Justin B. Moore

Comparison of traditional versus mobile app self-monitoring of physical activity and dietary intake among overweight adults participating in an mHealth weight loss program.

OBJECTIVE Self-monitoring of physical activity (PA) and diet are key components of behavioral weight loss programs. The purpose of this study was to assess the relationship between diet (mobile app, website, or paper journal) and PA (mobile app vs no mobile app) self-monitoring and dietary and PA behaviors. MATERIALS AND METHODS This study is a post hoc analysis of a 6-month randomized weight loss trial among 96 overweight men and women (body mass index (BMI) 25-45 kg/m(2)) conducted from 2010 to 2011. Participants in both randomized groups were collapsed and categorized by their chosen self-monitoring method for diet and PA. All participants received a behavioral weight loss intervention delivered via podcast and were encouraged to self-monitor dietary intake and PA. RESULTS Adjusting for randomized group and demographics, PA app users self-monitored exercise more frequently over the 6-month study (2.6±0.5 days/week) and reported greater intentional PA (196.4±45.9 kcal/day) than non-app users (1.2±0.5 days/week PA self-monitoring, p<0.01; 100.9±45.1 kcal/day intentional PA, p=0.02). PA app users also had a significantly lower BMI at 6 months (31.5±0.5 kg/m(2)) than non-users (32.5±0.5 kg/m(2); p=0.02). Frequency of self-monitoring did not differ by diet self-monitoring method (p=0.63); however, app users consumed less energy (1437±188 kcal/day) than paper journal users (2049±175 kcal/day; p=0.01) at 6 months. BMI did not differ among the three diet monitoring methods (p=0.20). CONCLUSIONS These findings point to potential benefits of mobile monitoring methods during behavioral weight loss trials. Future studies should examine ways to predict which self-monitoring method works best for an individual to increase adherence.

A qualitative examination of perceived barriers and facilitators of physical activity for urban and rural youth

Many adolescents, both rural and urban, are not meeting the recommended levels for physical activity (PA). This investigation was designed to elicit socioecologic barriers and facilitators for PA in rural and urban middle school youth and their parents. Thirteen focus groups were conducted with 41 youth and 50 parents from eastern North Carolina. Distance, cost, crime/danger and television were mentioned as the primary barriers among parents. Youth mentioned school policies related to PA and crime/danger as the main PA barriers. The most salient facilitators discussed by parents were social/peer facilitators, facilities available and parental role modeling of PA. The primary facilitators mentioned by youth were social outlets and facilities available. Results indicate that intrapersonal, interpersonal, environmental and policy factors related to PA resonated with both youth and parents. Since rural and urban residents often perceive and interact differently with PA environments, more research is needed to properly adapt interventions.

Measuring Enjoyment of Physical Activity in Children: Validation of the Physical Activity Enjoyment Scale

This study sought to determine the reliability and validity of the Physical Activity Enjoyment Scale (PACES) in elementary school children. The sample consisted of 564 3rd grade students (M age = 8.72 ±.54; 268 male, 296 female) surveyed at the beginning of the fall semester. Results indicated that the PACES displayed good internal consistency and item-total correlations. Confirmatory factor analyses supported a unidimensional factor structure. Scores on the PACES were significantly correlated with task goal orientation (r = .65, p < .01), athletic competence (r = .23, p < .01), physical appearance (r = .20, p < .01), and self-reported physical activity (r = .16, p < .01). However, results of invariance analysis suggested the factor structure is variant across sex. The present findings suggest support for the validity of the PACES as a valid measure of enjoyment of physical activity in children; nevertheless, further research examining the invariance of the factor structure across sex is warranted.

Cost-Effectiveness of a School-Based Obesity Prevention Program

BACKGROUND A school-based obesity prevention study (Medical College of Georgia FitKid Project) started in the fall of 2003 in 18 elementary schools. Half of the schools were randomized to an after-school program that included moderate-to-vigorous physical activity, healthy snacks, homework assistance, and academic enrichment. All third graders were invited to enroll. The objective of this study was to assess the cost-effectiveness (CE) of the first-year intervention. METHODS Standard CE analysis methods and a societal perspective were used. Program delivery costs incurred during the first-year intervention and the usual after-school care costs that would occur in the absence of the intervention were estimated (in 2003 dollars). Net intervention costs were calculated by subtracting the usual after-school care costs from the intervention costs. The effectiveness of the intervention was measured as percent body fat (%BF) reduction compared with a control condition. The CE was assessed as the net intervention cost divided by the effectiveness of the intervention. RESULTS The intervention costs totaled

An After-School Physical Activity Program for Obesity Prevention in Children The Medical College of Georgia FitKid Project

174,070,

The Medical College of Georgia Fitkid Project : the relations between program attendance and changes in outcomes in year 1

558/student, or

Effects of acute resistance training of different intensities and rest periods on anxiety and affect.

956/student who attended > or = 40% of the intervention sessions. The usual after-school care costs were estimated at

Physical Activity, Metabolic Syndrome, and Overweight in Rural Youth

639/student. Students who attended > or = 40% of the intervention reduced %BF by 0.76% (95% confidence interval: -1.42 to -0.09) at an additional cost of

Re-examining the role of interscholastic sport participation in education

317/student. CONCLUSIONS Subjects who attended > or = 40% of the intervention achieved a significant reduction in %BF at a relatively low cost. School-based obesity prevention programs of this type are likely to be a cost-effective use of public funds and warrant careful consideration by policy makers and program planners.

The Impact of a 3-Year After-School Obesity Prevention Program in Elementary School Children

This article describes the process of setting up a 3-year, school-based after-school physical activity intervention in elementary schools. The primary aim of the study is to determine whether adiposity and fitness will improve in children who are exposed to a fitogenic versus an obesogenic environment. Eighteen schools were randomized to the control (obesogenic) or intervention (fitogenic) group. The study design, program components, and evaluation of the intervention are described in detail. The intervention consists of (a) academic enrichment, (b) a healthy snack, and (c) physical activity in a mastery-oriented environment. Successful implementation would show the feasibility of schools’ being able to provide a fitogenic environment. Significant differences between the groups would provide evidence that a fitogenic environment after school has positive health benefits. If feasibility and efficacy are demonstrated, implementing an after-school program like this one in elementary schools could play a major role in preventing and reducing childhood obesity.