Mindfulness-based intervention for depression and insulin resistance in adolescents: Protocol for BREATHE, a multisite, pilot and feasibility randomized controlled trial.

BACKGROUND: Elevated depression symptoms have been associated with higher insulin resistance in adolescents, and consequently, greater risk for type 2 diabetes (T2D). Mindfulness-based intervention (MBI) may be suited for adolescents at risk for T2D given its potential to decrease depression and improve stress-related behavior/physiology underpinning insulin resistance. To prepare for a future multisite efficacy randomized controlled trial, a rigorous, multisite, pilot and feasibility study is needed to test this approach. The current paper describes the design and protocol for a multisite, pilot and feasibility randomized controlled trial of six-week MBI, cognitive-behavioral therapy (CBT), and health education (HealthEd) group interventions, to assess multisite fidelity, feasibility, and acceptability. METHODS: Participants are N = 120 adolescents ages 12-17, with body mass index (BMI) ≥85th percentile, elevated depression symptoms (20-item Center for Epidemiologic Studies-Depression Scale total score > 20), and family history of diabetes. Enrollment occurs across four United States (US) sites, two in Colorado, one in Washington, D·C., and one in Maryland. Group interventions are delivered virtually by trained psychologists and co-facilitators. Assessments occur at baseline, six-week follow-up, and one-year follow-up. RESULTS: Primary outcomes are intervention implementation fidelity, based upon expert ratings of audio-recorded sessions (≥80% adherence/competence), and recruitment feasibility, based upon percentage enrollment of eligible youth (≥80%). Secondary outcomes are intervention training fidelity/feasibility/acceptability, recruitment timeframe, and retention/assessment feasibility. CONCLUSION: Findings will inform optimization of training, recruitment, intervention delivery, retention, and assessment protocols for a multisite, efficacy randomized controlled trial evaluating MBI for decreasing depression and improving insulin resistance in adolescents at risk for developing T2D.

Momentary effects of life stressors on mindfulness and emotion regulation difficulties among adolescents exposed to chronic stressors.

Adolescents faced with chronic stressors (e.g., financial instability, interpersonal violence) are at heightened risk for developing mental health problems, likely due in part to stressors that interfere with effective emotion regulation. Although mindfulness may help to act as a buffer against the deleterious effects of life stressors, a relatively untested assumption is that adolescents can maintain mindfulness during periods of stress. This paper explores this assumption by investigating the real-time, dynamic relationships among life stressors, mindfulness, and emotion regulation difficulties among adolescents exposed to chronic stressors. Eighty-one participants who were 10-18 years old (M = 14.33; SD = 2.20; 56% male; 57% Non-Hispanic White) completed ecological momentary assessments (EMA) three times a day for 7 days and contributed a total of 1186 EMA reports. Multilevel structural equation modelling revealed that the presence (vs. absence) of stressors was associated with lower momentary mindfulness and greater momentary emotion regulation difficulties concurrently and prospectively. Stressors with greater severity were also concurrently, but not prospectively, associated with lower momentary mindfulness and greater momentary emotion regulation difficulties. Findings highlight that exposure to life stressors may degrade momentary mindfulness and emotion regulation. Given that mindfulness and emotion regulation are closely associated with mental health, these results also demonstrate one way that stressors may contribute to health disparities at the micro-level. Going forward, it will be important to investigate methods of helping adolescents learn to maintain mindfulness and adaptive emotion regulation in the face of stressful events. This study was preregistered (NCT04927286).

The Effect of Mental Activation of One's Pet Dog on Stress Reactivity.

Research suggests that mental activation of human social support may reduce stress reactivity. However, the extent to which social support from pets elicits a similar effect has been less explored. This study aims to determine whether the mental activation of one's pet dog reduces stress reactivity to a subsequent experimental stressor. In a 2 × 2 design, 132 dog-owning participants (Mage = 20.14; 80% female) were randomly assigned to one of two mental activation conditions (pet dog; general) and one of two stressor conditions (social-evaluative; cognitive). Data were analyzed with two-way ANOVAs with self-reported (positive/negative affect, negative self-evaluation) and physiological (blood pressure, heart rate) dependent variables. Results indicated that participants randomized to the pet dog mental activation condition had smaller decreases in positive affect from baseline to post-stressor compared to the general mental activation condition. However, there were no significant interactions between time and mental activation condition on negative affect, negative self-evaluation, heart rate, or blood pressure. Thus, the mental activation of one's pet dog had a minimal effect on stress reactivity to a cognitive or social-evaluative stressor. Results suggest that the physical presence of an animal may be an essential mechanism underlying the benefits of animal-derived social support.

