Relação entre o perfil de adesão e as barreiras para a permanência no programa de extensão "yoga: awaken one" / Relationship between the membership profile and the barriers to stay in the "yoga: awaken one" extension program

Objetivo: Investigar a relação entre o perfil de adesão e barreiras percebidas por estudantes universitários para permanência no Programa de Extensão "Yoga: Awaken ONE". Métodos: Foram realizados dois cortes transversais com universitários da Universidade Federal do Recôncavo da Bahia. O primeiro foi composto por 16 indivíduos e investigou o perfil demográfico, socioeconômico, antropométrico, da aptidão física e da qualidade de vida dos universitários que ingressaram no Programa de Extensão. O segundo visou identificar as barreiras para permanência de 13 estudantes (dentre os 16 iniciais) que haviam se afastado do Programa após quatro meses do início. Resultados: Houve predominância de indivíduos do sexo feminino, dos cursos de graduação em Educação Física e Pedagogia e da classe socioeconômica C. A maioria dos participantes estava com indicadores adequados de gordura corporal. Observou-se grande proporção de indivíduos com indicadores baixos de flexibilidade e força muscular. Para a qualidade de vida, a menor mediana foi observada para o domínio meio ambiente e a maior para o domínio relações sociais. As principais barreiras percebidas para a prática de yoga pelos universitários foram "jornada de estudos extensa" e "jornada de trabalho extensa". Observou-se correlação do perfil sociodemográfico, indicadores de obesidade, variáveis hemodinâmicas, flexibilidade, força muscular e qualidade de vida com barreiras percebidas para permanência no Programa de Extensão universitária "Yoga: Awaken ONE". Conclusões: Estes achados sugerem que o perfil do público universitário pode ser determinante para a permanência ou evasão de programas de promoção de exercícios físicos e precisa ser considerado em propostas de programas de extensão universitária.

Objective: Investigate the relationship between the member adherence profile and barriers perceived by university students to remain in the "Yoga: Awaken ONE" Extension Program. Methods: Two cross-sections were carried out with university students from the Federal University of Recôncavo da Bahia. The first was composed of 16 individuals and investigated the demographic, socioeconomic, anthropometric, physical fitness, and quality of life profile of university students joining the Extension Program. The second aimed at identifying the barriers to remain in the program faced by 13 students (out of the initial 16) who had withdrawn from the Program four months after the beginning. Results: There was a predominance of female individuals, from undergraduate courses in Physical Education and Pedagogy, and from the C socioeconomic class. Most participants had adequate body fat indexes. There was a large proportion of individuals with low flexibility and muscle strength. For quality of life, the lowest median was observed for the environment domain, while the highest could be noted for the social relationship domain. The main barriers perceived for the practice of yoga by university students were "long study hours" and "long work hours". There was a correlation between sociodemographic profile, obesity indicators, hemodynamic variables, flexibility, muscle strength, and QOL with the perceived barriers to stay in the "Yoga: Awaken ONE" university extension program. Conclusions: These findings suggest that the profile of the university audience can be a determinant for the permanence or dropout of programs that promote physical exercise and therefore, it should be taken into consideration in proposals for university extension programs.

Cross-sectional study of the relationship between the spiritual wellbeing and psychological health among university Students.

University students' spiritual wellbeing has been shown to be associated with quality, satisfaction, and joy of life. This study tested the relationship between spiritual wellbeing and symptoms of psychological disorders (i.e., depression, anxiety and stress) among Chinese university students in Hong Kong. Cross-sectional data were collected from N = 500 students (aged 17-24; 279 women). The participants were asked to complete the Spiritual Health and Life-Orientation Measure (SHALOM) to evaluate the status of their spiritual wellbeing in the personal and communal, environmental, and transcendental domains, and the Depression, Anxiety and Stress Scale-21 (DASS-21) to assess their emotional states of depression, anxiety and stress. All domains of spiritual wellbeing were negatively associated with psychological distress. Hierarchical Multiple Regression showed that together the three domains of spirituality explained 79.9%, 71.3% and 85.5% of the variance in students' depression, anxiety and stress respectively. The personal and communal domain of spiritual wellbeing was the strongest predictor of psychological distress.

Effects of aerobic exercise, traditional Chinese exercises, and meditation on depressive symptoms of college student: A meta-analysis of randomized controlled trials.

