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Nagata JM, Weinstein S, Alsamman S, Lee CM, Dooley EE, Ganson KT, Testa A, Gooding HC, Kiss O, Baker FC, Pettee Gabriel K. Association of physical activity and screen time with cardiovascular disease risk in the Adolescent Brain Cognitive Development Study. BMC Public Health 2024; 24:1346. [PMID: 38762449 PMCID: PMC11102349 DOI: 10.1186/s12889-024-18790-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 05/08/2024] [Indexed: 05/20/2024] Open
Abstract
BACKGROUND According to the Physical Activity Guidelines Advisory Committee Scientific Report, limited evidence is available on sedentary behaviors (screen time) and their joint associations with physical activity (steps) for cardiovascular health in adolescence. The objective of this study was to identify joint associations of screen time and physical activity categories with cardiovascular disease (CVD) risk factors (blood pressure, hemoglobin A1c, cholesterol) in adolescence. METHODS This study analyzed data from the Adolescent Brain Cognitive Development (ABCD) Study, comprising a diverse sample of 4,718 U.S. adolescents aged 10-15 years between 2018 and 2021. Steps were measured by a Fitbit wearable device and levels were categorized as low (1,000-6,000), medium (> 6,000-12,000), and high (> 12,000) averaged daily step counts. Self-reported recreational screen time hours per day were classified as low (0-4), medium (> 4-8), and high (> 8) hours per day. CVD risk factors including blood pressure, hemoglobin A1c, and cholesterol (total and HDL) were measured. RESULTS The analytical sample averaged 6.6 h of screen time per day and 9,722 steps per day. In models including both screen time and steps, the high screen time category was associated with a 4.27 higher diastolic blood pressure percentile (95% CI 1.83-6.73) and lower HDL cholesterol (B= -2.85, 95% CI -4.77 to -0.94 mg/dL) compared to the low screen time category. Medium (B = 3.68, 95% CI 1.24-6.11) and low (B = 7.64, 95% CI 4.07-11.20) step categories were associated with higher diastolic blood pressure percentile compared to the high step category. The medium step category was associated with lower HDL cholesterol (B= -1.99, 95% CI -3.80 to -0.19 mg/dL) compared to the high step category. Findings were similar when screen time and step counts were analyzed as continuous variables; higher continuous step count was additionally associated with lower total cholesterol (mg/dL). CONCLUSIONS Combinations of low screen time and high steps were generally associated with favorable cardiovascular health markers including lower diastolic blood pressure and higher HDL cholesterol, which can inform future adolescent health guidelines.
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Affiliation(s)
- Jason M Nagata
- Department of Pediatrics, University of California, San Francisco, 550 16th Street, 4th Floor, Box 0503, San Francisco, CA, 94143, USA.
| | - Shayna Weinstein
- Department of Pediatrics, University of California, San Francisco, 550 16th Street, 4th Floor, Box 0503, San Francisco, CA, 94143, USA
| | - Sana Alsamman
- Department of Pediatrics, University of California, San Francisco, 550 16th Street, 4th Floor, Box 0503, San Francisco, CA, 94143, USA
| | - Christopher M Lee
- Department of Pediatrics, University of California, San Francisco, 550 16th Street, 4th Floor, Box 0503, San Francisco, CA, 94143, USA
| | - Erin E Dooley
- Department of Epidemiology, University of Alabama at Birmingham, 1665 University Boulevard. Birmingham, Alabama, 35233, USA
| | - Kyle T Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor St W, Toronto, ON, M5S 1V4, Canada
| | - Alexander Testa
- Department of Management, Policy and Community Health, University of Texas Health Science Center at Houston, 1200 Pressler Street, Houston, TX, 77030, USA
| | - Holly C Gooding
- Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, 2015 Uppergate Drive, Atlanta, GA, 30322, USA
| | - Orsolya Kiss
- Center for Health Sciences, SRI International, 333 Ravenswood Ave, Menlo Park, CA, 94025, USA
| | - Fiona C Baker
- Center for Health Sciences, SRI International, 333 Ravenswood Ave, Menlo Park, CA, 94025, USA
- School of Physiology, University of the Witwatersrand, 1 Jan Smuts Ave, Braamfontein, Johannesburg, 2000, South Africa
| | - Kelley Pettee Gabriel
- Department of Epidemiology, University of Alabama at Birmingham, 1665 University Boulevard. Birmingham, Alabama, 35233, USA
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Agarwal K, Manza P, Tejeda HA, Courville AB, Volkow ND, Joseph PV. Risk Assessment of Maladaptive Behaviors in Adolescents: Nutrition, Screen Time, Prenatal Exposure, Childhood Adversities - Adolescent Brain Cognitive Development Study. J Adolesc Health 2023:S1054-139X(23)00443-3. [PMID: 37804305 PMCID: PMC10999504 DOI: 10.1016/j.jadohealth.2023.08.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 08/05/2023] [Accepted: 08/21/2023] [Indexed: 10/09/2023]
Abstract
PURPOSE We aimed to identify significant contributing factors to the risk of maladaptive behaviors, such as alcohol use disorder or obesity, in children. To achieve this, we utilized the extensive adolescent brain cognitive development data set, which encompasses a wide range of environmental, social, and nutritional factors. METHODS We divided our sample into equal sets (test, validation; n = 3,415 each). On exploratory factor analysis, six factor domains were identified as most significant (fat/sugar intake, screen time, and prenatal alcohol exposure, parental aggressiveness, hyperactivity, family violence, parental education, and family income) and used to stratify the children into low- (n = 975), medium- (n = 967), high- (n = 977) risk groups. Regression models were used to analyze the relationship between identified risk groups, and differences in reward sensitivity, and behavioral problems at 2-year follow-up. RESULTS The functional magnetic resonance imaging analyses showed reduced activation in several brain regions during reward or loss anticipation in high/medium-risk (vs. low-risk) children on a monetary incentive delay task. High-risk children exhibited heightened middle frontal cortex activity when receiving large rewards. They also displayed increased impulsive and motivated reward-seeking behaviors, along with behavioral problems. These findings replicated in our validation set, and a negative correlation between middle frontal cortexthickness and impulsivity behavior was observed in high-risk children. DISCUSSION Our findings show altered reward function and increased impulsiveness in high-risk adolescents. This study has implications for early risk identification and the development of prevention strategies for maladaptive behaviors in children, particularly those at high risk.
