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Growth mixture models (GMMs) are applied to intervention studies with repeated measures to explore heterogeneity in the intervention effect. However, traditional GMMs are known to be difficult to estimate, especially at sample sizes common in single-center interventions. Common strategies to coerce GMMs to converge involve post hoc adjustments to the model, particularly constraining covariance parameters to equality across classes. Methodological studies have shown that although convergence is improved with post hoc adjustments, they embed additional tenuous assumptions into the model that can adversely impact key aspects of the model such as number of classes extracted and the estimated growth trajectories in each class. To facilitate convergence without post hoc adjustments, this paper reviews the recent literature on covariance pattern mixture models, which approach GMMs from a marginal modeling tradition rather than the random effect modeling tradition used by traditional GMMs. We discuss how the marginal modeling tradition can avoid complexities in estimation encountered by GMMs that feature random effects, and we use data from a lifestyle intervention for increasing insulin sensitivity (a risk factor for type 2 diabetes) among 90 Latino adolescents with obesity to demonstrate our point. Specifically, GMMs featuring random effects--even with post hoc adjustments--fail to converge due to estimation errors, whereas covariance pattern mixture models following the marginal model tradition encounter no issues with estimation while maintaining the ability to answer all the research questions. [For the corresponding grantee submission, see ED618691.]

Teachers are responsible for children at school during peak ultraviolet (UV) times of the day. It is paramount that teachers have knowledge and understanding of UV to effectively protect themselves and their students. The aim of this pilot study was to investigate the effect of a short intervention on preservice teachers' sun protective behaviours, knowledge and perceived skill to teach sun safety. Participants (n =161; median age=20 years) attended a 45-minute preservice teacher sun safety intervention and completed pre- and post-test surveys. Post-intervention, most participants indicated they felt: (1) more informed about the dangers of UV and risks of developing skin cancer (93.3%); (2) more knowledgeable about the importance of sun protection (92%); and (3) more skilled to teach sun safety (87.4%). Our findings indicate that the targeted preservice teacher sun safety education intervention improved understandings of UV, effective sun-protective practices, and their perceived skills to teach sun safety.

African Americans are disproportionately burdened by mental health issues (e.g., stress, chronic depression, and post-traumatic stress disorder). Upon review of mental health local/state/national data, a highly-engaged faith-based Community Action Board (CAB) raised concerns about the mental health needs of African Americans and addressed mental health as a priority health area in African American Kansas City churches. African Americans tend to experience barriers to mental health services (e.g., limited access, high cost, mental health-related stigma, non-culturally tailored mental health care). African American churches have many strengths that could increase reach, acceptability feasibility, and impact of mental health interventions tailored for African Americans. The CAB conducted a health needs assessment survey (N=463; 11 churches) to identify health concerns and potential strategies to inform the design of a church-based mental health intervention. Using a faith-community-engaged approach, the CAB developed the survey and used its findings to design a religiously-tailored, multilevel mental health intervention focused on prevention, screening, and linkage to care. The needs assessment identified intervention strategies (e.g., church-based screening, stress reduction/exercise programs, pastors promoting mental health) that were: (1) rated as highly important/feasible to implement, (2) included in the intervention design, and (3) successfully implemented in African American churches by faith leaders and university students and faculty.

Our study examined the relationship between improved personal health behaviors of Head Start teachers and the promotion of positive health behaviors in their classrooms. Thirty-three Head Start teachers across seven centers received six 30-min nutrition education lessons. Dietary intake, physical activity, and self-efficacy for promoting positive health behaviors in the classroom were measured at baseline and following intervention. Significant improvements were observed for dietary intake and physical activity. Self-efficacy for promoting health behaviors in the classroom did not significantly improve. Additional education is needed to improve health promotion practices. Lessons learned contributed to program refinement. Implications for Extension are discussed.