BACKGROUND: Non-pharmacological intervention methods such as rehabilitation training or psychological treatment are mostly used in the treatment of depression owing to the limitation of adverse reactions such as drug treatment. However, the best non-pharmacological treatment strategy for depression in college students is unclear. Therefore, it is significant to discover non-drug intervention methods that can improve the depression symptoms of college students. METHOD: Electronic databases as of Sep 15, 2019, were searched, and reference lists and pharmaceutical dossiers were reviewed to detect published and unpublished studies from the date of their inception to Sep 15, 2019. With document quality evaluations and data extraction, Meta-Analysis was performed using a random effect model to evaluate the intervention effect of the aerobic exercise, traditional Chinese exercises, and meditation. RESULTS: A total of 44 original studies were included. The random effect model was used to combine the effect values with Standard Mean Difference (SMD), and the results were: aerobic exercise [SMD = -0.53, 95% CI (-0.77, -0.30), I2 = 80%, P < .001], traditional Chinese exercises [SMD = -0.42, 95% CI (-0.74, -0.10), I2 = 90%, P = .01], meditation [SMD = -0.51, 95% CI (-0.90, -0.12), I2 = 79%, P = .01]. There was greater heterogeneity among the included studies: aerobic exercise (I2 = 80%, P < .001), traditional Chinese medicine methods (I2 = 90%, P < .001), and meditation (I2 = 79%, P < .001). CONCLUSIONS: This study revealed that the depression symptoms of college students can be effectively improved by aerobic exercise, traditional Chinese exercises, and meditation. Aerobic exercise would have a better effect on anxiety and stress while traditional Chinese exercise would have a better effect on stress. Further research (such as high-quality randomized controlled trials and long-term follow-up) is required to evaluate the effects of aerobic exercise, traditional Chinese exercise, and meditation on the depressive symptoms of college students to further apply complementary and alternative therapies. ETHICS AND DISSEMINATION: The results of the effects of aerobic exercise, traditional Chinese exercises, and meditation on depressive symptoms for a college student will be reported in a peer-reviewed publication. Hopefully, our findings from this meta-analysis can provide the most up-to-date evidence for the contribution to preventing the occurrence of depressive symptoms in college students.

Women's experience of stress and related use of diet and/or dietary supplements.

Women's lives are negatively impacted by chronic psychological stress. Dietary supplement use to manage stress is prolific despite inadequate evidence to support supplementation. The researchers used participatory action research to examine the experience of living with stress and the role that diet and/or dietary supplements played in the self-reported ability to manage stress among community dwelling women. Convenience sampling was used to recruit eight women. Focus group sessions were held across eight consecutive weeks wherein personal experiences of stress and dietary strategies to manage stress were audio-recorded. Verbatim transcripts of the sessions, journal notes, and email correspondence were analyzed, identifying codes, categories, and six themes: "causes and effects of stress," "thinking patterns and stress," "confusion and skepticism about using dietary strategies to manage stress," "the role of relationships in experiencing stress," "the role of relationships in managing physical health and stress," and "stress-management strategies." Participants experienced habitual stress responses, skepticism about dietary stress management strategies, and long-reaching physical and psychological effects on key relationships. Health professionals may find similar perspectives influencing the choices of chronically stressed women they support.

Partnerships between universities and nonprofit transition coaching organizations to increase student success.

AIMS: This study aims to understand the motivations and benefits for universities and nonprofit college access and success organizations to develop formal partnerships. METHODS: Participants in this study were staff from a major urban research university (n = 22) and four nonprofit organizations (n = 17) that promote college access and success among underrepresented, low-income, and first-generation college students. Participants engaged in an audio-recorded interview that was transcribed and analyzed using thematic analysis. RESULTS: Data suggested that staff from the universities and nonprofit organizations were both holistic in their understanding of college student success. In addition, they were both motivated to form partnerships in an effort to reduce barriers to success, although they, at times, identified different barriers that they wanted the partnership to address. Both university and nonprofit staff saw increased effectiveness of their practice as a result of partnering and university staff gained a better understanding of the greater nonprofit college access and success community. CONCLUSION: Given the intense support that nonprofit organizations are able to provide with their level of funding, partnerships with universities can increase the success of underrepresented, low-income, and first-generation college students.

Effect of Tai Chi on psychological disorder in college students: A protocol of systematic review and meta-analysis.