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Affiliation(s)
- Khushbu Agarwal
- Section of Sensory Science and Metabolism, National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland; National Institute of Nursing Research, Bethesda, Maryland
| | - Peter Manza
- Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland
| | - Hugo A Tejeda
- Unit on Neuromodulation and Synaptic Integration, National Institute of Mental Health, Bethesda, Maryland
| | - Amber B Courville
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland
| | - Nora D Volkow
- Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland.
| | - Paule V Joseph
- Section of Sensory Science and Metabolism, National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland; National Institute of Nursing Research, Bethesda, Maryland.
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Liu Y, Sun X, Zhang E, Li H, Ge X, Hu F, Cai Y, Xiang M. Association between Types of Screen Time and Weight Status during the COVID-19 Pandemic: A Longitudinal Study in Children and Adolescents. Nutrients 2023; 15:2055. [PMID: 37432199 PMCID: PMC10181058 DOI: 10.3390/nu15092055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 04/19/2023] [Accepted: 04/20/2023] [Indexed: 07/12/2023] Open
Abstract
BACKGROUND This study aimed to investigate the changes in distinct types of screen time and explore their longitudinal association with children and adolescents' weight status. METHODS A two-wave longitudinal study was conducted among 2228 children and adolescents (6-19 years) in Shanghai, China, before and during the pandemic. Recreational screen time (watching TV/videos, online gaming, using social media, and browsing webpages), educational screen time (online homework and online class), and BMI were measured using a self-reported questionnaire. Mixed-effects models were constructed to assess the associations between screen time and weight status. RESULTS The prevalence of overweight and obesity was 20.5% and 10.2% at baseline, respectively. Both recreational and educational screen time increased significantly over two months. While recreational screen time was found to be a risk factor for obesity, it was not the case for educational screen use. Specifically, adolescents who spent more time watching TV/videos had a higher obesity risk (OR = 1.576). No significant associations were found in children. CONCLUSIONS Overweight and obesity were prevalent among children and adolescents in China. Reducing screen-based activities is a promising strategy to prevent unhealthy weight gain in Chinese children and adolescents, while it is necessary to consider the content and distinguish between educational and recreational screen use.
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Affiliation(s)
- Yujie Liu
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, South Chongqing Road No. 227, Shanghai 200025, China
- School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China
| | - Xiaomin Sun
- Global Health Institute, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an 710061, China
| | - Erliang Zhang
- School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China
| | - Huilun Li
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, South Chongqing Road No. 227, Shanghai 200025, China
- School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China
| | - Xin Ge
- School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China
| | - Fan Hu
- School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China
| | - Yong Cai
- School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China
| | - Mi Xiang
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, South Chongqing Road No. 227, Shanghai 200025, China
- School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China
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Gallardo LO, Esteban-Torres D, Rodríguez-Muñoz S, Moreno-Doña A, Abarca-Sos A. Is There Any Relationship between Physical Activity Levels and Academic Achievement? A Cross-Cultural Study among Spanish and Chilean Adolescents. Behav Sci (Basel) 2023; 13:bs13030238. [PMID: 36975263 PMCID: PMC10045662 DOI: 10.3390/bs13030238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 03/03/2023] [Accepted: 03/06/2023] [Indexed: 03/11/2023] Open
Abstract
The current scientific literature has shown significant disparity in results when physical activity is linked to academic achievement among adolescents. Thus, the main objectives of this study were (1) to analyze the relationship among students’ academic achievement, intention to be physically active, and physical activity levels depending on the country (Spain or Chile), as well as to analyze these relationships based on students’ socio-economic status, type of school, school year, gender, and body mass index; and (2) to analyze the differences between all these variables depending on the students’ country and gender. In total, 3052 adolescents participated in the research (14.58 ± 1.39 years): 734 Chilean students (336 males and 398 females) and 2318 Spanish students (1180 males and 1138 females). Various questionnaires were used to measure the study variables. The results revealed significant relationships between academic achievement and the rest of the variables in Spanish adolescents, but in the Chilean population, academic achievement was significantly related only to socio-economic status and the type of school. Moreover, Spanish students obtained higher scores, especially the males, except for academic achievement, which was higher in females. There were also significant differences in academic achievement, intention to be physically active, physical activity levels, and socio-economic status depending on the country, with all scores being higher in Spain. Given the results, the country seems to be an important factor when comparing academic achievement and physical activity levels, besides other demographic variables.
