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Objective: The Keep It Off trial evaluated the efficacy of a phone-based weight loss maintenance intervention among adults who had recently lost weight in Minnesota (2007-2010).Methods: 419 adults who had recently lost ≥ 10% of their body weight were randomized to the "Guided" or "Self-Directed" intervention. Guided participants received a 10 session workbook, 10 biweekly, eight monthly and six bimonthly phone coaching calls, bimonthly weight graphs and tailored letters based on self-reported weights. Self-Directed participants received the workbook and two calls. Primary outcomes are weight change and maintenance (regain of <2.5% of baseline body weight).Results: Mixed model repeated-measures analysis examining weight change revealed a significant time by treatment group interaction (p<0.0085). Guided participants regained significantly less weight than the Self-Directed participants at 12 and 24 months. The odds of 24 month maintenance were 1.37 (95% CI: 0.97-2.03) times greater in the Guided than in the Self-Directed group. When maintenance rates were compared across all follow-ups, there was a consistently higher maintenance rate for Guided participants (HR 1.31, 95% CI: 1.12-1.54).Conclusions: A sustained, supportive phone- and mail-based intervention promotes weight loss maintenance relative to a brief intervention for participants who have recently lost weight. [ABSTRACT FROM AUTHOR]

Abstract: Objective: The Keep It Off trial evaluated the efficacy of a phone-based weight loss maintenance intervention among adults who had recently lost weight in Minnesota (2007–2010). Methods: 419 adults who had recently lost ≥10% of their body weight were randomized to the “Guided” or “Self-Directed” intervention. Guided participants received a 10 session workbook, 10 biweekly, eight monthly and six bimonthly phone coaching calls, bimonthly weight graphs and tailored letters based on self-reported weights. Self-Directed participants received the workbook and two calls. Primary outcomes are weight change and maintenance (regain of <2.5% of baseline body weight). Results: Mixed model repeated-measures analysis examining weight change revealed a significant time by treatment group interaction (p<0.0085). Guided participants regained significantly less weight than the Self-Directed participants at 12 and 24months. The odds of 24month maintenance were 1.37 (95% CI: 0.97–2.03) times greater in the Guided than in the Self-Directed group. When maintenance rates were compared across all follow-ups, there was a consistently higher maintenance rate for Guided participants (HR 1.31, 95% CI: 1.12–1.54). Conclusions: A sustained, supportive phone- and mail-based intervention promotes weight loss maintenance relative to a brief intervention for participants who have recently lost weight. [Copyright &y& Elsevier]

Abstract: Objective: To evaluate the efficacy at 6-, 12-, and 24-month follow-up of Keep Active Minnesota (KAM), a telephone and mail-based intervention designed to promote physical activity (PA) maintenance among currently active adults age 50 to 70. Method: Participants who reported having recently increased their MVPA to a minimum of 2d/wk, 30min/bout, (N =1049) were recruited in 2004 and 2005 from one large managed care organization in Minnesota, and randomly assigned to either treatment (KAM; N =523), or Usual Care (UC; N =526) with PA assessed using the CHAMPS questionnaire, and expressed as kcal/wk energy expenditure. Results: We find a sustained, significant benefit of the intervention at 6, 12 and 24months. kcal/wk expenditure in moderate or vigorous activities was higher at 6 (p <.03, Cohen''s d 6m =.16), 12 (p <.04, d 12m =.13) and 24months (p <.01, d 24m =.16) for KAM participants, compared to UC participants. Conclusions: The KAM telephone- and mail-based PA maintenance intervention was effective at maintaining PA in both the short-term (6months) and longer-term (12 and 24months) relative to usual care. [Copyright &y& Elsevier]

