Negative emodiversity is associated with emotional eating in adolescents: An examination of emotion dynamics in daily life.

INTRODUCTION: Emotional eating is a mental health concern, common in adolescents, that develops as a result of their tendency to use high-energy food to regulate their fluctuating emotions. Due to their highly fluctuating emotional life, adolescents tend to have unique within-person profiles of emotional experiences that change across moments and days, often lost in global assessments of emotions. Hence, it is imperative to examine individual differences in dynamics of emotions, as experienced in daily life, in relation to emotional eating in adolescents. METHODS: In an Ecological Momentary Assessment study, we examined individual differences in three within-person dynamic characteristics (baseline levels, intraindividual variability, and emodiversity) of emotions in 158 dominantly Hispanic adolescents in the United States, aged 14-17 years old, predicting trait-level emotional eating. RESULTS: Results indicated that higher negative emodiversity, baselines, and variability in stress were predictive of emotional eating in adolescents. When all considered together, negative emodiversity (i.e., variety of the types of negative emotions experienced in one's daily life) remained the only significant predictor of emotional eating. CONCLUSIONS: This study affirms the importance of diversity in emotional experiences in relation to emotional eating, particularly in daily contexts of adolescents' lives. Additionally, the study emphasizes the importance of distinguishing between diversity (i.e., variety in types) in positive versus negative emotional experiences with regard to emotional eating. By taking into account the ecological validity of adolescents' daily lives and individual differences in dynamical changes in emotions, we are taking a step forward by shedding light on how the dynamics of negative emotions-in terms of within-person baselines, variability, and diversity-might be related to general levels of emotional eating in adolescents.

Exploring mediation pathways on the relationship between acculturation and binge eating among Latino adolescents.

The objective of this study was to explore the mediating effects of emotional eating, restrained eating, and external eating on the relationship between acculturation and binge eating among Latino adolescents. Adolescents who self-identified as Latino (N = 285) at public high schools in Southern California were recruited and completed a self-report survey. Acculturation was assessed using the 8-item Acculturation, Habits, Interests for Multicultural Adolescents (AHIMSA) scale for adolescents, mediators were assessed using Dutch Eating Behavior Questionnaire (DEBQ), and binge eating was assessed using a 13-item Eating Disorder Diagnostic Scale. A bootstrapped multiple mediation model was used to test mediation pathways. Findings suggest that individually each eating style-emotional, restrained and external eating pathway did not reach significance singly, but that jointly, their combined effect was significant with a total indirect effect (B = 0.15, CI 0.01-0.30) indicating an additive effect of the three eating styles. Future research should examine additional mediators of the relationship between acculturation and binge eating.

Randomized controlled trial evaluating an intervention supporting implementation of sun safety policies in California public elementary schools.

Solar ultraviolet radiation (UV) exposure is the primary risk factor for skin cancer and children receive about one-quarter of lifetime UV exposure before age 18. Thus, skin cancer prevention is essential for children. The objective of this study was to test an intervention to facilitate implementation of district sun safety policies. Elementary schools (N = 118) from 40 California public school districts with a school board-approved policy for sun safety were recruited along with one principal and teacher from each school. Elementary schools were randomly assigned to receive the 20-month Sun Safe Schools intervention (N = 58) or to a minimal informational control condition (N = 60). Principals were 47.8 and teachers 44.3 years of age and were predominately female (principals 72.7%; teachers 86.7%) and White (principals 72.0%; teachers 68.2%). The 20-month Sun Safe Schools intervention was delivered to principals and included a coaching session, telephone and email contacts, provision of resources for practice implementation, and a small grant program. The principal (N = 118) and a teacher (N = 113) at each school reported on school sun protection practices 20-months post-baseline. The schools were diverse in student characteristics (M = 64.1% free/reduced price meals; M = 54.5% Hispanic). Intervention principals reported implementing more sun safety practices overall (control M = 2.7, intervention M = 4.2, p < .005) and more practices not present in the district's policy (control M = 0.4, intervention M = 0.9, p = .005). Principals and teachers combined replicated these findings and also reported implementing more practices present in the district policy (control M = 0.9, intervention M = 1.3, p = .005). In sum, the intervention increased sun safety practices in public elementary schools. Trial Registration. This study is registered in ClinicalTrials.gov, www.clinicaltrials.gov, with the identification number of NCT03243929.