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Affiliation(s)
- Laura O. Gallardo
- Faculty of Social Sciences and Humanities, University of Zaragoza, C/Atarazana 4, 44003 Teruel, Spain
| | - Diego Esteban-Torres
- Faculty of Social Sciences and Humanities, University of Zaragoza, C/Atarazana 4, 44003 Teruel, Spain
| | - Sheila Rodríguez-Muñoz
- Faculty of Social Sciences and Humanities, University of Zaragoza, C/Atarazana 4, 44003 Teruel, Spain
| | - Alberto Moreno-Doña
- Faculty of Medicine, Universidad de Valparaíso, Casa Central—Angamos, Viña del Mar 655, Chile
| | - Alberto Abarca-Sos
- Faculty of Social Sciences and Humanities, University of Zaragoza, C/Atarazana 4, 44003 Teruel, Spain
- Correspondence: ; Tel.: +34-978618101
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Blinder H, Narang I, Chaput JP, Katz SL. Sleep quality, physical activity, screen time, and substance use in children with obesity: associations with obstructive sleep apnea. J Clin Sleep Med 2023; 19:511-518. [PMID: 36468645 PMCID: PMC9978425 DOI: 10.5664/jcsm.10376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 10/27/2022] [Accepted: 10/27/2022] [Indexed: 12/12/2022]
Abstract
STUDY OBJECTIVES The association between obstructive sleep apnea (OSA) and lifestyle habits in children with obesity is largely unknown. This study aimed to determine whether there was an association between lifestyle patterns (sleep quality, physical activity, recreational screen time, and substance use) and OSA presence and severity in children with obesity. METHODS This cross-sectional study recruited children with obesity, aged 8-17 years, who were referred to undergo polysomnography. Children completed questionnaires on sleep quality, physical activity, recreational screen time, and substance use. Children also had a diagnostic polysomnography. The association between questionnaire scores and OSA severity, after adjusting for body mass index z-score, age, and sex, was evaluated using negative binomial multiple regression. Correlations were conducted between sleep quality, physical activity, screen time, substance use, and OSA severity. RESULTS A total of 100 children were included in the analysis (mean age: 14.3 ± 2.6 years; 44% female; mean body mass index z-score: 2.5 ± 0.4; 65% with OSA). In the adjusted regression analysis, each additional substance-use behavior was associated with a 17% (95% confidence interval: 1%, 36%) increase in OSA severity. Correlations were identified between poorer sleep quality and lower physical activity (r = -.42), poorer sleep quality and more substance-use behaviors (r = .40), and greater physical activity and less substance-use behaviors (r = -.26). CONCLUSIONS In children with obesity, more substance-use behaviors were independently associated with greater OSA severity. As there are complex, bidirectional relationships between lifestyle behaviors and OSA severity, interventions need to be comprehensive and multifactorial to ensure successful treatment of OSA and its sequelae in children. CITATION Blinder H, Narang I, Chaput J-P, Katz SL; on behalf of the Canadian Sleep and Circadian Network. Sleep quality, physical activity, screen time, and substance use in children with obesity: associations with obstructive sleep apnea. J Clin Sleep Med. 2023;19(3):511-518.
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Affiliation(s)
- Henrietta Blinder
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Indra Narang
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Division of Respiratory Medicine, Department of Pediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Jean-Philippe Chaput
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Sherri Lynne Katz
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Division of Respiratory Medicine, Department of Pediatrics, Children’s Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - on behalf of the Canadian Sleep and Circadian Network
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Division of Respiratory Medicine, Department of Pediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Division of Respiratory Medicine, Department of Pediatrics, Children’s Hospital of Eastern Ontario, Ottawa, Ontario, Canada
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Nagata JM, Smith N, Alsamman S, Lee CM, Dooley EE, Kiss O, Ganson KT, Wing D, Baker FC, Gabriel KP. Association of Physical Activity and Screen Time With Body Mass Index Among US Adolescents. JAMA Netw Open 2023; 6:e2255466. [PMID: 36757695 PMCID: PMC9912127 DOI: 10.1001/jamanetworkopen.2022.55466] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/10/2023] Open
Abstract
IMPORTANCE The Physical Activity Guidelines Advisory Committee Scientific Report identified important research gaps to inform future guidance for adolescents, including limited evidence on the importance of sedentary behaviors (screen time) and their interactions with physical activity for adolescent health outcomes, including overweight and obesity. OBJECTIVE To identify the independent associations of physical activity and screen time categories, and the interactions between physical activity and screen time categories, with body mass index (BMI) and overweight and obesity in adolescents. