Food Insecurity is Associated with Objectively Measured Sleep Problems.

Objective/Background: Food Insecurity (FI) can be a profound source of stress, which may increase the risk for sleep disturbance. This is the first study to examine the association between FI and objectively and subjectively measured sleep. Participants: The sample included 785 adults living in two low-income neighborhoods (mean age = 56; 95% African American). Methods: FI was measured using a validated 10-item survey that assesses conditions and behaviors that characterize households when they lack financial resources to meet basic food needs. Sleep duration, efficiency, wakefulness after sleep onset (WASO), and variability in sleep duration were measured via actigraphy. Sleep quality was assessed via sleep diary. Sleep outcomes were analyzed as a function of FI, adjusting for covariates. Psychological distress was tested as a potential mediator. Results: Greater FI was associated with shorter actigraphy-assessed sleep duration (B = -2.44; SE = 1.24; i.e., 24 minutes shorter for the most as compared to least insecure group), poorer sleep efficiency (B = -.27; SE = .13); p's < .05), and poorer subjective sleep quality (B = -.03; SE = .01; p < .01). Greater FI was also associated with greater likelihood of short (<7 hours; OR = 1.11; CI: 1.02-1.21) and long sleep (>9 hours; OR = 1.19; CI: 1.01-1.39), compared to the recommended sleep duration of 7-9 hours. Psychological distress partially mediated the association between FI and subjective sleep quality. Conclusions: Addressing or mitigating food insecurity may present a novel opportunity for improving sleep health among low-income populations.

Online versus in-person comparison of Microscale Audit of Pedestrian Streetscapes (MAPS) assessments: reliability of alternate methods.

BACKGROUND: An online version of the Microscale Audit of Pedestrian Streetscapes (Abbreviated) tool was adapted to virtually audit built environment features supportive of physical activity. The current study assessed inter-rater reliability of MAPS Online between in-person raters and online raters unfamiliar with the regions. METHODS: In-person and online audits were conducted for a total of 120 quarter-mile routes (60 per site) in Phoenix, AZ and San Diego, CA. Routes in each city included 40 residential origins stratified by walkability and SES, and 20 commercial centers. In-person audits were conducted by raters residing in their region. Online audits were conducted by raters in the alternate location using Google Maps (Aerial and Street View) images. The MAPS Abbreviated Online tool consisted of four sections: overall route, street segments, crossings and cul-de-sacs. Items within each section were grouped into subscales, and inter-rater reliability (ICCs) was assessed for subscales at multiple levels of aggregation. RESULTS: Online and in-person audits showed excellent agreement for overall positive microscale (ICC = 0.86, 95% CI [0.80, 0.90]) and grand scores (ICC = 0.93, 95% CI [0.89, 0.95]). Substantial to near-perfect agreement was found for 21 of 30 (70%) subscales, valence, and subsection scores, with ICCs ranging from 0.62, 95% CI [0.50, 0.72] to 0.95, 95% CI [0.93, 0.97]. Lowest agreement was found for the aesthetics and social characteristics scores, with ICCs ranging from 0.07, 95% CI [-0.12, 0.24] to 0.27, 95% CI [0.10, 0.43]. CONCLUSIONS: Results support use of the MAPS Abbreviated Online tool to reliably assess microscale neighborhood features that support physical activity and may be used by raters residing in different geographic regions and unfamiliar with the audit areas.

Reliability between online raters with varying familiarities of a region: Microscale Audit of Pedestrian Streetscapes (MAPS).

