An examination of electronic nicotine delivery system use among college students using social cognitive theory.

Objective: Using social cognitive theory as a framework, this study examined electronic nicotine delivery systems (ENDS) use, related cognitions, and context among college students. Participants: Respondents were 1229 students attending a mid-sized, northeastern university. Methods: A cross-sectional survey was administered and SPSS was used for analysis. Results: Almost 41% of respondents reported ENDS use in the prior month (past-month user), 26.8% reported trying ENDS but no use in the prior month (occasional user), and 32.3% reported never trying ENDS. The results highlight significant associations in past-month versus occasional use and reasons for initation, location for ENDS use, perceived norms for ENDS use, and outcome expectations for ENDS use. Conclusions: This study highlights a need for theory-based, multi-level strategies to reduce ENDS use. Interventions should increase awareness about the risks of ENDS, include peer-based interventions to foster health-promoting campus social environments, and explore the use of policies restricting campus ENDS use.

Objectively measured chronic disease risk among food pantry patrons.

OBJECTIVES AND DESIGN: This cross-sectional, observational study examined the prevalence of objectively measured chronic disease risk factors among a diverse group of food pantry patrons. SAMPLE AND MEASUREMENT: Public health nurses performed biometric screenings in community settings for 1,685 unduplicated adults attending food pantries. RESULTS: Over three fourths of participants (81.1%) were overweight or obese. High cholesterol and high blood pressure were detected in 38.4% and 37.7% of participants, respectively. Over half (58%) of the participants were referred to a local community health clinic for follow-up services. CONCLUSION: Interventions should target food pantry patrons to reduce the prevalence of chronic disease conditions among this vulnerable population.

Simultaneous Use of Alcohol and Electronic Nicotine Delivery Systems among College Students: Vaping History, Motivations for Use, and Outcome Expectancies.

Introduction: Simultaneous polydrug use of electronic nicotine delivery systems (ENDS) and alcohol among college students is not well understood despite high rates of vaping and alcohol use among this population. The current study examined rates of simultaneous use and compared demographic characteristics, vaping history, motivations for initiating use, and outcome expectancies based on polydrug use status. Methods: An online and paper-and pencil questionnaire was administered to undergraduate students at a university in the northeast of the U.S. Purposive sampling strategies were used and a raffle was offered to incentivize participation. Results: Simultaneous polydrug use was prevalent in the sample of 670 college students, with 55.6% reporting simultaneous and non-simultaneous use, 34.0% reporting simultaneous use only, and 10.4% reporting non-simultaneous use only. An examination of differences based on polydrug use status indicated that students who reported simultaneous and non-simultaneous use were more likely to be males, report vaping daily, and endorse a wide range of motivations for use. Students who engaged in simultaneous use only were more likely to be females, indicate a social contextual-related motivation for initiating use, and had higher scores on appetite control, emotion regulation, and taste sensation outcome expectancies. Students who engaged in non-simultaneous use only were more likely to be nonwhite students and report the lowest expectation of health risks. Conclusions: The findings reveal differences based on simultaneous polydrug use status that can be informative in the development of contextually relevant prevention programming. Future research is needed to further explore simultaneous use of ENDS and alcohol.

Food insecurity: Comparing odds between working-age veterans and nonveterans with children.

BACKGROUND: Low-income, working-age Veterans with children have risk for food insecurity. Less known is extent to which their risk compares to nonveterans. PURPOSE: To evaluate odds of food insecurity for working-age Veterans with children compared to socioeconomically-matched nonveterans with children. METHOD: We constructed a propensity score-matched cohort using 2011-2014 National Health and Nutrition Examination Survey data. Covariate-adjusted logistic regressions estimated Veterans' odds for overall food insecurity and for each level of severity compared to nonveterans. FINDINGS: We matched 155 Veterans to 310 nonveterans on gender, race/ethnicity, education, income. Models were adjusted for age, marital-status, depression, and listed matched variables. Although Veteran-status had no effect on overall food insecurity (odds ratio = 1.09, 95% confidence interval [0.62,1.93]), Veteran-status increased odds for very low food security (odds ratio = 2.71, 95% confidence interval [1.21, 6.07]). DISCUSSION: Veterans do not have higher odds of food insecurity than non-veterans, but they are more likely to have the more severe very low food security (often associated with hunger) than non-veterans. Investigation of food insecurity's impact on Veteran health/well-being is needed.

