Stacey G. Moe

Physical Activity Attitudes, Preferences, and Practices in African American, Hispanic, and Caucasian Girls

Physical activity levels in girls decline dramatically during adolescence, most profoundly among minorities. To explore ethnic and racial variation in attitudes toward physical activity, semistructured interviews (n = 80) and physical activity checklists (n = 130) are conducted with African American, Hispanic, and Caucasian middle school girls in six locations across the United States. Girls from all groups have similar perceptions of the benefits of physical activity, with staying in shape as the most important. Girls have similar negative perceptions of physical activity, including getting hurt, sweating, aggressive players, and embarrassment. Chores, running or jogging, exercises, and dance are common activities for girls regardless of ethnicity. Basketball, swimming, running, and dance are commonly cited favorite activities, although there are slight differences between ethnic groups. The results suggest that factors other than ethnicity contribute to girls’ physical activity preferences and that distinct interventions may not be needed for each ethnic group.

Adolescent sleep, risk behaviors, and depressive symptoms: are they linked?

OBJECTIVE To explore how weekday and weekend sleep patterns are related to adolescent substance use, depressive symptoms, and school truancy. METHODS Selfreport surveys of 242 youth (93.4% white, mean age 16.4 years). RESULTS Longer weekday sleep duration was inversely associated with depressive symptoms, past month alcohol use, and drunkenness. Later weekend bedtime and wake-times, compared to those of weekdays, were associated with increased substance use and truancy. CONCLUSIONS Weekday sleep duration appears to be protective for substance use, depression and school truancy for teenagers. However, inconsistent sleep patterns between weekdays and weekends were associated with a range of markers for adolescent risk.

Adoption of Risk-Related Factors Through Early Adolescence: Associations with Weight Status and Implications for Causal Mechanisms

PURPOSE To examine cross-sectional and longitudinal associations between weight status and measures of risk and protective factors in youth. METHODS Participants included 3010 students (72.1% white, 27.9% nonwhite), with a baseline mean age of 12.7 years from the Teens Eating for Energy and Nutrition at School (TEENS) study. Surveys were administered in grades 7 and 8. Cross-sectional and longitudinal mixed-effects regression analyses were conducted to determine the association between body mass index z-score percentiles (BMI) and risk and protective factors (including substance use, depression, fighting, optimism, and spirituality). RESULTS Only depression was associated with BMI at the beginning of grade 7. However, by the end of grade 8, binge drinking, alcohol, tobacco, and other drug (ATOD) use, fighting, and depression were all cross-sectionally associated with BMI. Longitudinally, BMI in grade 7 did not predict risk and protective factors in grade 8. However, ATOD use, fighting, depression, and optimism in grade 7 predicted BMI in grade 8. CONCLUSIONS This study suggests there is a notable co-occurrence of unhealthy factors (including weight status, ATOD use, depression) which appears to develop during the critical transition period through early adolescence. Specifically, earlier ATOD use, depression, increased fighting, and decreased optimism may lead to unhealthy increases in weight status, whereas early indicators of increased weight status do not appear to predict increases in these factors. This work yields important insights into the causal mechanisms underlying adolescent behavior patterning and the progression with which these unhealthy risk factor profiles are adopted during this critical age.

Recruiting a Diverse Group of Middle School Girls into the Trial of Activity for Adolescent Girls

BACKGROUND School-based study recruitment efforts are both time consuming and challenging. This paper highlights the recruitment strategies employed by the national, multisite Trial of Activity for Adolescent Girls (TAAG), a study designed to measure the effectiveness of an intervention to reduce the decline of physical activity levels among middle school-aged girls. TAAG provided a unique opportunity to recruit large cohorts of randomly sampled girls within 36 diverse middle schools across the United States. METHODS Key elements of the formative planning, coordination, and design of TAAGs recruitment efforts included flexibility, tailoring, and the use of incentives. Various barriers, including a natural disaster, political tension, and district regulations, were encountered throughout the recruitment process, but coordinated strategies and frequent communication between the 6 TAAG sites were helpful in tailoring the recruitment process at the 36 intervention and control schools. RESULTS Progressively refined recruitment strategies and specific attention to the target audience of middle school girls resulted in overall study recruitment rates of 80%, 85%, and 89%, for the baseline, posttest, and follow-up period, respectively. DISCUSSION The steady increase in recruitment rates over time is attributed to an emphasis on successful strategies and a willingness to modify less successful methods. Open and consistent communication, an increasingly coordinated recruitment strategy, interactive recruitment presentations, and participant incentives resulted in an effective recruitment campaign.