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study used data from the Adolescent Brain Cognitive Development (ABCD) Study collected from September 10, 2018, to September 29, 2020. Data were analyzed from July 8 to December 20, 2022. A total of 5797 adolescents aged 10 to 14 years from 21 racially and ethnically diverse study sites across the US were included in the analysis. EXPOSURES Categories of total step count per day (with 1000 to 6000 steps per day indicating low, >6000 to 12 000 steps per day indicating medium, and >12 000 steps per day indicating high), as measured by a wearable digital device (Fitbit), and categories of self-reported screen time hours per day (with 0 to 4 hours per day indicating low, >4 to 8 hours per day indicating medium, and >8 hours per day indicating high). MAIN OUTCOMES AND MEASURES Participant BMI was calculated as weight in kilograms divided by height in meters squared and converted into sex- and age-specific percentiles in accordance with the Centers for Disease Control and Prevention growth curves and definitions. Individuals were classified as having overweight or obesity if their BMI was in the 85th percentile or higher for sex and age. RESULTS Among 5797 adolescents included in the analytic sample, 50.4% were male, 61.0% were White, 35.0% had overweight or obesity, and the mean (SD) age was 12.0 (0.6) years. Mean (SD) reported screen time use was 6.5 (5.4) hours per day, and mean (SD) overall step count was 9246.6 (3111.3) steps per day. In models including both screen time and step count, medium (risk ratio [RR], 1.24; 95% CI, 1.12-1.37) and high (RR, 1.29; 95% CI, 1.16-1.44) screen time categories were associated with higher overweight or obesity risk compared with the low screen time category. Medium (RR, 1.19; 95% CI, 1.06-1.35) and low (RR, 1.30; 95% CI, 1.11-1.51) step count categories were associated with higher overweight or obesity risk compared with the high step count category. Evidence of effect modification between screen time and step count was observed for BMI percentile. For instance, among adolescents with low screen use, medium step count was associated with a 1.55 higher BMI percentile, and low step count was associated with a 7.48 higher BMI percentile. However, among those with high screen use, step count categories did not significantly change the association with higher BMI percentile (low step count: 8.79 higher BMI percentile; medium step count: 8.76 higher BMI percentile; high step count: 8.26 higher BMI percentile). CONCLUSIONS AND RELEVANCE In this cross-sectional study, a combination of low screen time and high step count was associated with lower BMI percentile in adolescents. These results suggest that high step count may not offset higher overweight or obesity risk for adolescents with high screen time, and low screen time may not offset higher overweight or obesity risk for adolescents with low step count. These findings addressed several research gaps identified by the Physical Activity Guidelines Advisory Committee Scientific Report and may be used to inform future screen time and physical activity guidance for adolescents.
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Affiliation(s)
- Jason M. Nagata
- Department of Pediatrics, University of California, San Francisco, San Francisco
| | - Natalia Smith
- Department of Pediatrics, University of California, San Francisco, San Francisco
| | - Sana Alsamman
- Department of Pediatrics, University of California, San Francisco, San Francisco
| | - Christopher M. Lee
- Department of Pediatrics, University of California, San Francisco, San Francisco
| | - Erin E. Dooley
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham
| | - Orsolya Kiss
- Center for Health Sciences, SRI International, Menlo Park, California
| | - Kyle T. Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - David Wing
- Exercise and Physical Activity Resource Center, University of California, San Diego, La Jolla
- Center for Wireless and Population Health Systems, University of California, San Diego, La Jolla
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla
| | - Fiona C. Baker
- Center for Health Sciences, SRI International, Menlo Park, California
- School of Physiology, University of the Witwatersrand, Braamfontein, Johannesburg, South Africa
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Bakour C, Mansuri F, Johns-Rejano C, Crozier M, Wilson R, Sappenfield W. Association between screen time and obesity in US adolescents: A cross-sectional analysis using National Survey of Children's Health 2016-2017. PLoS One 2022; 17:e0278490. [PMID: 36454793 PMCID: PMC9714705 DOI: 10.1371/journal.pone.0278490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 11/16/2022] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE This study examines the association between time spent watching TV, playing video games, using a computer or handheld device (screen time), and BMI among U.S. adolescents, and potential effect modification of these associations by sex, sleep duration, and physical activity. METHODS A secondary analysis of 10-17-year-old participants in the 2016-2017 National Survey of Children's Health was conducted. Multivariable logistic regression was used to examine the association between parent-reported screen time and BMI categories and effect modification by sex, sleep duration and physical activity. RESULTS The analysis included 29,480 adolescents (49.4% female). Those with ≥1 hour (vs <1 hour) of TV/video games per day were more likely to be overweight/obese (adjusted Odds Ratio (aOR) 1-3 hours = 1.4; 95% Confidence Interval (CI)1.19, 1.65; aOR ≥4 hours = 2.19; 95% CI 1.73, 2.77). This association was stronger in adolescents who did not meet the guidelines for physical activity (aOR ≥ 4 hours = 3.04; 95% CI: 2.1, 4.4) compared with those who did (aOR ≥ 4 hours = 1.64; 95% CI: 0.72, 3.72). Using computers/handheld devices was associated with a smaller increase in odds of overweight/obesity (aOR ≥4 hours = 1.53; 95% CI:1.19, 1.97). CONCLUSION Watching TV or playing video games for ≥1 hour per day is associated with obesity in adolescents who did not meet the guidelines for physical activity. Using computers or handheld devices seems to have a weaker association with BMI compared with TV/video games.