Walking Toward a Brighter Future: A Participatory Research Process to Advocate for Improved Walk-to-School Corridors.

Inclusive place-making is an important strategy to ensure that built-environment improvements contribute rather than detract from community health. We conducted participatory research to support 15 youth leaders as they advocated for improvements to their walk-to-school environment. The project included four phases. During Phase 1 (Route and Experience Identification), we visited 21 classrooms in three Bridgeport high schools and used an interactive mapping process with students to identify the most often used walk-to-school routes. Youth leaders also collected questionnaires from 187 peers about their school travel experiences. During Phase 2 (Route Assessment), the youth leaders examined the quality of these routes using the Microscale Audit of Pedestrian Streetscapes assessment tool. During Phase 3 (Data Analysis), the University partners analyzed the data collected in the prior phases. Percentage scores were calculated for each segment and crossing along the routes assessed. We used chi-square tests to examine associations between students' travel model and negative travel-related experiences. Almost all segments (82%) and crossings (91%) examined received a failing grade (<64%). In addition, a greater proportion of students who walk/cycle/skate to school rather than ride in a motor vehicle reported feeling unsafe (p = .001), missing first period (p = .006), and lower grades (p = .001) due to travel-related challenges. The findings from these assessments were used during Phase 4 (Youth Campaign) to advocate for safer routes to schools. We describe both the lessons learned and successes from the project. Other municipalities might benefit from replicating the youth-led, participatory approach used in this study.

Implementation and Evaluation of a Physical Activity and Dietary Program in Federal Incarcerated Females.

The purpose of this 3-month quasi-experimental pilot study was to examine the effect of a physical activity and dietary education program on body mass index (BMI) and resilience. Participants were given data-storing pedometers to record their physical activity, attended classes on healthy eating, and used portion control tools from http://ChooseMyPlate.gov . MyPlate usage and commissary purchases were collected weekly. BMI and resilience scores were measured at baseline, 6 weeks, and 12 weeks. Twenty-nine female prisoners completed the study. There was a statistically significant reduction in BMI after 12 weeks (χ2 = 7.56, p = .023) and resilience levels increased but did not reach statistical significance (χ2 = 1.66, p = .437). A physical activity and dietary intervention delivered by a correctional health nurse practitioner was an efficacious approach to reducing BMI and improving resilience among female prisoners.

Formative Research to Create a Farm-to-School Program for High School Students in a Lower Income, Diverse, Urban Community.

BACKGROUND: Using Social Cognitive Theory as a framework, we examined opportunities for promoting local produce consumption among high school students in a lower-income, ethnically diverse, urban community. METHODS: Six focus groups (N = 53) were conducted with students. Using Atlas.ti qualitative software, data were coded and reviewed to identify code categories which could be taken to represent themes. RESULTS: Students (56.8% girls, 86.5% nonwhite) described local produce as being grown "nearby" or "in Connecticut." Overwhelmingly, students perceived local produce to be of higher quality (eg, "tastes better," "fresher") than nonlocal produce. Students reported that the foods served at school are "unnatural" and "made in a factory." Salient perceived outcomes associated with consuming local produce included "benefits the environment," "builds community and trust," and "keeps taxes down." Students recommended hanging large colorful posters highlighting the positive outcomes associated with consuming local produce in school locations with captive audiences such as lunch lines and classrooms. Labels identifying the food origins of cafeteria foods provided as well as taste tests of local produce might support students' self-efficacy for consuming local fruits and vegetables. CONCLUSIONS: These findings provide theory-based strategies for how to promote local produce consumption among a diverse group of urban high schools students.