The University System of Georgia (USG) has a state-wide initiative aimed at increasing the well-being of faculty and staff by incentivizing a decrease in tobacco product usage by employees covered by a USG healthcare plan. This incentive is positive in that aid in stopping tobacco product usage is offered to each member; and negative in that each member who is a tobacco product user is penalized. A healthcare surcharge is added to the monthly health insurance premium paid by each faculty/staff member for themselves and covered dependents over 18 years of age who are tobacco product users. The current policy considers covered employees and their applicable dependents to be users of tobacco products unless they annually opt-out. This paper includes summaries of the incidence of cigarette and tobacco product usage in the U.S., a summary of USG's policies related to the current tobacco initiative, a brief literature review regarding opt-in and opt-out programs, and a discussion of the possible negative impact of the current USG tobacco use policy. Support is provided for the present tobacco surcharge penalty being either eliminated or its implementation changed, and for the current opt-out default being changed to an opt-in program.

The onset of COVID-19 left people feeling unsettled, confused, and afraid of what tomorrow may hold. As university professors specializing in health communication, we too were left with these same feelings. As health communication scholars, we focus on issues surrounding illness, risk, crisis, care, health inequities, and wellness. COVID-19 is a health crisis, yes, but it has also changed the way we operate not only in higher education but in daily life. We begin this essay with an overview of COVID-19 and its impact on students, educators, and administrators. Then, we suggest four best practices to foster a community of care in the classroom during and beyond the COVID-19 pandemic.

The majority of schools across Australia rapidly implemented online education during the first wave of COVID-19 restrictions. The school closure disproportionately affected the routines and socialisation of vulnerable students, including those with a refugee background. Refugee-background students have been impacted by COVID-19 as school closures interrupted face-to-face education, including English language and tutorial support and counselling services. School shutdown also impeded refugee-background students' activities outside the home, which could render adverse effects on their physical, mental and social wellbeing. Holistic efforts are urgently needed in Australia to support refugee-background students in order to prevent further learning loss and promote health and wellbeing. [The page range (71-91) on p. 71 of the .pdf is incorrect. The correct page range is p71-76.]

Various studies have shown that teachers are subject to an increased stress level and the associated physical and psychological consequences. In this article, the possibilities of coping of stressful situations in everyday school life are systematized. In addition, the knowledge and usage of available programs and trainings for coping with stress at school in German-speaking countries will be assessed. This is a descriptive study based on a survey of 32 teachers. Effects due to contextual variables (gender, school type, and work experience) were examined. The results indicate that only a few of the programs surveyed are known and used in schools. Effects in connection with the gender of the teachers as well as their professional experience could not be determined. Instead, significantly more special education teachers knew and used programs to strengthen protective context factors (school type effect). The fact that a high proportion of teachers are unaware of and do not use available programs, despite their high importance for healthy coping with personal job demands, suggests deficiencies in teacher education and training. In addition, lack of resources at schools may be limiting. The successful management of stressful situations must not be seen as a task for individual employees; rather, systemic solutions must be found. Particularly due to the increased stress experienced by teachers in connection with the COVID-19 pandemic, aspects of health promotion in schools should play a significant role. The aim must be to provide more detailed information about stress management approaches in schools and to support their implementation.

To contain the initial spread of the SARS-CoV2 virus and the COVID-19 disease, many countries opted to close schools. However, the importance of schooling to mitigate inequalities motivated many economies to reopen schools after having formulated various COVID-19 mitigation and containment strategies. Using an exploratory sequential mixed method design, we explore the measures undertaken by countries when reopening schools and how these measures varied cross-nationally. We find that countries formulated a wide number (total: 242) and range of school reopening measures to mitigate the spread of the virus in the early months of the COVID-19 pandemic. From a policy diffusion theoretical perspective, findings from our statistical analyses suggest that cross-national diversity in policies is related to both internal and external country factors such as peer emulation mechanisms, income, and past pandemic experiences. We urge international agencies for more explicit guidelines for effective school reopening measures.

The "School Pantry: Mystery Food Box Cook-Off " is a program designed to increase awareness of food insecurity among youth and teach strategies to prepare healthy foods on a budget. A pre-and-post survey showed a statistically significant difference in participants' overall knowledge, skills, and confidence level after the program compared to before the program. Findings revealed a hands-on nutrition education strategy via cook-off could educate youth on food insecurity and increase their knowledge and confidence to make healthy and affordable meals at home. Other Extension educators seeking to address food insecurity and food preparation skills among youth can replicate this program.