Background: To test inter-rater reliability of the online Microscale Audit of Pedestrian Streetscapes (MAPS) tool between raters with varying familiarities of Phoenix, Arizona. Methods: The online MAPS tool, based on the MAPS in-field audit tool and scoring system, was used for audits. Sixty route pairs, 141 segment pairs, and 92 crossing pairs in Phoenix were included. Each route, segment or crossing was audited by two independent raters: one rater in Phoenix and the other in San Diego, California, respectively. Item, subscale scores, and total scores reliability analyses were computed using Kappa or intra-class correlation coefficient (ICC). Results: The route overall score had substantial reliability (ICC: 0.832). Of the route subscale and overall scores, sixteen out of twenty had moderate to substantial reliability (ICC: 0.616-0.906), and the four subscales had fair reliability (ICC: 0.409-0.563). Sixteen out of twenty scores in segment and crossing sections demonstrated fair to substantial reliability (ICC: 0.448-0.897), and the remaining four had slight reliability (ICC: 0.348-0.364). Conclusions: Most of the online MAPS items, subscales, and overall scores demonstrated fair to substantial reliability between raters with varied familiarities of the Phoenix area. Results support use of online MAPS to measure microscale elements of the built environment by raters unfamiliar with a region.

GIS-measured walkability, transit, and recreation environments in relation to older Adults' physical activity: A latent profile analysis.

An infrequently studied question is how diverse combinations of built environment (BE) features relate to physical activity (PA) for older adults. We derived patterns of geographic information systems- (GIS) measured BE features and explored how they accounted for differences in objective and self-reported PA, sedentary time, and BMI in a sample of older adults. Senior Neighborhood Quality of Life Study participants (N=714, aged 66-97years, 52.1% women, 29.7% racial/ethnic minority) were sampled in 2005-2008 from the Seattle-King County, WA and Baltimore, MD-Washington, DC regions. Participants' home addresses were geocoded, and net residential density, land use mix, retail floor area ratio, intersection density, public transit density, and public park and private recreation facility density measures for 1-km network buffers were derived. Latent profile analyses (LPAs) were estimated from these GIS-based measures. In multilevel regression models, profiles were compared on accelerometer-measured moderate-to-vigorous PA (MVPA) and sedentary time and self-reported PA, adjusting for covariates and clustering. Analyses were conducted in 2014-2015. LPAs yielded three profiles: low walkability/transit/recreation (L-L-L); mean walkability/transit/recreation (M-M-M); and high walkability/transit/recreation (H-H-H). Three PA outcomes were more favorable in the HHH than the LLL profile group (difference of 7.2min/day for MVPA, 97.8min/week for walking for errands, and 79.2min/week for walking for exercise; all ps<0.02). The most and least activity-supportive BE profiles showed greater differences in older adults' PA than did groupings based solely on a 4-component walkability index, suggesting that diverse BE features are important for healthy aging.

Feasibility of three wearable sensors for 24 hour monitoring in middle-aged women.

BACKGROUND: The purpose of this study is to determine the feasibility of three widely used wearable sensors in research settings for 24 h monitoring of sleep, sedentary, and active behaviors in middle-aged women. METHODS: Participants were 21 inactive, overweight (M Body Mass Index (BMI) = 29.27 ± 7.43) women, 30 to 64 years (M = 45.31 ± 9.67). Women were instructed to wear each sensor on the non-dominant hip (ActiGraph GT3X+), wrist (GENEActiv), or upper arm (BodyMedia SenseWear Mini) for 24 h/day and record daily wake and bed times for one week over the course of three consecutive weeks. Women received feedback about their daily physical activity and sleep behaviors. Feasibility (i.e., acceptability and demand) was measured using surveys, interviews, and wear time. RESULTS: Women felt the GENEActiv (94.7%) and SenseWear Mini (90.0%) were easier to wear and preferred the placement (68.4, 80% respectively) as compared to the ActiGraph (42.9, 47.6% respectively). Mean wear time on valid days was similar across sensors (ActiGraph: M = 918.8 ± 115.0 min; GENEActiv: M = 949.3 ± 86.6; SenseWear: M = 928.0 ± 101.8) and well above other studies using wake time only protocols. Informational feedback was the biggest motivator, while appearance, comfort, and inconvenience were the biggest barriers to wearing sensors. Wear time was valid on 93.9% (ActiGraph), 100 % (GENEActiv), and 95.2% (SenseWear) of eligible days. 61.9, 95.2, and 71.4% of participants had seven valid days of data for the ActiGraph, GENEActiv, and SenseWear, respectively. CONCLUSION: Twenty-four hour monitoring over seven consecutive days is a feasible approach in middle-aged women. Researchers should consider participant acceptability and demand, in addition to validity and reliability, when choosing a wearable sensor. More research is needed across populations and study designs.