BACKGROUND: This study will explore the effect of Tai Chi on psychological disorder (PD) in college students (CS). METHODS: A comprehensive literature search of relevant randomized controlled trials will be carried out in electronic databases from inception to the February 29, 2020: PUBMED, EMBASE, Cochrane Library, Web of Science, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure. There are not limitations related to the language and publication time. Study quality will be assessed by Cochrane risk of bias tool, and evidence quality will be appraised by the grading of recommendations assessment, development, and evaluation approach. RevMan 5.3 software will be exploited to perform statistical analysis. RESULTS: The protocol of this proposed study will investigate the effect of Tai Chi on PD in CS. CONCLUSION: The findings of this study will provide helpful evidence for clinical practice, and health related policy maker to develop a better intervention plan for PD in CS. STUDY REGISTRATION NUMBER: INPLASY202040140.

History of Islamic Medical Schools in Turkey's Territory

In today's political borders of the Republic of Turkey, there exist very old institutions that train physicians according to Islamic medical science. In this study, 19 health institutions whose locations have been determined and documents finalized were approached in a chronological order and classified according to the historical periods: XIIth and XIIIth centuries (Seljukian period)-10, XIVth century (Ilkhanate dominion)-1, and XVth-XVIIth centuries (Ottoman period)-8 institutions. Some of them have a history of 900 years (Konya Mâristan-i Atik, 1113; and Mardin Eminüddin Bimaristani, 1122). In addition, some are in the form of a medical madrasah and an application hospital (Kayseri, 1206; Sivas, 1217). In these institutions, great masters of Islamic medicine (Razi, Fârâbî, Bîrûnî, Ibni Sina) and ancient authorities (Hippocrates, Dioscorides, Aretaeus, Galenos) were taught. These institutions had builders, rulers (sultan, melik) or mothers, wives, daughters, and sisters (the presence of female builders in these institutions attracted attention). During the Seljuk period, powerful viziers also built such institutions. These hospitals also provided free services which were considered as "charities" according to the Islamic religion. These institutions were financed by sources (shops, inns, Turkish baths, bridges, mills, vineyards, gardens, fields and annual taxes of many villages) that donated funds through the "foundation" method. Donations were made in the presence of the "kadi" (muslim judges) and many witnesses, with the written document "endowment." These foundations were not touched by subsequent monarchs. Payment of fees, daily expenses of the physicians, assistant personel and repairing of buildings was done by the board of trustees. Twelve of these institutions are still in use for public interest (polyclinic, museum, health museum, library, university, and education center). When modern medical schools (1827) and hospitals (1842) began to be established as of the XIXth century, these historic buildings were allocated to mental patients, while some were devastated by neglect. However, in the Republic period, they have been restored and used for health and educational purposes.

The Impact of Three-Dimensional Printed Anatomical Models on First-Year Student Engagement in a Block Mode Delivery.

Student engagement is known to have several positive effects on learning outcomes and can impact a student's university experience. High levels of engagement in content-heavy subjects can be difficult to attain. Due to a major institutional restructure, the anatomy prosection laboratory time per subject was dramatically reduced. In response, the authors set out to redesign their anatomy units with a focus on engaging the learning activities that would increase time-on-task both within and outside of the classroom. One of these curriculum changes was the implementation of a suite of anatomy learning activities centered on sets of three-dimensional printed upper limb skeleton models. A two-part mixed-method sequential exploratory design was used to evaluate these activities. Part one was a questionnaire that evaluated the students' engagement with and perceptions of the models. Part two involved focus groups interviews, which were an extension of the survey questions in part one. The results of the study indicated that the majority of students found the models to be an engaging resource that helped improve their study habits. As a result, students strongly felt that the use of the models inspired greater academic confidence and overall better performance in their assessments. Overall, the models were an effective way of increasing the engagement and deep learning, and reinforced previous findings from the medical education research. Future research should investigate the effects of these models on student's grades within osteopathy and other allied health courses.

The Community-Academic Aging Research Network: A Pipeline for Dissemination.

