The Gehan test identifies life-extending compounds overlooked by the log-rank test in the NIA Interventions Testing Program: Metformin, Enalapril, caffeic acid phenethyl ester, green tea extract, and 17-dimethylaminoethylamino-17-demethoxygeldanamycin hydrochloride.

The National Institute on Aging Interventions Testing Program (ITP) has so far identified 12 compounds that extend the lifespan of genetically heterogeneous mice using the log-rank test. However, the log-rank test is relatively insensitive to any compound that does not uniformly reduce mortality across the lifespan. This test may thus miss compounds that only reduce mortality before midlife, for example, a plausible outcome if a compound only mitigates risk factors before midlife or if its efficacy is reduced at later ages. We therefore reanalyzed all data collected by the ITP from 2004-2022 using the Gehan test, which is more sensitive to mortality differences earlier in the life course and does not assume a uniformly reduced mortality hazard across the lifespan. The Gehan test identified 5 additional compounds, metformin, enalapril, 17-dimethylaminoethylamino-17-demethoxygeldanamycin hydrochloride (17-DMAG), caffeic acid phenethyl ester (CAPE), and green tea extract (GTE), which significantly increased survival but were previously missed by the log-rank test. Three (metformin, enalapril, and 17-DMAG) were only effective in males and two (CAPE and GTE) were only effective in females. In addition, 1,3-butanediol, which by log-rank analysis increased survival in females but not males, increased survival in males by the Gehan test. These results suggest that statistical tests sensitive to non-uniformity of drug efficacy across the lifespan should be included in the standard statistical testing protocol to minimize overlooking geroprotective interventions.

Extending lifespan by modulating the growth hormone/insulin-like growth factor-1 axis: coming of age.

Progress made in the years of aging research have allowed the opportunity to explore potential interventions to slow aging and extend healthy lifespan. Studies performed in yeast, worms, flies and mice subjected to genetic and pharmacological interventions have given insight into the cellular and molecular mechanisms associated with longevity. Furthermore, it is now possible to effectively modulate pathways that slow aging at different stages of life (early life or at an adult age). Interestingly, interventions that extend longevity in adult mice have had sex-specific success, suggesting a potential link between particular pathways that modulate aging and sex. For example, reduction of the growth hormone (GH)/insulin-like growth factor-1 (IGF-1) axis at an adult age extends lifespan preferentially in females. Moreover, several postnatal dietary interventions tested by the 'Intervention Testing Program (ITP)' from the National Institute of Aging (NIA) have shown that while pharmacological interventions like rapamycin affect the IGF-1/insulin pathway and preferentially extend lifespan in females; dietary compounds that target other cellular pathways are effective only in male mice-indicating mutually exclusive sex-specific pathways. Therefore, a combination of interventions that target non-overlapping aging-related pathways appears to be an effective approach to further extend healthy lifespan in both sexes. Here, we review the germline and postnatal mouse lines that target the GH/IGF-1 axis as a mechanism to extend longevity as well as the dietary compounds that tested positive in the NIA program to increase lifespan. We believe that the interventions reviewed in this paper could constitute feasible combinations for an extended healthy lifespan in both male and female mice.

Does Skin in the Game Matter if You Aren't Playing? Examining Participation in Oregon's Public Employee Health Engagement Model.

PURPOSE: Employers are increasingly exploring health benefits that incentivize lifestyle change for employees. We used early data from an ongoing study of one such model-the Health Engagement Model (HEM), which Oregon implemented for all public employees in 2012-to analyze variation in employee participation and engagement. DESIGN: A survey was designed to assess program engagement, opinions of the program, and self-reported lifestyle changes. SETTING: Data were collected in 2012, about 9 months after HEM launched. SUBJECTS: A representative random sample of 4500 state employees served as the study subjects. MEASURES: Primary measures included whether employees signed up for the program, completed its required activities, and reported making lifestyle changes. ANALYSIS: Logistic regression was used to analyze survey results. RESULTS: Most employees (86%) chose to participate, but there were important socioeconomic differences: some key target populations, including smokers and obese employees, were the least likely to sign up; less educated employees were also less likely to complete program activities. Despite mostly negative opinions of the program, almost half of participants reported making lifestyle changes. CONCLUSION: Oregon's HEM launch was largely unpopular with employees, but many reported making the desired lifestyle changes. However, some of those the program is most interested in enrolling were the least likely to engage. People involved with implementing similar programs will need to think carefully about how to cultivate broad interest among employees.

