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Purpose: The purpose of this study was to assess the relationship between the walkability/bikeability of college campuses and students’ body mass index (BMI) with student physical activity (PA) attitudes and behaviors as potential mediators. Design: Cross-sectional. Setting: Thirteen university campuses. Participants: A total of 1384 student participants. Measures: Walkability/bikeability environmental score (ES): 12-item audit assessed an average of 44 path segments per campus. Students were measured for height and weight and completed online surveys. Physical activity stage of change/behavior intentions were assessed using the transtheoretical model. The Cognitive Behavioral Physical Activity Questionnaire assessed outcome expectations, self-regulation, and personal barriers. International Physical Activity Questionnaire assessed walking-, moderate-, and vigorous-intensity PA. Analysis: Descriptive statistics, zero-order correlations, and path analysis with maximum likelihood estimation. Results: The overall model fit was good with χ2 of 171.388 ( df = 18), P < .001, comparative fit index value of .95, and a root mean square of approximation of .079. After controlling for gender, there was a direct negative association between walkability/bikeability ES and BMI (β = −.085) and positive association between personal barriers and BMI (β = .134). Walkability/bikeability ES was positively associated with walking-intensity PA (β = .010). Self-regulation was positively associated with moderate-intensity PA (β = .213), which, in turn, was negatively associated with BMI (β = −.057). Conclusions: The ease of walking and biking on a campus was related to college students’ walking behavior and their BMI. Students’ PA behavioral intentions were associated with moderate PA and lower BMI. These results provide evidence to focus on policies and structural supports for walkable/bikeable environments to supplement and enhance interventions encouraging individual behavior change for PA and weight management.

Many health promotion practitioners and researchers use the self-report International Physical Activity Questionnaire (IPAQ) to estimate physical activity (PA) level. Reporting days/week and minutes/day engaging in PA can be challenging for participants. Thus, the purpose of this study was to develop a streamlined, enhanced scoring method of the IPAQ that could reduce participant burden and improve research reporting. IPAQ data from 1471 U.S. university students (79% White, 58% female) at 8 universities were scored using IPAQ traditional short-form scoring algorithm (IPAQ-TSA) to generate metabolic equivalents (METS/minute/week) and an IPAQ Streamlined Scoring Algorithm (IPAQ-SSA) without minutes/day using weighted exercise intensity and days/week. IPAQ-TSA and IPAQ-SSA measures categorize participants into high, moderate, or low PA level based on their PA patterns. Spearman rank correlations between IPAQ-SSA and IPAQ METS (r = 0.69, p

Background: When dietary behaviors are habitual, intentions are low, and environmental cues, such as the consumer food environment, might guide behavior. How might intentions to eat healthily and ultimately actual dietary behaviors, be influenced by the consumer food environment (including the availability and affordability of healthy foods) in convenience stores? This study will determine pathways between the healthfulness of convenience stores and college students&rsquo, dietary intentions/behaviors, and body mass index (BMI). Methods: Through multilevel structural equation modeling, a comparison was made of students&rsquo, healthful meal intentions (HMI), intake (fruits/vegetables, %kcal/fat, sugar-sweetened beverages (SSBs) and whole-grains), and measured BMI, as well as the healthfulness of convenience stores (fruits/vegetables availability/quality, healthy food availability/affordability). Data was collected on 1401 students and 41 convenience stores across 13 US college campuses. Results: Controlling for gender, HMI was negatively associated with SSBs (&beta, = &minus, 0.859) and %kcal/fat (&beta, 1.057) and positively with whole-grains (&beta, = 0.186) and fruits/vegetables intake (&beta, = 0.267), %Kcal/fat was positively (&beta, = 0.098) and fruits/vegetables intake (&beta, 0.055) negatively associated with BMI. Campus level, fruits/vegetables availability were positively associated to HMI (&beta, = 0.214, &beta, = 0.129) and directly/negatively to BMI (&beta, 2.657, &beta, 1.124). Conclusions: HMI modifies dietary behaviors, with energy from fat and fruit/vegetable intake the most predictive of weight. Availability of fruit/vegetables in convenience stores make it easier for young adults to eat well.