An Examination of Family Variables as Mediators of the Association of Acculturation With Sugar-Sweetened Beverage Consumption Among Latinx Adolescents.

The objective of this study was to examine the mediating effects of family support for dietary habits and family meal frequency on the relationship between acculturation and sugar-sweetened beverage (SSB) consumption among Latinx adolescents (N = 131). Acculturation was positively associated with SSB consumption (B = 0.07, P < .01). Results suggest that family support for dietary habits and family meal frequency did not mediate the relationship between acculturation and SSB consumption. However, acculturation was negatively associated with family support for dietary habits (B = -0.10, P < .01) and family meal frequency (B = -0.11, P < .05). Future research should examine other family influences as mediators of the relationship between acculturation and SSB consumption.

Family functioning, moods, and binge eating among urban adolescents.

This study builds upon prior research on associations between moods, family functioning, and binge eating, using ecological momentary assessment to examine moderating effects of family functioning on associations between moods and binge eating. This study was conducted among a nonclinical sample of urban adolescents. Family functioning was assessed using five constructs adopted from the FACES-IV measure: 'family cohesion,' 'family flexibility' 'family communication,' 'family satisfaction,' and 'family balance.' Mood data was gathered using 13 items from a daily affect scale. Binge eating was assessed using two subscales from the Eating Disorder Diagnostic Scale-binge eating associated with 'embarrassment' (BE1), and binge eating associated with a sense of 'loss of control' (BE2). A multilevel modeling approach was employed to examine how associations between momentary moods and binge eating behaviors were moderated by family functioning. Results indicated that measures of negative affect, stress/frustration, and tiredness/boredom were significantly and positively associated with two measures of binge eating (BE1 and BE2; p values ≤ 0.05), and that multiple factors of family functioning buffered the positive predictive effects of moods on binge eating. Findings indicate the importance of inclusion of family functioning in the development of eating behavior interventions for adolescents.

Acculturation and sugar-sweetened beverage consumption among Hispanic adolescents: The moderating effect of impulsivity.

Consumption of sugar-sweetened beverages is a risk factor for obesity. Acculturation to the United States (US) might increase sugar-sweetened beverage consumption among Hispanic adolescents, but few moderators of this relationship have been examined. This study examined the moderating influence of impulsivity on the association between acculturation and sugar-sweetened beverages. Hispanic adolescents (n = 154), 14-17 years, were identified and screened for eligibility through low-SES high schools and parents provided consent. Adolescents completed measures of acculturation using Unger's 8-item acculturation scale, impulsivity, and diet. Multiple linear regression was used to examine the main effect of acculturation and the interaction of acculturation with impulsivity on the diet outcomes: sugar-sweetened beverage consumption and percent of calories from sugar. Acculturation was positively associated with sugar-sweetened beverages (ß = 0.43; p < .05). The interaction of acculturation x impulsivity was significant (ß = 0.42, p < .05). Among youth who were more acculturated, those who were more impulsive consumed more sugar-sweetened beverages. Youth who were more acculturated, but less impulsive consumed less sugar-sweetened beverages. Neurocognitive variables such as impulsivity may be important moderators of the influence of acculturation on dietary behavior. Targeted messaging strategies based on levels of acculturation and impulsivity might enhance the effectiveness of interventions designed to reduce the intake of sugar-sweetened beverages among Hispanic adolescents.

Accuracy of Principal and Teacher Knowledge of School District Policies on Sun Protection in California Elementary Schools.

INTRODUCTION: Policy is a key aspect of school-based efforts to prevent skin cancer. We explored the extent and accuracy of knowledge among principals and teachers in California public school districts about the elements specified in their district's written sun safety policy. METHODS: The sample consisted of California public school districts that subscribed to the California School Boards Association, had an elementary school, adopted Board Policy 5141.7 for sun safety, and posted it online. The content of each policy was coded. Principals (n = 118) and teachers (n = 113) in elementary schools were recruited from September 2013 through December 2015 and completed a survey on sun protection policies and practices from January 2014 through April 2016. RESULTS: Only 38 of 117 principals (32.5%) were aware that their school district had a sun protection policy. A smaller percentage of teachers (13 of 109; 11.9%) than principals were aware of the policy (F108 = 12.76, P < .001). We found greater awareness of the policy among principals and teachers who had more years of experience working in public education (odds ratio [OR] = 1.05, F106 = 4.71, P = .03) and worked in schools with more non-Hispanic white students (OR = 7.65, F109 = 8.61, P = .004) and fewer Hispanic students (OR = 0.28, F109 = 4.27, P = .04). CONCLUSION: Policy adoption is an important step in implementing sun safety practices in schools, but districts may need more effective means of informing school principals and teachers of sun safety policies. Implementation will lag without clear understanding of the policy's content by school personnel.