Advancing School and Community Engagement Now for Disease Prevention (ASCEND).

PURPOSE: To compare two intensity levels (standard vs. enhanced) of a nutrition and physical activity intervention vs. a control (usual programs) on nutrition knowledge, body mass index, fitness, academic performance, behavior, and medication use among elementary school students. DESIGN: Quasi-experimental with three arms. SETTING: Elementary schools, students' homes, and a supermarket. SUBJECTS: A total of 1487 third-grade students. INTERVENTION: The standard intervention (SI) provided daily physical activity in classrooms and a program on making healthful foods, using food labels. The enhanced intervention (EI) provided these plus additional components for students and their families. MEASURES: Body mass index (zBMI), food label literacy, physical fitness, academic performance, behavior, and medication use for asthma or attention-deficit hyperactivity disorder (ADHD). ANALYSIS: Multivariable generalized linear model and logistic regression to assess change in outcome measures. RESULTS: Both the SI and EI groups gained less weight than the control (p < .001), but zBMI did not differ between groups (p = 1.00). There were no apparent effects on physical fitness or academic performance. Both intervention groups improved significantly but similarly in food label literacy (p = .36). Asthma medication use was reduced significantly in the SI group, and nonsignificantly (p = .10) in the EI group. Use of ADHD medication remained unchanged (p = .34). CONCLUSION: The standard intervention may improve food label literacy and reduce asthma medication use in elementary school children, but an enhanced version provides no further benefit.

Active8! Technology-Based Intervention to Promote Physical Activity in Hospital Employees.

PURPOSE: Increase physical activity in health care employees using health messaging, and compare e-mail with mobile phone short-message service (SMS) as delivery channels. DESIGN: Randomized controlled trial Setting. U.K. hospital workplace. SUBJECTS: Two hundred ninety-six employees (19-67 years, 53% of study Web site visitors). INTERVENTION: Twelve-week messaging intervention designed to increase physical activity and delivered via SMS (n =147) or e-mail (n =149); content tailored using theory of planned behavior (TPB) and limited to 160 characters. MEASURES: Baseline and 6, 12, and 16 weeks. Online measures included TPB constructs, physical activity behavior on the Global Physical Activity Questionnaire, and health-related quality of life on the Short-Form 12. ANALYSIS: General linear models for repeated measures. RESULTS: Increase in duration (mean h/d) of moderate work-related activity and moderate recreational activity from baseline to 16 weeks. Short-lived increase in frequency (d/wk) of vigorous recreational activity from baseline to 6 weeks. Increase in duration and frequency of active travel from baseline to 16 weeks. E-mails generated greater changes than SMS in active travel and moderate activity (work and recreational). CONCLUSION: Minimal physical activity promotion delivered by SMS or e-mail can increase frequency and duration of active travel and duration of moderate intensity physical activity at work and for leisure, which is maintained up to 1 month after messaging ends. Both channels were useful platforms for health communication; e-mails were particularly beneficial with hospital employees.

Using mHealth to Deliver Behavior Change Interventions Within Prenatal Care at Community Health Centers.

PURPOSE: To test an iPad-delivered multiple behavior tailored intervention (Healthy Pregnancy: Step by Step) for pregnant women that addresses smoking cessation, stress management, and fruit and vegetable consumption. DESIGN: A randomized 2 × 5 factorial repeated measures design was employed with randomization on the individual level stratified on behavior risk. Women completed three sessions during pregnancy and two postpartum at postdelivery months 1 and 4. SETTING: Women were recruited from six locations of federally funded health centers across three states. SUBJECTS: Participants (N = 335) were English- and Spanish-speaking women at up to 18 weeks gestation. INTERVENTION: The treatment group received three interactive sessions focused on two priority health behavior risks. The sessions offered individually tailored and stage-matched change strategies based on the transtheoretical model of behavior change. The usual care group received March of Dimes brochures. MEASURES: The primary outcome was the number of behavior risks. Stage of change and continuous measures for all behaviors also were assessed. ANALYSIS: Data were analyzed across all time points using generalized estimating equations examining repeated measures effects. RESULTS: Women in the treatment group reported significantly fewer risks than those in usual care at 1 month (.85 vs. 1.20, odds ratio [OR] = .70) and 4 months postpartum (.72 vs. .91, OR = .81). CONCLUSION: Healthy Pregnancy is an evidence-based and personalized program that assists pregnant women with reducing behavior risks and sustaining healthy lifestyle behaviors.