Physical exercise is good for health, both physical and morale for every human being, leading to a happy life. Sports training have an important place in schools activities. Higher education institutions usually have good human and facilities resources to support learners to increase physical exercise, athletes train, serve the community, thereby improving the quality of training. In this context, the head of the higher education institutions has an important role in leading and organizing sports activities inside and outside the school. The universities need to institutionalize extracurricular activities, especially to encourage sports exercise.

Global policy makers increasingly adopt subjective wellbeing as a framework within which to measure and address human development challenges, including policies to mitigate consequential societal problems. In this review, we take a systems-level perspective to assemble evidence from studies of wellbeing, of collective intelligence, and of metacognition and argue for a virtuous cycle for health promotion in which the increased collective intelligence of groups: (1) enhances the ability of such groups to address consequential societal problems; (2) promotes the wellbeing of societies and the individual wellbeing of people within groups; and, finally, (3) enables prosocial actions that further promote collective problem-solving and global wellbeing. Notably, evidence demonstrates that effective collaboration and teamwork largely depend on social skills for metacognitive awareness--the capacity to evaluate and control our own mental processes in the service of social problem-solving. Yet, despite their importance, metacognitive skills may not be well-captured by measures of general intelligence. These skills have instead been the focus of decades of research in the psychology of human judgment and decision-making. This literature provides well-validated tests of metacognitive awareness and demonstrates that the capacity to use analysis and deliberation to evaluate intuitive responses is an important source of individual differences in decision-making. Research in network neuroscience further elucidates the topology and dynamics of brain networks that enable metacognitive awareness, providing key targets for intervention. As such, we further discuss emerging scientific interventions to enhance metacognitive skills (e.g., based on mindfulness meditation, and physical activity and aerobic fitness), and how such interventions may catalyze the virtuous cycle to improve collective intelligence, societal problem-solving, and global wellbeing.

The purpose of this preliminary study was to identify oral problems and promote a healthy lifestyle at gimnazial school pupils, from a Romanian disadvantaged area. We wanted to identify the progress made by pupils following theoretical or practical interventions. Thus, along with the theoretical notions transmitted, either in the optional course of Health Education, to 6th grade pupils, or in Biology lessons, to 7th grade pupils, the new factor brought was the reinventing of the visit method, by extending the documentary feature, with that of practical applicability, extremely useful for participants coming from rural environment. Theoretical elements have been presented to all pupils. Additionally, at the 5th grade pupils, we added a practical intervention, respectively a dental control made during a visit to the dentist. Both through theoretical and practical methods, pupils have made progress concerning intellectual and practical skills in oral hygiene, which are essential to a healthy and responsible behavior. The visit at the dentist's office, the identification of the oral diseases, the recommendation and the treatment offered contributed decisively awareness of the importance of oral disease prevention, but also to identifying concrete solutions, connected to food, regular visits and correct brushing.

This perspective article discusses how a health-related learning community was incorporated to help freshman students learn about health and wellness and prevent weight gain at an HBCU. Freshman students often gain weight during their first year away from home. These students make poor diet and exercise choices during their transition to college which can cause future health concerns. A health-related learning community, LIVE WELL, was established to teach health, nutrition, and wellness strategies. LIVE WELL also included self-care, future career exploration, service-learning/civic engagement, and lifetime learning experiences. Valuable lessons were learned from the faculty members who managed LIVE WELL. Challenges were presented to the faculty members who integrated solutions into the learning community. Integrating positive health changes to freshman students' lifestyles needs to be a priority and needs further exploration.

Students with disabilities comprise a significant portion of college students and helping more students with disabilities succeed would be beneficial. Currently, colleges have successfully offered assistance to these students, and it has enhanced their ability to both attend and succeed in college. However, students with disabilities are less likely to access available resources through the Department of Disability Support Services once enrolled in college and are less likely to complete their education once started. Improved ability to manage life and school has been cited as important factors related to success at college for all students. Disabilities make managing life and school an even more pressing issue. This exploratory pilot study assessed whether Disability Support Services undergraduate students' grit, resilience, satisfaction with life, wellness, and perceived health were associated with higher grade point averages. Findings indicated that better health was associated with higher grade point averages. Significant relationships were also found between frequency of engagement in health behaviors by students with disabilities and their resilience, grit, and life satisfaction. These findings suggest that Disability Support Services should work with students to manage and develop general health promoting lifestyle habits and encourage students with disabilities to access available resources.