The Role of Front-of-Package Nutrition Labels with and without Explanatory Videos on Parent and Child Food Choices.

The aim of this research was to determine whether parent/child pairs choosing products from a grocery aisle labeled with front-of-package (FOP) nutrition labels would make more healthful choices than pairs who viewed the same items without labels, and to determine the added value of viewing an explanatory video before choosing. In this experiment, 175 parent/child pairs chose USD 20 worth of packaged foods and beverages from a grocery aisle in a research laboratory and were randomly assigned to see products that either did or did not have 0-4-star FOP labels, with more stars indicating more healthful products. Among those participants with access to FOP labels, half were randomly assigned to view a 30 s video explaining the FOP labels before selecting foods. Participants who saw the explanatory video before selecting among products with FOP labels chose foods with significantly more stars than participants who saw the FOP-labeled products without the video; however, there was no significant difference in mean stars on selected products between the group that saw the videos and the control group that saw neither the video nor FOP labels. We conclude that explaining new FOP labels to consumers may be necessary for the labels to prompt more healthful choices.

Relations Between Stress-Adapted Communication Skills and Toxic Social Networks Among Young Adults with Childhood Adversity.

Adverse childhood experiences are associated with deleterious outcomes across the lifespan. However, some individuals who grow up in adverse environments may develop stress-adapted skills or resilience factors that enable them to function in their current lived environments. This study explored whether communication is a stress-adapted skill among young adults with co-occurring forms of childhood adversity and the extent to which these communication skills are implicated in toxic social networks. This cross-sectional study included 384 young adults, ages 18-35 years, who completed an online survey. Mixture modeling was used to conduct latent class models estimating subgroups of young adults with co-occurring forms of early adversity; then, regression models estimated the association between communication skills and toxic social networks among subgroups. Four latent classes were identified: (1) high childhood adversity; (2) high to moderate household dysfunction and emotional abuse; (3) high emotional abuse and moderate physical abuse and emotional neglect; and (4) low or no childhood adversity. Results from regression models indicate that participants classified in the high emotional abuse and moderate physical abuse and emotional neglect class had more adaptive communication skills with friends than their counterparts in the low or no childhood adversity class, and participants in the high childhood adversity or low or no childhood adversity classes with higher communication skills were less likely to report toxic social networks. Findings suggest that stress-adapted communication skills may be one resilience factor that supports adaptation among young adults with early adversity exposures.

Daily mindfulness, negative affect, and eating behaviors in adolescents at risk for excess weight gain.

OBJECTIVE: Loss-of-control and overeating are common in adolescents with high body mass index (BMI). Mindfulness may affect negative affect, and both may relate to loss-of-control and overeating. Yet, there is limited understanding of these associations in adolescents' daily lives. METHODS: Forty-five adolescents (77% female; Mage = 14.4 years, SDage = 1.7 years) with high weight (92% with BMI [kg/m2 ] ≥85th percentile for age/sex) provided daily, repeated measurements of mindfulness, negative affect, loss-of-control, and overeating for ~7 days (M = 5.6 days; range = 1-13). Multilevel mixed modeling was conducted to test within-person (intraindividual) and between-person (interindividual) associations for the same-day (concurrent) and next-day (time-ordered/prospective). RESULTS: There were within-person and between-person associations of higher mindfulness with lower negative affect on the same-day and next-day. Greater between-person mindfulness related to lower odds of adolescents' loss-of-control occurrence (same-day) and conversely, more perceived control over eating (same-day and next-day). Greater within-person mindfulness related to less odds of next-day overeating. DISCUSSION: Dynamic relations exist among mindfulness, negative affect, and eating in adolescents at-risk for excess weight gain. Mindfulness may be an important element to consider in loss-of-control and overeating. Future work using momentary-data within an experimental design would help disentangle the intraindividual effects of increasing mindfulness/decreasing negative affect on disordered eating. PUBLIC SIGNIFICANCE: Loss-of-control and overeating are common in teenagers with high weight. Greater mindfulness-present-moment, non-judgmental attention-and less negative emotions may relate to healthier eating, but we do not know how these processes play out in teenagers' daily lives. Addressing this knowledge gap, the current findings showed that greater daily mindfulness, but not negative affect, related to less loss-of-control/overeating, suggesting the importance of mindfulness for eating patterns in teenagers' daily lives.