Improvements in Health Behaviors, Eating Self-Efficacy, and Goal-Setting Skills Following Participation in Wellness Coaching.

Purpose . This project examined potential changes in health behaviors following wellness coaching. Design . In a single cohort study design, wellness coaching participants were recruited in 2011, data were collected through July 2012, and were analyzed through December 2013. Items in the study questionnaire used requested information about 11 health behaviors, self-efficacy for eating, and goal-setting skills. Setting . Worksite wellness center. Participants . One-hundred employee wellness center members with an average age of 42 years; 90% were female and most were overweight or obese. Intervention . Twelve weeks of in-person, one-on-one wellness coaching. Method . Participants completed study questionnaires when they started wellness coaching (baseline), after 12 weeks of wellness coaching, and at a 3-month follow-up. Results . From baseline to week 12, these 100 wellness coaching participants improved their self-reported health behaviors (11 domains, 0- to 10-point scale) from an average of 6.4 to 7.7 (p < .001), eating self-efficacy from an average of 112 to 142 (on a 0- to 180-point scale; p < .001), and goal-setting skills from an average of 49 to 55 (on a 16- to 80-point scale; p < .001). Conclusion . These results suggest that participants improved their current health behaviors and learned skills for continued healthy living. Future studies that use randomized controlled trials are needed to establish causality for wellness coaching.

A Multicomponent Intervention Helped Reduce Sugar-Sweetened Beverage Intake in Economically Disadvantaged Hispanic Children.

PURPOSE: This study aimed to examine the effect of a multicomponent intervention program on consumption of sugar-sweetened beverages (SSBs), and lifestyle factors associated with SSB intake, in Hispanic children from low-income families. DESIGN: A five-wave longitudinal study using a quasi-experimental design was conducted. SETTING: Five elementary schools in West Texas served as the setting. SUBJECTS: Participants included 555 predominantly Hispanic children (ages 5-9 years) from low-income families and their parents (n = 525). INTERVENTION: A multicomponent intervention program was implemented. MEASURES: Children's anthropometric measures were obtained. Their weight status was determined based on body mass index for age and gender. Parents responded to a demographic questionnaire, a shelf inventory, an acculturation scale, and a family survey. ANALYSIS: Growth curve analyses were used to test differences between intervention and comparison participants' SSB intake and to examine potential covariates. RESULTS: Comparison group children's daily SSB intake significantly increased over time (B = 1.06 ± .40 ounces per month, p < .01), but this linear increase of SSB was slowed down by the intervention (B = -.29 ± .12, p < .05). More daily TV time, more fast food intake, and more types of SSBs available at home were associated with higher SSB intake. CONCLUSION: Risk factors of childhood obesity were associated with each other. The intervention program produced a modest reduction in SSB consumed by economically disadvantaged and predominantly Hispanic children.

Making Healthy Eating Policy Practice: A Group Randomized Controlled Trial on Changes in Snack Quality, Costs, and Consumption in After-School Programs.

PURPOSE: The aim of this study was to evaluate an intervention designed to assist after-school programs (ASPs) in meeting snack nutrition policies that specify that a fruit or vegetable be served daily and sugar-sweetened beverages/foods and artificially flavored foods eliminated. DESIGN: The study used a 1-year group-randomized controlled trial. SETTING: The study took place in ASPs operating in South Carolina, United States. SUBJECTS: Twenty ASPs serving over 1700 children were recruited, match-paired postbaseline on enrollment size and days fruits/vegetables were served per week, and randomized to either intervention (n = 10) or control (n = 10) groups. INTERVENTION: The study used Strategies To Enhance Practice for Healthy Eating (STEPs-HE), a multistep adaptive intervention framework that assists ASP leaders and staff to serve snacks that meet nutrition policies while maintaining cost. MEASURES: Direct observation of snacks served and consumed and monthly snack expenditures as determined by receipts were used. ANALYSIS: The study used nonparametric and mixed-model repeated measures. RESULTS: By postassessment, intervention ASPs increased serving of fruits/vegetables to 3.9 ± 2.1 vs. 0.7 ± 1.7 d/wk and decreased serving sugar-sweetened beverages to 0.1 ± 0.7 vs. 1.8 ± 2.4 d/wk and sugar-sweetened foods to 0.3 ± 1.1 vs. 2.7 ± 2.5 d/wk compared to controls, respectively. Cost of snacks increased by $0.02/snack in the intervention ASPs ($0.36 to $0.38) compared to a $0.01 per snack decrease in the control group ($0.39 to $0.38). Across both assessments and groups, 80% to 100% of children consumed FVs. CONCLUSIONS: The STEPs-HE intervention can assist ASPs in meeting nationally endorsed nutrition policies with marginal increases in cost.