Effective newsletters have theory-based content and designs tailored to their readers and offer limited-cost community-level approaches to providing helpful, relevant, and engaging information. In accordance with this, we offer an example of a newsletter intervention that supported grandfamilies' physical wellness needs. Six issues of a brief mail-delivered newsletter were sent yearly for up to 5 years to low-income custodial grandparents. In evaluating the newsletter, most respondents reported reading it, discussing its information, and having greater awareness, knowledge, and motivation or confidence regarding wellness recommendations. Furthermore, 91% described improving 1 or more of their grandfamilies' cooking, eating, or physical activity practices.

This study aimed to explore the perceptions of other branch teachers towards physical education teachers and lessons through metaphors. A basic qualitative research model was used in this study. Two hundred twenty-one teachers working in various types of schools and branches in the 2018/2019 education year in Burdur, Turkey, constituted the study group. For data collection, the teachers were asked to fill in the blanks in the metaphor form, including the sentences "physical education lesson is like…, because …" and "physical education teacher is like…, because…" The data were analyzed using the content analysis method. As a result of the analysis, the teachers produced 118 metaphors for the perception of physical education lessons and 120 different metaphors for the perception of physical education teachers. Metaphors for physical education lessons were gathered under the themes of "expected and beloved lesson," "unifying factor," "disciplinary tool" "entertaining, relaxing and health-improving lesson," "gathering, discovering and directing different talents," "mobility," "free environment," and "basic lesson." The teacher produces metaphors for physical education teachers under the themes of "hard-working and versatile," "physical strength element," "exploring and guiding," "providing control and discipline," "savior," "student-friendly," "comfortable and active personality," and "health-giving." Consequently, the metaphors that the branch teachers produced both for the physical education lessons and physical education teachers were similar, and it was seen that the branch teachers had positive perceptions about both the lesson and teacher.

In order for societies to normalize in educational, economic, social and mental health areas, the COVID-19 pandemic must be ended as soon as possible. Currently, the most critical factor in eliminating the pandemic seems to be the vaccine. Vaccination is one of the most successful public health interventions and is a cornerstone for communicable disease prevention. Both current teachers and teacher candidates should be competent in the field of health literacy as well as in the education and training process. In this study, we tried to reveal the views of teacher candidates regarding COVID-19 and its vaccines based on the studies reporting that anti-vaccination increased in individuals with more education. Six hundred thirty-eight teacher candidates participated in the study. The research data were collected through an 11-item questionnaire, and the data were analyzed using descriptive and cross-tabulation analyzes. Research findings mainly showed that vaccine acceptance was low, and most of the participants thought the virus is artificial. Another finding of the research revealed that most of the participants who complied with all the rules regarding COVID-19 did not get the virus; however, it was seen that nearly all of the participants who caught COVID-19 had an infected individual in their family. Given the importance of vaccination, measures should be taken for vaccination hesitation and rejection.

Health education is one of the key components of pre-school education. Preschool age children have acquired knowledge about health, and this forms the basis for developing, maintaining, and strengthening their health. However, children's knowledge of health is insufficient and their healthy lifestyle skills are insufficiently developed. On the one hand, the deteriorating trends in children's health raise certain challenges to the process of pre-school education, on the other hand, their health education possibilities are not fully known and exploited. Health education integration into pre-school/pre-primary education programmes remains a key priority of education policy. Although the importance of developing children's health competence is already noted in pre-school/pre-primary education programmes, various research studies show that children's health indicators are deteriorating. In January - March 2021, a qualitative research study was conducted, in which 102 kindergarten teachers from various Lithuanian preschool educational institutions participated. The aim of the research was to analyse the factors that promote, limit, and determine the integration of health education into pre-school education programmes and to reveal improvement possibilities. It has been established that the integration of health education is promoted by children's health problems and the changing understanding of the importance of children's health education. Proper teacher preparation, purposeful activities of the institution, and community involvement in health education remain essential components that determine the effectiveness of health education. Despite the positive attitude and motivation of teachers towards health education, there are still many unused opportunities for improving health education, which should be assessed both at the level of education policy and educational practice, respectively.