Reallocating time to sleep, sedentary behaviors, or active behaviors: associations with cardiovascular disease risk biomarkers, NHANES 2005-2006.

Sleep and sedentary and active behaviors are linked to cardiovascular disease risk biomarkers, and across a 24-hour day, increasing time in 1 behavior requires decreasing time in another. We explored associations of reallocating time to sleep, sedentary behavior, or active behaviors with biomarkers. Data (n = 2,185 full sample; n = 923 fasting subanalyses) from the cross-sectional 2005-2006 US National Health and Nutrition Examination Survey were analyzed. The amounts of time spent in sedentary behavior, light-intensity activity, and moderate-to-vigorous physical activity (MVPA) were derived from ActiGraph accelerometry (ActiGraph LLC, Pensacola, Florida), and respondents reported their sleep duration. Isotemporal substitution modeling indicated that, independent of potential confounders and time spent in other activities, beneficial associations (P < 0.05) with cardiovascular disease risk biomarkers were associated with the reallocation of 30 minutes/day of sedentary time with equal time of either sleep (2.2% lower insulin and 2.0% lower homeostasis model assessment of ß-cell function), light-intensity activity (1.9% lower triglycerides, 2.4% lower insulin, and 2.2% lower homeostasis model assessment of ß-cell function), or MVPA (2.4% smaller waist circumference, 4.4% higher high-density lipoprotein cholesterol, 8.5% lower triglycerides, 1.7% lower glucose, 10.7% lower insulin, and 9.7% higher homeostasis model assessment of insulin sensitivity. These findings provide evidence that MVPA may be the most potent health-enhancing, time-dependent behavior, with additional benefit conferred from light-intensity activities and sleep duration when reallocated from sedentary time.

Sociodemographic correlates of meeting US Department of Health and Human Services muscle strengthening recommendations in middle-aged and older adults.

INTRODUCTION: A growing body of evidence demonstrates the health benefits of muscular strength training. Physical activity recommendations encourage all adults to participate regularly in muscle strengthening activities. The purpose of this study was to examine the prevalence of meeting the US Department of Health and Human Services (DHHS) muscular strengthening recommendations by middle-aged and older adults and the sociodemographic characteristics associated with meeting these recommendations, using data from the 2011 Behavioral Risk Factor Surveillance System (BRFSS). METHODS: Data from the 2011 BRFSS were used to examine the prevalence of meeting the DHHS muscle strengthening recommendations by adults older than 45. Simple and multiple regression analyses were used to examine the sociodemographic characteristics associated with meeting the recommendations. RESULTS: Of respondents to the muscle strengthening question (N = 333,507), 79,029 (23.7%) reported meeting the muscle strengthening recommendations. Respondents who were female (odds ratio [OR] = 0.80; 95% confidence interval [CI] 0.78-0.83), widowed (OR = 0.69; 95% CI, 0.66-0.72), 85 or older (OR = 0.63; 95% CI, 0.58-0.68), Hispanic (OR = 0.73; 95% CI, 0.67-0.78), with a body mass index of 30.0 kg/m(2) or higher (OR = 0.47; 95% CI, 0.45-0.49), and with less than a high school education (OR = 0.32, 95% CI, 0.30-0.35) were less likely to meet the recommendations than their counterparts. CONCLUSION: Sociodemographic characteristics such as sex, age, education, and race/ethnicity are significantly associated with meeting the muscle strengthening recommendations, suggesting a need to create tailored interventions and messages to promote participation in strength training.