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Affiliation(s)
- Chighaf Bakour
- College of Public Health, University of South Florida, Tampa, Florida, United States of America
- University of South Florida, The Chiles Center, Tampa, Florida, United States of America
| | - Fahad Mansuri
- College of Public Health, University of South Florida, Tampa, Florida, United States of America
| | - Courtney Johns-Rejano
- Morsani College of Medicine, University of South Florida, Tampa, Florida, United States of America
| | - Michelle Crozier
- College of Public Health, University of South Florida, Tampa, Florida, United States of America
- School of Global Health Management and Informatics, University of Central Florida, Orlando, Florida, United States of America
| | - Ronee Wilson
- College of Public Health, University of South Florida, Tampa, Florida, United States of America
- University of South Florida, The Chiles Center, Tampa, Florida, United States of America
| | - William Sappenfield
- College of Public Health, University of South Florida, Tampa, Florida, United States of America
- University of South Florida, The Chiles Center, Tampa, Florida, United States of America
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Yang L, Liang C, Yu Y, Xiao Q, Xi M, Tang L. Family sports interventions for the treatment of obesity in childhood: a meta-analysis. JOURNAL OF HEALTH, POPULATION AND NUTRITION 2022; 41:40. [PMID: 36056414 PMCID: PMC9440531 DOI: 10.1186/s41043-022-00317-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 08/04/2022] [Indexed: 12/03/2022] Open
Abstract
Background Obesity in children has become one of the key concerns of the World Health Organization, and the incidence of related non-communicable diseases is also rising. This study evaluates the effect of family sports participation on the treatment and prevention of obesity in children aged 0–14 years by systematic analysis. Method A literature review from 2000 to 2020 was conducted. According to PRISMA-IPD (Preferred Reporting Items for MetaAnalyses of individual participant data) guidelines. The two researchers independently assessed the risk and bias of the articles, obtained a comprehensive, high-quality result, and extracted the data based on the Cochrane intervention system review manual. Randomized controlled trials (RCTs) were selected from the searches that used family sports interventions or family sports combined with dietary adjustments and behavioral habits change. Only studies targeting overweight or obese children aged 0–14 years were included. Results The search resulted in a total of 16 studies. Across all 16 studies, there were a total of 1680 participants in the experimental groups and 1701 participants in the control groups. The results are as follows: body mass index (BMI) (SMD-RE = − 4.10, 95% CI (− 0.84 to 0.02), Z = 1.88, p = 0.06); Body weight (SMD-RE = − 0.77, 95% CI (− 1.53 to − 0.01), Z = 2.00, p = 0.05); Waist circumference (SMD-RE = − 0.45, 95% CI (− 1.36 to 0.47), Z = 0.96, p = 0.34); and Body fat rate (SMD-FE = − 0.06, 95% CI (− 0.22 to 0.11), Z = 0.69, p = 0.49). Hence, through family sports intervention among obese children, juvenile and obese body composition—BMI, body weight, waist circumference, and body fat rate—are all reduced. But only body weight was statistically significant. Conclusions Compared with the samples without family sports, the weight of obese children participating in family sports decreased, but there were no significant differences in other relevant physical indicators. Follow-up research should examine large-scale clinical trials with family sports as a single factor intervention, which are needed to provide stronger evidence of the intervention effect. However, family activities can help obese children grow and develop by improving their exercise capacity, enhancing their lifestyles, and facilitating communication and relationships with their parents. In the future, long-term sports training plans for children with obesity should be implemented.
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Van Dyck D, Barnett A, Cerin E, Conway TL, Esteban-Cornejo I, Hinckson E, Rubín L, Rush E, Baron-Epel O, Cain KL, Christiansen LB, Islam MZ, Mitáš J, Molina-García J, Oyeyemi A, Ranjani H, Reis R, Santos MP, Sit C, Timperio A, Muda WAMW, Sallis JF. Associations of accelerometer measured school- and non-school based physical activity and sedentary time with body mass index: IPEN Adolescent study. Int J Behav Nutr Phys Act 2022; 19:85. [PMID: 35836235 PMCID: PMC9284738 DOI: 10.1186/s12966-022-01324-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 06/23/2022] [Indexed: 11/24/2022] Open
Abstract
Background This study examined the strength, shape and direction of associations of accelerometer-assessed overall, school- and non-school-based moderate-to-vigorous physical activity (MVPA) and sedentary time (ST) with BMI among adolescents across the world. Second, we examined whether these associations differed by study site and sex. Methods Cross-sectional data from the IPEN Adolescent study, an observational multi-country study, were used. Participants wore an accelerometer for seven days, reported height and weight, and completed a socio-demographic survey. In total, 4852 adolescents (46.6% boys), aged 11–19 years (mean age = 14.6, SD = 1.7 years) were included in the analyses, using generalized additive mixed models. Results Adolescents accumulated on average 41.3 (SD = 22.6) min/day of MVPA and 531.8 (SD = 81.1) min/day of ST, and the prevalence of overweight and obesity was 17.2% (IOTF), but these mean values differed by country. Linear negative associations of accelerometer-based MVPA and ST with standardized BMI scores and the likelihood of being overweight/obese were found. School-based ST and non-school-based MVPA were more strongly negatively associated to the outcomes than non-school based ST and school-based MVPA. Study site moderated the associations; adolescent sex did not. No curvilinear associations were found. Conclusions This multi-country study confirmed the importance of MVPA as a potential protective factor against overweight/obesity in adolescents. Non-school-based MVPA seemed to be the main driver of these associations. Unexpected results were found for ST, calling for further examination in methodologically sound international studies but using inclinometers or pressure sensors to provide more precise ST measures. Supplementary Information The online version contains supplementary material available at 10.1186/s12966-022-01324-x.