Advancing the Study of Mindfulness-Based Interventions in Relation to Psychological Health.

Since 2006, there has been exponential growth in the number of publications on mindfulness [...].

Observations of parent-adolescent interactions relate to food parenting practices and adolescent disordered eating in adolescents at risk for adult obesity.

Adolescent disordered eating and obesity are interrelated and adversely relate to mental and metabolic health. Parental feeding practices have been associated with adolescent disordered eating and obesity. Yet, observable interactions related to food parenting have not been well characterized. To address this gap, N = 30 adolescents (M ± SD 14 ± 2 year) at risk for adult obesity due to above-average body mass index (BMI ≥70th percentile) or parental obesity (BMI ≥30 kg/m2 ) participated in a video-recorded parent-adolescent task to discuss a food/eating-related disagreement. Interactions were coded for individual/dyadic affect/content using the Interactional Dimensions Coding System. We examined associations of interaction qualities with parent-reported food practices, adolescent disordered eating behaviors/attitudes, and insulin resistance. Reported parenting practices were correlated with multiple interaction qualities (p-values <0.05), with the most consistent correspondence between parent-reported pressure to eat (e.g., pressure to eat more healthy foods) and negative aspects of parent-adolescent interactions. Also, after accounting for adolescent age, sex, and BMI-standard score, parent-adolescent interaction qualities were associated with adolescents' disordered eating and insulin resistance. Specifically, greater adolescent problem-solving related to less adolescent global disordered eating, shape, and weight concern (p-values <0.05); adolescent autonomy related to less weight concern (p = 0.03). Better parent communication skills were associated with less adolescent eating concern (p = 0.04), and observed dyadic mutuality related to adolescents' lower insulin resistance (p = 0.03). Parent-adolescent interaction qualities during food/eating-related disagreements show associations with parent-reported food practices and adolescent disordered eating. This method may offer a tool for measuring the qualities of parent-adolescent food/eating-related interactions. A nuanced understanding of conversations about food/eating may inform family-based intervention in youth at-risk for adult obesity.

Associations Between Children's Emotion Regulation, Mindful Parenting, Parent Stress, and Parent Coping During the COVID-19 Pandemic.

Stress among parents has increased during the COVID-19 pandemic. Research prior to the pandemic indicates that parents of children who struggle with emotion regulation (ER) and who themselves are less mindful report more stress and diminished coping abilities. We know little, however, about these associations in the context of COVID-19. To prevent COVID-related deteriorations in parent well-being and child outcomes and to support parents during this potentially challenging time, it is important to understand the factors that are associated with increased stress as well as adaptive coping. This paper discusses the association between children's ER, mindful parenting (MP), parent stress, and parents' coping with parenting during the pandemic in a sample of 217 caregivers of school-aged children (91.0% mothers). Results indicated that children's ER was associated with parents' self-reported coping with parenting in the pandemic but was not associated with increased stress. Further, MP moderated the association between children's ER and coping, such that parents who were the most mindful and had children with better ER skills reported significantly greater ability to cope with pandemic parenting. Coping was lower for other combinations of ER and mindful parenting. These findings contradict those from before COVID, suggesting the relationship between children's ER and parent outcomes may differ in the COVID-19 context, and offering insights into which parents may be most likely to struggle with coping with pandemic parenting.

Mental health and health behaviors among college student mentors in a randomized controlled trial interrupted by COVID-19.

Objective: The benefits of mindfulness-training and mentoring for college students have yet to be investigated. We aimed to provide an exploratory and descriptive account of their potential benefits during the COVID-19 pandemic. Participants: In February 2020, 49 undergraduates (M = 20.51 years-old; 94% female) participated in a randomized trial of 12-week mentoring + mindfulness or mentoring-as-usual. After five weekly mentoring-sessions, programs were interrupted by COVID-19; mentoring continued online. Methods: Undergraduates completed questionnaires about mental health, behaviors, and regulatory processes in February and July 2020, with additional COVID-19-related questions at follow-up. Results: Participants reported moderate COVID-19-related perceived stress, but mental health, health behaviors, and regulatory processes did not diminish over time, with no condition differences. Undergraduates described using contemplative practices and social support to cope with COVID-19-stress. Conclusions: Undergraduates showed stable mental health/health behaviors despite moderate COVID-19-related-stress. Future research on mentoring with a mindfulness component among a larger and more heterogeneous sample will be necessary.