Explorative Characterization of GI Complaints, General Physical and Mental Wellbeing, and Gut Microbiota in Trained Recreative and Competitive Athletes with or without Self-Reported Gastrointestinal Symptoms.

The current state of the literature lacks a clear characterization of gastrointestinal (GI) symptoms, gut microbiota composition, and general physical and mental wellbeing in well-trained athletes. Therefore, this study aimed to characterize differences in self-reported symptoms, gut microbiota composition, and wellbeing (i.e., sleep quality, mood, and physical (PHQ) and mental wellbeing) between athletes with and without GI symptoms. In addition, we assessed the potential impact of a 3-week multi-ingredient fermented whey supplement in the GI complaints group, without a control group, on the gut microbiota and self-reported GI symptoms and wellbeing. A total of 50 athletes (24.7 ± 4.5 years) with GI issues (GI group at baseline, GI-B) and 21 athletes (25.4 ± 5.3 years) without GI issues (non-GI group, NGI) were included. At baseline, there was a significant difference in the total gastrointestinal symptom rating scale (GSRS) score (24.1 ± 8.48 vs. 30.3 ± 8.82, p = 0.008) and a trend difference in PHQ (33.9 ± 10.7 vs. 30.3 ± 8.82, p = 0.081), but no differences (p > 0.05) were seen for other outcomes, including gut microbiota metrics, between groups. After 3-week supplementation, the GI group (GI-S) showed increased Bifidobacterium relative abundance (p < 0.05), reported a lower number of severe GI complaints (from 72% to 54%, p < 0.001), and PHQ declined (p = 0.010). In conclusion, well-trained athletes with GI complaints reported more severe GI symptoms than an athletic reference group, without showing clear differences in wellbeing or microbiota composition. Future controlled research should further investigate the impact of such multi-ingredient supplements on GI complaints and the associated changes in gut health-related markers.

Predictors of Active Transportation Among Safe Routes to School Participants in Arizona: Impacts of Distance and Income.

BACKGROUND: Active transportation to school (ATS) is a component of a whole school approach to health promotion among youth. METHODS: Individual- and school-level predictors of ATS were examined using data from parent surveys (N = 11,100) of students in grades 3-8 attending 112 schools in Arizona (United States) administering Safe Routes to School (SRTS) programs between 2007 and 2018. Multilevel logistic models were estimated to predict the likelihood of students using active (walking or biking) versus inactive travel (riding bus or car) to and from school, and across distance and school-level income categories. RESULTS: Student grade, parent education, asking permission to use ATS, perceived health and school support for ATS, distance, and school income were predictive of ATS. The impact of demographic factors persisted across distances of ½ mile or less and at low- and medium-income schools but diminished as distance and income increased. Asking permission and perceived school support persisted across levels of distance and income, while perceiving ATS as healthy was significant only for distances under 1 mile. CONCLUSIONS: SRTS programs should continue promoting health benefits and school support for ATS. SRTS may be particularly effective at low- and medium-income schools and among families living within ½ mile distances.

A Randomized Pilot Study of Online Hatha Yoga for Physical and Psychological Symptoms Among Survivors of Allogenic Bone Marrow Transplant.

