Golf is a popular sport that increases UV exposure because it is played outdoors in daylight. This study evaluated adult golfers' interest in multilevel sun-protection strategies and characterized differences in interest as a function of golfer characteristics. Adult golfers (N = 347) completed a web survey to rate their interest in 20 sun-protection strategies. We estimated descriptive statistics and evaluated differences in interest as a function of demographics, perceived risk, sun-protective behavior, and golf exposure. Golfers reported the greatest interest in environmental supports for sun protection, but these ratings were driven by golfers who already perceived golf as a risk behavior and used sunscreen diligently. Vulnerable golfers-those with a golf-related sunburn in the past year or who spend more time golfing-expressed interest in a broader range of intervention components, including education, family support, and text messages. Multilevel skin cancer prevention interventions are needed for golfers. Intervention components of interest involved support and reminders, which suggests they are open to sun-safety behaviors but need help executing them.

Early effects of the COVID-19 pandemic on physical activity locations and behaviors in adults living in the United States.

COVID-19 restrictions and social-distancing may inhibit adults from attaining recommended levels of physical activity. This study examined early impact of COVID-19 pandemic on physical activity in adults during the first two months of restrictions in the U.S. and how physical activity locations were associated with physical activity levels during this period. Adults (N = 268) completed an online survey between April 10-May 25, 2020. Participants reported minutes of vigorous, moderate, and walking physical activity for past 7 days (early-COVID-19) and for a typical week in February 2020 (pre-COVID-19). Adults reported locations (e.g., home/garage, parks/trails) were they were active over the past 7 days. Past 12-month step count data were extracted from participants' personal smartphones. Participants (18-74 years old, 22% Hispanic/Latino, 81% female) showed reductions in vigorous (M diff  = -66.9 min/week), moderate (M diff  = -92.4 min/week), walking (M diff -70.8 min/week), and step counts (M diff  = -2232 steps/day) from the pre- to early-COVID19 periods. Reductions in walking and steps were larger for low-income and Hispanic/Latino adults. During early-COVID19, more vigorous and moderate activity were reported by those who were active in their home/garage or driveway/yard, and more steps were recorded by those who were active on the roads in their neighborhood or at parks/trails. We observed a decline in adults' physical activity during the first two months of the COVID-19 pandemic based on retrospective self-report and device-based measures. Although these restrictions were necessary to slow the spread of the virus, data indicate that there may be unintended consequences on health-related behaviors.

Using Ecological Momentary Assessment to Examine the Effects of Duty Status on Acute Stress and Tiredness in Firefighters: A Pilot Study.

OBJECTIVE: Characterize firefighters' acute stress and tiredness by duty status (ie, "off night/day," "on night/day"). METHODS: Thirty nine career firefighters completed three, eight-day smartphone-based ecological momentary assessment periods with seven surveys per day assessing stress and tiredness. Mixed-effects location scale models examined duty status effects on stress and tiredness. RESULTS: Firefighters' lowest stress and tiredness levels were when off-duty (ß = 16.27 and ß = 24.71, respectively) and their highest levels were when on-duty (ß = 24.47 and ß = 32.18, respectively). Within-subject effects of duty status accounted for a larger proportion of variability in stress and tiredness for all duty types, except for stress when "on-duty night/off-duty day." CONCLUSIONS: Firefighters had more similar stress and tiredness outcomes when they were on-duty and less similar outcomes when off-duty. This could be due to firefighters having more similar experiences when they are on- versus off-duty.

Parent Support, Perceptions, and Child Attributes Affect Child Activity.

Objectives: In this study we examined the moderation effects of child attributes on the relationship between parent perception of child coordination, physical activity (PA) parenting practices, child enjoyment of PA, and child PA participation and examined the mediation effects of PA par enting practices and child PA enjoyment on the association between parent perception of child coordination and PA participation. Methods: Parents (N = 120) provided consent and completed data about their children's PA and related correlates. We used linear regression to examine child sex, age, race, and weight status as moderators, and to examine parent support and child enjoyment as mediators of the relationship between child coordination and PA participation. Results: Child race (b = 0.70, 95% CI: 0.20, 1.20) and weight status (b = 0.52, 95% CI: 0.05, 0.99) moderated the relationship between child coordination and parent support of child PA. Parent support of child PA and child enjoyment fully mediated the relationship between child coordination and PA participation (95% CI: 0.08, 0.36), mediating 56% of the observed effect. Conclusions: Our findings suggest that future interventions need to examine parent and child attributes (eg, perception of child coordination and race/weight status) as effect modifiers of the relationship between PA parenting practices and child PA participation.

Assessment of Accuracy of Overall Energy Expenditure Measurements for the Fitbit Charge HR 2 and Apple Watch.

Objectives: In this study, we sought to determine the accuracy of energy expenditure (EE) esti- mation for the Fitbit Charge HR 2 (Fitbit) and the Apple Watch. Design: An observational study. Methods: Thirty young adults (15 men and 15 women, aged 23.5 ± 2.96 years) completed the Bruce treadmill protocol. We measured gross EE by a PARVO metabolic cart (MetCart) and concurrently estimated by the Fitbit and Apple Watch. We calculated concordance correlation coefficients (CCC, rc) and relative error rates to indicate the difference between each device and the MetCart system. Results: For the Apple Watch and Fitbit, the relative error rate was 24.3%, 20.1% for the pooled sample, 18.6%, 24.2% for men, and 29.9%, 16.7% for women, respectively. The Apple Watch overestimated EE for women and underestimated EE for men; the Fitbit underestimated EE for both. Moderate CCCs between estimated EEs and MetCart measured EEs were found for both Apple Watch (rc =0.65, 0.43, and 0.39 overall, men and women, respectively) and Fitbit (rc =0.53, 0.39, and 0.21 overall, men and women, respectively). Conclusion: Neither device showed accurate results compared with EE measured by a MetCart. Users should consider these results when designing programs or personal training plans where physical activity EE is a key outcome assessed with a wearable device.

Motor skill development in low-income, at-risk preschoolers: A community-based longitudinal intervention study.

OBJECTIVES: This study aimed to: (1) determine the status of fundamental movement skill (FMS) performance in low-income, at-risk preschoolers; and (2) evaluate the impact of the Food Friends Get Movin' with Mighty Moves (MM) program on improving children's FMS at two-year follow-up. DESIGN: Longitudinal, quasi-experimental study with matched controls. METHODS: The Colorado LEAP study was conducted in four Head Start/preschools (two intervention, two control) serving children aged 3-5 years. MM was delivered to the intervention group during preschool. The Bruininks-Oseretsky Test of Motor Proficiency, Second Edition (BOT-2) subtests for balance, running speed and agility, upper-limb coordination (object control (OC) skills) and strength were administered to children at baseline, post-intervention in preschool, one-year follow-up (kindergarten), and two-year follow-up (first grade). RESULTS: Compared to the normative sample's mean, the mean scaled score for all participants at baseline was significantly lower for balance (p=0.016) and OC skills (p<0.001). At two-year follow-up, the means of balance for all participants and OC skills for just the control group were significantly lower than those of the normative sample (p≤0.001). Hierarchical linear regression analyses revealed a significant intervention effect for OC skills with the overall model accounting for 41% of variance at two-year follow-up, F(6,165)=20.45, p<0.001. No intervention effects were found for the other three BOT-2 subtests. CONCLUSIONS: Delivering the MM program in preschool confers a lasting impact on FMS, specifically OC skills, in at-risk elementary school children. Results suggest that at-risk preschoolers are already behind in FMS development and these delays will continue through first grade.