Qualitative Exploration of Family Influences on Physical Activity in Hispanic Families.

BACKGROUND: Limited information exists on how the family unit aids or impedes physical activity (PA) engagement within Hispanic populations. This qualitative study explored family-level influences on PA in dyads of adult Hispanic family members (eg, parent-adult child, siblings, spouses). METHODS: In-person interviews and brief surveys were conducted together with 20 dyads lasting 1.5 hours each. Two researchers coded and analyzed text using thematic analysis in NVivo (version 11.0). They resolved discrepancies through consensus and used matrix coding analysis to examine themes by participants' demographics. RESULTS: The participants were mainly women (70%), from Mexico (61.5%), and they reported low levels of acculturation (87.5%). Themed facilitators for PA included "verbal encouragement," "help with responsibilities," "exercising with someone," and "exercising to appease children." Themed challenges included "lack of support," "challenges posed by children," "sedentary behaviors," and "competing responsibilities." Women more so than men described family-level challenges and facilitators, and dyads where both study partners were physically active provided more positive partner interaction descriptions for PA support than other dyads. CONCLUSIONS: This study suggests that leveraging family support may be an important approach to promote and sustain PA, and that family-focused interventions should integrate communication-building strategies to facilitate family members' ability to solicit support from each other.

Mobile Ecological Momentary Diet Assessment Methods for Behavioral Research: Systematic Review.

BACKGROUND: New methods for assessing diet in research are being developed to address the limitations of traditional dietary assessment methods. Mobile device-assisted ecological momentary diet assessment (mEMDA) is a new dietary assessment method that has not yet been optimized and has the potential to minimize recall biases and participant burden while maximizing ecological validity. There have been limited efforts to characterize the use of mEMDA in behavioral research settings. OBJECTIVE: The aims of this study were to summarize mEMDA protocols used in research to date, to characterize key aspects of these assessment approaches, and to discuss the advantages and disadvantages of mEMDA compared with the traditional dietary assessment methods as well as implications for future mEMDA research. METHODS: Studies that used mobile devices and described mEMDA protocols to assess dietary intake were included. Data were extracted according to Preferred Reporting of Systematic Reviews and Meta-Analyses and Cochrane guidelines and then synthesized narratively. RESULTS: The review included 20 studies with unique mEMDA protocols. Of these, 50% (10/20) used participant-initiated reports of intake at eating events (event-contingent mEMDA), and 50% (10/20) used researcher-initiated prompts requesting that participants report recent dietary intake (signal-contingent mEMDA). A majority of the study protocols (60%, 12/20) enabled participants to use mobile phones to report dietary data. Event-contingent mEMDA protocols most commonly assessed diet in real time, used dietary records for data collection (60%, 6/10), and provided estimates of energy and nutrient intake (60%, 6/10). All signal-contingent mEMDA protocols used a near real-time recall approach with unannounced (ie, random) abbreviated diet surveys. Most signal-contingent protocols (70%, 7/10) assessed the frequency with which (targeted) foods or food groups were consumed. Relatively few (30%, 6/20) studies compared mEMDA with the traditional dietary assessment methods. CONCLUSIONS: This review demonstrates that mEMDA has the potential to reduce participant burden and recall bias, thus advancing the field beyond current dietary assessment methods while maximizing ecological validity.

An Electronic Ecological Momentary Assessment Study to Examine the Consumption of High-Fat/High-Sugar Foods, Fruits/Vegetables, and Affective States Among Women.

OBJECTIVE: To examine the associations between high-fat/high-sugar foods (HFHS) and fruit and vegetable (FV) consumption and affective states in women. METHODS: The researchers used electronic ecological momentary assessment to capture HFHS and FV consumption in the past 2 hours (predictor) and current affective states (outcome) across 1 week among 202 women. Multilevel linear regression was conducted. Weight status was tested as a moderator. RESULTS: Consumption of FV in the past 2 hours was positively associated with feeling happy (P < .05). Women who consumed more HFHS or fewer FV than others in the study reported higher average sadness (both P < .05). Overweight or obese women who reported more frequent HFHS consumption than others had higher average stress than normal weight women (P < .05). CONCLUSIONS AND IMPLICATIONS: The association between HFHS consumption and stress might be stronger in overweight or obese than normal weight women. Future studies could further enhance the electronic ecological momentary assessment method to explore other time-varying moderators and mediators of food consumption and affect.

Impact of an online healthful eating and physical activity program for college students.

PURPOSE: To identify impact of an online nutrition and physical activity program for college students. DESIGN: Randomized, controlled trial using online questionnaires and on-site physical and fitness assessments with measurement intervals of 0 (baseline), 3 (postintervention), and 15 months (follow-up). SETTING: Online intervention delivered to college students; a centralized Web site was used for recruitment, data collection, data management, and intervention delivery. SUBJECTS: College students (18-24 years old, n = 1689), from eight universities (Michigan State University, South Dakota State University, Syracuse University, The Pennsylvania State University, Tuskegee University, University of Rhode Island, University of Maine, and University of Wisconsin). INTERVENTION: A 10-lesson curriculum focusing on healthful eating and physical activity, stressing nondieting principles such as size acceptance and eating competence (software developer: Rainstorm, Inc, Orono, Maine). MEASURES: Measurements included anthropometrics, cardiorespiratory fitness, fruit/vegetable (FV) intake, eating competence, physical activity, and psychosocial stress. ANALYSIS: Repeated measures analysis of variance for outcome variables. RESULTS: Most subjects were white, undergraduate females (63%), with 25% either overweight or obese. Treatment group completion rate for the curriculum was 84%. Over 15 months, the treatment group had significantly higher FV intake (+.5 cups/d) and physical activity participation (+270 metabolic equivalent minutes per week) than controls. For both groups, anthropometric values and stress increased, and fitness levels decreased. Gender differences were present for most variables. First-year males and females gained more weight than participants in other school years. CONCLUSION: A 10-week online nutrition and physical activity intervention to encourage competence in making healthful food and eating decisions had a positive, lasting effect on FV intake and maintained baseline levels of physical activity in a population that otherwise experiences significant declines in these healthful behaviors.

Differences by race/ethnicity in older adults' beliefs about the relative importance of dietary supplements vs prescription medications: results from the SURE Study.

Dietary supplement use is widespread among adults across races/ethnicities, yet reasons for use can vary across these groups. The Supplement Reporting (SURE) study quantified dietary supplement use and reasons for taking supplements in a multiethnic sample of adults who took at least one supplement. This study explored sociodemographic differences, including by race/ethnicity, associated with specific reasons/motivations for taking dietary supplements, including perceived importance of taking supplements relative to prescription medications. The study time period was March 2005 to August 2006. Participants (n=397) were older adults (ages 52 to 88 years) recruited from the Multiethnic Cohort Study in Hawaii and Los Angeles, CA, with equal representation of males and females from six ethnic groups (ie, white, Japanese American, Native Hawaiian, African American, US-born Latino, and foreign-born Latino). Subgroups of participants were compared by χ(2) tests and logistic regression. The most common reasons for taking supplements were to maintain a healthy life, because they were recommended by a health professional, and to prevent a disease/medical problem. A majority (76%) of participants reported that their dietary supplements were as important as prescription medications, with foreign-born Latinos and Japanese Americans being most likely to state this belief. The relative importance of supplements was not associated with excessive use, but 27% of participants exceeded the upper limit for a nutrient. It is crucial for health professionals to better understand why individuals take supplements and the importance that they attach to their use. This information could lead to better monitoring and education efforts to prevent overuse of supplements and possible interactions with medications.