Purpose – Recruiting college students for research studies can be challenging. The purpose of this paper is to describe the lessons learned in the various recruitment strategies used for enrolling college students in a theory-based, tailored, and web-delivered health intervention at 13 US universities. Design/methodology/approach – The community-based participatory research (CBPR) model was used to develop a staged-tailored, web-based, randomized control trial, focussing on eating behavior, physical activity, and stress management. Participant feedback during baseline assessments was used to evaluate recruitment strategies. Findings – Findings from this feedback suggest that traditional recruitment strategies, such as newspaper ads and flyers, may not be the best approach for recruiting college students; instead, web-based efforts proved to be a better recruitment strategy. Research limitations/implications – This project included results from 13 US universities and thus may not be generalizable: more research is needed to determine successful recruitment methods for 18-24 years old college students. Originality/value – This paper lessens the gap regarding successful recruitment strategies for 18-24 years old college students.

This study assessed the nutritional quality of snacks and beverages sold in vending machines. The contents of snack and beverage vending machines in 78 buildings on 11 US post-secondary education campuses were surveyed. Of the 2607 snack machine slots surveyed, the most common snacks vended were salty snacks (e.g., chips, pretzels) and sweets (i.e., candy and candy bars). The 1650 beverage machine slots assessed contained twice as many sugar-sweetened beverages as non-calorie-containing beverages. Only two institutions sold both milk and 100% juice in vending machines. The portion of snacks and beverages sold averaged more than 200 cal. Neither snacks nor beverages were nutrient dense. The majority of snacks were low in fiber and high in calories and fat and almost half were high in sugar. Most beverages were high in calories and sugar. This study's findings suggest that vending machines provide limited healthful choices. Findings from benchmark assessments of components of the food environment, like the vending options reported here, can provide valuable input to campus administrators, health services, food service, and students who want to establish campus policies to promote healthful eating.

Weight gain and an increase in overweight and obesity in college students raise serious health concerns. Weight management interventions for college-age men and women might be more effective if they were tailored to subgroups of students with similar behavioral and psychosocial characteristics associated with body weight status. The purpose of this study was to use cluster analysis to identify homogenous subgroups of college-aged men and women enrolled in a weight gain prevention study (Project WebHealth) using baseline data collected in 2008. Project WebHealth was a 15-month nutrition and physical activity intervention designed to decrease the rate of unwanted weight gain in 1,689 college students at eight geographically diverse universities in the United States. Outcome measures included anthropometrics, fruit and vegetable intake, physical activity, cardiorespiratory fitness, and psychosocial variables associated with weight status in college students. Cluster analysis was performed separately by sex using a two-step clustering procedure using weight-related eating and exercise behaviors and psychosocial variables. Cluster groupings were validated against students' measured weight status and waist circumference as indicators of health risk. The study design was cross-sectional. Results showed that three similar clusters were identified for each sex. Validity of the cluster solution was supported by significant group differences in body mass index and waist circumference with the High Risk cluster at elevated health risk compared to the others. For men, variability in eating competence and cognitive restraint scores contributed most to the difference between clusters, whereas for women, emotional eating and uncontrolled eating scores did. These findings could be used to improve effectiveness of messages and interventions by tailoring them to subgroups of college students with similar behavioral and psychosocial characteristics associated with elevated health risk.

Purpose To determine the degree of overlap between foods considered part of African American (AA) culture and those considered to be healthy. Methods A total of 44 AA men and women were recruited from the Birmingham, AL area, 25 years of age and older to participate in four Nominal Group Technique (NGT) meetings. Participants from the first two groups generated 90 unique food items in response to the question “What are the foods you associate with being African American?” Participants individually ranked their top three most unhealthy foods. The next two groups generated 116 unique food items in response to the question “What foods do you consider to be healthy?” Participants individually ranked their top three foods that were considered most associated with AA. Results The top five foods associated with AA were chitterlings, fried chicken, pig parts, greens prepared with ham hock, and pork ribs. Of the foods associated with AA, chitterlings, pig parts, fatback, fried chicken, and greens prepared with ham hocks were ranked as the unhealthiest. The top five healthy foods were broccoli, boiled greens, baked fish, grapefruit, and broiled fish. From these top five healthy foods, only boiled greens were considered to be associated with AA. Conclusions Many of the foods AA consider as traditional foods are also perceived as unhealthy. On the contrary, foods perceived to have the most health value may not be a routine part of AA food patterns. Understanding AA perceptions of the healthfulness of foods can be informative for culturally appropriate nutrition intervention development.