Bone marrow transplant (BMT) is a curative procedure for patients with hematological malignancies, hemoglobinopathies, and errors of inborn metabolism. Survivors are not without symptom burden. The purpose of this study was to assess the feasibility of a 12-week online yoga intervention compared to an educational control group in survivors of allogenic BMT. Participants were recruited nationally. Consenting participants were assigned to online yoga or a podcast control. Yoga and control group participants were instructed to complete 12 weeks of 60 minutes/week of online yoga and podcasts, respectively. Study participants were asked to complete online questionnaires at baseline (wk 0), midpoint (wk 6), postintervention (wk 12), and follow-up (wk 20). Feasibility benchmarks included > 70% satisfied with intervention and > 70% intending to continue participating in online yoga (acceptability); > 70% of participants achieving > 42 minutes/week of online yoga (demand); > 70% completing all four questionnaires (practicality); and at least small effect sizes of the intervention on Lee Symptom Score, physical function, fatigue, anxiety, sleep disturbance, social functioning, pain interference, depression, and quality of life as compared to control group (limited efficacy). Seventy-two participants consented and enrolled in the study (yoga group n = 33; podcast group n = 39). Of the yoga group participants, 54.5% (n = 19) completed the postintervention questionnaire, with 73.7% (n = 14) indicating they were satisfied/very satisfied and 15.8% (n = 3) likely/very likely to continue online yoga. Yoga participation averaged 31.98 minutes/week across 12 weeks. Both groups experienced a significant improvement in the Lee Symptom Score (6.2%-8.7% improvement from baseline) and depressive symptoms (5.3%-6.6% improvement from baseline). The yoga group experienced a significant reduction in pain (6.1% from baseline), and the podcast group experienced a significant reduction in fatigue (6.4% improvement from baseline). Online yoga was not found to be feasible to deliver to this population of survivors of BMT. However, there was satisfaction with online yoga among the majority of survivors of BMT, and beneficial effects were experienced in the yoga group on Lee Symptom Score, depressive symptoms, and pain. Future research is needed to enhance our understanding of barriers to online yoga participation for survivors of BMT and to determine its efficacy.

Former Foster System Youth: Perspectives on Transitional Supports and Programs.

Youth aging out of the foster care system have well-documented challenges when transitioning to adulthood. Multiple transition services provide support in the transition process; however, limited research is available regarding youth's perceptions of programming. In this pilot study, sixteen youth between ages 18 and 20 participated in semi-structured interviews, support mapping, and resiliency measurements to gather the experiences of the transition from foster care. Comparisons between those who chose initial transition supports and those who did not receive or delayed receiving transition supports were initially explored. Common themes emerged in participants' needs and perceived resiliency regardless of transition support services. All youth reported relationship, trust, and concern for well-being as highly important characteristics in transition team members. A need for earlier transition programming, decision-making opportunities, and life skills courses were important themes in transition programming needs. Implications for policy, research, and practice are presented based upon findings.

Online yoga to reduce post traumatic stress in women who have experienced stillbirth: a randomized control feasibility trial.

BACKGROUND: About 1 in every 150 pregnancies end in stillbirth. Consequences include symptoms of post traumatic stress disorder (PTSD), depression, and anxiety. Yoga has been used to treat PTSD in other populations and may improve health outcomes for stillbirth mothers. The purpose of this study was to determine: (a) feasibility of a 12-week home-based, online yoga intervention with varying doses; (b) acceptability of a "stretch and tone" control group; and (c) preliminary efficacy of the intervention on reducing symptoms of PTSD, anxiety, depression, perinatal grief, self-compassion, emotional regulation, mindfulness, sleep quality, and subjective health. METHODS: Participants (N = 90) were recruited nationally and randomized into one of three groups for yoga or exercise (low dose (LD), 60 min per week; moderate dose (MD), 150 min per week; and stretch-and-tone control group (STC)). Baseline and post-intervention surveys measured main outcomes (listed above). Frequency analyses were used to determine feasibility. Repeated measures ANCOVA were used to determine preliminary efficacy. Multiple regression analyses were used to determine a dose-response relationship between minutes of yoga and each outcome variable. RESULTS: Over half of participants completed the intervention (n = 48/90). Benchmarks (≥70% reported > 75% satisfaction) were met in each group for satisfaction and enjoyment. Participants meeting benchmarks (completing > 90% of prescribed minutes 9/12 weeks) for LD and MD groups were 44% (n = 8/18) and 6% (n = 1/16), respectively. LD and MD groups averaged 44.0 and 77.3 min per week of yoga, respectively. The MD group reported that 150 prescribed minutes per week of yoga was too much. There were significant decreases in PTSD and depression, and improvements in self-rated health at post-intervention for both intervention groups. There was a significant difference in depression scores (p = .036) and grief intensity (p = .009) between the MD and STC groups. PTSD showed non-significant decreases of 43% and 56% at post-intervention in LD and MD groups, respectively (22% decrease in control). CONCLUSIONS: This was the first study to determine the feasibility and preliminary efficacy of an online yoga intervention for women after stillbirth. Future research warrants a randomized controlled trial. TRIAL REGISTRATION: ClinicalTrials.gov. NCT02925481. Registered 10-04-16.