BACKGROUND/OBJECTIVES: The Community-Academic Aging Research Network (CAARN) was created to increase the capacity and effectiveness of Wisconsin's Aging Network and the University of Wisconsin to conduct community-based research related to aging. The purpose of this article is to describe CAARN's infrastructure, outcomes, and lessons learned. DESIGN: Using principles of community-based participatory research, CAARN engages stakeholders to participate in the design, development, and testing of older adult health interventions that address community needs, are sustainable, and improve health equity. SETTING: Academic healthcare and community organizations. PARTICIPANTS: Researchers, community members, and community organizations. INTERVENTION: CAARN matches academic and community partners to develop and test evidence-based programs to be distributed by a dissemination partner. MEASUREMENTS: Number of partnerships and funding received. RESULTS: CAARN has facilitated 33 projects since its inception in 2010 (30 including rural populations), involving 46 academic investigators, 52 Wisconsin counties, and 1 tribe. These projects have garnered 52 grants totaling $20 million in extramural and $3 million in intramural funding. Four proven interventions are being prepared for national dissemination by the Wisconsin Institute for Healthy Aging: one to improve physical activity; one to reduce bowel and bladder incontinence; one to reduce sedentary behavior; and one to reduce falls risk among Latinx older adults. Additionally, one intervention to improve balance using a modified tai chi program is being disseminated by another organization. CONCLUSION: CAARN's innovative structure creates a pipeline to dissemination by designing for real-world settings through inclusion of stakeholders in the early stages of design and by packaging community-based health interventions for older adults so they can be disseminated after the research has been completed. These interventions provide opportunities for clinicians to engage with community organizations to improve the health of their patients through self-management. J Am Geriatr Soc 68:1325-1333, 2020.

The Effect of Auricular Acupressure and Positive Group Psychotherapy With Motivational Interviewing for Smoking Cessation in Korean Adults.

The aim of this study was to investigate the effects of positive group psychotherapy with auricular acupressure on tobacco withdrawal symptoms and smoking cessation. This study used a randomized controlled trial design. Participants were randomly assigned to 1 of 3 groups: group 1 (counseling and auricular acupressure), group 2 (counseling and placebo acupressure), and the control group (self-help for smoking cessation). Positive group psychotherapy and auricular acupressure were performed once a week for 6 weeks. The smoking cessation rates for 1 year in groups 1 and 2 were higher than that in the control group (9.5%, 15.6%, and 0%, respectively; odd ratio: 7.98, P = .019, n = 109). There was a significant difference of tobacco withdrawal symptoms among the 3 groups over 4 weeks (F = 2.9, P = .04). The mean differences between week 1 and week 4 among the 3 groups were statistically significant (4.7 ± 6.96, 5.18 ± 7.9, and 0.14 ± 7.15, F = 4.25, P = .018).

Healthy Universities. The development and implementation of a holistic health promotion intervention programme especially adapted for staff working in the higher educational sector: the ARK study.

Underpinned by the Healthy Universities settings concept, this paper presents a holistic intervention approach, called ARK, to improve the health and well-being of academic staff. ARK (a Norwegian acronym for work environment and climate study) has been conducted in 18 universities and university colleges in Norway. The survey has collected information on employees' perceptions of the psychosocial work environment, well-being, and health from over 15,000 respondents. Further, it has provided valuable information and experiences on organizational development processes on how to successfully implement a health-promoting intervention programme. The aim of this paper is to present the ARK project and provide suggestions on how to conduct a health-promoting intervention programme in a university setting based on the experience and knowledge acquired from ARK. This understanding can inform and inspire the planning of future Health Promoting University initiatives to meet the distinctive needs of its employees.

Preparticipation Cardiovascular Screening: An Infrastructure Assessment in Collegiate Athletics.

OBJECTIVE: To assess the available infrastructure for secondary testing after preparticipation cardiovascular screening of collegiate athletes. DESIGN: Cross-sectional study. SETTING: National Collegiate Athletic Association (NCAA) athletic programs PARTICIPANTS:: Team physicians. INTERVENTIONS: Online survey distributed by the NCAA and American Medical Society for Sports Medicine. MAIN OUTCOME MEASURES: Availability of secondary cardiovascular diagnostic testing and services. RESULTS: Team physicians from 235 schools completed the assessment, representing 21% of all NCAA schools. Ninety (38.3%) NCAA team physicians reported screening athletes using electrocardiogram (ECG). Division I schools were more likely than Division II and III schools to perform both screening ECG (RR, 2.38, P < 0.0001) and echocardiogram (RR, 2.83, P = 0.01). More than 97% of schools had access to resting echocardiogram, stress ECG/echocardiogram, and Holter monitoring within 25 miles with no significant variability between divisions, regions, or size of undergraduate student body. Cardiac magnetic resonance imaging and electrophysiology studies were available within 25 miles of more than 80% of schools, and genetics testing was available within 25 miles for 64.8%. CONCLUSIONS: Secondary testing for cardiovascular abnormalities seems to be readily available for NCAA athletes, regardless of division, region, or school size.