During the second decade of the 21st century families and schools world-wide have been affected by several critical events, with economic recession, the refugee crisis, and lately the COVID-19 pandemic being the most prominent. Pertaining to the school community (students, educators, administration, parents, school personnel etc.), evidence-based interventions for improving mental health and supporting psychosocial adjustment are necessary. In this paper the development, implementation, and evaluation of the international WeCARE (We Connect, Accept, Respect, Empower) program, an online multilevel intervention for promoting well-being and resilience in the school community during unsettling times, is presented. The Program has a multicultural perspective and provides the opportunity to students from different countries to cooperate and develop multicultural skills. The intervention is based on a conceptual model for enhancing positive development, resilience, social and emotional skills, and competence. The interventions were implemented on individual and system levels over four consecutive years, including web-based teachers' training and supervision, seminars for parents, and classroom implementation. Furthermore, collaboration amongst schools and educational settings was highlighted, in the form of networking at national and international level. Based on the evaluation results, the necessity for further development and implementation of programs for the promotion of resilience and well-being during unsettling times is discussed.

This article encourages teacher educators to focus their work on healing and well-being in response to the array of precarities in the world. Framing this work is a driving question inspired by the current political moment and articles in this issue of "Teacher Education Quarterly": How can teacher educators promote well-being and healing in our programs as models for healthier schools? In response, three phases of the pre-service to profession pathway are discussed: (1) pathways to teacher education programs, (2) pre-service preparation, and (3) transitions to the profession.

The COVID-19 pandemic experience has brought to the forefront the importance of leadership as institutions across the world are now trying to emerge from hibernation and rebuild broken academic practices. As such, this study sought to examine school principals' experiences on school management in the context of COVID-19 stringency in four rural schools in the Eastern Cape Province of South Africa. Underpinned by a qualitative research approach, the study employed a case study design in which semi-structured interviews were used to collect data from four rural school principals who had been purposively sampled. Findings of the study revealed that in order to combat challenges associated with teaching and learning, school principals engaged among other things, in mobilization of resources, engendering a technological culture among teachers, ensuring effective delivery of content. We further ascertained that although hamstrung by resource inadequacies, school principals in rural schools promoted school safety by ensuring transparent and effective communication, striving for the provision of safe and adequate facilities, among other things. Finally, our study also revealed that rural school principals ensured clear and consistent communication with staff, provided psychosocial assistance to staff members, and adapted performance and workload expectations.

Depression and suicide rates among youths tended to increase. From reviews, many applications and online counseling could reduce depression and anxiety to promote well-being of youths and university students effectively. This study was conducted to develop "Friend from heart" application based on LINE system to promote well-being for undergraduate students of faculty of education, Kasetsart University. The research method included the survey of basic data for developing the application and evaluation of the application by specialists. A total of 72 voluntary students were invited to join an online survey. It was found that most of the students (81.94%) wanted applications that provide physical health information such as exercise, eating healthy food, and health care. However, about 16.66% of students needed an application that can speak or listen problems with video calls. Then, researchers took the services that students were interested more than 50% to develop the applications. It worked through the application, consisting of chatbot, physical health, mental health, and appointment with counselor. The index of item-objective congruence was 0.66-1.00 with additional specialists commenting that the application had an interesting design with good structure to help students. For ethical approval, it was obtained from the Kasetsart University Research Ethics Committee.

The purpose of this research was to explore student perceptions of mindfulness meditation (MM) in an introductory health promotion course, and how the use of MM during class might relate to the transitions experienced by students. Qualitative data collection took place through an online survey and in-person interviews. Data were analyzed using thematic analysis. Four key themes were identified from this research. First, that MM facilitates a sense of peace and calm; second, that MM encourages students to focus; third, MM helps promote student mental health; and finally, MM positively changes the classroom environment. Challenges and recommendations were also described.

The rapid growth of the U.S. Latinx population has led to an increased need for community organizations and academic institutions to develop partnerships focused on addressing gaps in health maintenance and education of Latinx individuals. Medical schools also have a responsibility to educate future physicians in delivering culturally sensitive care through community-oriented learning experiences. This case study approach outlines the logistics of establishing a youth mentoring program between a medical school and a Latinx community and demonstrates the benefits to the institution, medical students, and the population served. We also discuss the challenges arising from this partnership and present early program evaluation data showing consistent mentor satisfaction reported over time. This description of the program development provides a framework for creating similar initiatives in medical education to address known disparities in health and well-being of Latinx individuals and other minority populations.