Measuring organizational mentoring climate: Importance and availability scales.

INTRODUCTION: Although organizational climate may affect faculty's mentoring behaviors, there has not been any way to measure that climate. The purpose of this study was to test the reliability and validity of two novel scales to measure organizational mentoring climate importance and availability at two public research universities. METHODS: We developed 36 content-valid mentoring climate items in four dimensions: Structure, Programs/Activities, Policies/Guidelines, and Values. In total, 355 faculty completed an anonymous, structured, online survey asking about the importance (very important to very unimportant) and availability (no, don't know, yes) of each of the items. We conducted reliability analyses and construct validity testing using exploratory common factor analysis, principal axis factoring, and oblique rotation. RESULTS: The majority of the predominantly female, White non-Hispanic, senior, tenure-track faculty were not currently mentoring another faculty or being mentored. Analyses demonstrated a 15-item solution for both the Organizational Mentoring Climate Importance (OMCI) and the Availability (OMCA) Scales, with three factors each: Organizational Expectations, Mentor-Mentee Relationships, and Resources. Standardized Cronbach alphas ranged from 0.74 to 0.90 for the subscales, and 0.94 (OMCI) and 0.87 (OMCA) for the full scales. Faculty rated all items as somewhat to very important; however, perceived availability was very low ranging from mentor training programs (40%) to guidelines for evaluating mentoring success or managing conflict (2.5%). CONCLUSIONS: The scales will allow studying of how organizational climate may affect mentoring behavior and whether climate can be changed to improve faculty mentoring outcomes. We provide recommendations for furthering the science of organizational mentoring climate and culture.

Smartphone-Based Meditation for Myeloproliferative Neoplasm Patients: Feasibility Study to Inform Future Trials.