Identifying Windows of Opportunity for Active Living and Healthy Eating Policies in Connecticut, 2016.

We examined the relative importance of 23 community issues among elected officials and health directors in Connecticut in 2016. For this cross-sectional study, 74 elected officials (40.7% response rate) and 47 health directors (62.7% response rate), who were purposively sampled, completed a questionnaire to rate their perceived importance of 23 community issues. Eight of these issues were related to active living, healthy eating, or obesity. We used χ2 tests to evaluate differences in responses. Compared with elected officials, health directors significantly more often perceived obesity, access to healthy groceries, poor nutrition, lack of pedestrian walkways, and pedestrian safety as important. Elected officials significantly more often than health directors perceived lack of good jobs, quality of public education, and cost of living as important. Health advocates should work with both groups to develop and frame policies to address both upstream (eg, jobs, education) and downstream (eg, healthy eating policies) determinants of obesity.

Use of a Unique Farmers' Market Program Targeting Lower-Income Community Members.

We examined use of a farmers' market that leverages community partnerships to provide free produce to lower-income persons. Participants (n = 422) were asked to complete a questionnaire and given an ID number, which was used to track market use from 2014 to 2015. Chi square tests were used to examine associations between 2014/2015 market use and reasons for market use, financial support received, and how attendees had learned about the market. Ordinal regression was used to identify household characteristics associated with increased market attendance. Although the proportion of lower-income attendees declined over the study period, a substantial proportion of households in 2014 (69.1%) and 2015 (54.6%) were below the poverty threshold. We identified significant differences in attendees' reasons for market use and ways attendees heard about the market from 2014 to 2015. The most frequently reported reason for 2014 market use was retirement/fixed income (P < 0.001) and in 2015 was low-income (P < 0.001). Most attendees heard about the market through flyers (P < 0.001) and word of mouth (P ≤ 0.001) in 2014 and through local, non-profit services (P < 0.001) in 2015. In the ordinal regression, households with an older person registering the household for the market used the market more times per year (P < 0.001). Impoverished households (P = 0.020) and households receiving more financial support services (P < 0.001) used the market fewer times per year. While a substantial proportion of lower-income persons used the free-produce market, frequency of use was still lowest among this group indicating a need to address barriers beyond produce cost.

Agricultural Experiences Are Positively Associated With High School Students' Fruit and Vegetable Perceptions and Consumption.

OBJECTIVE: To examine the relationship between high school students' agricultural experiences and their (1) attitudes about consuming local fruits and vegetables, (2) willingness to try new fruits and vegetables, and (3) fruit and vegetable consumption. DESIGN: Cross-sectional survey research. SETTING: Public high schools in a lower-income, diverse, urban, northeastern community. PARTICIPANTS: A total of 327 students from 3 public high schools. MAIN OUTCOME MEASURE(S): Exposures were prior experience helping on a farm or community garden (yes/no) and having a home garden (yes/no). Outcomes were perceptions about local produce consumption (α = .73), willingness to try new fruits (α = .86) and vegetables (α = .86), and adequate fruit and vegetable consumption (yes/no) as measured by a valid 2-item cup screener. ANALYSIS: Independent t tests, 1-way ANOVA, and chi-square tests were used. RESULTS: Half of students (52.9%) reported prior farm experience; 29.7% reported having a garden at home. Few students reported consuming at least 3 cups/d of vegetables (9.8%) or 2 cups/d of fruit (37.0%). Students with prior farm experience had more favorable scores for local produce perceptions (P = .002) and willingness to try new fruits (P = .001) and vegetables (P < .001) than were students without prior experience. Students with a home garden had more favorable scores for local produce perceptions (P = .02) and willingness to try new fruits (P = .001) and vegetables (P = .001) and more often consumed adequate vegetables (P = .007) than did students without a garden. CONCLUSIONS AND IMPLICATIONS: Those working with high school students might consider offering agriculture experiences that could promote positive fruit and vegetable attitudes and behaviors.

Development of the Clinical Teaching Effectiveness Questionnaire in the United States.