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Affiliation(s)
- Delfien Van Dyck
- Faculty of Medicine and Health Sciences, Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium.
| | - Anthony Barnett
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
| | - Ester Cerin
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia.,School of Public Health, The University of Hong Kong, Hong Kong, China.,Baker Health and Diabetes Institute, Melbourne, Australia
| | - Terry L Conway
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, San Diego, CA, USA
| | - Irene Esteban-Cornejo
- PROmoting FITness and Health Through Physical Activity Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
| | - Erica Hinckson
- Faculty of Health and Environmental Science, School of Sport and Recreation, Auckland University of Technology, Auckland, New Zealand
| | - Lukáš Rubín
- Institute of Active Lifestyle, Faculty of Physical Culture, Palacký University Olomouc, Olomouc, Czech Republic.,Department of Physical Education and Sport, Faculty of Science, Humanities and Education, Technical University of Liberec, Liberec, Czech Republic
| | - Elaine Rush
- Faculty of Health and Environmental Science, School of Sport and Recreation, Auckland University of Technology, Auckland, New Zealand
| | | | - Kelli L Cain
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, San Diego, CA, USA
| | - Lars Breum Christiansen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Mohammed Zakiul Islam
- Department of Architecture, Bangladesh University of Engineering & Technology (BUET), Dhaka, Bangladesh
| | - Josef Mitáš
- Institute of Active Lifestyle, Faculty of Physical Culture, Palacký University Olomouc, Olomouc, Czech Republic
| | - Javier Molina-García
- AFIPS Research Group, Department of Musical, Visual and Corporal Expression Teaching, University of Valencia, Valencia, Spain
| | - Adewale Oyeyemi
- Department of Physiotherapy, College of Medical Sciences, University of Maiduguri, Maiduguri, Nigeria
| | | | - Rodrigo Reis
- Prevention Research Center, Brown School, Washington University, St Louis, USA.,Graduate Program in Urban Management, Pontifical Catholic University of Parana, Curitiba, Brazil
| | - Maria Paula Santos
- Faculty of Sport, Research Centre in Physical Activity, Health and Leisure (CIAFEL), University of Porto, Porto, Portugal
| | - Cindy Sit
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong, China
| | - Anna Timperio
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | | | - James F Sallis
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia.,Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, San Diego, CA, USA
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10
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Julian V, Ring-Dimitriou S, Wyszyńska J, Mazur A, Matlosz P, Frelut ML, Erhardt E, Vlachopapadopoulou E, Forslund A, Boyland E, Weghuber D, Thivel D. There is a clinical need to consider the physical activity - sedentary pattern in children with obesity. Position paper of the European Childhood Obesity Group. ANNALS OF NUTRITION AND METABOLISM 2022; 78:236-241. [PMID: 35500549 DOI: 10.1159/000524570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 04/09/2022] [Indexed: 11/19/2022]
Abstract
INTRODUCTION While international prevention guidelines recently advocated, in addition to moderate and vigorous physical activity (MVPA) guidelines, for a minimization of sedentary time (SED), recommendations remain to be developed for youths with obesity. METHODS A literature search was conducted in PubMed, the Cochrane Library plus the reference lists of selected articles for relevant publications in English, including original papers, systematic reviews, and meta-analyses, with search terms "sedentary behaviors" or "sedentary time" or "screen time" AND "children" or "adolescents" AND "obesity" or "adiposity" or "cardiometabolic risk" or "cardiometabolic disease". The results were summarized as a narrative review and presented to the scientific board of the European Childhood Obesity Group (ECOG) who then discussed their implication in clinical practice and proposed the position outlined in this paper. RESULTS SED and screen times are associated with adiposity and cardiometabolic risks independently of youths' physical activity level. Besides considering MVPA and SED times as separate variables, comprehensive studies have questioned the impact of different patterns of MVPA and SED levels. Although lower body adiposity and better cardiometabolic health are achieved among those with desirable movement behaviors patterns (i.e., more MVPA/less SED or active/not sedentary), youths with intermediate patterns (i.e., high MVPA/high SED and low MVPA/low SED, or active /sedentary and inactive/not sedentary) have been found to be associated with intermediate risks. CONCLUSION There is a need to decrease SED behaviors irrespective of MVPA and to consider PA-SED patterns in youths with obesity. The European Childhood Obesity Group (ECOG) encourages anti-obesity strategies targeting both physical activity (PA) and SED behaviors to support the shift from long periods of SED time, especially screen time, to daily routines incorporating bouts of PA. Stepwise or sequential approaches to movement behavior counseling might start with targeting SED at first to decrease cardiometabolic risks when implementing MVPA is not yet possible.