Stages of change and patient activation measure scores in the context of incentive-based health interventions.

PURPOSE: To determine if two widely used behavioral change measures-Stages of Change (SoC) and Patient Activation Measure (PAM)-correlate with each other, are affected by financial incentives, or predict positive outcomes in the context of incentive-based health interventions. DESIGN: Secondary analysis of two randomized controlled trials of incentives for weight loss and for improved diabetes self-monitoring. SETTING: Philadelphia, Pennsylvania; Newark, New Jersey. SUBJECTS: A total of 132 obese and 75 diabetic adults enrolled in one of two trials. MEASURES . SoC and PAM scores; weight loss and usage rate of diabetes self-monitoring equipment. ANALYSIS: Multiple regression; Kruskal-Wallis test. RESULTS: We found no association between baseline SoC and PAM scores in either study (p = .30 and p = .89). Regression models showed no association between baseline PAM score and SoC and subsequent outcomes for either study (weight loss study: PAM: p = .14, SoC: p = .1; diabetes study: PAM: p = .45, SoC: p = .61). Change in PAM score and SoC among participants in the intervention groups did not differ by study arm or among participants with better outcomes. CONCLUSION . PAM score and SoC may not effectively predict success or monitor progress among individuals enrolled in incentive-based interventions.

Self-reported changes in the implementation of hospital-based health promotion in Taiwan.

PURPOSE: To evaluate the pattern of perceived changes in the implementation of the Health Promoting Hospital (HPH) Initiative. DESIGN: This was a cross-sectional study with a self-administered questionnaire, asking the correspondents what changes they perceived before and after adopting the HPH initiative. SETTING: This study was conducted with 55 hospitals committed to the HPH in Taiwan, and 52 completed the questionnaire. SUBJECTS: One coordinator in each of the 55 hospitals served as subject. INTERVENTION: HPH seeks to improve health gains for its stakeholders by developing structure, cultures, decisions, and process conducive to health promotion. MEASURES: Perceived changes were measured in the areas of more resource inputs, changing work models, realigned implementation strategies, more programs, higher service volume, and improved quality control. Regarding realigned strategies, emphasizing the impact of healthy public policies, supportive environments, staff participation, individual knowledge and skills, and reorienting health services were measured. ANALYSIS: Descriptive analysis was used to examine the pattern of "prevalence of changes." RESULTS: Changes were more prevalent in the domains of patients and community (both with averaged ranks = 1.8); "realigning strategies" was the area in which more changes were perceived (average rank = 1). Emphases on healthy public policies and reorienting health services were the leading changes (both averaged ranks = 2.4) regarding realigning strategies. CONCLUSION: The HPH initiative appeared to be an effective approach to build organizational capacity for health promotion.

A multicenter randomized controlled trial of a nutrition intervention program in a multiethnic adult population in the corporate setting reduces depression and anxiety and improves quality of life: the GEICO study.

PURPOSE: To determine whether a plant-based nutrition program in a multicenter, corporate setting improves depression, anxiety, and productivity. DESIGN: A quasi-experimental study examined the impact of diet on emotional well-being and productivity. SETTING: The study was conducted in 10 corporate sites of a major U.S. insurance company. SUBJECTS: There were 292 participants (79.8% women, 20.2% men), with body mass index ≥25 kg/m(2) and/or previous diagnosis of type 2 diabetes. INTERVENTION: Either weekly instruction in following a vegan diet or no instruction was given for 18 weeks. MEASURES: Depression and anxiety were measured using the Short Form-36 questionnaire. Work productivity was measured using the Work Productivity and Activity Impairment questionnaire. ANALYSIS: Baseline characteristics were examined by t-test for continuous variables and χ(2) test for categorical variables. Analysis of covariance models were adjusted for baseline covariates. Paired t-tests were used to determine within-group changes and t-tests for between-group differences. RESULTS: In an intention-to-treat analysis, improvements in impairment because of health (p < .001), overall work impairment because of health (p = .02), non-work-related activity impairment because of health (p < .001), depression (p = .02), anxiety (p = .04), fatigue (p < .001), emotional well-being (p = .01), daily functioning because of physical health (p = .01), and general health (p = 0.02) in the intervention group were significantly greater than in the control group. Results were similar for study completers. CONCLUSION: A dietary intervention improves depression, anxiety, and productivity in a multicenter, corporate setting.