Purpose. Assess effectiveness of an intervention to improve fruit and vegetable consumption in economically disadvantaged young adults. Design. Randomized treatment-control, pre-post design. Setting. Ten states. Subjects. Young adults (n = 2024, ages 18–24) were recruited from noncollege venues; 1255 (62%) completed assessment interviews at baseline and at 4 and 12 months. Intervention. Treatment participants received a series of mailed materials and two educational calls in 6 months. Controls received a mailed pamphlet. Measures. Assessment calls determined two measures of fruit and vegetable intakes, demographics and stage of change at baseline, 4 and 12 months, plus treatment participants' decisional balance, processes, and self-efficacy. Analysis. Repeated measure analysis of variance, intent-to-treat, χ2, and logistic regression. Results. At follow-up, participants in the experimental group had higher intakes of fruit and vegetables than controls (perceived daily intakes of 4.90 vs. 4.60 servings per day, F = 3.49, p < .05 and 4.31 vs. 3.92 servings/day via 5-A-Day Screener, F = 4.78, p < .01) and greater progression to action or maintenance stages (66% progress in fruit for intervention vs. 55% progress in fruit for controls; 47% vs. 32% progress for vegetables, p = .0080 and .0001, respectively). Lower education, non-White ethnicity, male gender, living with children, and experimental group assignment predicted attrition (X26df = 288, p < .001, Cox R2 = .132). Conclusions. Tailored educational messages and research-extension partnerships are advantageous for improving fruit and vegetable intakes of young adults.

This study examined associations between college students' self-report and measured height and weight.Participants (N = 1,686) were 77% white, 62% female, aged 18-24 years (mean ± SD, 19.1 ± 1.1 years), and enrolled at 8 US universities. Body mass index (BMI) was calculated for self-report (via online survey); trained researchers measured height and weight and categorized them as normal (18.5 to25), overweight (25 to30), obese (30 to35), and morbidly obese (≥ 35).Concordance of self-report vs objectively measured BMI groups using chi-square revealed that 93% were accurate, 4% were underestimated, and 2.7% were overestimated. Pearson correlations and adjusted linear regression revealed significant associations between self-report and measured BMI (r = .97; P.001) and BMI adjusted for age, gender, and race/ethnicity (R² = .94). Concordance was also high between BMI categories (kappa = 0.77; P.001).Findings provide support for the utility of self-report height and weight for survey research in college students.

The inaccuracy of self-report height (Ht) and weight (Wt) in survey research is frequently cited as a limitation. This study examined associations between 1686 college students’ self-report, via on...

Objective To assess the effectiveness of a tailored theory-based, Web-delivered intervention (Young Adults Eating and Active for Health) developed using community-based participatory research process. Design A 15-month (10-week intensive intervention with a 12-month follow-up) randomized, controlled trial delivered via Internet and e-mail. Setting Thirteen college campuses. Participants A total of 1,639 college students. Intervention Twenty-one mini-educational lessons and e-mail messages (called nudges) developed with the non-diet approach and focusing on eating behavior, physical activity, stress management, and healthy weight management. Nudges were short, frequent, entertaining, and stage-tailored to each behavior, and reinforced lesson content. Main Outcome Measure All participants were assessed at baseline, postintervention (3 months from baseline), and follow-up (15 months from baseline) for primary outcomes of weight, body mass index (BMI), fruit and vegetable intake (FVI), physical activity (PA), and perceived stress; and secondary outcomes of waist circumference, percent dietary fat, energy from sugar-sweetened beverages, servings of whole grains, self-instruction and regulation for mealtime behavior, hours of sleep, and stage of readiness for change for consuming 5 cups of FVI, completing 150 minutes of PA/wk, and managing stress on most days of the week. Demographics were collected at baseline. Analysis Chi-square analysis and mixed-models repeated measures analysis were performed to determine differences between experimental and control outcomes. Results There were no differences between experimental and control participants in BMI, weight, and waist circumference. There were small improvements in FVI ( P = .001), vigorous PA in females ( P = .05), fat intake ( P = .002), self-instruction ( P = .001), and regulation ( P = .004) for mealtime behavior, and hours of sleep ( P = .05) at postintervention, but improvements were not maintained at follow-up. At postintervention, a greater proportion of experimental participants were in the action/maintenance stages for FVI ( P = .019) and PA ( P = .002) than control. Conclusions and Implications Young Adults Eating and Active for Health is one of the first studies to use the community-based participatory research process of PRECEDE-PROCEED to develop a non-diet approach intervention. Although there were no differences between experimental and control participants in weight change or BMI, the intervention supported positive change in behaviors that may mediate excessive weight gain, such as increasing FVI and more healthful self-regulation mealtime behaviors immediately postintervention. Additional strategies to maintain the behavior changes need to be explored.