The transition into higher education stretches students socially, academically and within their personal lives requiring adaptation and development of resilience. For many, such demands may lead to decreased mental wellbeing and, for some, mental ill-health. This project aimed to trial simple mental health awareness and well-being tasks with first year undergraduate students, and to determine whether students find these interventions beneficial and worthy of embedding as transition activities within the first-year curriculum. Four activities were trialled with 185 first-year students who reported the activities as beneficial. All activities caused an overall increase in student knowledge of how to maintain good mental well-being. In the light of this project's findings, such activities are recommended for embedding into the first-year curriculum and throughout higher education. [Note: The citation (v15 n1 2020) shown on the first page of the PDF is incorrect. The correct citation is v16 n1 2021.]

The purpose of this study is to examine factors influencing the adjustments made to physical education and sports learning among students in the Faculty of Education at Thailand National Sports University after the COVID-19 pandemic. 595 students were selected using stratified random sampling from undergraduates in the Faculty of Education at Thailand National Sports University during Academic Year 2020. The data were then analyzed in terms of descriptive statistics, Pearson correlation, and Stepwise Multiple Regression Analysis. The potential influences to the adjustments made to physical education and sports learning after the COVID-19 pandemic among students in Faculty of Education at Thailand National Sports University comprised these 5 variables: 1) activities to promote knowledge of COVID-19 prevention within the university; 2) the university's policies promoting the prevention of COVID-19; 3) facilities within the university; 4) imitating a classmate's adjusted behaviors; and 5) learning in class. These 5 factors could predict the adjustments in physical education and sports learning after the COVID-19 pandemic in the studied group with the percentage of 73.60. The significance predicted by equations were as follows: In terms of raw scores: Y[superscript /] = -0.175 + 0.384 (X[subscript 3]) + 0.265 (X[subscript 1]) + 0.224 (X[subscript 4]) + 0.084 (X[subscript 5]) + 0.064 (X[subscript 6]) In term of standard scores: Z[superscript /] [subscript Y] = 0.357 (ZX[subscript 3]) + 0.356 (ZX[subscript 1]) + 0.207 (ZX[subscript 4]) + 0.067 (ZX[subscript 5]) + 0.062 (ZX[subscript 6]).

Nursing faculty with expertise in community health are well poised to introduce nursing students to the rewarding experience of caring for vulnerable populations. Multiple partnerships have been established over the years within the central Connecticut region that have benefited both the university's nursing students and the affiliated agency, as well as the individuals served. Utilizing knowledge related to the common health issues faced by the homeless population, faculty worked with community partners to discuss needs and create a plan involving nursing students, which specifically focused on vision and foot health.

Campuses have never had such an intense focus on health promotion as they do at present as we work toward a post-pandemic future. This article examines the evolution of approaches from a student-centric focus to a systems approach, tracing the history of health promotion on Canadian campuses. Universities have evolved from the initial attempts at providing oversight over student behaviour, to the increased need for supports after the influx of World War II veterans, to the focus on providing a much broader range of supports from a holistic stance. The current context of a more intentional and organized approach to health promotion for students, faculty, and staff is explored; the shift includes adoption of the Okanagan Charter (2015) at many campuses. Lastly, the authors suggest future directions for campuses to take in addressing the current health issues and in supporting well-being on Canadian campuses now and in the future.

Background: Many children with intellectual developmental disorders are insufficiently physically active and do not reach recommendations for physical activity. Pediatric healthcare providers play a key role in addressing these children's needs, including promoting interventions for physical activity. Aim: To explore pediatric healthcare providers' perceived needs, barriers, and facilitators for promoting physical activity for children with intellectual developmental disorders. Methods: Semi-structured focus groups, analyzed using qualitative content analysis. Sixteen healthcare providers participated. Results: Main findings are the importance of parental support and engagement, need for structure, and stakeholder collaboration to bridge the gap between pediatric organizations and external stakeholders. Conclusion: The study highlights the need for developing and implementing strategies to promote physical activity for children with intellectual developmental disorders in pediatric health care, and for producing guidelines regarding physical activity interventions for this vulnerable group.

