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Objective: Each year, humanitarian groups provide health education programmes and interventions to underserved communities in Nicaragua. The purpose of this study was to identify the health education needs of a small community in rural Nicaragua to inform health education programming. Design: Mixed methods approach that used a quantitative survey and a qualitative questionnaire to determine health education priorities. Setting: Rural community in the Jinotega region of northern Nicaragua. Methods: The quantitative survey was completed by 125 participants to gauge the importance of specific health topics, while 49 of those participants also completed a qualitative questionnaire that solicited information about participants' current health knowledge, beliefs and practices. Results: Quantitative results showed that participants ranked the prevention of respiratory illness as their highest education need, while exercise was their lowest priority. Smoking cessation and reducing alcohol use were viewed as significantly higher priorities by men than by women. Qualitative findings revealed five major themes related to reproductive health, respiratory health, nutrition, stress and exercise. Within each theme, participants demonstrated knowledge of health promoting behaviours; however, barriers to adopting healthy behaviours were also evident. For example, some female participants expressed feelings of powerlessness in sexual relationships despite knowledge of how sexually transmitted infections could be prevented. Participants also identified the importance of nutrition but described poor access to healthy foods. Conclusion: Findings from this study provided information to develop future health education programmes that build upon the community's strengths while addressing the health topics most important to residents.

Purpose: The aim of this research was to assess the association between university-based instructional physical activity (PA) courses and changes in overall PA levels and negative mood and their interrelations. The study also sought to determine the amount of change in PA required to significantly improve mood in course enrollees. Method: Participants were university students initially completing PA below the level recommended for health who were either presently enrolled in an elective instructional PA course (treatment group, n = 52, 69% female) or not presently enrolled in such a course (comparison group, n = 32, 69% female). Validated surveys assessed volumes of PA completed per week and overall negative mood from baseline to course end. Mediation analyses assessed group effects on mood through PA changes and reciprocal relations between PA and mood changes. Results: There was a significantly greater increase in PA and significantly more reduction in negative mood in the treatment group. Change in PA completely mediated the relationship between group and change in negative mood, and change in mood completely mediated the relationship between group and PA. These findings indicated a reciprocal, mutually reinforcing relationship between changes in PA and mood. An increase in PA of at least 2 days/week was associated with a significant reduction in negative mood, with no greater effect for more increase. Conclusions: Results provided an improved understanding of the effects of university-based instructional PA courses and how they might be leveraged to improve students' mental health and possibly contribute to their academic success.

Objective: Small-scale pilot testing of supplementing a required college health-related fitness course with a cognitive-behavioral exercise-support protocol (The Coach Approach). Participants: Three classes were randomly assigned to Usual processes (n = 32), Coach Approach-supplemented: Mid-size Groups (n = 32), and Coach Approach-supplemented: Small Groups (n = 34) conditions. Methods: Repeated-measures analyses of variance (ANOVAs) assessed overall and between-class changes in the behavioral/physiological factors of exercise, fruit/vegetable intake, and body mass index (BMI); and the psychosocial factors of self-regulation, exercise self-efficacy, mood, and body satisfaction. Dependent t tests evaluated within-class changes. Multiple regression analyses tested prediction of exercise by changes in self-regulation, self-efficacy, and mood. Results: Significant improvements in self-regulation and fruit/vegetable intake were found in all classes. The Coach Approach-supplemented classes demonstrated significant increases in exercise. Significant improvements in BMI, self-efficacy, and body satisfaction were found in only The Coach Approach-supplemented: Small Groups class. Psychosocial changes predicted increased exercise. Self-regulation was the strongest contributor. Conclusions: Overall, results were positive and warrant more comprehensive testing.