The whole and inclusive university: a critical review of health promoting universities from Aotearoa New Zealand.

As well as serving as a critic and conscience for societies, universities are elite sites of privilege which, at a surface level, are unlikely locations for health promotion interventions. This paper provides a critical review of the existing health promoting universities (HPU) approaches which is informed by health promotion values. It explores the silence in the global literature around issues of structural discrimination such as the sexism, homophobia and institutional racism that can thrive within university settings. The existing literature also reveals a very limited engagement about positive mental health or indigeneity. In response, this paper brings together these three factors-structural discrimination, mental health, and indigeneity-all of which the authors consider are criterial to health and its promotion. The authors introduce the New Zealand university landscape, in which there are eight Western universities and three whare wananga (Maori universities), and, drawing on a survey of their Charters and other official statements, offer a moemoea (vision or dream) of an HPU that addresses structural discrimination, is based on holistic conceptions of health, and is centred on indigenous worldviews and concerns.

Engaging older people as university-based instructors: A model to improve the empathy and attitudes of pharmacists in training.

BACKGROUND AND PURPOSE: Clinical guidelines increasingly emphasise the importance of comprehensive and holistic care for older people. The objective of this education brief is to describe a workshop designed to improve first year pharmacy students' empathy and attitudes towards older people. EDUCATIONAL ACTIVITY AND SETTING: A two-hour, interactive, university-based workshop was developed and evaluated. Small groups of first year pharmacy students (approximately five per group) worked with an older person to complete a number of scaffolded activities focused on the older person's life experiences with pharmacy and medication usage. The effectiveness of this intervention was measured using an eight-item, pre- and post-workshop survey adapted from published scales. FINDINGS: Engaging older people as university-based instructors for first year pharmacy students was associated with significant improvements in three of the eight attitudinal items. Following the workshop, students were more likely to report that older people are: pleasant to be with (p < 0.001), more likely to understand what it feels like to have problems with aging (p < 0.005) and less likely to believe older people become less organised and more confused as they age (p < 0.001). SUMMARY: Engaging older people as university-based instructors for first year pharmacy students may be a useful strategy to develop empathy and positive attitudes towards older people. Further research is needed to determine if the attitudinal improvements are sustained over time.

Language, Culture, and Collectivism: Uniting Coalition Partners and Promoting Holistic Health in the Menominee Nation.

Recent perspectives on Indigenous health have recognized language, culture, and values as central to well-being and recovery from historical trauma. Health coalitions, which identify community health concerns and mobilize members to implement strategies for change, have begun to shift their focus from programs to policy, systems, and environmental change but have been slower to recognize the possibilities of centering Indigenous ways of being in their work. This article details a case study of the Menominee Wellness Initiative, an Indigenous health coalition that has increasingly made language, culture, and collective values the focus of their health promotion work, and often due to the participation and influence of community organizers in the coalition. The study is presented as a collaborative writing effort between coalition members and academic partners. Qualitative data were gathered through observations of coalition meetings; in-depth, semistructured interviews with coalition members; and interactive data analysis discussions within the collaborative writing team. In the results, we describe how the shift in the coalition's framework came to be and the influence this shift has had on the coalition, its activities, and its community impacts. These findings illustrate and extend understanding of several principles of Collaborating for Equity and Justice and supports literature and practice related to health promotion through the centering of Indigenous ways.

Developing and Pilot Testing an Integrated Technology-Moderated Institutional Health Promotion Model Using Operational Research Approach.

The study aimed to develop and pilot test an Integrated Technology-Moderated Institutional Health Promotion Model for university staff in Nigeria. An operational research approach using mixed concurrent design was adopted to develop the model, and pretest-posttest method was used to evaluate the utilization and effectiveness of the developed model. The participants in the study were university staff. Health-promoting lifestyle behavior and health status were measured via the adapted Health-Promoting Lifestyle Profile II instrument. The emerging model (an Integrated Technology-Moderated Institutional Health Promotion Model, which is an Android phone app named Tertiary Staff Health Promotion App) was deployed. Data were collected before and 12 weeks after the app deployment. The quantitative and qualitative data findings were combined to develop an integrated technology-moderated institutional health promotion model as a means to enhance health-promoting lifestyle behavior and health status of staff. The result of the pilot testing of the model showed that the model enhances health-promoting lifestyle behaviors and improves the health status of staff. Nurses, especially in community/public health nursing practice, can provide innovative interventions to drive and enhance health-promoting lifestyle behavior and improve health status of workers and other population groups through effective use of information and communication technology.