Mindful Partnering: Introducing a Theoretical Construct and Testing Psychometric Properties of the Mindful Partnering Measure.

Although evidence suggests many benefits of mindfulness, interpersonal forms of mindfulness are understudied. We present the conceptualization of a novel theoretical construct, mindful partnering, as interpersonal mindfulness with ones' romantic partner; we also present initial validation of the Mindful Partnering Measure (MPM). Participants were 599 individuals from: 1) an undergraduate student sample recruited from a University subject pool (used for exploratory factor analyses, N= 335) and 2) a sample of married adults that was recruited through Mechanical Turk (used for confirmatory factor analyses, N= 264, subsets used for construct validity N= 147, and test-retest analyses N= 53). Results of the EFA and CFA supported a five-factor structure with the subscales: (1) mindful awareness, (2) nonreactivity, (3) emotional awareness, (4) acceptance/compassion, and (5) self-compassion. Tests of internal consistency, construct validity, and test-retest reliability in the sample of married adults provided evidence for reliability and validity of the total MPM to assess mindful partnering, as well as the mindful awareness and acceptance/compassion subscales. However, the other subscales did not demonstrate adequate test-retest reliability. Use of this measure in further research will allow for the study of the potential correlates and benefits of mindful partnering to further our understanding of this novel construct.

Environmental Physical Activity Cues and Children's Active vs. Sedentary Recreation.

Physical activity (PA) benefits health, and intensive environmental modifications can increase children's PA. Research has not yet addressed if subtle environmental cues, such as posters depicting PA, increase child PA. In the current study, it was hypothesized that children exposed to active posters (vs. nature posters) would spend a larger proportion of free play time engaging with active toys (relative to sedentary toys). Participants were randomly assigned to one of two conditions in which posters on a laboratory wall depicted 1. People being active, or 2. Nature scenes. Children aged 5-10 years (N = 175) could play with up to eight toys (four active, four sedentary) while parents completed study-related surveys. The proportion of playtime that was active was compared between groups. Poster type did not have a significant effect on proportion of active playtime. Previous environmental interventions that increase children's PA have done so through enhancing access to active opportunities, rather than via signage. It is possible that poster interventions such as this may not influence children's PA, or perhaps other types of cues would have been more effective. Future research should investigate subtle environmental cues that match both the target audience and the accessible PA options (e.g., posters depicting children playing with available active toys) and explore other low-investment environmental modifications to boost children's PA.

Inadequate sleep moderates effects of interparental conflict appraisals on adolescent adjustment.

OBJECTIVES: Previous research and theory suggest that interparental conflict that is perceived by youth as frequent/intense, threatening, and/or the responsibility of the youth is predictive of adjustment problems. In contrast, sleep, an important precursor to emotion regulation, is likely a protective factor for youth experiencing interparental conflict. The goal of the current study was to investigate the extent to which adolescents who maintain better and/or longer sleep are buffered from the adjustment problems associated with greater interparental conflict. METHODS: One-hundred and fifty adolescents completed questionnaires assessing interparental conflict (frequency/intensity perceptions as well as threat and self-blame appraisals) as well as internalizing and externalizing behaviors. Participants also wore an actigraph over 1 week to objectively measure sleep quantity and quality; 123 participants had valid actigraphy data. RESULTS: Results of structural equation modeling analyses revealed that greater sleep quality weakened the association between interparental conflict and adjustment problems, particularly internalizing behaviors. However, sleep quantity was not a moderator. CONCLUSION: These results suggest that higher quality sleep may protect adolescents from the negative effects of interparental conflict.

Testing Bidirectional Within-Person Associations between Mindful Attention and Sleep in Adolescence.

Developments during adolescence increase risk for sleep problems. Research in adults suggests mindfulness and sleep are associated, with two different theoretical explanations for direction of effects. Our goal was to directly test these competing theoretical models at the daily level in adolescents using objective and self-reported measurements of sleep. Adolescents (N=138; 14-21yrs) reported mindful attention and sleep for a week, while wearing an actigraph. Results indicated that, within-person, poor sleep at night predicted less mindful attention the next day; however, mindful attention during the day did not predict sleep that night. These findings provide support for the developmental model of sleep and regulation and suggest poor sleep may impair regulatory abilities the following day.