Background. Previous research has shown significant associations between depression and substance use and eating disordered behaviors. However, no research to date has described associations between depressive symptoms and nutritional intake or physical activity among adolescents in a nonclinical, population-based sample.Methods. Classroom surveys were completed by 4,734 ethnically diverse, middle- and high school students. Based on their depressive symptom scores, males and females were categorized with low-, moderate-, or high-depressive symptom status. Linear models were used to examine eating and health behavior variables by depressive symptom groups.Results. Depressive symptoms were positively associated with health-compromising attitudes such as perceived barriers to healthy eating and weight concerns, and health-compromising behaviors such as unhealthy weight-control behaviors and substance use, including caffeine. Depressive symptoms were negatively associated with health-promoting behaviors such as eating breakfast, lunch, and dinner. However, most associations between depressive symptoms and dietary micronutrients were not statistically significant. Health-promoting moderate-to-vigorous physical activity was negatively associated with depressive symptoms among males.Conclusions. Adolescents who report depressive symptoms are at risk for other health-compromising attitudes and behaviors and are also less likely to engage in health-promoting behaviors. Depressive symptoms may be an underlying trait in the expression of health behaviors among adolescents. [Copyright &y& Elsevier]

Background. This paper presents reliability and validity analyses of physical activity-related psychosocial questionnaires completed by 8- to 10-year-old African-American girls at baseline and follow-up assessments of pilot intervention studies in the Girls health Enrichment Multi-site Study (GEMS).Methods. Two hundred ten girls participated in the GEMS 12-week pilot studies and had their height and weight measured, wore an accelerometer for 3 days and completed a measure of their usual physical activity (PA) at baseline and after the 12-week intervention. Subgroups of girls also completed physical activity-related psychosocial measures at these two time points including: (a) self-concept; (b) self-efficacy; (c) outcome expectancies; and d) preferences. Principal components analysis was conducted on the psychosocial measures obtained at baseline. Cronbach''s alpha and test–retest reliability were computed. Convergent validity was assessed by correlating the baseline psychosocial measures with baseline physical activity measures and body mass index (BMI).Results. The following sub-scales were derived: Activity Preference, Positive Expectancies and Negative Expectancies for physical activity. Physical Performance Self-Concept and Self-Efficacy for physical activity were kept as single dimensional scales. Sub-scales, derived from principal components analyses, were Activity Preference, Positive Expectancies, and Negative Expectancies for physical activity. Internal consistency estimates for the various scales were substantial to excellent (0.67–0.85), while test–retest reliability estimates were fair to moderate (0.22–0.56). Correlations between the PA psychosocial sub-scales and measured levels of activity measures showed evidence of convergent validity for the Activity Preference sub-scale, although social desirability may have influenced the significant associations observed.Conclusions. The Activity Preference was a fairly reliable and valid measure. Further studies are needed to examine the utility of activity-related psychosocial measures in interventions to increase physical activity among preadolescent African-American girls. [Copyright &y& Elsevier]

Background. Reliability and validity were established for weight concern measures completed by 8–10-year-old African-American girls participating in a pilot obesity prevention program.Methods. Two hundred ten girls and parents participated in the program. Girls completed subscales of the McKnight Risk Factor Survey (MRFS) and body silhouette ratings, had height, weight, and body fat measured, wore accelerometers for 3 days, and completed two dietary recalls. Principal components analysis, internal consistency, and test–retest reliability were computed for weight concerns and body image measures along with convergent validity with body mass index (BMI), percent body fat (PBF), physical activity, and dietary intake.Results. A Moderate Weight Control Behaviors (MWCB) subscale was derived from the MRFS. Overconcern with Weight and Shape (OWS) was a stand-alone scale. Internal consistency estimates for the scales were substantial ranging from 0.71 to 0.84. Test–retest reliabilities were moderate (0.45–0.58). OWS, MWCB, body silhouette rating, and body size discrepancy were positively associated with BMI and PBF. The “like to look” silhouette rating was negatively associated with PBF.Conclusions. Weight concern measures had reasonable levels of internal consistency and promising validity, but only moderate test–retest reliability among preadolescent African-American girls. Refinement and further validation of weight concern measures in this population are warranted. [Copyright &y& Elsevier]

