The Association of School Learning Environment With Adolescent Health Behaviors.

BACKGROUND: In 2020, schools shifted to remote learning in response to mitigating COVID-19. Since then, students have fluctuated between in-person and remote learning environments. Changes to instructional models raise questions about the impact on health. METHODS: This study leveraged a statewide surveillance system (Healthy Kids Colorado Survey) to examine the relationship between learning environment and adolescent health. The survey was administered in Fall 2020 to 26 high schools, resulting in 4564 respondents. RESULTS: Overall, results suggested positive and negative associations between the 3 learning environments. Notably, as compared to in-person students, hybrid and remote students reported more stress (OR = 1.82, p < .001; OR = 1.41, p = .001), less school connectedness (OR = 0.71 and 0.61, p < .001); remote students reported more parental abuse (OR = 1.33, p = .010) and less alcohol consumption (OR = 0.61, p < .001). CONCLUSION: This study may be used to better understand risk and protective factors experienced by youth at school and home with the goal of improving prevention strategies.

My Baby, My Move+: feasibility of a community prenatal wellbeing intervention.

BACKGROUND: Excessive gestational weight gain (EGWG), insufficient prenatal physical activity and sleep, and poor psychological wellbeing independently increase risks for adverse maternal and infant outcomes. A novel approach to mitigate these risks is utilizing peer support in a community-based prenatal intervention. This study assessed the feasibility (acceptability, demand, implementation, and practicality) of a remotely delivered prenatal physical activity intervention called My Baby, My Move + (MBMM +) that aims to increase prenatal physical activity, enhance mood and sleep hygiene, and reduce EGWG. METHODS: Participants were recruited through community organizations, local clinics, and social media platforms in the Fall of 2020 and Spring of 2021. Eligible pregnant women were randomized to either the MBMM + intervention or the control group. Each group met over Zoom for 16 sessions (twice weekly for 60 min over 8 weeks) to learn either behavioral change and wellbeing knowledge and skills (MBMM +) or knowledge and skills related to parenting (control group). Multiple methods of evaluation to better understand the feasibility of the intervention were conducted. RESULTS: A total of 49 women (25 MBMM + intervention, 24 control) completed both pre- and post-survey assessments and were included in the analyses. A subsample of 19 (39%) intervention participants completed a combination of semi-structured interviews/surveys to assess acceptability, demand, implementation, and practicality. Participants expressed positive feedback regarding acceptability (satisfaction and intent to continue use) and were extremely likely or likely to recommend the program to a friend (demand). Implementation metrics were assessed by observation and feedback forms completed by peer leaders and demonstrated high-quality control. Findings suggest that the intervention was practical due to remote sessions and cost-effectiveness. CONCLUSION: The MBMM + intervention was deemed to be a feasible intervention with high acceptability, demand, implementation, and practicality. These findings can be used to inform the scalability of the intervention and implementation of a larger efficacy trial. TRIAL REGISTRATION: 19-1366, initial date is on January 23, 2020.

Impact of maternal body mass index on neonate birthweight and body composition.

OBJECTIVE: The purpose of this study was to compare bodyweight and composition (percent fat, fat mass, and fat-free mass) in neonates born to mothers with a normal pregravid body mass index (BMI; < 25 kg/m(2)) vs neonates born to mothers with an overweight/obese pregravid BMI (> or = 25 kg/m(2)). STUDY DESIGN: Seventy-two neonates (33 from normal mothers and 39 from overweight/obese mothers) of singleton pregnancies with normal glucose tolerance had their bodyweight and body composition assessed by air-displacement plethysmography. RESULTS: After controlling for neonate age at time of testing, significant differences were found between groups for percent fat (12.5 +/- 4.2% vs 13.6 +/- 4.3%; P < or = .0001), fat mass (414.1 +/- 264.2 vs 448.3 +/- 262.2 g; P < or = .05), and fat-free mass (3310.5 +/- 344.6 vs 3162.2 +/- 343.4 g; P < or = .05), with no significant differences between birth length (50.7 +/- 2.6 vs 49.6 +/- 2.6 cm; P = .08) or birthweight (3433.0 +/- 396.3 vs 3368.0 +/- 399.6 g; P = .44). CONCLUSION: Neonates born to mothers who have a normal BMI have significantly less total and relative fat and more fat-free mass than neonates born to overweight/obese mothers. Although preliminary, these data suggest that the antecedents of future disease risk (eg, cardiovascular disease, diabetes, and obesity) occur early in life.