Mindfulness-based intervention in adolescents at risk for excess weight gain: 1.5-year follow-up of pilot randomized controlled trial.

BACKGROUND: Mindfulness-based intervention (MBI) may offer a novel means of preventing excess weight gain in adolescents, theoretically by decreasing stress-eating through altering executive functioning (EF) and food-reward sensitivity. METHODS: N = 54 12-17y girls and boys at-risk for excess weight gain (i.e., BMI ≥70th percentile or two biological parents with reported obesity [BMI ≥30 kg/m2]) participated in a 1.5-year follow-up of a pilot randomized controlled trial comparing 6-week/6-session MBI (n = 29) and a health education (HE) control (n = 25). Laboratory stress-eating, food-reward sensitivity, EF, perceived stress, and BMI/adiposity were re-assessed at 1.5-years with validated measures. Changes from baseline to 1.5-year follow-up were explored with ANCOVA, accounting for the respective baseline outcome, age, and sex. RESULTS: Compared to MBI (M = -21, SE = 59), HE had greater increases in stress-eating from baseline to 1.5-years (M = 194, SE = 63, Cohen's d = 0.59, p = .01). There were no other between-condition differences. DISCUSSION: MBI may prevent worsening stress-eating for adolescents at-risk for excess weight gain. The potential for MBI as an intervention for stress-eating and ultimately, weight stabilization warrants testing in an adequately-powered trial.

Dispositional Mindfulness is Cross-Sectionally Predicted by Interactions between Interparental Conflict and Parent-Child Relationships.

Theory emphasizes the importance of the family environment for the development of dispositional mindfulness, but past research has focused exclusively on parent-child attachment relationships as family-level predictors of mindfulness. Our goal was to examine unique and joint associations of both interparental conflict and parent-child relationship quality with dispositional mindfulness. Participants were 150 youth (14-21 yrs) who reported the warmth and support in their relationships with mothers and fathers separately, as well as their appraisals of the properties of their parents' conflict, how threatening that conflict is, and how responsible for it they feel, in addition to dispositional mindfulness. Results indicated consistent interactions between conflict properties and mother-child relationship quality in relation to dispositional mindfulness. Dispositional mindfulness was lowest for youth who reported low levels of frequent/intense interparental conflict and poor-quality relationships with mothers. In contrast, either self-blame/threat or poor-quality relationships with mothers predicted lower levels of dispositional mindfulness. Implications for theory and practice are discussed.

Health effects of COVID-19 for vulnerable adolescents in a randomized controlled trial.

Emerging evidence suggests the coronavirus disease 2019 (COVID-19) pandemic is adversely affecting adolescents' mental health and health behaviors, particularly among those with preexisting mental health conditions and from lower socioeconomic backgrounds. However, direct tests of changes in health outcomes among vulnerable adolescents from before to during COVID-19 are limited. In addition, little is known about how to buffer adolescents, particularly those who are most vulnerable, against stress-related decrements in health. This randomized controlled trial begins to fill these gaps in the literature by exploring changes in mental health, health behaviors, executive function, emotion regulation, and mindfulness among vulnerable adolescents involved in a mentoring program during the COVID-19 pandemic. It also examined to what extent there were protective benefits of incorporating mindfulness training within a mentoring program for buffering adolescents from negative pandemic health effects. Thirty-five adolescents (Mage = 12.9, 37% female) and 32 parents (Mage = 44.75, 80% female) completed questionnaires at baseline (February 2020) and follow-up (July 2020). There were few significant reductions in health; instead, on average, youth reported improvements in sleep, emotion regulation, executive function, and mindfulness over time. Adolescents randomized to mentoring + mindfulness displayed significantly less posttraumatic stress disorder (PTSD) symptomatology and emotional impulsivity at follow-up, compared to the mentoring-as-usual condition. These pilot findings suggest that mentoring with a mindfulness training component may offer an effective strategy for protecting adolescents from deteriorations in health outcomes during COVID-19. Further, there may be unique benefits of mindfulness training for vulnerable youth as a way to adapt to stressful events. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Associations of adverse childhood experiences with stress physiology and insulin resistance in adolescents at risk for adult obesity.