BACKGROUND: Myeloproliferative neoplasm (MPN) patients often report high symptom burden that persists despite the best available pharmacologic therapy. Meditation has gained popularity in recent decades as a way to manage cancer patient symptoms. OBJECTIVE: The aim of this study was to examine the feasibility of 2 different consumer-based meditation smartphone apps in MPN patients and to examine the limited efficacy of smartphone-based meditation on symptoms compared with an educational control group. METHODS: Patients (n=128) were recruited nationally through organizational partners and social media. Eligible and consented patients were enrolled into 1 of 4 groups, 2 of which received varying orders of 2 consumer-based apps (10% Happier and Calm) and 2 that received one of the apps alone for the second 4 weeks of the 8-week intervention after an educational control condition. Participants were asked to perform 10 min of meditation per day irrespective of the app and the order in which they received the apps. Feasibility outcomes were measured at weeks 5 and 9 with a Web-based survey. Feasibility outcomes were acceptability, demand, and limited efficacy for depression, anxiety, pain intensity, sleep disturbance, sexual function, quality of life, global health, and total symptom burden. RESULTS: A total of 128 patients were enrolled across all 4 groups, with 73.4% (94/128) patients completing the intervention. Of the participants who completed the 10% Happier app, 61% (46/76) enjoyed it, 66% (50/76) were satisfied with the content, and 77% (59/76) would recommend to others. Of those who completed the Calm app, 83% (56/68) enjoyed it, 84% (57/68) were satisfied with the content, and 97% (66/68) would recommend to others. Of those who completed the educational control, 91% (56/61) read it, 87% (53/61) enjoyed it, and 71% (43/61) learned something. Participants who completed the 10% Happier app averaged 31 (SD 33) min/week; patients completing the Calm app averaged 71 (SD 74) min/week. 10% Happier app participants saw small effects on anxiety (P<.001 d=-0.43), depression (P=.02; d=-0.38), sleep disturbance (P=.01; d=-0.40), total symptom burden (P=.13; d=-0.27), and fatigue (P=.06; d=-0.30), and moderate effects on physical health (P<.001; d=0.52). Calm app participants saw small effects on anxiety (P=.29; d=-0.22), depression (P=.09; d=-0.29), sleep disturbance (P=.002; d=-0.47), physical health (P=.005; d=0.44), total symptom burden (P=.13; d=-0.27), and fatigue (P=.13; d=-0.27). Educational control participants (n=61) did not have effects on any patient-reported outcome except for a moderate effect on physical health (P<.001; d=0.77). CONCLUSIONS: Delivering meditation via the Calm app is feasible and scored higher in terms of feasibility when compared with the 10% Happier app. The Calm app will be used to implement a randomized controlled trial, testing the effects of meditation on symptom burden in MPNs. TRIAL REGISTRATION: ClinicalTrials.gov NCT03726944; https://clinicaltrials.gov/ct2/show/NCT03726944 (Archived by WebCite at http://www.webcitation.org/77MVdFJwM).

Patterns of food and physical activity environments related to children's food and activity behaviors: A latent class analysis.

Relationships between food and physical activity (PA) environments and children's related behaviors are complex. Latent class analyses derived patterns from proximity to healthy and unhealthy food outlets, PA facilities and parks, and counts of residential dwellings and intersections. Regression analyses examined whether derived classes were related to food consumption, PA, and overweight among 404 low-income children. Compared to children living in Low PA-Low Food environments, children in High Intersection&Parks-Moderate Density&Food, and High Density-Low Parks-High Food environments, had significantly greater sugar-sweetened beverage consumption (ps<0.01) and overweight/obesity (ps<0.001). Children in the High Density-Low Parks-High Food environments were more likely to walk to destinations (p = 0.01) Recognizing and leveraging beneficial aspects of neighborhood patterns may be more effective at positively influencing children's eating and PA behaviors compared to isolating individual aspects of the built environment.

Patterns of Walkability, Transit, and Recreation Environment for Physical Activity.

INTRODUCTION: Diverse combinations of built environment (BE) features for physical activity (PA) are understudied. This study explored whether patterns of GIS-derived BE features explained objective and self-reported PA, sedentary behavior, and BMI. METHODS: Neighborhood Quality of Life Study participants (N=2,199, aged 20-65 years, 48.2% female, 26% ethnic minority) were sampled in 2001-2005 from Seattle / King County WA and Baltimore MD / Washington DC regions. Their addresses were geocoded to compute net residential density, land use mix, retail floor area ratio, intersection density, public transit, and public park and private recreation facility densities using a 1-km network buffer. Latent profile analyses (LPAs) were estimated from these variables. Multilevel regression models compared profiles on accelerometer-measured moderate to vigorous PA (MVPA) and self-reported PA, adjusting for covariates and clustering. Analyses were conducted in 2013-2014. RESULTS: Seattle region LPAs yielded four profiles, including low walkability/transit/recreation (L-L-L); mean walkability/transit/recreation (M-M-M); moderately high walkability/transit/recreation (MH-MH-MH); and high walkability/transit/recreation (H-HH). All measures were higher in the HHH than the LLL profile (difference of 17.1 minutes/day for MVPA, 146.5 minutes/week for walking for transportation, 58.2 minutes/week for leisure-time PA, and 2.2 BMI points; all p<0.05). Baltimore region LPAs yielded four profiles, including L-L-L; M-M-M; high land use mix, transit, and recreation (HLU-HT-HRA); and high intersection density, high retail floor area ratio (HID-HRFAR). HLU-HT-HRA and L-L-L differed by 12.3 MVPA minutes/day; HID-HRFAR and L-L-L differed by 157.4 minutes/week for walking for transportation (all p<0.05). CONCLUSIONS: Patterns of environmental features explain greater differences in adults' PA than the four-component walkability index.