Improving Health Care Career Pipeline Programs for Underrepresented Students: Program Design that Makes a Difference.

BACKGROUND: Health care career pipeline training programs are one solution to increasing the number of minority and underrepresented health care providers. The Chicago Cancer Health Equity Collaborative (ChicagoCHEC) Research Fellows Program, a tri-institutional effort between the University of Illinois at Chicago (UIC), Northeastern Illinois University (NEIU), and Northwestern University (NU), provides a holistic, 8-week summer research fellowship that facilitates self-reflection, professional development, and exposes and guides the novice undergraduate and postbaccalaureate student toward a health care career inclusive of research and scientific discovery. OBJECTIVES: The number of underrepresented students achieving health care careers is minimal. We outline curriculum development, innovation, lessons learned, and selected outcomes from the first three cohorts of the ChicagoCHEC Research Fellows program. METHODS: A tri-institutional, collaborative curricular team was formed consisting of research faculty and staff at NEIU, UIC and NU. Once accepted, fellows experience a cohort model curriculum with particular emphasis to mindful inclusion of nontraditional students. The ChicagoCHEC Research Fellows Program uses evidence-based mentorship models, group reflection, and extensive program evaluation to continuously improve its program model. CONCLUSIONS: The 48 fellow alumni from the first 3 years reported high satisfaction with the program and will continued to be tracked for academic success. The ChicagoCHEC Research Fellows program will continue to provide academic and professional tools, sponsorship, and mentorship opportunities to underrepresented students as they progress toward health care careers. A program such as the ChicagoCHEC Fellows Program can serve as a useful model for increasing the number of minority researchers in health care careers.

Efficacy of the Mindfulness Meditation Mobile App "Calm" to Reduce Stress Among College Students: Randomized Controlled Trial.

BACKGROUND: College students experience high levels of stress. Mindfulness meditation delivered via a mobile app may be an appealing, efficacious way to reduce stress in college students. OBJECTIVE: We aimed to test the initial efficacy and sustained effects of an 8-week mindfulness meditation mobile app-Calm-compared to a wait-list control on stress, mindfulness, and self-compassion in college students with elevated stress. We also explored the intervention's effect on health behaviors (ie, sleep disturbance, alcohol consumption [binge drinking], physical activity, and healthy eating [fruit and vegetable consumption]) and the feasibility and acceptability of the app. METHODS: This study was a randomized, wait-list, control trial with assessments at baseline, postintervention (8 weeks), and at follow-up (12 weeks). Participants were eligible if they were current full-time undergraduate students and (1) at least 18 years of age, (2) scored ≥14 points on the Perceived Stress Scale, (3) owned a smartphone, (4) were willing to download the Calm app, (5) were willing to be randomized, and (7) were able to read and understand English. Participants were asked to meditate using Calm at least 10 minutes per day. A P value ≤.05 was considered statistically significant. RESULTS: A total of 88 participants were included in the analysis. The mean age (SD) was 20.41 (2.31) years for the intervention group and 21.85 (6.3) years for the control group. There were significant differences in all outcomes (stress, mindfulness, and self-compassion) between the intervention and control groups after adjustment for covariates postintervention (all P<.04). These effects persisted at follow-up (all P<.03), except for the nonreacting subscale of mindfulness (P=.08). There was a significant interaction between group and time factors in perceived stress (P=.002), mindfulness (P<.001), and self-compassion (P<.001). Bonferroni posthoc tests showed significant within-group mean differences for perceived stress in the intervention group (P<.001), while there were no significant within-group mean differences in the control group (all P>.19). Similar results were found for mindfulness and self-compassion. Effect sizes ranged from moderate (0.59) to large (1.24) across all outcomes. A significant group×time interaction in models of sleep disturbance was found, but no significant effects were found for other health behaviors. The majority of students in the intervention group reported that Calm was helpful to reduce stress and stated they would use Calm in the future. The majority were satisfied using Calm and likely to recommend it to other college students. The intervention group participated in meditation for an average of 38 minutes/week during the intervention and 20 minutes/week during follow-up. CONCLUSIONS: Calm is an effective modality to deliver mindfulness meditation in order to reduce stress and improve mindfulness and self-compassion in stressed college students. Our findings provide important information that can be applied to the design of future studies or mental health resources in university programs. TRIAL REGISTRATION: ClinicalTrials.gov NCT03891810; https://clinicaltrials.gov/ct2/show/NCT03891810.