Impact of a supervised worksite exercise program on back and core muscular endurance in firefighters.

PURPOSE: Low back pain is a leading cause of disability in firefighters and is related to poor muscular endurance. This study examined the impact of supervised worksite exercise on back and core muscular endurance in firefighters. DESIGN: A cluster randomized controlled trial was used for this study. SETTING: The study occurred in fire stations of a municipal fire department (Tampa, Florida). SUBJECTS: Subjects were 96 full-duty career firefighters who were randomly assigned by fire station to exercise (n = 54) or control (n = 42) groups. INTERVENTION: Exercise group participants completed a supervised exercise targeting the back and core muscles while on duty, two times per week for 24 weeks, in addition to their usual fitness regimen. Control group participants continued their usual fitness regimen. MEASURES: Back and core muscular endurance was assessed with the Biering-Sorensen test and plank test, respectively. ANALYSIS: Changes in back and core muscular endurance from baseline to 24 weeks were compared between groups using analysis of covariance and linear mixed effects models. RESULTS: After 24 weeks, the exercise group had 12% greater (p = .021) back muscular endurance and 21% greater (p = .0006) core muscular endurance than did the control group. The exercise intervention did not disrupt operations or job performance. CONCLUSION: A supervised worksite exercise program was safe and effective in improving back and core muscular endurance in firefighters, which could protect against future low back pain.

Effect of a park-based after-school program on participant obesity-related health outcomes.

PURPOSE: The objective of this study was to examine the effect of a structured after-school program housed in a large county parks system on participant health and wellness outcomes. DESIGN: Longitudinal cohort study over one school year (fall 2011-spring 2012). SETTING: A total of 23 county parks in Florida. SUBJECTS: Children ages 5 to 16 (N = 349, 55% non-Hispanic black, 40% Hispanic, mean age 8.9 years). INTERVENTION: An after-school program called Fit-2-Play that integrates daily standardized physical activity and health and wellness education components. MEASURES: Preintervention (August/September 2011) and postintervention (May/June 2012) anthropometric, systolic/diastolic blood pressure, fitness, and health and wellness knowledge measurements were collected. ANALYSIS: Comparison of pre-post outcome measure means were assessed via general linear mixed models for normal-weight (body mass index [BMI] <85th percentile for age and sex) and overweight/obese (BMI ≥85th percentile for age and sex) participants. RESULTS: The overweight/obese group significantly decreased their mean (1) BMI z score (2.0 to 1.8, p < .01) and (2) subscapular skinfold measurements (19.4 to 17.5 mm, p < .01) and increased (1) mean laps on the Progressive Aerobic Cardiovascular Endurance Run test (10.8 to 12.5, p = .04) and (2) percentage with normal systolic blood pressure (58.1% to 71.0%, p = .03) from pretest to posttest. On average, participants significantly improved their health and wellness knowledge over the school year (p < .01). Normal-weight participants maintained healthy BMI ranges and significantly increased fitness levels. CONCLUSION: Findings suggest that the Fit-2-Play after-school programs can be a significant resource for combating childhood obesity and instilling positive physical health in children, particularly among ethnic and socioeconomically diverse communities.

Point-of-Decision Signs and Stair Use in a University Worksite Setting: General Versus Specific Messages.

PURPOSE: This study tested the effectiveness of two point-of-decision signs to increase stair use and investigated message content by comparing signs with general and specific messages. DESIGN: This study used a quasi-experimental time series design, including a 2-week baseline period: 2 weeks with a general message and 2 weeks with a specific message. SETTING: The signs were placed in an eight-story university building. SUBJECTS: The subjects comprised all adults entering the building. During the study, 2997 observations of stair/elevator choice were made. INTERVENTION: A stair-prompt sign with a general message and a sign with a specific message served as the interventions. MEASURES: Observers measured stair/elevator choice, demographics, and traffic volume. ANALYSIS: Logistic regression analyses were employed, adjusting for covariates. RESULTS: The specific sign intervention showed significantly increased odds of stair use compared to baseline (odds ratio [OR] = 2.04, 95% confidence interval [CI] = 1.46-2.84). The odds of stair use were also significantly greater with the specific sign than the general sign (OR = 1.57, 95% CI = 1.13-2.20). CONCLUSION: Only the specific sign significantly increased stair use. The results indicate that a specific message may be more effective at promoting stair use.

Effectiveness of interventions targeting health behaviors in university and college staff: a systematic review.