Background. Valid and reliable physical activity checklists are needed to assess effectiveness of interventions. This study tested the validity and reliability of the Girls health Enrichment Multi-site Studies (GEMS) Activity Questionnaire.Methods. Two-hundred and ten African-American girls completed the GEMS Activity Questionnaire (GAQ), a checklist of 28 physical and 7 sedentary activities, including TV viewing, inquiring whether performed on the previous day (“yesterday”), and whether usually performed (“usual”). The girls wore an accelerometer (used as the criterion for validity) for three consecutive days at baseline and after a 12-week pilot intervention. Data from 172 girls at baseline and follow-up were usable for this report.Results. Girls were (mean ± SD) 8.8 ± 0.8 years old with a BMI of 22.3 ± 5.9 kg/m2. The intraclass correlation (ICC) examining reliability for the accelerometer across 3 days at baseline for the combined group was fair (ICC = 0.33, P < 0.21). The test–retest reliability coefficient for the 18-item MET-weighted GAQ yesterday scores for the comparison group of girls was 0.57 (P < 0.001). At baseline and follow-up, nonsignificant correlations were observed between 3-day accelerometer counts/minute and GAQ 18-item usual score for both comparison and intervention groups. A significant correlation was found between change in accelerometer minutes of moderate-to-vigorous activity (MVPA) between 12 noon and 6 PM and change in GAQ physical activities in the comparison girls (R = 0.35, P < 0.01). The TV-usual score was correlated with 3-day accelerometer counts/minute (R = −0.19, P = 0.02) at baseline for the total sample.Conclusions. Correlations between the GAQ and accelerometer were low, indicating low validity. Although the GAQ may be helpful in describing types of physical activities performed, it needs further development to improve its psychometric properties. [Copyright &y& Elsevier]

Abstract: Objective. : We evaluate the 6-month efficacy of Keep Active Minnesota, a phone- and mail-based physical activity maintenance intervention designed for use with adults age 50 to 70 years who have increased their physical activity within the past year. Method. : Participants (N =1049) recruited in 2004 and 2005 from one large managed-care organization in Minnesota were randomly assigned to either treatment (N =523) or usual care (N =526) with physical activity assessed using the Community Healthy Activities Model Program for Seniors questionnaire, and expressed as kcal/week expenditures. Results. : Total physical activity at baseline was similar for treatment and usual care participants (p <0.44) as was moderate/vigorous physical activity (p <0.21). Maintenance of physical activity was higher among treatment participants whose mean 6-month change in total kcal/week energy expenditure was −91, compared to −683 for usual care participants (p <0.002). Mean 6-month change in kcal/week expenditure in moderate or vigorous activities was −49 for treatment participants, compared to −612 for usual care participants (p <0.001). Conclusions. : This phone- and mail-based physical activity maintenance intervention is efficacious at maintaining physical activity at 6 months. [Copyright &y& Elsevier]

Objective. This paper presents the reliability and validity of several diet-related psychosocial questionnaires.Methods. At baseline and 12 weeks follow-up, parents/caregivers of one hundred fifty 8- to 10-year-old African-American completed questionnaires on food preparation habits for their daughter, perceived home barriers to healthy eating, and fruit, juice, vegetable (FJV), low-fat and high-fat food availability. Girls completed a sweetened beverage preferences questionnaire and two 24-h dietary recalls to assess intake. Principal components analyses were conducted for two newly designed measures. Internal consistency was calculated and construct validity was assessed between the psychosocial scales and obesity-related dietary variables.Results. Low-fat and high-fat food preparation for daughters, and perceived home barriers to eating low-fat food and FJV subscales were derived from the new questionnaires. Internal consistency reliabilities were moderate (0.58) to substantial (0.80) across all new and existing scales. Test–retest reliabilities were moderate (0.44) to substantial (0.79). Girls'' intake of fat as a percentage of energy was positively related to parental high-fat food preparation for daughters (P < 0.01) and negatively related to parental low-fat food preparation practices for daughters (P < 0.05).Conclusions. Measures of family influences on FJV, fat, and sweetened beverage consumption were internally consistent with moderate to substantial stability. Scales for low-fat and high-fat food preparation practices for daughters achieved construct validity with fat consumption in the hypothesized direction. Family food preparation habits appear to be important targets for future interventions. [Copyright &y& Elsevier]