Inhibitory control effects in adolescent binge eating and consumption of sugar-sweetened beverages and snacks.

Inhibitory control and sensitivity to reward are relevant to the food choices individuals make frequently. An imbalance of these systems can lead to deficits in decision-making that are relevant to food ingestion. This study evaluated the relationship between dietary behaviors - binge eating and consumption of sweetened beverages and snacks - and behavioral control processes among 198 adolescents, ages 14 to 17. Neurocognitive control processes were assessed with the Iowa Gambling Task (IGT), a generic Go/No-Go task, and a food-specific Go/No-Go task. The food-specific version directly ties the task to food cues that trigger responses, addressing an integral link between cue-habit processes. Diet was assessed with self-administered food frequency and binge eating questionnaires. Latent variable models revealed marked gender differences. Inhibitory problems on the food-specific and generic Go/No-Go tasks were significantly correlated with binge eating only in females, whereas inhibitory problems measured with these tasks were the strongest correlates of sweet snack consumption in males. Higher BMI percentile and sedentary behavior also predicted binge eating in females and sweet snack consumption in males. Inhibitory problems on the generic Go/No-Go, poorer affective decision-making on the IGT, and sedentary behavior were associated with sweetened beverage consumption in males, but not females. The food-specific Go/No-Go was not predictive in models evaluating sweetened beverage consumption, providing some initial discriminant validity for the task, which consisted of sweet/fatty snacks as no-go signals and no sugar-sweetened beverage signals. This work extends research findings, revealing gender differences in inhibitory function relevant to behavioral control. Further, the findings contribute to research implicating the relevance of cues in habitual behaviors and their relationship to snack food consumption in an understudied population of diverse adolescents not receiving treatment for eating disorders.

Sweetened drink and snacking cues in adolescents: a study using ecological momentary assessment.

The objective of this study was to identify physical, social, and intrapersonal cues that were associated with the consumption of sweetened beverages and sweet and salty snacks among adolescents from lower SES neighborhoods. Students were recruited from high schools with a minimum level of 25% free or reduced cost lunches. Using ecological momentary assessment, participants (N=158) were trained to answer brief questionnaires on handheld PDA devices: (a) each time they ate or drank, (b) when prompted randomly, and (c) once each evening. Data were collected over 7days for each participant. Participants reported their location (e.g., school grounds, home), mood, social environment, activities (e.g., watching TV, texting), cravings, food cues (e.g., saw a snack), and food choices. Results showed that having unhealthy snacks or sweet drinks among adolescents was associated with being at school, being with friends, feeling lonely or bored, craving a drink or snack, and being exposed to food cues. Surprisingly, sweet drink consumption was associated with exercising. Watching TV was associated with consuming sweet snacks but not with salty snacks or sweet drinks. These findings identify important environmental and intrapersonal cues to poor snacking choices that may be applied to interventions designed to disrupt these food-related, cue-behavior linked habits.

A quantitative survey measure of moral evaluations of patient substance misuse among health professionals in California, urban France, and urban China.

BACKGROUND: The merits and drawbacks of moral relevance models of addiction have predominantly been discussed theoretically, without empirical evidence of these potential effects. This study develops and evaluates a novel survey measure for assessing moral evaluations of patient substance misuse (ME-PSM). METHODS: This measure was tested on 524 health professionals (i.e., physicians, nurses, and other health professionals) in California (n = 173), urban France (n = 102), and urban China (n = 249). Demographic factors associated with ME-PSM were investigated using analyses of variance (ANOVAs) and t-tests, with results suggesting that ME-PSM is higher among younger health professionals, nurses (when compared with physicians and other health professionals), and Chinese health professionals (when compared with French and American health professionals). RESULTS: Results provide preliminary support for the psychometric quality of the survey measure introduced in this study, including the existence of a single latent structure and partial invariance of collected data across countries. CONCLUSION: The survey measure for ME-PSM which was developed and tested in the current study appears to hold potential utility for use as a measure of moral views of patient substance misuse. With development, this measure may be used to examine moral evaluations, both as factors of stigma and of other clinical factors associated with the treatment of patients with substance use disorders.