Effect of the summer months on body weight and composition in college women.

BACKGROUND AND OBJECTIVES: College students and young adults are experiencing the greatest increases in rates of obesity, and 20% of college students are classified as obese. The objective of this study was to compare changes and rates of change in body weight and body composition between the freshman academic year and the summer after the freshman year among female college students. METHODS: Participants were recruited early in their freshman year of college to participate in a prospective longitudinal study examining changes in body weight and composition over the college years. Height and weight were measured, and body composition was assessed using dual energy x-ray absorptiometry (DEXA) at the beginning and end of the freshman year. Upon return from the summer for their sophomore year, participants returned to have all measurements repeated. Sixty-nine female participants completed all three visits. RESULTS: Body weight increased 1.3 kg during the academic period and an additional 0.1 kg during the summer period. Body mass index (BMI) increased between the first two visits but did not change between the last two visits. However, percent fat increased at each visit. Fat-free mass significantly increased 0.5 kg over the academic year but decreased by 1.1 kg over the summer (p<0.05). Greater rates of change were detected in percent fat, fat-free mass, and BMI during the summer compared with the academic year (p<0.05). CONCLUSIONS: Differences in body composition between the academic and summer periods may reflect changes in living situations between these periods. Unfavorable changes during the summer suggest the need to promote healthy lifestyles to freshman women before they leave campus for the summer.

Characterization of body weight and composition changes during the sophomore year of college.

BACKGROUND: Years spent in college represents a critical time for obesity development though little information is known regarding how body weight and composition changes beyond the first year of college. The aim of this study was to investigate changes in body weight and composition and the factors influencing those changes among sophomore females. METHODS: Body composition by dual energy X-ray absorptiometry was obtained in participants beginning during their freshman year and continued through their sophomore year. RESULTS: No difference was observed between sophomore year fall and spring visits for body weight (60.4 versus 60.6 kg) or fat mass (19.3 versus 18.7 kg). However, a significant (P < or = 0.05) decrease was observed for body fat (31.9 versus 30.9 %fat) and a significant increase was observed for fat-free mass (37.7 versus 38.4 kg). Participants living off campus significantly (P < or = 0.05) declined in body fat (33.0 versus 31.0 %fat) and fat mass (19.4 versus 18.2 kg) and increased in fat-free mass (36.1 versus 37.2 kg) with no differences in those living on campus. CONCLUSION: No change in body weight was observed in females during their sophomore year. However, an increase in fat-free mass accompanied with a decrease in fat mass resulted in a decrease in body fat. Participants living off campus had favorable changes in their body composition by means of decreasing %fat and fat mass while increasing fat-free mass. Participants living on campus did not demonstrate these favorable changes.

Comparison of two email-delivered, pedometer-based interventions to promote walking among insufficiently active women.

Research on the effect of email-delivered, pedometer-based interventions on walking behavior and transtheoretical model (TTM) constructs is lacking. Therefore, the purpose of this study was to compare the effectiveness of two email-delivered, pedometer-based interventions designed to increase walking and TTM construct scores among insufficiently active women. Participants were randomly assigned to one of two 6-week intervention groups. Both groups wore pedometers, submitted step logs, and received weekly email reminders. One group also received in the emails suggested strategies based on TTM for increasing physical activity. Of the 74 women who began the study, 56 (age=41.5+/-7.6 years; body mass index=31.2+/-6.6kg/m(2); 86% Caucasian) completed the International Physical Activity Questionnaire and TTM questionnaires at baseline and post-intervention. Participants in both groups combined increased weekly time spent walking (p=0.002) and their scores on TTM cognitive processes, behavioral processes, pros, and cons changed (p< or =0.001) from baseline to post-intervention. The changes in walking and TTM scores did not differ between groups (p>0.05). The results of this study indicate that email-delivered, pedometer-based interventions may impact walking and most TTM scores among insufficiently active women. Although preliminary, the findings provide additional evidence that this low-cost method of intervening may be an effective approach to combat physical inactivity in women.

Demographic Trends in Utah College Students' Vigorous Physical Activity, 2003-2007.