PURPOSE: The purpose of this study was to develop a valid measure for assessing clinical teaching effectiveness within the field of physical therapy. METHODS: The Clinical Teaching Effectiveness Questionnaire (CTEQ) was developed via a 4-stage process, including (1) initial content development, (2) content analysis with 8 clinical instructors with over 5 years of clinical teaching experience, (3) pilot testing with 205 clinical instructors from 2 universities in the Northeast of the United States, and (4) psychometric evaluation, including principal component analysis. RESULTS: The scale development process resulted in a 30-item questionnaire with 4 sections that relate to clinical teaching: learning experiences, learning environment, communication, and evaluation. CONCLUSION: The CTEQ provides a preliminary valid measure for assessing clinical teaching effectiveness in physical therapy practice.

Acute Effects of Plyometric and Resistance Training on Running Economy in Trained Runners.

Marcello, RT, Greer, BK, and Greer, AE. Acute effects of plyometric and resistance training on running economy in trained runners. J Strength Cond Res 31(9): 2432-2437, 2017-Results regarding the acute effects of plyometrics and resistance training (PRT) on running economy (RE) are conflicting. Eight male collegiate distance runners (21 ± 1 years, 62.5 ± 7.8 ml·kg·min V[Combining Dot Above]O2 peak) completed V[Combining Dot Above]O2 peak and 1 repetition maximum (1RM) testing. Seven days later, subjects completed a 12 minutes RE test at 60 and 80% V[Combining Dot Above]O2 peak, followed by a PRT protocol or a rested condition of equal duration (CON). The PRT protocol consisted of 3 sets of 5 repetitions at 85% 1RM for barbell squats, Romanian deadlifts, and barbell lunges; the same volume was used for resisted lateral lunges, box jumps, and depth jumps. Subjects completed another RE test immediately after the treatments and 24 hours later. Subjects followed an identical protocol 6 days later with condition assignment reversed. Running economy was determined by both relative V[Combining Dot Above]O2 (ml·kg·min) and energy expenditure (EE) (kcal·min). There was a significant (p ≤ 0.05) between-trial increase in V[Combining Dot Above]O2 (37.1 ± 4.2 ml·kg·min PRT vs. 35.5 ± 3.9 ml·kg·min CON) and EE (11.4 ± 1.3 kcal·min PRT vs. 11.0 ± 1.4 kcal·min CON) immediately after PRT at 60% V[Combining Dot Above]O2 peak, but no significant changes were observed at 80% V[Combining Dot Above]O2 peak. Respiratory exchange ratio was significantly (p ≤ 0.05) reduced 24 hours after PRT (0.93 ± 0.0) as compared to the CON trial (0.96 ± 0.0) at 80% V[Combining Dot Above]O2 peak. Results indicate that high-intensity PRT may acutely impair RE in aerobically trained individuals at a moderate running intensity, but that the attenuation lasts less than 24 hours in duration.

Park Use and Physical Activity Among Mostly Low-to-Middle Income, Minority Parents and Their Children.

BACKGROUND: Limited research has examined park use and physical activity among economically and ethnically diverse families. This study fills that gap. METHODS: Parents (n = 326) completed a questionnaire about their park use (yes/no, parks visited, reasons for nonuse) and physical activity (Godin Leisure Time questionnaire). Geographical Information Systems was used to calculate the distance from respondents' home address to their nearest park. The number of activity features (eg, playgrounds) in parks was determined objectively using the Community Park Audit Tool. RESULTS: Half of respondents were sufficiently active; 87.6% reported park use in the prior 6 months. Among sufficiently active respondents, 92.4% reported park use (P = .011). We found no difference in park proximity between respondents who did and did not report distance as a park use barrier. An objective assessment confirmed fewer activity features in parks near the homes of respondents reporting few activity features as a barrier to park use. The most often visited parks were significantly larger than the less-often visited parks. CONCLUSION: Parks might best support physical activity for families when activity features are carefully planned and equitably distributed across parks. Efforts to promote families' awareness of park locations might be warranted to reduce perceived proximity barriers.