Objective To develop a tailored, theory-based, Web-delivered intervention to prevent excessive weight gain in young adults using a Community-Based Participatory Research model. Design Investigators from 14 universities developed the intervention and supporting administrative portal using the 4 phases of the PRECEDE model. Steering committees were composed of the target audience (aged 19–24 years) and key health/wellness personnel were formed at each institution and provided information during each phase that was used to guide development of the intervention, Project YEAH (Young Adults Eating and Active for Health). Piloting results were used to refine the curriculum and identify and avoid barriers to delivery. Results Qualitative and quantitative data collected at each phase informed Project YEAH development. In Phase 1, factors of highest priority to young adults were identified. In Phase 2, environmental supports for healthful lifestyles were elucidated. In Phase 3, behavior and environmental changes considered important and changeable were identified. In Phase 4, the 10-week, theory-based, stage-tailored, interactive-learning intervention with a 10-month reinforcement period was developed. Conclusions and Implications Applying the PRECEDE model with fidelity during development of Project YEAH resulted in an intervention that pilot participants found relevant and useful, gained attention, instilled confidence in the ability to apply the information, and provided a sense of satisfaction.

This study aimed to identify relationships between above average SSB intake of 1160 college students from 9 campuses, their weight, and prevalence of SSB sold in 67 vending machines on those campus...

Purpose. To identify impact of an online nutrition and physical activity program for college students. Design. Randomized, controlled trial using online questionnaires and on-site physical and fitness assessments with measurement intervals of 0 (baseline), 3 (postintervention), and 15 months (follow-up). Setting. Online intervention delivered to college students; a centralized Web site was used for recruitment, data collection, data management, and intervention delivery. Subjects. College students (18–24 years old, n = 1689), from eight universities (Michigan State University, South Dakota State University, Syracuse University, The Pennsylvania State University, Tuskegee University, University of Rhode Island, University of Maine, and University of Wisconsin). Intervention. A 10-lesson curriculum focusing on healthful eating and physical activity, stressing nondieting principles such as size acceptance and eating competence (software developer: Rainstorm, Inc, Orono, Maine). Measures. Measurements included anthropometrics, cardiorespiratory fitness, fruit/vegetable (FV) intake, eating competence, physical activity, and psychosocial stress. Analysis. Repeated measures analysis of variance for outcome variables. Results. Most subjects were white, undergraduate females (63%), with 25% either overweight or obese. Treatment group completion rate for the curriculum was 84%. Over 15 months, the treatment group had significantly higher FV intake (+.5 cups/d) and physical activity participation (+270 metabolic equivalent minutes per week) than controls. For both groups, anthropometric values and stress increased, and fitness levels decreased. Gender differences were present for most variables. First-year males and females gained more weight than participants in other school years. Conclusion. A 10-week online nutrition and physical activity intervention to encourage competence in making healthful food and eating decisions had a positive, lasting effect on FV intake and maintained baseline levels of physical activity in a population that otherwise experiences significant declines in these healthful behaviors.