OBJECTIVES: This analysis of a large-scale survey of college students from 2003 to 2007 explores relationships between meeting vigorous physical activity (VPA) recommendations and key demographic, lifestyle, and personal characteristics. METHODS: Multivariate logistic regression modeling was used to analyze VPA data from the Utah Higher Education Health Behavior Survey, a descriptive cross-sectional survey conducted in 2003 (N = 4574), 2005 (N = 9673) and 2007 (N = 7938). RESULTS: Factors consistently associated with meeting VPA recommendations included involvement in extracurricular sports, being single, and daily consumption of fruits or vegetables. In contrast, factors such as older age (> 23 years old), having a particularly low (<18.5 kg˙m2) or high BMI (> 34.9 kg˙m2), and being a current smoker were associated with not meeting the VPA recommendation. This corroborates paradoxical findings that binge alcohol consumption correlates with meeting VPA. CONCLUSIONS: Findings support the need for targeted interventions among college students to support the establishment of long-term protective behavioral patterns against chronic disease risk throughout the life course.

Accelerometer-determined physical activity of free-living college students.

PURPOSE: This study was conducted to provide descriptive data of accelerometer-determined ambulatory physical activity in a sample of free-living college students and to examine college students' ambulatory physical activity patterns. METHODS: All participants (245 females, age = 19.9 +/- 1.6 yr, body mass index (BMI) = 22.9 +/- 3.3 kg x m(-2); 209 males, age = 20.2 +/- 2.0 yr, BMI = 25.2 +/- 4.0 kg x m(-2)) wore an accelerometer for seven consecutive days. Accumulated physical activity (ct.d, ct x min(-1) x d(-1), and min x d(-1) spent at different intensities) and minutes per day spent in moderate or vigorous physical activity in sessions of at least 10 min were analyzed to describe the physical activity of the sample and examine physical activity patterns. RESULTS: The entire sample accumulated 362,750.1 +/- 112,824.1 ct x d(-1) (males = 383,787.2 +/- 112,001.3 vs females = 344,804.1 +/- 110,619.5 ct x d(-1), P < 0.01) and 46.7 +/- 18.9 min x d(-1) in moderate physical activity (males = 51.7 +/- 19.8 vs females = 42.5 +/- 17.0 min x d(-1), P < 0.01). They were more active on weekdays than weekend days (P < 0.05), and they spent 13.6 +/- 12.7 min x d(-1) (males = 13.2 +/- 12.0 vs females = 13.8 +/- 13.3, P > 0.05) in moderate or vigorous physical activity sessions of at least 10 min. CONCLUSION: Participants in this study accumulated a moderate amount of physical activity on most weekdays. Most participants, however, were not meeting the current moderate physical activity recommendation when moderate or vigorous physical activity sessions of at least 10 min were examined.

The effect of the Thanksgiving holiday on weight gain.

BACKGROUND: More people than ever are considered obese and the resulting health problems are evident. These facts highlight the need for identification of critical time periods for weight gain. Therefore the purpose was to assess potential changes that occur in body weight during the Thanksgiving holiday break in college students. METHODS: 94 college students (23.0 +/- 4.6 yrs, 72.1 +/- 14.0 kg, 172.6 +/- 9.3 cm, 24.0 +/- 3.9 kg/m2) reported to the human body composition laboratory at the University of Oklahoma following a 6-hour fast with testing occurring prior to, and immediately following the Thanksgiving holiday break (13 +/- 3 days). Body weight (BW) was assessed using a balance beam scale while participants were dressed in minimal clothing. Paired t-tests were used to assess changes in BW pre and post Thanksgiving holiday with additional analysis by gender, body mass index (BMI), and class standing (i.e. undergraduate vs. graduate). RESULTS: Overall, a significant (P < 0.05) increase in BW was found between pre (72.1 kg) and post (72.6 kg) Thanksgiving holiday. When stratified by gender and class standing a significant (P < 0.05) increase in body weight was observed between the pre and post Thanksgiving holiday in males (0.6 kg), females (0.4 kg) and graduate students (0.8 kg). When participants were classified by BMI as normal or as overweight/obese, a significant 1.0 kg BW gain was found (P < 0.05) in the overweight/obese (>/=25 kg/m2) group compared to a non significant 0.2 kg gain in the normal group (<25 kg/m2). CONCLUSION: These data indicate that participants in our study gained a significant amount of BW (0.5 kg) during the Thanksgiving holiday. While an increase in BW of half a kilogram may not be cause for alarm, the increase could have potential long-term health consequences if participants retained this weight gain throughout the college year. Additionally, because the overweight/obese participants gained the greatest amount of BW, this group may be at increased risk for weight gain and further obesity development during the holiday season.

