An 8-Week Peer Health Coaching Intervention among College Students: A Pilot Randomized Study.

This study explored the effects of an 8-week peer coaching program on physical activity (PA), diet, sleep, social isolation, and mental health among college students in the United States. A total of 52 college students were recruited and randomized to the coaching (n = 28) or the control group (n = 24). The coaching group met with a trained peer health coach once a week for 8 weeks focusing on self-selected wellness domains. Coaching techniques included reflective listening, motivational interviews, and goal setting. The control group received a wellness handbook. PA, self-efficacy for eating healthy foods, quality of sleep, social isolation, positive affect and well-being, anxiety, and cognitive function were measured. No interaction effects between time and group were significant for the overall intervention group (all p > 0.05), while the main effects of group difference on moderate PA and total PA were significant (p < 0.05). Goal-specific analysis showed that, compared to the control group, those who had a PA goal significantly increased vigorous PA Metabolic Equivalent of Task (METs) (p < 0.05). The vigorous METs for the PA goal group increased from 1013.33 (SD = 1055.12) to 1578.67 (SD = 1354.09); the control group decreased from 1012.94 (SD = 1322.943) to 682.11 (SD = 754.89); having a stress goal significantly predicted a higher post-coaching positive affect and well-being, controlling the pre-score and other demographic factors: B = 0.37 and p < 0.05. Peer coaching showed a promising effect on improving PA and positive affect and well-being among college students.

Relationships between prosocial factors and college student health.

Objective This study examined relationships between prosocial factors including altruism, compassion, social connectedness, spirituality, and volunteerism and measures of health in college students. Participants: A total of N = 1,075 participants from four institutions across various regions of the U.S. were included. Methods: Participants were sent email invitation via student listserv to participate in a survey of health and prosocial factors that was open for one month. Results: Hierarchical linear regressions were completed to examine the influence of prosocial variables on perceptions of health and engagement in health behaviors. Social connectedness was a significant contributor to variance in all health measures, and the variables with the most variance explained were symptoms of depression (28.6%) and Health-Related Quality of Life (24.6%). Conclusions: Institutions should prioritize programing to enhance social connectedness and other prosocial behaviors because of the positive effect these factors can have on health and health behaviors.

Bariatric patients' reported motivations for surgery and their relationship to weight status and health.

BACKGROUND: Literature on patient motivation for bariatric surgery remains limited. A few studies have examined relation to outcomes and found no established connection between motivation and weight loss. SETTING: A retrospective convenience sample of 345 participants was recruited from an obesity support website to complete an online survey. METHODS: Content analysis was used to describe motivations for surgery, and analysis of variance and covariance were completed to compare groups of participants created from the qualitative analysis on pre- and postsurgical factors like body mass index, number of co-morbidities, and percentage of excess weight loss. RESULTS: A primary perceived affective response category for motivation was created that included 3 levels: desperate, tired, and pragmatic. Within these levels participants reported motivations related to quality of life, prevent death, last option, and trigger. Participants in the desperate level exhibited higher presurgical body mass index, greater number of presurgical co-morbidities, more attempted methods for weight loss, and more negative perceptions of health before surgery. Participants in the tired group experienced the greatest percentage of excess weight loss and participants in desperate and tired showed greater weight loss, percentage of weight lost, and percentage of excess weight lost compared with the pragmatic group when controlling for presurgical weight. CONCLUSIONS: Most participants reported a physical health-related motivation, but participants with greater perceived affective motivational responses cited prevention of death and viewing surgery as their last option to a higher extent. Participants with greater perceived affective response exhibited significantly better weight loss outcomes, indicating that some emotional component to motivation may improve long-term success. Presurgical consultation might incorporate principles from the Transtheoretical Model and Motivational Interviewing to connect the emotional impacts of obesity on patients' health and well being to health behaviors promoting weight maintenance.

A Qualitative Analysis of Post-operative Nutritional Barriers and Useful Dietary Services Reported by Bariatric Surgical Patients.

BACKGROUND: Outcomes studies show many bariatric patients fail to lose optimal weight or regain significant weight post-surgery. One reason for weight regain may be difficulty adhering to the postoperative diet. METHODS: Cross-sectional survey methodology collected text data on perceived postoperative nutritional barriers and helpful dietary services reported by bariatric patients. Participants were solicited from an online obesity support website, and 440 responses related to perceived barriers and 330 responses regarding postoperative services were examined using inductive content analysis. RESULTS: Barriers were categorized as being Internal, External, and None. Internal barriers were classified as Psychological, Physiological, and Psychophysiological, with Psychophysiological being the most commonly reported (85.9 %). Helpful services reported included categories of None, Provided, and On their Own. Sixty-two percent of participants reported receiving at least one Provided service that was helpful, including knowledge and support from professionals like registered dietitian nutritionists (RDNs). However, 22 % of participants reported seeking out at least one service On their Own such as through the Internet, and 27 % of participants reported not receiving or not using any helpful services. CONCLUSIONS: The physiological nature of post-surgical changes and the mental stamina required of positive eating habits contribute to postoperative adherence difficulties. Many patients likely exhibit poor habits pre-surgery, and without added help to change these behaviors may regain weight. Participants in this study indicated that convenient access to an RDN was helpful. Bariatric facilities should include staff well-trained in the specific nutritional barriers patients face and provide availability of staff beyond the initial postoperative phase.