Objective: To evaluate the motivational effect of the Project WebHealth study procedures and intervention components on weight-related health behavior changes in male and female college students. Design: Process evaluation. Setting: Eight universities in the United States. Participants: Project WebHealth participants (n ¼ 653; 29% men). Main Outcome Measures: Participants rated motivational effects of study procedures and intervention components. Participants were grouped into outcome-based health behavior categories based on achievement of desired targets for fruit and vegetable intake, physical activity, and/or body weight. Analysis: Differences in motivation from each procedure and component were analyzed by gender- and outcome-based health behavior category. Results: Women were generally more motivated than men. Compared to those who did not meet any target health behaviors, men with improved health outcomes (68%) were significantly more motivated by the skills to fuel the body lesson, goal setting, and research snippets. Their female counterparts (63%) were significantly more motivated by the lessons on body size and eating enjoyment, and by the suggested weekly activities. Conclusions and Implications: Specific study procedures and components of Project WebHealth motivated study participants to improve their weight-related health behaviors, and they differed by gender. Findings support the need for gender-tailored interventions in this population.

Objective To develop and test the validity of the Behavior, Environment, and Changeability Survey (BECS) for identifying the importance and changeability of nutrition, exercise, and stress management behavior and related aspects of the environment. Design A cross-sectional, online survey of the BECS and selected validated instruments. Setting Ten state universities. Participants A convenience sample of college students (n = 1,283), ages 18-24 years. Analysis Principal component analysis was used to confirm a 6-component structure of the BECS in 2 independent samples for the purpose of cross-validation. Internal consistency was measured and construct and criterion-related analyses were conducted to test the reliability and validity of the BECS subscales. Results Six components representing 34 BECS items were revealed from the original 69 items and explained 64% of the total variance. Six scales were retained, and internal consistency of each ranged from α = .82 to .93. BECS Nutrition Behavior and Nutrition Changeability scale scores were highest for participants in action/maintenance Stages of Change for fruit and vegetable intake. Conclusions and Implications There is strong support for the use of the BECS when planning health programs to gain insight into behavior that young adults are willing to improve, specifically related to nutrition, exercise, and sleep.

Author(s): T. Tench, O. Brown, C. Byrd-Bredbenner, S. Colby, G. Greene, M. Koenings, S. Hoerr, T. Horacek, T. Kidd, J. Morrell, M. Olfert, B. Phillips, K. Shelnutt, A. White, K. Kattelmann; Nutrition, Dietetics, and Hospitality Management, Auburn Univ., Auburn, AL, Rutgers Univ., New Brunswick, NJ, Univ. of Tennessee, Knoxville, TN, Univ. of Rhode Island, Kingston, RI, Michigan State Univ., East Lansing, MI, Syracuse Univ., Syracuse, NY, Kansas State Univ., Manhattan, KS, Univ. of New Hampshire, Durham, NH, West Virginia Univ., Morgantown, WV, Tuskegee Univ., Tuskegee, AL, Univ. of Florida, Gainesville, FL, Univ. of Maine, Orono, ME, South Dakota State Univ., Brookings, SD

LEARNING OUTCOME: To assess the dietary lipid consumption and nutrition knowledge related to risks of cardiovascular disease based on socioeconomic and demographic characteristics The purpose of this study was to determine the effect of socioeconomic and demographic factors on total energy nutrients, protein, lipids and dietary fiber of free-living rural African American elderly in two Black belt Alabama Counties together with the participant's nutrition knowledge as related to the risk of cardiovascular disease. Participants of the study consisted of an available sample of 120 African-Americans elderly of both genders (60 per county). All subjects were at least 60 years of age and participants in the Title III Congregate Meal Program for the Elderly. The survey instrument consisted of a questionnaire which solicited information in five different areas (socio-demographic characteristics, attitudinal characteristics, cardiovascular disease risk factor assessment, nutrition knowledge assessment and dietary intake). Dietary intake included a 24-hour recall and food records for two additional consecutive days (1 weekend day). Each participant was seen atleast twice to collect data. Descriptive, univariate and multivariate statistics were used to analyze the data. Results indicated that kilocalorie intake was consistent with recommendations but there was no significant co-relationship with income, age, gender and county of residence. A significant effect (p