Exploring Potential Mediation Pathways on the Relationship Between Acculturation and Body Mass Index (BMI) Among Latino Adolescents.

BACKGROUND: Positive associations have been observed between acculturation and body mass index (BMI), but the mediators of this relationship are not well established. Acculturation researchers have called for investigating the influence of socio-contextual variables as mediators. The objective of this study was to test the mediating effects of salty snacks, sweet snacks, physical activity, and sedentary behavior on the relationship between acculturation and BMI among Latino adolescents. METHODS: Adolescents who self-identified as Latino (n = 431) at public high schools in Southern California were recruited and completed a self-report survey. A bootstrapped multiple mediation model was used to test mediation pathways. RESULTS: Acculturation was positively associated with physical activity (B = 0.09, p < .05). The indirect effects of salty snacks, sweet snacks, physical activity, and sedentary behavior were not associated with BMI, suggesting no mediation. CONCLUSIONS: Future research should examine additional mediating variables on the relationship between acculturation and BMI.

Loneliness and cravings for sugar-sweetened beverages among adolescents.

PURPOSE: The consumption of sugar-sweetened beverages (SSBs) is associated with weight gain in both children and adults. In addition to environmental factors, such as food availability, psychological variables, including mood states, also impact intake. In the current study, we focus on momentary associations between feelings of loneliness and craving for SSBs among adolescents and explore the moderating role of family functioning. Loneliness has been associated with a wide range of health outcomes, but to date, few studies have examined its association with cravings for SSBs. METHODS: Using an ecological-momentary assessment design, data were collected on 158 (males = 68, mean age = 15.13 ± 2.27 years) participants. Multilevel mixed-effects models were used to examine the relations between the main and interactive effects of loneliness and family functioning on cravings for SSBs, independent of other negative emotions. RESULTS: Results suggest that loneliness in adolescents was associated with a small increase in craving for SSBs. Importantly, the relationship held after controlling for negative emotions, suggesting the unique role of loneliness. However, positive family functioning did not mitigate the relations between loneliness and craving for SSBs. CONCLUSIONS: Loneliness uniquely contributes to cravings for SSBs. At the same time, family functioning did not buffer the influence of loneliness on cravings for SSBs among adolescents.

Parent reports of sun safety communication and behaviour for students in a randomised trial on a school policy implementation intervention.

OBJECTIVE: Schools are an important setting for skin cancer prevention. An intervention for implementation of school sun safety policy, Sun Safety Schools (SSS), was evaluated. METHODS: Primary schools (n=118) in California school districts that had already adopted a sun safety policy were enrolled in a study with a randomised controlled design. Half of the schools were randomised to SSS intervention (N=58). Parents completed an online post-test. RESULTS: More parents in intervention schools received information about sun safety (mean=26.3%, sd=3.1%, p=0.017) and children more frequently wore sun-protective clothing when not at school (mean=2.93, sd=0.03, p=0.033) than in control schools (mean=18.0%, sd=2.5%; mean=2.83, sd=0.03, respectively). In schools where principals reported implementing sun safety practices, parents reported that children spent less time outdoors at midday (mean=14.78 hours, sd=0.25, p=0.033) and fewer were sunburned (mean=12.7%, sd=1.1%, p=0.009) than in non-implementing schools (M=16.3 hours, sd=0.67; mean=21.2%, sd=3.8%, respectively). Parents who received sun safety information (mean=3.08, sd=0.04, p=0.008) reported more child sun protection than parents not receiving information (mean=2.96, sd=0.02). CONCLUSIONS: A school district sun protection policy and support for implementation increased dissemination of sun safety information to parents and student sun safety. Implications for public health: Technical assistance for sun safety policies may increase sun protection of children.

School-Level Factors Associated with Sun Protection Practices in California Elementary Schools.

