Development, Implementation, and Evaluation of Active Lions: A Campaign to Promote Active Travel to a University Campus.

PURPOSE: To outline the development, implementation, and evaluation of a multistrategy intervention to promote active transportation, on a large university campus. DESIGN: Single group pilot study. SETTING: A large university in the Northeastern United States. PARTICIPANTS: University students (n = 563), faculty and staff (employees, n = 999) were included in the study. INTERVENTION: The Active Lions campaign aimed to increase active transportation to campus for all students and employees. The campaign targeted active transport participation through the development of a smartphone application and the implementation of supporting social marketing and social media components. MEASURES: Component-specific measures included app user statistics, social media engagement, and reach of social marketing strategies. Overall evaluation included cross-sectional online surveys preintervention and postintervention of student and employee travel patterns and campaign awareness. ANALYSIS: Number of active trips to campus were summed, and the percentage of trips as active was calculated. T tests compared the differences in outcomes from preintervention to postintervention. RESULTS: Students had a higher percentage of active trips postintervention (64.2%) than preintervention (49.2%; t = 3.32, P = .001), although there were no differences for employees (7.9% and 8.91%). Greater awareness of Active Lions was associated with greater active travel. CONCLUSION: This multistrategy approach to increase active transportation on a college campus provided insight on the process of developing and implementing a campaign with the potential for impacting health behaviors among campus members.

Interest in Using Workplace Energy Expenditure Devices Among Primary Care Patients.

BACKGROUND: Workplace energy expenditure devices (WEEDs), such as bicycle desks and treadmill desks, can contribute to weight gain prevention and disease risk-reduction. Little is known about the extent to which adults with diverse health risk factors are interested in using WEEDs. METHODS: Primary care patients aged 18 to 65 years at 2 outpatient clinics in Central Pennsylvania completed a cross-sectional survey in April, 2014 to assess interest in using "a small pedaling device under the desk" and "walking on a treadmill with a desk attached" if these options were provided at no cost. Demographic and health risk factors were also assessed. Multiple logistic regression analyses were used to examine the associations of demographic and health risk factors with interest in using WEEDs. RESULTS: Among 240 patients, 106 (44.2%) reported interest in using WEEDs. Of these 106 patients, interest in using a bicycle desk (91.5%) was higher than interest in using a treadmill desk (65.1%), P < .001. Females were more likely than males to be interested in using a bicycle desk, and patients aged 18 to 44 years were more likely than those aged 45 to 65 years to be interested in using a treadmill desk. CONCLUSIONS: Results suggest that diverse patient populations may have interest in using WEEDs. Promoting use of WEEDs in primary care practices could help meet national standards for providing comprehensive, patient-centered care.

A Growing Opportunity: Community Gardens Affiliated with US Hospitals and Academic Health Centers.

BACKGROUND: Community gardens can reduce public health disparities through promoting physical activity and healthy eating, growing food for underserved populations, and accelerating healing from injury or disease. Despite their potential to contribute to comprehensive patient care, no prior studies have investigated the prevalence of community gardens affiliated with US healthcare institutions, and the demographic characteristics of communities served by these gardens. METHODS: In 2013, national community garden databases, scientific abstracts, and public search engines (e.g., Google Scholar) were used to identify gardens. Outcomes included the prevalence of hospital-based community gardens by US regions, and demographic characteristics (age, race/ethnicity, education, household income, and obesity rates) of communities served by gardens. RESULTS: There were 110 healthcare-based gardens, with 39 in the Midwest, 25 in the South, 24 in the Northeast, and 22 in the West. Compared to US population averages, communities served by healthcare-based gardens had similar demographic characteristics, but significantly lower rates of obesity (27% versus 34%, p < .001). CONCLUSIONS: Healthcare-based gardens are located in regions that are demographically representative of the US population, and are associated with lower rates of obesity in communities they serve.

Characterizing customers at medical center farmers' markets.

Approximately 100 farmers' markets operate on medical center campuses. Although these venues can uniquely serve community health needs, little is known about customer characteristics and outreach efforts. Intercept survey of markets and market customers between August 2010 and October 2011 at three medical centers in different geographic regions of the US (Duke University Medical Center, Cleveland Clinic, and Penn State Hershey Medical Center) were conducted. Markets reported serving 180-2,000 customers per week and conducting preventive medicine education sessions and community health programs. Customers (n = 585) across markets were similar in sociodemographic characteristics--most were middle-aged, white, and female, who were employees of their respective medical center. Health behaviors of customers were similar to national data. The surveyed medical center farmers' markets currently serve mostly employees; however, markets have significant potential for community outreach efforts in preventive medicine. If farmers' markets can broaden their reach to more diverse populations, they may play an important role in contributing to community health.

Feasibility of using a compact elliptical device to increase energy expenditure during sedentary activities.