Adverse childhood experiences (ACEs) heighten the risk for adult obesity and cardiometabolic disease, but physiological factors underlying this connection are not well understood. We determined if ACEs were associated with physiological stress response and insulin resistance in adolescents at risk for adult obesity. Participants were 90 adolescents 12.0-17.5 years (50% female, 30% Hispanic/Latinx), at risk for adult obesity by virtue of above-average body mass index (BMI; kg/m2 ≥ 70th percentile) or parental obesity (BMI ≥ 30 kg/m2 ). ACEs were determined as presence (vs. absence) based upon the Schedule for Affective Disorders and Schizophrenia for School-Aged Children. Physiological stress response was measured as heart rate/blood pressure response to the Trier Social Stress Test. Homeostatic model assessment of insulin resistance was determined from fasting glucose/insulin. Sixty-one percent of adolescents reported positive ACE history. The presence of ACEs predicted greater heart rate (p < .001) and diastolic blood pressure (p = .02) response to stress, controlling for age, sex, race/ethnicity, puberty, and BMI standard score. Systolic blood pressure and insulin resistance did not differ by ACE history (p-values > .08). Findings suggest heightened sympathetic stress response in adolescence could be explanatory in how ACEs increase the risk for later cardiometabolic disease. Future studies should characterize ACEs in relationship to day-to-day variations in adolescents' stress physiology and glucose homeostasis.

The role of mindfulness in associations among depression symptoms, sleep duration, and insulin resistance in adolescents.

Sleep difficulties may be one explanatory factor in the association between depression and insulin resistance; yet, explicit tests of this hypothesis are lacking. We determined if there was an indirect effect of depression symptoms on insulin resistance through sleep duration in adolescents at risk for excess weight gain. We also investigated whether dispositional mindfulness moderated the interconnections among depression, sleep, and insulin resistance. Ninety adolescents (14.2 ± 1.6y; 50% female) at risk for excess weight gain (body mass index [BMI, kg/m2] z score 1.6 ± 0.6) participated in the cross-sectional, baseline phase of a health behaviors study. Depression was assessed with the Center for Epidemiologic Studies-Depression Scale, sleep duration with the Sleep Habits Survey, and mindfulness with the Mindful Attention and Awareness Scale. Homeostatic model assessment of insulin resistance was determined from fasting insulin and glucose. The product-of-coefficients method was used to test the indirect effect of depression on insulin resistance through sleep duration, accounting for age, sex, BMIz, puberty, and socioeconomic status (SES). Dispositional mindfulness was tested as a moderator of the associations among depression, sleep, and insulin resistance. There was a significant indirect effect of depression on insulin resistance through sleep duration, controlling for age, sex, BMIz, puberty, and SES, 95%CI [0.001, 0.05]. Dispositional mindfulness moderated the association between sleep duration and insulin resistance, such that lower sleep duration related to greater insulin resistance only among adolescents with lower mindfulness (p < .001). Short sleep may be one explanatory factor in the depression-insulin resistance connection in adolescents at risk for excess weight gain. Adolescents with poorer mindfulness and short sleep are at highest risk for insulin resistance, whereas higher mindfulness may be protective.

Feasibility and Acceptability of Accelerometer Measurement of Physical Activity in Pregnant Adolescents.

During pregnancy, physical activity relates to better maternal and child mental and physical health. Accelerometry is thought to be effective for assessing free-living physical activity, but the feasibility/acceptability of accelerometer use in pregnant adolescents has not been reported. In this short communication, we conducted secondary analysis of a small pilot study to describe the feasibility/acceptability of accelerometry in pregnant adolescents and the preliminary results of physical activity characteristics. Participants were recruited from a multidisciplinary adolescent perinatal clinic. Physical activity was assessed with wrist-worn accelerometers. Feasibility was described as median days of valid wear (≥10 h of wear/day) for the total sample and the number/percentage of participants with ≥4 days of valid wear. Sensitivity analyses of wear time were performed. Acceptability ratings were collected by structured interview. Thirty-six pregnant (14.6 ± 2.1 gestational weeks) adolescents (17.9 ± 1.0 years) participated. Median days of valid wear were 4 days. Seventeen participants (51.5%) had ≥4 days of valid wear. There were no differences in characteristics of adolescents with vs. without ≥4 days of valid wear. Twenty participants (60.6%) had ≥3 days of valid wear, 24 (72.7%) ≥2 valid days, and 27 (81.8%) ≥1 valid wear day. Acceptability ratings were neutral. Assessing physical activity with accelerometry in pregnant adolescents was neither feasible nor acceptable with the current conditions. Future research should investigate additional incentives and the potential utility of a lower wear-time criterion in pregnant adolescents.