BACKGROUND: This study examined implementation of district sun safety policy in schools and tested correlates of implementation in California public school districts. METHODS: Principals (N = 118) and teachers (N = 113) in California public elementary schools (N = 118) were recruited and completed a survey on sun protection policies and practices. The sample contained schools whose districts subscribed to the California School Boards Association and adopted Board Policy 5141.7 for sun safety. Principals and teachers reported on implementation of 10 school practices related to BP 5141.7 indicating which practices were implemented in the school. RESULTS: Years in public education (Exponentiated Score (ES) = 0.51, p < .001), years worked in the current district (ES = 0.49, p < .001), perception that parents should take action to protect children from the sun (ES = 0.43, p < .01), and personal skin phenotype (Low Risk ES = 0.55; High Risk ES = 0.09, p < .05) were associated with number of practices implemented in the school using multiple Poisson regression. CONCLUSIONS: Policy implementation is more likely among schools with experienced faculty, when parents are seen as important partners in student skin cancer prevention, and when school principals and teachers have a lower personal risk phenotype.

Economic Evaluation of a Sun Protection Promotion Program in California Elementary Schools.

BACKGROUND: An economic evaluation of Sun Safe Schools intervention designed to aid California elementary schools with implementing sun safety practices consistent with local board-approved policy. DESIGN: Program cost analysis: intervention delivery and practice implementation. SETTING: California elementary schools (58 interventions and 60 controls). Principals at 52 intervention and 53 control schools provided complete implementation data. PARTICIPANTS: Principals completing pre-/postintervention surveys assessing practice implementation. INTERVENTION: Phone-based 45-minute session with a project coach on practice implementation, follow-up e-mails/phone contacts, $500 mini-grant. Schools chose from a list of 10 practices for implementation: ultraviolet monitoring, clothing, hats, and/or sunscreen recommendations, outdoor shade, class education, staff training and/or modeling, parent outreach, and resource allocation. The duration of intervention was 20 months. Rolling recruitment/intervention: February 2014 to December 2017. MEASURES: Intervention delivery and practice implementation costs. Correlations of school demographics and administrator beliefs with costs. ANALYSIS: Intervention delivery activities micro-costed. Implemented practices assessed using costing template. RESULTS: Intervention schools: 234 implemented practices, control schools: 157. Twenty-month delivery costs: $29 310; $16 653 (per school: $320) for project staff, mostly mini-grants and coaching time. Administrator costs: $12 657 (per school: $243). Per-student delivery costs: $1.01. Costs of implemented practices: $641 843 for intervention schools (per-school mean: $12 343, median: $6 969); $496 365 for controls (per-school mean: $9365, median: $3123). Delivery costs correlated with implemented practices (0.37, P < .01) and total practice costs (0.37, P < .05). Implemented practices correlated with principal beliefs about the importance of skin cancer prevention to student health (0.46, P < .001) and parents (0.45, P < .001). CONCLUSION: Coaching of elementary school personnel can stimulate sun safety practice implementation at a reasonable cost. Findings can assist schools in implementing appropriate sun safety practices.

The Association of Trail Features With Self-Report Trail Use by Neighborhood Residents.

BACKGROUND: Urban trails are a useful resource to promote physical activity. This study identified features of urban trails that correlated with trail use. METHODS: Multiuse urban trails were selected in Chicago, Dallas, and Los Angeles. An audit of each trail was completed using the Systematic Pedestrian and Cyclist Environmental Scan for Trails instrument, identifying built environmental features. A self-report of trail use was obtained from trailside residents (N = 331) living within 1 mile of each trail. Univariate and multivariate Poisson regressions controlled for trail time from home and motivation for physical activity. RESULTS: Positive associations with the past month's hours on the trail were observed for the presence of distance signs, vegetation height, vegetation maintenance, and trail crowding, and a negative association was observed for the presence of crossings on the trail. Positive associations with dichotomous trail use were observed for the presence of distance signs, vegetation height, and vegetation maintenance, and a negative association was observed for the presence of crossings on the trail. CONCLUSIONS: These correlates should be confirmed in other studies and, if supported, should be considered in the promotion and design of urban trails.

Acculturation and sun-safe behaviors among US Latinos: findings from the 2005 Health Information National Trends Survey.

OBJECTIVES: We examined the relationship between acculturation and sun safety among US Latinos. METHODS: We used linear regression models to analyze data from 496 Latino respondents to the 2005 Health Information National Trends Survey. Using sunscreen, seeking shade, and wearing protective clothing were the primary outcomes and were assessed by frequency scales. Acculturation was assessed with a composite index. RESULTS: In bivariate models, acculturation was negatively associated with use of shade and protective clothing and positively associated with sunscreen use (all, P < .004). In adjusted models, acculturation was negatively associated with seeking shade and wearing protective clothing across gender and region of residence (all, P < .05). CONCLUSIONS: Our results demonstrated both adverse and beneficial effects of acculturation on Latinos' risk behaviors relating to skin cancer. Education about sun safety is needed for all Latinos and should be tailored to different levels of acculturation. Initiatives for Latinos who are not yet acculturated could focus on reinforcing existing sun-safe behaviors and presenting new ones, such as use of sunscreen; initiatives for highly acculturated Latinos might require more resources because the objective is behavior modification.