The Mindfulness App Trial for Weight, Weight-Related Behaviors, and Stress in University Students: Randomized Controlled Trial.

BACKGROUND: University students are at risk of weight gain during their studies. Key factors related to weight gain in this population include unhealthy weight-related behaviors because of stress. Mindfulness holds promise for weight management. However, there has not been any previous trial that has explored the effectiveness of a student-tailored mindfulness app for stress, weight-related behaviors, and weight. There is limited evidence that current mindfulness apps use evidence-based mindfulness techniques. A novel app was developed that combined evidence-based, mindfulness-based stress reduction and mindful eating (ME) techniques that were tailored to university students, with student-relevant themes for targeting weight behaviors, weight, and stress. OBJECTIVES: The aim of this study was to test the effectiveness, acceptability, and feasibility of a student-tailored mindfulness app for weight, weight-related behaviors, and stress. Testing this app in a rigorous randomized controlled trial (RCT) for these outcomes is a novelty and contribution to this emerging field. METHODS: A 2-arm RCT of an 11-week duration was undertaken at the University of Queensland. Students were either randomized to the mindfulness app (n=45) or to a behavioral self-monitoring electronic diary (e-diary; n=45) for diet and exercise. Analysis of covariance was used to compare differences in weight, stress, mindfulness, ME, physical activity, and eating behaviors between both groups. RESULTS: Neither the mindfulness app group nor the e-diary group lost weight and there were no differences between the groups at follow-up. The mindfulness app group had significantly lower stress levels (P=.02) (adherers only), lower emotional eating (P=.02), and uncontrolled eating (P=.02) as well as higher mindfulness (P≤.001) and ME levels overall (P≤.001). The e-diary group had higher metabolic equivalents of moderate activity levels (P≤.01). However, the effect sizes were small. Regular adherence to mindfulness exercises in the app was low in the group. The majority of students (94%) liked the app and found it to be acceptable. Compared with other exercises, the most helpful reported meditation was the short breathing exercise observing the breath (39.4% [13/33] preferred it). This was the first RCT that tested a mindfulness app for weight and weight-related behaviors in students. The modest level of user adherence likely contributes to the lack of effect on weight loss. However, there was a small, albeit promising, effect on weight-related eating behavior and stress. CONCLUSIONS: A mindfulness app demonstrated effectiveness for stress, eating behaviors, mindfulness, and ME, but the effect sizes were small. Future studies should be conducted over longer periods of time and with greater participant compliance. TRIAL REGISTRATION: Australian New Zealand Trial Registry ACTRN12616001349437; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=371370 (Archived by WebCite at http://www.webcitation.org/761cc2K6ft).

An investigation of Australian midwifery curricula for obesity management and health behaviour change training.

INTRODUCTION: Fifty percent of Australian women enter pregnancy overweight or obese. Unfortunately, few women receive weight management advice from health professionals during pregnancy. The aim of this study was to investigate current midwifery curricula from Australian universities to identify strengths and deficits in the teaching of preconception and antenatal weight management. METHODS: Midwifery courses from 20 universities were identified. Of the 568 units taught at these universities, 252 course outlines were obtained. Data were coded using the qualitative analysis technique of Framework Analysis for the following main themes: 1) the effect of weight, diet and physical activity on health outcomes for women who are pregnant or planning a pregnancy; 2) weight management advice in any population; and 3) health behaviour change techniques in any context. RESULTS: Analysis revealed a variety of teaching methods and skills training that emphasised the importance of clinical judgement and autonomous clinical practice, in conjunction with critical enquiry and sourcing reputable evidence. There was little evidence, however, that weight management advice was taught explicitly to midwifery students in the curricula. DISCUSSION: A greater emphasis on skilling midwifery students to address weight gain during pregnancy, and behavioural techniques to achieve this, is required.