ABSTRACT. Severely obese men and women (body mass index ≥ 35 ≤ 55 kg/m2;Mage= 44.8 years,SD= 9.3) were randomly assigned to a 6-month physical activity support treatment paired with either nutrition education (n= 83) or cognitive-behavioral nutrition (n= 82) methods for weight loss. Both groups had significant improvements in physical activity, fatigue, self-regulation for eating, and fruit and vegetable intake. Compared to those in the nutrition education group, participants in the behavioral group demonstrated greater overall increases in fruit and vegetable intake and physical activity. These group differences were associated with changes that occurred after Month 3. Increased physical activity predicted reduced fatigue, β = −.19,p=.01. A reciprocal relationship between the mediators of that relationship, which were changes in self-regulation and fruit and vegetable intake, was identified. There was significantly greater weight loss over six months in the behavioral nutrition group when contrasted with the nutrition education group. Self-regulation for eating and fruit and vegetable intake were significant predictors of weight loss over both three and six months. Findings enabled a better understanding of psychosocial effects on temporal aspects of weight loss and may lead to more effective behavioral treatments for weight loss. [ABSTRACT FROM PUBLISHER]

Improvements in self-image and mood are often reported as outcomes of obesity interventions. However, they may also concurrently influence weight loss, suggesting a reciprocal effect. Although previously reported for overweight women, such relationships were untested in morbidly obese women whose psychosocial responses to treatment may be different, and health-risks greater. Women (N = 161, Meanage = 42 years) with morbid obesity (MeanBMI = 45.1 kg/m2) participated in a 6-month, behaviorally based physical activity and nutrition treatment. Significant within-group improvements in weight-loss behaviors (physical activity and eating), weight, body satisfaction, physical self-concept, and depression were found. After controlling for age, mediation analyses indicated that, as a result of the treatment, weight loss was both an outcome and mediator of improvements in body-areas satisfaction and physical self-concept (reciprocal effects), but not depression. Results replicated findings from women with lower degrees of overweight, and suggested that weight-loss treatments emphasize changes in self-perception. [ABSTRACT FROM AUTHOR]

The relationship of physical activity with weight loss may largely be due to its association with psychosocial factors. The goal of this research was to clarify such relationships using a field design lasting 24 weeks. In Study 1, change in self-regulation for controlled eating, but not energy expenditure, mediated the relationship between changes in physical activity and weight in formerly sedentary, severely obese adults (n = 174). In Study 2 (n = 148), the addition of a cognitive-behavioral nutrition treatment was associated with significantly greater improvement in self-regulation for eating. Physical activity-related self-regulation changes were related to those improvements. Changes in self-efficacy for controlled eating and mood mediated the prediction of changes in eating-related self-regulation from changes on physical activity-related self-regulation. Change in body satisfaction was not a significant mediator. Based on the findings, practical uses of physical activity to enhance self-regulatory skills for controlled eating were suggested. [ABSTRACT FROM AUTHOR]

The purpose of this pilot study was to evaluate the effectiveness of an interdisciplinary faculty team-led competency-based interprofessional undergraduate course for health and human services pre-professional students. Today's complex health and social problems require inter-professional knowledge and skills. Most interprofessional education occurs in graduate-level healthcare programs. Students graduating from health and allied health professions at the undergraduate level are ill prepared to work on interprofessional teams. Using a quasi-experimental design, this study examined the impact of an innovative experiential course on interprofessional competencies. Eleven undergraduate students in human services, public health, and nursing participated in the course. Students and faculty completed a modified Interprofessional Education Collaborative Competency Survey after each simulation and results were compared. At the end of the semester, each student also responded to open-ended prompts describing their reflections pertaining to team experiences. The results of this study indicate that an undergraduate course can increase students' interprofessional competencies, and that group dynamics influence how students view their skill levels. Consistent with other studies on this topic, students' self-ratings on the survey were mostly higher than those completed by faculty members. Educators need to process group dynamics (e.g., storming, norming) and individual styles of work regularly throughout the semester in order to maximize students' development of interprofessional competencies. Pre-professional students should be provided interprofessional learning opportunities to improve their competencies for addressing complex health and social challenges.