Barriers to Physical Activity Among Gay Men.

Gay men may not be physically active at recommended levels to achieve health benefits. Thus, a need exists to identify general (i.e., common across populations) and population-specific barriers that hinder or stop gay men from participating in physical activity (PA). Salient barriers may be identified through the extent each barrier limits PA (i.e., barrier limitation) and the level of one's confidence to overcome barriers and engage in PA (i.e., self-regulatory efficacy). The purposes of this study were to (1) provide a description of general and population-specific barriers to PA among sufficiently and insufficiently active gay men, (2) identify barrier limitation and self-regulatory efficacy for the reported barriers, and (3) examine the associations between meeting the current PA recommendation, barrier limitation, and self-regulatory efficacy. Participants were 108 self-identified gay males aged 21 to 64 years who completed a web-based survey. A total of 35 general barriers and no population-specific barriers were identified by the sufficiently and insufficiently active groups. The sufficiently active group reported higher self-regulatory efficacy and lower barrier limitation for nearly all reported barriers. A binary logistic regression used to examine the associations between PA, barrier limitation, and self-regulatory efficacy was statistically significant, χ(2)(2, N = 108) = 19.26, p < .0001, R(2) = .16. Only barrier limitation significantly contributed to the model. Future research should continue to examine barriers to PA among gay men to determine whether an intervention needs to be designed specifically for gay men or whether a one-size-fits-all intervention would be effective in helping all men overcome common barriers to engaging in PA.

Feasibility of a minimal contact intervention to promote walking among insufficiently active women.

PURPOSE: To examine the impact of a 6-week minimal contact intervention on walking behavior, the 10 processes of change of the transtheoretical model (TTM), and self-efficacy among insufficiently active women. METHODS: This study used a pre-experimental design. Of the 43 women who began the study, 36 (84%) completed questionnaires at baseline and postintervention. They were given brochures and pedometers and were sent e-mails that contained messages designed to positively affect TTM constructs. Changes in time spent walking, use of the 10 processes of change, and self-efficacy were analyzed using Wilcoxon signed rank tests and paired t-tests. RESULTS: Participants significantly increased their total walking minutes (p = .001) and use of counterconditioning, dramatic relief reinforcement management, self-liberation, stimulus control, and social liberation (p < .05). DISCUSSION: The findings of this feasibility study provide preliminary evidence that this theoretically based, minimal contact lifestyle intervention may be an effective, low-cost approach to increase walking among insufficiently active women.

An Examination of Health Inequities among College Students by Sexual Orientation Identity and Sex.

BACKGROUND: Lesbian, gay, and bisexual (LGB) college students may have an increased number of health inequities compared to their heterosexual counterparts. However, to date, no research has provided a comprehensive examination of health-related factors by sexual orientation identity and sex among a national sample of college students. Thus, the purpose of this study was to examine physical, sexual, interpersonal relations/safety, and mental health inequities by sexual orientation identity and sex among a national sample of college students. DESIGN AND METHODS: Participants (n=39,767) completed the National College Health Assessment II during the fall 2008/spring 2009 academic year. Hierarchical binary logistic regression analyses were used to examine health inequities by sexual orientation identity and sex. RESULTS: LGB students compared to heterosexual students, experienced multiple health inequities including higher rates of being verbally threatened and lower rates of physical activity and condom use. CONCLUSIONS: An understanding of health inequities experienced by LGB college students is critical as during these years of transition, students engage in protective (e.g., physical activity) and risky (e.g., lack of condom use) health behaviours, establishing habits that could last a lifetime. Future research should be used to design and implement targeted public health strategies and policies to reduce health inequities and improve health-related quality of life among LGB college students. Significance for public healthHealth inequities based on sexual orientation identity and sex among college students is a critical public health concern. Based on the results of the current study, lesbian, gay, and bisexual (LGB) college students experienced multiple physical, sexual, interpersonal relations and safety, and mental health inequities. This understanding of health inequities experienced by LGB college students is critical as during these years of transition, students engage in protective (e.g., physical activity) and risky (e.g., lack of condom use) health behaviours, establishing habits that could last a lifetime. By intervening during the college years, targeted public health strategies and policies can be designed and implemented to reduce health inequities and improve health-related quality of life among LGB individuals during mid-to-later adulthood.