OBJECTIVES: This study aimed to evaluate the feasibility of using a compact elliptical device to increase energy expenditure during sedentary activities. A secondary aim was to evaluate if two accelerometers attached to the elliptical device could provide reliable and valid assessments of participants' frequency and duration of elliptical device use. DESIGN: Physically inactive adults (n=32, age range=25-65) were recruited through local advertisements and selected using stratified random sampling based on sex, body mass index (BMI), and age. METHODS: Indirect calorimetry was used to assess participants' energy expenditure while seated and while using the elliptical device at a self-selected intensity level. Participants also self-reported their interest in using the elliptical device during sedentary activities. Two Actigraph GT3X accelerometers were attached to the elliptical device to record time-use patterns. RESULTS: Participants expended a median of 179.1 kilocalories per hour while using the elliptical device (range=108.2-269.0), or a median of 87.9 more kilocalories (range=19.7-178.6) than they would expend per hour of sedentary sitting. Participants reported high interest in using the elliptical device during TV watching and computer work, but relatively low interest in using the device during office meetings. Women reported greater interest in using the elliptical device than men. The two accelerometers recorded identical time-use patterns on the elliptical device and demonstrated concurrent validity with time-stamped computer records. CONCLUSIONS: Compact elliptical devices could increase energy expenditure during sedentary activities, and may provide proximal environmental cues for increasing energy expenditure across multiple life domains.

Complete home smoking bans and antitobacco contingencies: a natural experiment.

INTRODUCTION: The California antitobacco culture may have influenced home smoking bans in Mexico. Based on the Behavioral Ecological Model, exposure to socially reinforcing contingencies or criticism may explain adoption of home smoking bans in Tijuana, Mexico, approximating rates relative to San Diego, California, and higher than those in Guadalajara, Mexico. METHODS: A representative cross-sectional population survey of Latinos (N = 1,901) was conducted in San Diego, Tijuana, and Guadalajara between June 2003 and September 2004. Cities were selected to represent high-, medium-, and low-level exposure to antitobacco social contingencies of reinforcement in a quasiexperimental analysis of possible cultural influences across borders. RESULTS: Complete home smoking ban prevalence was 91% in San Diego, 66% in Tijuana, and 38% in Guadalajara (p < .001). Sample cluster-adjusted logistic regression showed significantly lower odds of complete home smoking bans in Guadalajara (odds ratio [OR] = .048) and in Tijuana (OR = .138) compared to San Diego after control for demographics. Odds of complete home smoking bans in both Guadalajara and Tijuana in comparison with San Diego were weakened when mediators for bans were controlled in predictive models. Direction of association was consistent with theory. When theoretical mediators were explored as possible moderators, weak and nonsignificant associations were obtained for all interaction terms. Bootstrap analyses demonstrated that our multivariable logistic regression results were reliable. CONCLUSIONS: Results suggest that California antismoking social contingencies mediate complete home smoking bans in all 3 cities and may account for the greater effects in Tijuana contrasted with Guadalajara.

Public health potential of farmers' markets on medical center campuses: a case study from Penn State Milton S. Hershey Medical Center.

There are currently 7175 farmers' markets in the United States, and these organizations are increasingly viewed as one facet of the solution to national health problems. There has been a recent trend toward establishing markets on medical center campuses, and such partnerships can augment a medical center's ability to serve community health. However, to our knowledge no studies have described the emergence of a market at a medical center, the barriers and challenges such an initiative has faced, or the nature of programming it may foster. We provide a qualitative description of the process of starting a seasonal, once-a-week, producers-only market at the Pennsylvania State Hershey Medical Center, and we call for greater public health attention to these emerging community spaces.

Reducing the gap between the economic costs of tobacco and funds for tobacco training in schools of public health.

Tobacco use costs approximately dollar 167 billion annually in the U.S., but few tobacco education opportunities are available in schools of public health. Reasons for the discrepancy between the costs of tobacco use and the creation of tobacco training opportunities have not been well explored. Based on the Behavioral Ecological Model, we present 10 recommendations for increasing tobacco training in schools of public health. Six recommendations focus on policy changes within the educational, legislative, and health care systems that influence funds for tobacco training, and four recommendations focus on strategies to mobilize key social groups that can advocate for change in tobacco control education and related policies. In addition, we present a model tobacco control curriculum to equip public health students with the skills needed to advocate for these recommended policy changes. Through concurrent changes in the ecological systems affecting tobacco control training, and through the collaborative action of legislators, the public, the media, and health professionals, tobacco control training can be moved to a higher priority in educational settings.

Characteristics of participants visiting the Canada on the move website.

BACKGROUND: The Internet is a potential medium to attain large groups of Canadians for physical activity monitoring and interventions, however, little is known about the characteristics of participants who could be recruited on a national level. Our objectives were to determine: 1) the extent to which our sample was representative of the Canadian population; 2) the demographic, social-cognitive and physical activity behaviour, and environmental characteristics of one-time and multi-time users of the Canada on the Move website; and 3) whether certain recruitment strategies were more likely to reach specific demographic subgroups. METHODS: Web-based self-report measures were collected on demographic, social-cognitive, physical activity behaviour, and environmental factors. Descriptive statistics were employed to address the study's research objectives. RESULTS: Significant differences (p<0.001) were found between our total sample and 2001 Canadian census/Canadian Community Health Survey (CCHS) data on all demographic and physical activity behaviour measures. One-time and multi-time users significantly differed on age (p<0.005) and being responsible for children under age 13 (p=0.01). No differences existed between the groups on any of the social-cognitive, behavioural or environmental variables. Source of knowledge about the Canada on the Move website between one-time and multi-time users was not significantly different. CONCLUSION: The Canada on the Move website presents a viable approach to reaching diverse demographic groups. Further work needs to be undertaken to: 1) develop engaging websites; 2) detail the monitoring of the web-based access information; 3) integrate the website with other organizations promoting physical activity; and 4) expand the number of recruitment sources.