Amy V. Ries

A Social Media-Based Physical Activity Intervention A Randomized Controlled Trial

BACKGROUND Online social networks, such as Facebook™, have extensive reach, and they use technology that could enhance social support, an established determinant of physical activity. This combination of reach and functionality makes online social networks a promising intervention platform for increasing physical activity. PURPOSE To test the efficacy of a physical activity intervention that combined education, physical activity monitoring, and online social networking to increase social support for physical activity compared to an education-only control. DESIGN RCT. Students (n=134) were randomized to two groups: education-only controls receiving access to a physical activity-focused website (n=67) and intervention participants receiving access to the same website with physical activity self-monitoring and enrollment in a Facebook group (n=67). Recruitment and data collection occurred in 2010 and 2011; data analyses were performed in 2011. SETTING/PARTICIPANTS Female undergraduate students at a large southeastern public university. INTERVENTION Intervention participants were encouraged through e-mails, website instructions, and moderator communications to solicit and provide social support related to increasing physical activity through a physical activity-themed Facebook group. Participants received access to a dedicated website with educational materials and a physical activity self-monitoring tool. MAIN OUTCOME MEASURES The primary outcome was perceived social support for physical activity; secondary outcomes included self-reported physical activity. RESULTS Participants experienced increases in social support and physical activity over time but there were no differences in perceived social support or physical activity between groups over time. Facebook participants posted 259 times to the group. Two thirds (66%) of intervention participants completing a post-study survey indicated that they would recommend the program to friends. CONCLUSIONS Use of an online social networking group plus self-monitoring did not produce greater perceptions of social support or physical activity as compared to education-only controls. Given their promising features and potential reach, efforts to further understand how online social networks can be used in health promotion should be pursued. TRIAL REGISTRATION This study is registered at clinicaltrials.govNCT01421758.

Understanding the Food Environment in a Low-Income Urban Setting: Implications for Food Store Interventions

ABSTRACT Obesity and other diet-related chronic disease affect low-income ethnic minority populations at high rates. Formative research was used to develop a food store–based intervention for low-income African Americans in Baltimore City. A combination of qualitative and quantitative methods were used, including in-depth interviews with food store owners (n = 19) and low-income residents (n = 17), food source assessment (n = 11 census tracts), a consumer survey (n = 50), and direct observations (n = 6). Healthy food options were poorly available in low-income census tracts, with no fresh fruits and vegetables sold in 6 census tracts. Local consumers purchase less healthy options and prepare foods in ways that add fat. Corner stores are a common food source, but store owners expressed reservations about stocking healthier food options, citing low consumer demand for healthier products. Residents were unhappy with the limited range of healthy food options available but tended to see obesity as the result of poor personal and parental choices. Neighborhood food stores have the potential to provide healthy food choices, reinforce health messages, increase the population reached by nutritional interventions, and work with local residents to facilitate healthier dietary choices.

The environment and urban adolescents' use of recreational facilities for physical activity: a qualitative study.

Purpose. Investigate environmental factors influencing the use of recreational facilities for physical activity by urban African-American adolescents. Design. Qualitative in-depth interviews and direct observation. Setting. Two public high schools and 24 public recreational facilities in Baltimore, Maryland. Participants. Forty-eight African-American adolescents aged 14 to 18 years. Methods. Data from 48 in-depth interviews and 26 observations were coded using NVivo software and analyzed using the constant comparative method. Results. Facility use is influenced by characteristics of the physical, social, organizational, and economic environments. Adolescents are attracted to low-cost, well-maintained facilities that offer preferred activities and that are within close proximity to home. Adolescents with limited access to facilities use alternative play spaces, like the streets or vacant lots, where they risk injury from falling or being hit by a car. They are drawn to facilities where they find active adolescents, and they avoid those where young people are engaged in drug or gang activity. Concerns about facility safety largely determine use, particularly for adolescent girls. Conclusion. Previous research points to the importance of increasing facility availability as a means of promoting physical activity, particularly in minority communities in which availability is disproportionately limited. This study shows that, while availability is important, additional facility characteristics should be considered when using environmental change to promote facility use for physical activity.

Tools for Healthy Tribes: Improving Access to Healthy Foods in Indian Country

There is growing recognition that policymakers can promote access to healthy, affordable foods within neighborhoods, schools, childcare centers, and workplaces. Despite the disproportionate risk of obesity and type 2 diabetes among American Indian children and adults, comparatively little attention has been focused on the opportunities tribal policymakers have to implement policies or resolutions to promote access to healthy, affordable foods. This paper presents an approach for integrating formative research into an action-oriented strategy of developing and disseminating tribally led environmental and policy strategies to promote access to and consumption of healthy, affordable foods. This paper explains how the American Indian Healthy Eating Project evolved through five phases and discusses each phases essential steps involved, outcomes derived, and lessons learned. Using community-based participatory research and informed by the Social Cognitive Theory and ecologic frameworks, the American Indian Healthy Eating Project was started in fall 2008 and has evolved through five phases: (1) starting the conversation; (2) conducting multidisciplinary formative research; (3) strengthening partnerships and tailoring policy options; (4) disseminating community-generated ideas; and (5) accelerating action while fostering sustainability. Collectively, these phases helped develop and disseminate Tools for Healthy Tribes-a toolkit used to raise awareness among participating tribal policymakers of their opportunities to improve access to healthy, affordable foods. Formal and informal strategies can engage tribal leaders in the development of culturally appropriate and tribe-specific sustainable strategies to improve such access, as well as empower tribal leaders to leverage their authority toward raising a healthier generation of American Indian children.

Engaging tribal leaders in an American Indian healthy eating project through modified talking circles.

Frequently used in the American Indian (AI) community and proven to be a valuable tool in health research, a Talking Circle is a method used by a group to discuss a topic in an egalitarian and nonconfrontational manner. Using community-based participatory research, a modified Talking Circle format was developed for engaging tribal leaders in an American Indian Healthy Eating Project in North Carolina. The culturally informed formative research approach enabled us to garner project support from 7 tribes, as well as insights on developing planning and policy strategies to improve access to healthy eating within each of the participating communities.

Physical activity interventions and changes in perceived home and facility environments.

OBJECTIVE To examine changes in environmental perceptions over time and associations between changes in perceptions and physical activity among participants in two physical activity interventions. METHODS Two independent trials were examined. Project STRIDE (STRIDE) (N=239) was conducted from 2000 to 2004 in Rhode Island. Step into Motion (SIM) (N=249) was conducted from 2003 to 2006 in Rhode Island and Pennsylvania. Both trials tested various delivery channels for providing individually tailored motivational materials to increase physical activity among sedentary adults. Neither intervention aimed to change perceptions of the environment. At baseline, 6, and 12 months, surveys assessed physical activity and perceived facility and home equipment availability. RESULTS In both trials, perceived facility availability increased from baseline to 6 months. Significant increases continued from 6 to 12 months in SIM only. Increases were not significantly different by treatment group. Perceived home equipment availability also increased from baseline to 6 months in both trials and from 6 to 12 months in SIM only. In STRIDE, greater increases were observed for intervention compared to control participants. Increased facility and home equipment availability were associated with increased minutes of physical activity in both trials. CONCLUSIONS Perceived facility and home equipment availability improved during participation in two individual-level physical activity interventions.