Minimal-contact physical activity interventions in women: a pilot study.

OBJECTIVE: To examine the impact of 3 minimal-contact lifestyle interventions on physical activity in women. METHODS: Fifty female volunteers were randomly assigned to one of 3 lifestyle physical activity interventions for 8 weeks. Subjects wore an accelerometer for a week at baseline and postintervention to objectively monitor their physical activity. RESULTS: Participants significantly increased their physical activity from baseline to postintervention; however, there was no significant difference in physical activity among the 3 intervention groups. CONCLUSIONS: Results of this pilot study support the use of minimal-contact lifestyle interventions to promote physical activity in women.

Associations between physical activity and health-related factors in a national sample of college students.

OBJECTIVE: To examine associations between meeting the current moderate to vigorous physical activity (MVPA) recommendation and health-related factors in a national sample of college students. PARTICIPANTS: Participants (N = 67,861) completed the National College Health Assessment II during the Fall 2008/Spring 2009 academic year. METHODS: Hierarchical binary logistic regression was used to examine the contribution of 19 variables in explaining whether or not participants met the MVPA recommendation. RESULTS: Meeting the MVPA recommendation was associated with several protective factors among college students, including adequate daily fruit and vegetable consumption, positive perception of general health, healthy body mass index, consistent seatbelt use, not smoking cigarettes, less perceived depression, and adequate sleep. In addition, meeting the MVPA recommendation was also significantly associated with a few risky behaviors including binge drinking, physical fighting, and multiple sexual partners. CONCLUSIONS: College student PA interventions should consider also addressing fruit/vegetable consumption and binge drinking.

Sociodemographic and lesbian-specific factors associated with physical activity among adult lesbians.

BACKGROUND: Although participation in moderate and vigorous physical activity (MVPA) results in health benefits, the majority of adult lesbians are not sufficiently active. The purpose of this study was to examine the relationships between sociodemographic factors (age, education level, body mass index [BMI], race, partner status, employment status, annual household income, general health status, diagnosis of chronic conditions, children under 18 years living at home) and lesbian-specific factors (connection with the lesbian community, public identification as a lesbian) to participation in MVPA. METHODS: Participants included 847 self-identified lesbians 18 to 74 years old (M(age) = 40.5; SD = 11.6) who completed a 20-minute, web-based survey. FINDINGS: The binary logistic regression model that included the 10 demographic factors was significantly associated with MVPA, χ(2) (15, N = 847) = 105.62, p < .001. However, when the two lesbian-specific factors were added, the model did not improve significantly, χ(2) (2, N = 847) = 5.20, p = .07. BMI and general health status were significantly associated with MVPA (Wald χ(2) (2) = 19.5, p < .001) and (Wald χ(2) (4) = 41.2, p < .001). Obese participants had 54.5% lower odds than healthy weight participants to engage in sufficient amounts of MVPA. Participants who reported general health status as excellent compared with those who reported poor had 12.7 times greater odds of engaging in sufficient amounts of MVPA. CONCLUSIONS: Future research should extend on this study by utilizing sampling methods that target the recruitment of lesbian women not actively involved in lesbian-related activities.

Comparisons of accelerometer and pedometer determined steps in free living samples.

BACKGROUND: The purpose of this study was to compare steps·d-1 between an accelerometer and pedometer in 2 free-living samples. METHODS: Data from 2 separate studies were used for this secondary analysis (Sample 1: N = 99, Male: n = 28, 20.9 ± 1.4 yrs, BMI = 27.2 ± 5.0 kg·m-2, Female: n = 71, 20.9 ± 1.7 yrs, BMI = 22.7 ± 3.0 kg·m-2; Sample 2: N = 74, Male: n = 27, 38.0 ± 9.5 yrs, BMI = 25.7 ± 4.5 kg·m-2, Female: n = 47, 38.7 ± 10.1 yrs, BMI = 24.6 ± 4.0 kg·m-2). Both studies used identical procedures and analytical strategies. RESULTS: The mean difference in steps·d-1 for the week was 1643.4 steps·d-1 in Study 1 and 2199.4 steps·d-1 in Study 2. There were strong correlations between accelerometer- and pedometer-determined steps·d-1 in Study 1 (r = .85, P < .01) and Study 2 (r = 0.87, P < .01). Bland-Altman plots indicated agreement without bias between steps recorded from the devices in Study 1 (r = -0.14, P < .17) and Study 2 (r = -0.09, P < .40). Correlations examining the difference between accelerometer-pedometer steps·d-1 and MVPA resulted in small, inverse correlations (range: r = -0.03 to -0.28). CONCLUSIONS: These results indicate agreement between accelerometer- and pedometer-determined steps·d-1; however, measurement bias may still exist because of known sensitivity thresholds between devices.