Patterns of neighborhood environment attributes in relation to children's physical activity.

Characterizing neighborhood environments in relation to physical activity is complex. Latent profiles of parents' perceptions of neighborhood characteristics were examined in relation to accelerometer-measured moderate-to-vigorous physical activity (MVPA) among 678 children (ages 6-12) in two US regions. Neighborhood environment profiles derived from walkability, transit access, aesthetics, crime and traffic safety, pedestrian infrastructure, and recreation/park access were created for each region. The San Diego County profile lowest on walkability and recreation/park access was associated with an average of 13 fewer min/day of children's out-of-school MVPA compared to profiles higher on walkability and recreation/park access. Seattle/King County profiles did not differ on children's MVPA. Neighborhood environment profiles were associated with children's MVPA in one region, but results were inconsistent across regions.

Validity of the Rapid Eating Assessment for Patients for assessing dietary patterns in NCAA athletes.

BACKGROUND: Athletes may be at risk for developing adverse health outcomes due to poor eating behaviors during college. Due to the complex nature of the diet, it is difficult to include or exclude individual food items and specific food groups from the diet. Eating behaviors may better characterize the complex interactions between individual food items and specific food groups. The purpose was to examine the Rapid Eating Assessment for Patients survey (REAP) as a valid tool for analyzing eating behaviors of NCAA Division-I male and female athletes using pattern identification. Also, to investigate the relationships between derived eating behavior patterns and body mass index (BMI) and waist circumference (WC) while stratifying by sex and aesthetic nature of the sport. METHODS: Two independent samples of male (n = 86; n = 139) and female (n = 64; n = 102) collegiate athletes completed the REAP in June-August 2011 (n = 150) and June-August 2012 (n = 241). Principal component analysis (PCA) determined possible factors using wave-1 athletes. Exploratory (EFA) and confirmatory factor analyses (CFA) determined factors accounting for error and confirmed model fit in wave-2 athletes. Wave-2 athletes' BMI and WC were recorded during a physical exam and sport participation determined classification in aesthetic and non-aesthetic sport. Mean differences in eating behavior pattern score were explored. Regression models examined interactions between pattern scores, participation in aesthetic or non-aesthetic sport, and BMI and waist circumference controlling for age and race. RESULTS: A 5-factor PCA solution accounting for 60.3% of sample variance determined fourteen questions for EFA and CFA. A confirmed solution revealed patterns of Desserts, Healthy food, Meats, High-fat food, and Dairy. Pattern score (mean ± SE) differences were found, as non-aesthetic sport males had a higher (better) Dessert score than aesthetic sport males (2.16 ± 0.07 vs. 1.93 ± 0.11). Female aesthetic athletes had a higher score compared to non-aesthetic female athletes for the Dessert (2.11 ± 0.11 vs. 1.88 ± 0.08), Meat (1.95 ± 0.10 vs. 1.72 ± 0.07), High-fat food (1.70 ± 0.08 vs. 1.46 ± 0.06), and Dairy (1.70 ± 0.11 vs. 1.43 ± 0.07) patterns. CONCLUSIONS: REAP is a construct valid tool to assess dietary patterns in college athletes. In light of varying dietary patterns, college athletes should be evaluated for healthful and unhealthful eating behaviors.