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Affiliation(s)
- Valérie Julian
- Department of Sport Medicine and Functional Explorations, University Teaching Hospital of Clermont-Ferrand, Diet and Musculoskeletal Health Team, Human Nutrition Research Center (CRNH), INRA, University of Clermont Auvergne, Clermont-Ferrand, France
- Department of Pediatrics, Paracelsus Medical University, Salzburg, Austria
| | | | | | - Artur Mazur
- Medical Faculty, University of Rzeszow, Rzeszow, Poland
| | - Piotr Matlosz
- Medical Faculty, University of Rzeszow, Rzeszow, Poland
| | | | - Eva Erhardt
- Department of Pediatrics, University of Pécs, Pécs, Hungary
| | | | - Anders Forslund
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Emma Boyland
- Appetite and Obesity Research Group, Department of Psychology, University of Liverpool, Liverpool, United Kingdom
| | - Daniel Weghuber
- Department of Pediatrics, Paracelsus Medical University, Salzburg, Austria
| | - David Thivel
- Laboratory of the Metabolic Adaptations to Exercise Under Physiological and Pathological Conditions (AME2P), Clermont Auvergne University, Clermont-Ferrand, France
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11
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Gomahr J, Julian V, Thivel D, Maruszczak K, Schneider AM, Weghuber D. Childhood obesity prevention: what can be achieved? Curr Opin Clin Nutr Metab Care 2022; 25:223-231. [PMID: 35256565 DOI: 10.1097/mco.0000000000000831] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW Childhood obesity is a pandemic generating an enormous individual and socioeconomic burden worldwide. This narrative review summarizes recent evidence on successful and recommended prevention strategies according to age groups and different levels of interventions. RECENT FINDINGS Effective prevention of childhood obesity is feasible and most successful early in life up to preschool age, and it should include a multicomponent approach, integrating individuals, family and society. Trials that improve nutrition and/or enhance physical activity are the cornerstones of childhood obesity prevention on an individual level. However, their efficacy is determined by the combination of interventions for the target age group. Further, improving family support and sleep, as well as reducing screen time, lead to favourable results. Many research gaps remain, including a lack of effective interventions for high-risk groups. SUMMARY As a multifactorial condition, childhood obesity requires a multicomponent approach. Interventions should be developmental stage-specific and adjusted to the setting. Current research gaps need to be targeted by future trials, with a special focus on the benefit of the most vulnerable groups. From a systems response perspective, a paradigm shift from interventions focusing on the individual to approaches that target society as a whole is warranted.
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Affiliation(s)
- Julian Gomahr
- Department of Pediatrics, Obesity Research Unit and Division of Pediatric Gastroenterology, Hepatology and Nutrition, Paracelsus Medical University, Salzburg, Austria
| | - Valérie Julian
- Department of Sport Medicine and Functional Explorations, University Teaching Hospital of Clermont-Ferrand, Diet and Musculoskeletal Health Team, CRNH, INRA, University of Clermont Auvergne, Clermont-Ferrand
| | - David Thivel
- Laboratory AME2P, University of Clermont Auvergne, Aubiere, Franoe
| | - Katharina Maruszczak
- Department of Pediatrics, Obesity Research Unit and Division of Pediatric Gastroenterology, Hepatology and Nutrition, Paracelsus Medical University, Salzburg, Austria
| | - Anna-Maria Schneider
- Department of Pediatrics, Obesity Research Unit and Division of Pediatric Gastroenterology, Hepatology and Nutrition, Paracelsus Medical University, Salzburg, Austria
| | - Daniel Weghuber
- Department of Pediatrics, Obesity Research Unit and Division of Pediatric Gastroenterology, Hepatology and Nutrition, Paracelsus Medical University, Salzburg, Austria
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12
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Julian V, Haschke F, Fearnbach N, Gomahr J, Pixner T, Furthner D, Weghuber D, Thivel D. Effects of Movement Behaviors on Overall Health and Appetite Control: Current Evidence and Perspectives in Children and Adolescents. Curr Obes Rep 2022; 11:10-22. [PMID: 35020189 PMCID: PMC9165266 DOI: 10.1007/s13679-021-00467-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/28/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE OF REVIEW To present the definitions and recommendations for movement behaviors in children and adolescents, including physical activity (PA), sedentary behaviors (SB), and sleep, and to provide an overview regarding their impact on health and obesity outcomes from childhood to adulthood, as well as interactions with appetite control. RECENT FINDINGS PA represents a variable proportion of daily energy expenditure and one can be active with high SB or vice versa. Studies have described movements across the whole day on a continuum from sleep to SB to varying intensities of PA. More PA, less SB (e.g., less screen time) and longer sleep are positively associated with indicators of physical health (e.g., lower BMI, adiposity, cardiometabolic risk) and cognitive development (e.g., motor skills, academic achievement). However, less than 10% of children currently meet recommendations for all three movement behaviors. Movement behaviors, adiposity, and related cardiometabolic diseases in childhood track into adolescence and adulthood. Furthermore, low PA/high SB profiles are associated with increased energy intake. Recent studies investigating energy balance regulation showed that desirable movement behavior profiles are associated with better appetite control and improved eating habits. Early identification of behavioral phenotypes and a comprehensive approach addressing all key behaviors that directly affect energy balance will allow for individual strategies to prevent or treat obesity and its comorbidities. Investigating exercise as a potential "corrector" of impaired appetite control offers a promising weight management approach.