Giving Economically Disadvantaged, Minority Food Pantry Patrons' a Voice: Implications for Equitable Access to Sufficient, Nutritious Food.

This study provides economically disadvantaged, minority food pantry patrons (hereafter, patrons) a meaning-ful voice by examining their experiences trying to obtain sufficient, nutritious food. Five focus groups were conducted using a semistructured discussion guide. Atlast.ti software was used to manage and analyze the data. Patrons reported that pantry staff who preserved their dignity by showing compassion were highly valued. Stigma and shame associated with pantry use were major concerns. Patrons suggested environmental and policy changes to improve their food acquisition experiences. These findings suggest that multilevel interventions addressing food access, food distribution policies, and patron-staff interactions are warranted.

Assessment of a Novel Tool for Identifying Hospitalized Patients with Heart Failure at Risk for 30-Day Readmission, High Cost, and Longer Length of Stay.

Hospitals are penalized financially for high 30-day readmission rates for specific diagnoses, including heart failure. The economic imperative exists to better manage the heart-failure population and acute care providers are in need of appropriate tools to aid in their efforts. This study was conducted to determine if the Rothman Index score may be useful to prospectively identify patients with heart failure at risk for extended hospitalization, high inpatient cost of care, and 30-day readmission. Results from this study suggest the Rothman Index score can be a useful adjunct to current clinical assessment methods in helping multidisciplinary teams better manage patient care and limited resources.

Reliability of BOD POD Measurements Remains High After a Short-Duration Low-Carbohydrate Diet.

The purpose of the current study was to determine whether expected changes in body weight via a 3-day low-carbohydrate (LC) diet will disrupt the reliability of air displacement plethysmography measurements via BOD POD. Twenty-four subjects recorded their typical diets for 3 days before BOD POD and 7-site skinfold analyses. Subjects were matched for lean body mass and divided into low-CHO (LC) and control (CON) groups. The LC group was given instruction intended to prevent more than 50 grams/day of carbohydrate consumption for 3 consecutive days, and the CON group replicated their previously recorded diet. Body composition measurements were repeated after dietary intervention. Test-retest reliability measures were significant (p < .01) and high for body fat percentage in both the LC and the CON groups (rs = .993 and .965, respectively). Likewise, skinfold analysis for body fat percentage reliability was high in both groups (rs = .996 and .997, respectively). There were significant differences between 1st and 2nd BOD POD measurements for body mass (72.9 ± 13.3 vs. 72.1 ± 13.0 kg [M ± SD]) and body volume (69.0 ± 12.7-68.1 ± 12.2 L) in the LC group (p < .05). However, there were no differences (p > .05) in BOD POD-determined body fat percentage, lean body mass, or fat mass between the 1st and 2nd trial in either group. Body composition measures via BOD POD and 7-site skinfolds remain reliable after 3 days of an LC diet despite significant decreases in body mass.

The effects of sedentary behavior on metabolic syndrome independent of physical activity and cardiorespiratory fitness.

BACKGROUND: To date, no longitudinal studies have examined the influence of sedentary behavior on metabolic syndrome development while accounting for cardiorespiratory fitness. PURPOSE AND METHODS: This prospective study examined the relationship between sedentary behavior and incident metabolic syndrome while considering the effects of physical activity and cardiorespiratory fitness on the association among 930 men enrolled in the Aerobics Center Longitudinal Study. RESULTS: A total of 124 men developed metabolic syndrome during 8974 person-years of exposure. After adjusting for covariates, men with middle and high sedentary behavior had 65% and 76% higher risks of developing metabolic syndrome, respectively, than men with low sedentary behavior (linear trend P = .011). This association remained significant after additional adjustment for activity status and cardiorespiratory fitness. Cardiorespiratory fitness and physical activity were also inversely associated with metabolic syndrome, even after adjustment for sedentary behavior. CONCLUSIONS: The findings highlight the importance of reducing sedentary behavior, increasing physical activity, and improving cardiorespiratory fitness for preventing metabolic syndrome.