Background: Adolescents and young adults with intellectual and developmental disabilities are at risk of obesity. Parents influence their diet and physical activity behaviours and therefore, can play important roles in weight management. The aims of this qualitative study were to explore parents' experiences assisting their son or daughter to participate in a weight management study. Methods: Interviews were completed at 6 months with 27 parents whose adolescent or young adult had completed the weight loss portion of an 18-month weight management study. Interviews were recorded, transcribed and thematic analysis performed. Results: Parents shared insights about how well program components worked with their family, and what strategies worked best to adopt healthier dietary choices and become more physically active. The importance of meeting regularly with someone outside the family to encourage healthier habits was stressed. Conclusions: Future weight management studies should involve parents and their adolescents to help tailor strategies and adapt intervention approaches.

This study aimed to identify barriers and facilitators to comprehensive, school-based physical activity (PA) promotion among adolescents prior to and during the coronavirus disease of 2019 (COVID-19) pandemic, considering the perspectives of students, parents, and school staff. Data were collected from 2020 to 2021 using semi-structured individual interviews with students (n = 15), parents (n = 20), and school staff (n = 8) at a Title I middle school (i.e. high percentage of students from low-income families). Two theoretical frameworks guided analysis: the Comprehensive School Physical Activity Program framework and Bronfenbrenner's ecological systems theory. Using an iteratively developed codebook, data were coded, thematically analyzed, and synthesized. PA barriers and facilitators were present throughout the school day, at home, and in the community. Key determinants included pandemic-induced challenges (e.g. COVID-19 exposure); neighborhood characteristics/weather (e.g. neighborhood safety); school-family communication/collaboration; implementation climate (i.e. school staff's support for programming); time, spatial, and monetary resources (e.g. funding); staffing capacity/continuity and school champions; staffing creativity and adaptability; PA opportunities before, during, and after school; and child's motivation/engagement. Efforts to improve school-based PA programs, irrespective of pandemic conditions, should include strategies that address factors at the community, school, family and individual levels. School-family communication/collaboration, school staff programming support, and PA opportunities throughout the day can help promote comprehensive, school-based PA.

American Indian (AI) communities experience persistent diabetes-related disparities, yet few nutrition interventions are designed for AI with type 2 diabetes or address socio-contextual barriers to healthy eating. We describe our process of adapting the evidence-based Cooking Matters® program for use by AI adults with type 2 diabetes in a rural and resource-limited setting in the North-Central United States. We conducted three focus groups with AI adults with diabetes to (i) identify Cooking Matters® adaptations and (ii) gather feedback on appropriateness of the adapted intervention using Barrera and Castro's cultural adaptation framework. Transcripts were coded using an inductive, constant comparison approach. Queries of codes were reviewed to identify themes. Contextual considerations included limited access to grocery stores and transportation barriers, reliance on government food assistance and the intergenerational burden of diabetes. Adaptations to content and delivery included incorporating traditional and locally available foods; appealing to children or others in multigenerational households and prioritizing visual over written content. Our use of Barrera and Castro's framework adds rigor and structure to the cultural adaptation process and increases the likelihood of future intervention success. Other researchers may benefit from using this framework to guide the adaptation of evidence-based interventions in AI communities.

Background: To address concerns that healthy weight and lifestyle campaigns (HWLCs) could have unintended psychological or behavioral consequences, this study tested reactions to TV advertisements from two HWLCs--"LiveLighter"® (employs graphic health effects messaging) and "Swap It Don't Stop It" (employs animation and light-hearted messaging). Methods: An online between-subjects experiment tested reactions to one of five advertisements: "Toxic Fat"; "Sugary Drinks" (both from "LiveLighter"); "Become a Swapper"; "How to Swap It" (both from "Swap It"); and "HSBC Bank" (control) among 2,208 adults from Western Australia and Victoria, Australia. Responses assessed were cognitive and emotional reactions, behavioral intentions, internalized weight bias, antifat attitudes, self-esteem and body dissatisfaction. Results: The HWLC advertisements prompted favorable cognitive reactions and weak to neutral positive and negative emotional responses. HWLC advertisements promoted stronger intentions to engage in adaptive lifestyle behaviors compared with the control advertisement. Intention to engage in maladaptive behaviors (e.g., skipping meals) was low overall and did not differ by condition. Compared with the control condition, participants who saw "LiveLighter" "Sugary Drinks" showed weaker disagreement with antifat attitudes; however, mean antifat attitude scores were still at the low end of the scale. HWLC advertisements did not promote internalized weight bias, reduced self-esteem or body dissatisfaction compared with the control advertisement. Conclusions: Overall, HWLC advertisements performed favorably compared with the control advertisement and showed no clear evidence of adverse impacts. Findings suggest HWLC advertisements may not promote negative psychological and behavioral consequences and can continue to be used in obesity prevention efforts.