Impact of portion-size control for school a la carte items: changes in kilocalories and macronutrients purchased by middle school students.

We assessed the impact of a pilot middle school a la carte intervention on food and beverage purchases, kilocalories, fat, carbohydrate, and protein sold per student, and nutrient density of the foods sold. A la carte sales were obtained from six middle schools in three states for 1 baseline week and daily during the 6-week intervention. Intervention goals included reducing sizes of sweetened beverages and chips, and increasing the availability of water and reduced-fat/baked chips. Nutrients sold per day were computed and weekly nutrient means per student and per number of items sold were calculated and compared between baseline and week 6. Five schools achieved all goals at 6 weeks. Four schools showed increases in the percentage of kilocalories from protein and decreases in the amount of sweetened beverages sold; five showed substantial increases in water sales. Changes in regular chips varied by school. There were significant changes in energy density of foods sold. School foodservice changes in middle school snack bar/a la carte lines can be implemented and can lead to a reduction in the caloric density of foods purchased.

Improving the school food environment: results from a pilot study in middle schools.

Our objective for this study was to examine the feasibility of instituting environmental changes during a 6-week pilot in school foodservice programs, with long-term goals of improving dietary quality and preventing obesity and type 2 diabetes in youth. Participants included students and staff from six middle schools in three states. Formative assessment with students and school staff was conducted in the spring of 2003 to inform the development of school foodservice policy changes. Thirteen potential policy goals were delineated. These formed the basis for the environmental change pilot intervention implemented during the winter/spring of 2004. Questionnaires were used to assess the extent to which the 13 foodservice goals were achieved. Success was defined as achieving 75% of goals not met at baseline. Daily data were collected on goal achievement using the schools' daily food production and sales records. Qualitative data were also collected after the pilot study to obtain feedback from students and staff. Formative research with staff and students identified potential environmental changes. Most schools made substantial changes in the National School Lunch Program meal and snack bar/a la carte offerings. Vending goals were least likely to be achieved. Only one school did not meet the 75% goal achievement objective. Based on the objective data as well as qualitative feedback from student focus groups and interviews with students and school staff, healthful school foodservice changes in the cafeteria and snack bar can be implemented and were acceptable to the staff and students. Implementing longer-term and more ambitious changes and assessing cost issues and the potential enduring impact of these changes on student dietary change and disease risk reduction merits investigation.

Trail characteristics as correlates of urban trail use.

PURPOSE: The purpose of this study was to identify the environmental correlates of urban trail use. DESIGN: Three multiuse urban trails at least 15 miles in length were selected. Trails were divided into one-half-mile segments (N = 102 total segments) and marked in the field. An audit of each trail was completed identifying built environmental features. A cross-sectional count of trail users was completed at each segment estimating the type of use, age, gender. SETTING: Data collection occurred on urban trails in Chicago, Dallas, and Los Angeles. SUBJECTS: Trained observers counted 17,338 users across the three trails. MEASURES: The SPACES for Trails instrument was used, and a trail count data collection sheet was developed. ANALYSIS: Univariate and multivariate Poisson regressions controlling for location of trail and density of the population within 1 mile of the trail. RESULTS: Positive associations with trail use were observed for mixed views (beta = .33, p < .0001), streetlights (beta = .30, p < .0001), good trail condition (beta = .28, p < .0001), and the presence of cafés (beta = .38, p < .0001) and other trailside facilities (beta =.08, p < .0001). Negative associations were observed for litter (beta = -.22, p < .0001), noise (beta = -.41, p < .0001), higher vegetation density (beta = -. 10, p < .001), drainage features (beta = -.67, p < .0003), natural areas adjacent to the trail (beta = -.39, p < .0001), and tunnel present (beta = -.20, p < .04). CONCLUSIONS: These correlates should be confirmed in other studies and if supported should be considered in the promotion and design of urban trails.