Food Use in Middle and High School Fundraising: Does Policy Support Healthful Practice? Results from a Survey of Minnesota School Principals

This descriptive, cross-sectional study aimed to examine classroom, school-wide, and club/sports teams fundraising policies and practices of middle and high schools; concordance between policy and practice; and associations between healthful policy/practice scores and selected school characteristics. In 2006, principals/designees of middle (n=45) and high (n=71) schools in the St Paul/Minneapolis, MN, metropolitan area completed a self-administered mailed survey. Schools were attended by a convenience sample of students (n=349) participating in a longitudinal measurement study of children and their environments to assess obesity-related factors. Descriptive statistics, chi(2) tests, and multivariate linear regression were used to examine variables and associations of interest. Across schools, 50% had policies addressing the nutrient quality of food and drink items used in fundraising or disallowed food use for fundraising. About one third used chocolate, candy, and high-fat baked goods for classroom and school-wide fundraising; 60% sold these items for club/sports teams fundraising. More middle than high schools reported healthful fundraising policies or practices, as well as greater concordance between policies and practices. For all fundraising activities, high schools had significantly lower healthful policy/practice scores than middle schools (P<0.01). For school-wide fundraising, scores were significantly lower for public than private schools (P=0.02). Policies to regulate food used for fundraising were common and most supported healthful practice, particularly in middle schools. However, use of foods high in fat and added sugars remains a prevalent fundraising practice, especially in high schools and for club/sports teams, and requires additional attention.

Designing a Weight Gain Prevention Trial for Young Adults: The CHOICES Study

Background Young adults are at risk for weight gain. Little is known about how to design weight control programs to meet the needs of young adults and few theory-based interventions have been evaluated in a randomized control trial. The Choosing Healthy Options in College Environments and Settings (CHOICES) study was funded to create a technology-based program for 2-year community college students to help prevent unhealthy weight gain. The purpose of this article is to (1) provide a brief background on weight-related interventions in young adults; (2) describe the study design for the CHOICES study, the conceptual model guiding the research and the CHOICES intervention; and (3) discuss implications of this research for health educators. Translation to Health Education Practice Our experiences from the CHOICES study will be useful in suggesting other theory-based models and intervention strategies that might be helpful in programs attempting to prevent unhealthy weight gain in young adults. In addition, this article discusses important considerations for working with 2-year colleges on this type of health promotion work.

Weight misperception and health risk behaviors among early adolescents

OBJECTIVES To examine associations between weight misperception and youth health risk and protective factors. METHODS Three thousand ten US seventh-graders (72.1% white, mean age: 12.7 years) self-reported height, weight, risk, and protective factors. Analyses were conducted to determine cross-sectional and longitudinal associations between weight overestimation and health risk and protective factors. RESULTS Risk and protective factors had significant cross-sectional associations with weight overestimation. However, only depressive symptoms and reduced optimism predicted weight overestimation in eighth grade. Weight overestimation did not predict engagement in risky behaviors. CONCLUSIONS Weight overestimation and risk factors appear to co-occur, suggesting a constellation of risk that warrants further research.

Using School-Level Interviews to Develop a Multisite PE Intervention Program

The Trial of Activity for Adolescent Girls (TAAG) is a randomized, multicenter field trial in middle schools that aims to reduce the decline of physical activity in adolescent girls. To inform the development of the TAAG intervention, two phases of formative research are conducted to gain information on school structure and environment and on the conduct of physical education classes. Principals and designated staff at 64 eligible middle schools were interviewed using the School Survey during Phase 1. The following year(Phase 2), physical education department heads of the 36 schools selected into TAAG were interviewed. Responses were examined to design a standardized, multicomponent physical activity intervention for six regions of the United States. This article describes the contribution of formative research to the development of the physical education intervention component and summarizes the alignment of current school policies and practices with national and state standards.

Weight and Weight-Related Behaviors among 2-Year College Students.

Abstract Objectives and Participants: The purpose of this article is to describe weight indicators and weight-related behaviors of students enrolled in 2-year colleges, including sex differences. Methods: During Fall 2011 and Spring 2012, 441 students from 3 Minnesota community colleges enrolled in the Choosing Healthy Options in College Environments and Settings (CHOICES) Study and completed baseline assessments. Participants completed a baseline survey evaluating eating and activity patterns, sleep, and stress and measures of height, weight, waist circumference, and body fat. Results: Participants were primarily female (68%), white (73%), with a mean age of 22.8 years, and 66.2% reporting an annual income <

Recruiting and retaining young adults in a weight gain prevention trial: Lessons learned from the CHOICES study

12,000. Almost half (47%) were overweight or obese. Young males appeared to engage the most in risky health behaviors and had higher levels of overweight or obesity, compared with young females. Conclusions: Findings confirm the need for innovative interventions targeting this understudied and underserved young adult population.