Motion sensor reactivity in physically active young adults.

The purpose of this study was to examine whether young adults changed their physical activity (PA) behavior when wearing motion sensors. PA patterns of 119 young adults (M age = 20.82 years, SD = 1.50, M body mass index = 23.93 kg/m2, SD = 4.05) were assessed during 2 consecutive weeks. In Week 1, participants wore an accelerometer. During Week 2, participants wore an accelerometer and a pedometer Counts/day from the accelerometer were examined over the entire study period. Steps/day from the pedometer were examined during Week 2. Descriptive statistics and two-factor repeated-measures analysis of variance were calculated. There were significant differences in counts/day by study day during both weeks of the study (Week 1, p < .0001; Week 2, p < .0001), and steps/day during Week 2 (p < .0001). However, reactivity was not evident. Subsequent investigation by day of the week revealed these differences were due to changes in participants' PA behavior by weekdays and weekends. With respect to gender, men were more active than women during both weeks of monitoring, but daily PA behavior between the genders followed a similar pattern. In conclusion, reactivity to accelerometers and pedometers was not evident in this sample.

Freshman 15: fact or fiction?

OBJECTIVE: The objective of this study was to investigate changes in body weight, BMI, body composition, and fat distribution among freshman women during their 1st year of college. RESEARCH METHODS AND PROCEDURES: Freshman women during the 2004 to 2005 academic year were recruited to participate. The initial baseline visit occurred within the first 6 weeks of the fall 2004 semester, with the follow-up visit occurring during the last 6 weeks of the spring 2005 semester. At each visit, height, weight, BMI, waist and hip circumferences, and body composition (by DXA) were obtained. RESULTS: One hundred thirty-seven participants completed both the fall and spring visits. Significant (p < 0.0001) increases between the fall and spring visits were observed for body weight (58.6 vs. 59.6 kg), BMI (21.9 vs. 22.3), percentage body fat (28.9 vs. 29.7), total fat mass (16.9 vs. 17.7 kg), fat-free mass (38.1 vs. 38.4 kg), waist circumference (69.4 vs. 70.3 cm), and hip circumference (97.4 vs. 98.6 cm), with no significant difference observed in the waist-to-hip ratio (0.71 vs. 0.71; p = 0.78). DISCUSSION: Although statistically significant, changes in body weight, body composition, and fat mass were modest for women during their freshman year of college. These results do not support the purported "freshman 15" weight gain publicized in the popular media.

Experiences of women in a minimal contact pedometer-based intervention: a qualitative study.

BACKGROUND: Minimal contact pedometer-based interventions are gaining in popularity as a cost-effective method of promoting physical activity. The experiences of women in these interventions, however, have not been adequately studied. PURPOSE: This study used focus groups to explore women's experiences in a minimal contact pedometer-based intervention. METHODS: Participants were women aged 31 to 51 years who completed a 6-week minimal contact pedometer-based intervention. Before the intervention, all participants were inactive or irregularly active. For the intervention, participants wore pedometers, completed weekly logs of daily steps taken, created physical activity goals, and received weekly emails. Email messages contained strategies for increasing physical activity and served as reminders to wear the pedometer and submit the step logs. After the intervention, participants were invited to attend focus groups to discuss their experiences in the intervention. A generic qualitative research approach was used to analyze the data. RESULTS: Wearing the pedometer helped participants set goals and motivated them to increase their physical activity. Submitting step logs made them accountable. They wanted more innovative tips in the emails for increasing physical activity. DISCUSSION: Our results suggest that the effectiveness of minimal contact interventions may be enhanced by including pedometers, step logs, and email reminders.