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Affiliation(s)
- Valérie Julian
- Department of Sport Medicine and Functional Explorations, University Teaching Hospital of Clermont-Ferrand, Diet and Musculoskeletal Health Team, Research Center in Human Nutrition, INRA, University of Clermont Auvergne, Clermont-Ferrand, France
- Obesity Research Unit, Paracelsus Medical University, Salzburg, Austria
| | - Ferdinand Haschke
- Department of Pediatrics, Paracelsus Medical University, Salzburg, Austria
| | - Nicole Fearnbach
- Pediatric Energy Balance Laboratory, Clinical Sciences Division, Pennington Biomedical Research Center, Baton Rouge, LA USA
| | - Julian Gomahr
- Obesity Research Unit, Paracelsus Medical University, Salzburg, Austria
- Department of Pediatrics, Paracelsus Medical University, Salzburg, Austria
| | - Thomas Pixner
- Obesity Research Unit, Paracelsus Medical University, Salzburg, Austria
- Department of Pediatrics and Adolescent Medicine, Salzkammergut-Klinikum, Vöcklabruck, Austria
| | - Dieter Furthner
- Obesity Research Unit, Paracelsus Medical University, Salzburg, Austria
- Department of Pediatrics and Adolescent Medicine, Salzkammergut-Klinikum, Vöcklabruck, Austria
| | - Daniel Weghuber
- Obesity Research Unit, Paracelsus Medical University, Salzburg, Austria
- Department of Pediatrics, Paracelsus Medical University, Salzburg, Austria
| | - David Thivel
- Laboratory AME2P, Research Center in Human Nutrition, University of Clermont Auvergne, Aubière, France
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13
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Association between Metabolic Syndrome Diagnosis and the Physical Activity-Sedentary Profile of Adolescents with Obesity: A Complementary Analysis of the Beta-JUDO Study. Nutrients 2021; 14:nu14010060. [PMID: 35010936 PMCID: PMC8746544 DOI: 10.3390/nu14010060] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 12/22/2021] [Accepted: 12/22/2021] [Indexed: 01/09/2023] Open
Abstract
Metabolic syndrome (MetS) is highly prevalent in children and adolescents with obesity and places them at an increased risk of cardiovascular-related diseases. However, the associations between objectively measured movement-related behaviors and MetS diagnosis remain unexplored in youths with obesity. The aim was to compare profiles of sedentary (SED) time (more sedentary, SED+ vs. less sedentary, SED−), moderate to vigorous physical activity (MVPA) time (more active, MVPA+ vs. less active, MVPA−) and combinations of behaviors (SED−/MVPA+, SED−/MVPA−, SED+/MVPA+, SED+/MVPA−) regarding the MetS diagnosis. One hundred and thirty-four adolescents with obesity (13.4 ± 2.2 years) underwent 24 h/7 day accelerometry, waist circumference (WC), blood pressure (BP), high-density lipoprotein-cholesterol (HDL-c), triglycerides (TG) and insulin-resistance (IR) assessments. Cumulative cardiometabolic risk was assessed by using (i) MetS status (usual dichotomic definition) and (ii) cardiometabolic risk z-score (MetScore, mean of standardized WC, BP, IR, TG and inverted HDL-c). SED− vs. SED+ and MVPA+ vs. MVPA− had lower MetS (p < 0.01 and p < 0.001) and MetScore (p < 0.001). SED−/MVPA+ had the lowest risk. While SED and MVPA times were lower in SED−/MVPA− vs. SED+/MVPA+ (p < 0.001), MetScore was lower in SED−/MVPA− independently of body mass index (BMI) (p < 0.05). MVPA, but not SED, time was independently associated with MetS diagnosis (p < 0.05). Both MVPA (p < 0.01) and SED times (p < 0.05) were associated with MetScore independently of each other. A higher MVPA and lower SED time are associated with lower cumulative cardiometabolic risk.
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14
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Fruh S, Williams S, Hayes K, Hauff C, Hudson GM, Sittig S, Graves RJ, Hall H, Barinas J. A practical approach to obesity prevention: Healthy home habits. J Am Assoc Nurse Pract 2021; 33:1055-1065. [PMID: 33534281 PMCID: PMC8313625 DOI: 10.1097/jxx.0000000000000556] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 11/06/2020] [Indexed: 12/11/2022]
Abstract
ABSTRACT Families have the potential to foster a healthy home environment aimed at reducing the risk of overweight and obesity. Establishing habits associated with reduced risk of obesity and overweight early in childhood can have lasting effects into adulthood. Nurse practitioners can encourage families to participate in healthy habits by addressing areas of growth for obesity prevention within the home. A review of the most recent literature, approximately over the past decade, was used to provide a consolidated source of reference for healthy home habits for the nurse practitioner. The search included terms such as "obesity," "overweight," "healthy habits," "physical activity," "obesogenic behaviors," "family meals," "screen time," "depression," "sugary beverages," and "portion sizes." The information was synthesized into three content areas: nutrition and consumption, patterns of activity, and stress within the home. Establishing healthy habits early in life can protect against the development of overweight and obesity. Nurse practitioners can serve a vital role in the prevention of pediatric, adolescent, and adult obesity. Equipped with the unique role of assisting those from a diverse patient base, nurse practitioners can inform patients how to improve healthy habits to decrease the likelihood of obesity or overweight. Encouraging behavior change related to the healthy habits associated with the prevention of overweight and obesity can have a long-term impact on the health of an entire family.
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Affiliation(s)
- Sharon Fruh
- Research, Evaluation, and Development, College of Nursing, University of South Alabama, Mobile, Alabama
| | - Susan Williams
- College of Nursing, University of South Alabama, Mobile, Alabama
| | - Katey Hayes
- Department of Psychology, University of South Alabama, Mobile, Alabama
| | - Caitlyn Hauff
- Department of Health, Kinesiology, and Sport, University of South Alabama, Mobile, Alabama
| | - Geoffrey M. Hudson
- Department of Health, Kinesiology, and Sport, University of South Alabama, Mobile, Alabama
| | - Scott Sittig
- Department of Information Systems and Technology, University of South Alabama, Mobile, Alabama
| | - Rebecca J. Graves
- Special Projects and Evaluation, College of Nursing, University of South Alabama, Mobile, Alabama
| | - Heather Hall
- College of Nursing, University of South Alabama, Mobile, Alabama
| | - Jennifer Barinas
- Combined-Integrated Clinical & Counseling Psychology Program, University of South Alabama, Mobile, Alabama
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