A qualitative analysis of bariatric patients' post-surgical barriers to exercise.

Research has shown that some bariatric patients overestimate post-surgical exercise levels, while others struggle with negative cognitions and follow-through on intentions to exercise; however, little exists on specific barriers affecting bariatric patients' post-surgical exercise behaviors. Considering that regular exercise is a predictor of weight loss maintenance, further research is warranted. Survey methodology was utilized to assess post-operative exercise barriers as well as beneficial post-surgical exercise services among a sample of bariatric patients solicited from an online support website. Qualitative assessment of responses was completed using inductive content analysis. Higher-order themes for exercise barriers included internal, external, and no barriers; generic categories determined for internal barriers included motivational and physical barriers. Of the participants, 78% reported at least one internal motivational barrier, and the most frequently reported subcategorical barrier was time (28%); physical barriers were reported related to surgery (9%) or other chronic conditions (19%). Higher-order themes for exercise services included positive descriptions such as benefits from exercise prescription as well as the importance of facilities and individuals, while negative descriptions included no services available or services that were unhelpful. Participants cited the benefit of community-based facilities, so providers might consider partnering with local professionals to deliver exercise services. Staff should be aware of physical barriers specific to bariatric populations including issues with post-surgical stamina and chronic comorbid conditions in order to provide appropriate exercise prescription. In addition, as motivational and time barriers occur frequently, providers should be well-trained on how to help patients overcome these impediments to exercise maintenance.

Survey of bariatric surgical patients' experiences with behavioral and psychological services.

BACKGROUND: Bariatric surgery continues to grow in popularity as a treatment of obesity; however, weight regain and noncompliance with behavioral recommendations remain an issue. Little is known about the type and frequency of services completed by bariatric patients and their satisfaction with these services. However, preliminary research has shown that the use of behavioral and psychological services is less common after surgery. We assessed the behavioral and psychological services completed by bariatric patients before and after surgery, patient satisfaction with the surgery and services, and the relationship between the completed services and the outcomes. The participants were solicited for participation using an on-line support Web site dedicated to obesity and bariatrics. METHODS: A convenience sample of 380 subjects were included in the present study. They completed an Internet-based survey that assessed the psychological, dietary, exercise, and lifestyle services completed before and after surgery, their satisfaction with these services, and their weight loss outcomes. RESULTS: Overall, the participants reported completing more services before surgery. After surgery, the most frequently reported services completed were support groups and dietary consultation. More than one half of the participants did not meet with either a mental health professional or an exercise professional after surgery. The participants expressed high satisfaction with their surgery and services, with exercise services receiving the lowest satisfaction rating. A statistically significant relationship was found between the total number of postoperative psychological and behavioral services completed and a greater percentage of excess weight lost. The t tests showed that participants who completed group exercise sessions and nutritional consultation after surgery lost more weight than did those who did not complete these services. CONCLUSION: The participants in the present sample reported completing few behavioral and psychological services after surgery. However, our findings showed that these services could promote greater weight loss and maintenance. Thus, it is recommended that bariatric facilities and insurance providers consider requiring patients to complete postoperative behavioral modification programs that target improvement in diet and physical activity behaviors.

An assessment of patient behavioral requirements pre- and post-surgery at accredited weight loss surgical centers.

BACKGROUND: Without changes to diet and exercise behaviors, weight losses achieved through surgical procedures may be short lived. There is no data currently available on how accredited bariatric facilities are implementing best-practice guidelines related to behavioral and psychological care to help patients make long-lasting change. METHODS: One hundred twenty-three ACS-accredited facility websites were analyzed using document and content analyses to determine behavioral and psychological services. Categories of common facility practices were identified according to best-practice recommendations and website data was coded by category. Descriptive statistics were then generated to summarize the implementation of services. RESULTS: Behavioral and psychological services were more likely to be required prior to surgery than after surgery. In addition, there is great variance in the staff employed by facilities to assist patients, with more facilities employing dietary staff than exercise staff. Data patterns are reported across the categories of psychological assessment, pre- and post-surgical behavioral requirements, type of support groups, follow-up protocol, and staffing. CONCLUSIONS: Most facilities implement some type of dietary counseling or consultation; however, few include services related to helping patients improve physical activity patterns. Greater incorporation of behavioral and psychological services following surgery is recommended to prevent weight regain and to help patients adopt and maintain regular physical activity.