Introduction: Peer-led health coaching is a realistic and sustainable way to support health behaviour change on university campuses. Motivational Interviewing (MI) is an effective framework to guide behaviour change conversations in peer health coaching sessions. However, research on the perceptions of peer coaches who provide health coaching using MI is scarce. Objective: The aims of this study were to examine (1) university peer health coaches' experiences as peer educators after participating in the training and implementation of MI; and (2) university peer health coaches' supervision experiences as they learn to use MI for health coaching. Design: Cross-sectional in-depth qualitative study using Interpretative Phenomenological Analysis (IPA). Setting: Peer health coaching programme in a mid-sized southwestern US university. Method: Five peer health coaches were interviewed about their training, implementation and supervision of using MI in a university health coaching programme. IPA was used to analyse the findings. Results: We identified four main themes: (1) learning MI, (2) using MI, (3) challenges of time and availability and (4) supervision and peer support. Results illustrated the developmental processes peer health coaches perceive as they develop their MI skills. Individual and group supervision supported MI growth and development while also building a sense of community. Conclusion: Apart from challenges in learning and using MI, supervision was an important factor that helped peer health coaches develop. Future research should investigate training methods and supervision strategies to improve the quality of peer health coach programmes.

Background: Adolescence is associated with a rise in the incidence of mental health issues. Thus, the factors, processes, and contexts that protect and promote positive mental health in adolescence are of key interest to policymakers. Objective: Our aim was twofold: First, to explore the coping strategies and sources of support that adolescents identify as protective (or not) in the face of difficulty over a three-year period; second, to examine how and why this may vary in line with the levels of adversity that they report experiencing in life. Methods: Participants were attending schools in England implementing a mental health prevention programme called HeadStart. 93 semi-structured interviews were conducted with 31 adolescents (age 11-12 at the outset of the study; 58% female) once per year over three years. The interviews were analysed using thematic analysis. Results: Six coping strategy themes (e.g., 'Disengaging from problems') and five support themes (e.g., 'Parents as a source of comfort and advice') were derived from the interviews. The types, quality, and consistency of reported coping strategies and support varied in line with whether adolescents were experiencing higher or lower levels of adversity in life over time, and according to the resources that they had available within their physical and social contexts. Conclusions: Our findings underscore the importance for mental health prevention programmes of bolstering both individual-level coping strategies and the resources available within adolescents' environments to help them to manage adversity.

This paper explores how various ideological positions or 'cosmoses' associated with physical literacy (PL) have come to be and, in doing so, extends scholarship by examining and presenting PL as a multiplicity of "physical literacies." Drawing on Stengers' notion of 'cosmopolitics' and Venturini's 'cartography of controversies' method, 167 scholarly articles and 23 non-scholarly texts were analysed to observe and describe how PL has been framed over time as a result of dynamic political factors. Findings reveal that three 'waves' of PL cosmoses have unfolded over time (PL as health-promoting physical activity, PL as motor competence and PL as phenomenological embodiment). Whilst all three seek to promote engagement in physical activity and have loose ties to 'health', each PL cosmos is bound by different objectives, actors and obligations and is orientated towards solving a different problem. Rather than continued confusion and controversy, we propose that PL be understood as a "multiverse" wherein the three different PL cosmoses are held apart as physical literacies that play co-existing roles based on the problem that each cosmos is trying to solve. While understanding PL as a multiverse is not a solution to the controversy and uncertainty surrounding PL, it provides those who are interested in or tasked with enacting PL an opportunity to become aware of and understand what the different PL cosmoses or physical literacies constitute and thus make possible (or not) on the basis of their ontological differences.