OBJECTIVE: Evaluate the literature on interventions targeting tertiary education staff within colleges and universities for improvements in health behaviors such as physical activity, dietary intake, and weight loss. DATA SOURCE: One online database, Medline, was searched for literature published between January 1970 and February 2013. STUDY INCLUSION AND EXCLUSION CRITERIA: All quantitative study designs, including but not limited to randomized controlled trials, quasi-experimental studies, nonrandomized experimental trials, cohort studies, and case-control studies, were eligible. DATA EXTRACTION: Data extraction was performed by one reviewer using a standardized form developed by the researchers. Extraction was checked for accuracy and consistency by a second reviewer. DATA SYNTHESIS: Data in relation to the above objective were extracted and described in a narrative synthesis. RESULTS: Seventeen studies were identified that focused on staff within the tertiary education setting. The review yielded overall positive results with 13 reporting significant health-related improvements. Weight loss, physical activity and fitness, and/or nutrition were the focus in more than half (n = 9) of the studies. CONCLUSION: This appears to be the first review to examine health interventions for tertiary education staff. There is scope to enhance cross-disciplinary collaboration in the development and implementation of a "Healthy University" settings-based approach to health promotion in tertiary education workplaces. Universities or colleges could serve as a research platform to evaluate such intervention strategies.

Cost-effectiveness of population-level physical activity interventions: a systematic review.

OBJECTIVE: This systematic review synthesizes the evidence on the cost-effectiveness of population-level interventions to promote physical activity. DATA SOURCE: A systematic literature search was conducted between May and August 2013 in four databases: PubMed, Scopus, Web of Science, and SPORTDiscus. STUDY INCLUSION AND EXCLUSION CRITERIA: Only primary and preventive interventions aimed at promoting and maintaining physical activity in wide population groups were included. An economic evaluation of both effectiveness and cost was required. Secondary interventions and interventions targeting selected population groups or focusing on single individuals were excluded. DATA EXTRACTION: Interventions were searched for in six different categories: (1) environment, (2) built environment, (3) sports clubs and enhanced access, (4) schools, (5) mass media and community-based, and (6) workplace. DATA SYNTHESIS: The systematic search yielded 2058 articles, of which 10 articles met the selection criteria. The costs of interventions were converted to costs per person per day in 2012 U.S. dollars. The physical activity results were calculated as metabolic equivalent of task hours (MET-hours, or MET-h) gained per person per day. Cost-effectiveness ratios were presented as dollars per MET-hours gained. The intervention scale and the budget impact of interventions were taken into account. RESULTS: The most efficient interventions to increase physical activity were community rail-trails ($.006/MET-h), pedometers ($.014/MET-h), and school health education programs ($.056/MET-h). CONCLUSION: Improving opportunities for walking and biking seems to increase physical activity cost-effectively. However, it is necessary to be careful in generalizing the results because of the small number of studies. This review provides important information for decision makers.

Eat for life: a work site feasibility study of a novel mindfulness-based intuitive eating intervention.

PURPOSE: To examine the efficacy of a novel intervention for problematic eating behaviors and body dissatisfaction. DESIGN: Participants enrolled in the intervention or waitlist comparison group were assessed at pre and post 10 weeks. SETTING: Midwestern university. SUBJECTS: One hundred twenty-four female employees or partners/spouses. INTERVENTION: Eat for Life is a 10-week group intervention integrating mindfulness and intuitive eating skills. MEASURES: Self-report questionnaires included the Intuitive Eating Scale, Body Appreciation Scale, Five-Facet Mindfulness Questionnaire, Questionnaire for Eating Disorder Diagnoses, and an author-constructed supplemental and demographic questionnaire. ANALYSIS: Analyses of covariance and ordinal regression measured group differences. Structural equation modeling examined mediation effects. Results . Significant differences between groups were observed for body appreciation (F1,121 = 40.17, p = .000, partial eta squared = .25), intuitive eating (F1,121 = 67.44, p = .000, partial eta squared = .36), and mindfulness (F1,121 = 30.50, p = .000, partial eta squared = .20), with mean scores significantly higher in the intervention group than waitlist comparison group after 10 weeks. The intervention group was 3.65 times more likely to be asymptomatic for disordered eating than the comparison group. Mindfulness served as a partial mediator. CONCLUSION: The study provides support for an intervention combining intuitive eating and mindfulness for treatment of problematic eating behaviors and body dissatisfaction, with limitations including self-selection and lack of active control group.