The independent and joint associations of cardiorespiratory fitness and adiposity with cardiometabolic risk factors and metabolic syndrome in United States college students

Objective To examine the association of CRF and adiposity with cardiometabolic risk factors and metabolic syndrome among emerging adults. Participants: 5681 (60.1% Men; 21 ± 1years) college students from a large university located in the northeast of the United States. Methods: Participants completed an objective health assessment that involved the assessment cardiometabolic risk factors, CRF, and adiposity. Data of 5681 students' (60.1% Men; 21 ± 1years) who had CRF, adiposity, all risk factors necessary to determine metabolic syndrome evaluated were analyzed using logistic regression analyses. Results: Poor CRF and elevated adiposity were associated with cardiometabolic risk factors and metabolic syndrome regardless of sex, with the association between adiposity and risk factors found to be stronger compared to CRF. Conclusions: Targeted and tailored screening and interventions are urgently needed to reduce adiposity and increase CRF to avoid serious short and long-term negative health outcomes in this population.

Power 5 conference institutions' summer transition program physical activity promotion efforts: A review

Objective: To review the physical activity promotion efforts of Power 5 conference institutions' summer transition programs. Methods: The websites of Power 5 Conference and affiliate member institutions (N = 78) were systematically reviewed and information on summer transition programs pertaining to health were extracted. Results: Most (n = 45, 57.7%) institutions had a summer transition program of some kind. Among those who had summer transition programs, 14 (31.1%) had a nonphysical activity health course (i.e. health and/or nutrition), while courses that incorporated a physical activity component were uncommon (n = 6, 13.3%). Only two institutions covered physical activity, nutrition, and health in at least one offered course. Conclusions: There is an opportunity for tertiary institution-level summer transitional programs to expand coverage to address a currently unmet need for physical activity promotion while avoiding perpetuation of existing inequities.

Weight stigma in Latin America, Asia, Middle East, and Africa: A scoping review

BACKGROUND

Being stigmatized because of one's weight can pose physical, mental, and social challenges. While weight stigma and its consequences are established throughout Europe, North America, and Australasia, less is known about weight stigma in other regions.

SUMMARY

The objective of this study was to identify the extent and focus of weight stigma research in Latin America, Asia, the Middle East, and Africa. A scoping review of weight stigma research in Latin America, Asia, the Middle East, and Africa was conducted. Results indicate that weight stigma has been investigated across populations and settings, mainly focusing on manifestations of weight stigma through experiences and practices and the drivers, and personal outcomes of these manifestations.

KEY MESSAGES

Weight stigma is a developing global health concern not restricted to Europe, North America, and Australasia. The extent and focus of weight stigma research in Latin America, Asia, the Middle East, and Africa vary between countries and regions leaving several research gaps that require further investigation.

Benefits and Harms of Mammography Screening in 75 + Women to Inform Shared Decision-making: a Simulation Modeling Study

BACKGROUND

Guidelines recommend shared decision-making (SDM) around mammography screening for women ≥ 75 years old.

OBJECTIVE

To use microsimulation modeling to estimate the lifetime benefits and harms of screening women aged 75, 80, and 85 years based on their individual risk factors (family history, breast density, prior biopsy) and comorbidity level to support SDM in clinical practice.

DESIGN, SETTING, AND PARTICIPANTS

We adapted two established Cancer Intervention and Surveillance Modeling Network (CISNET) models to evaluate the remaining lifetime benefits and harms of screening U.S. women born in 1940, at decision ages 75, 80, and 85 years considering their individual risk factors and comorbidity levels. Results were summarized for average- and higher-risk women (defined as having breast cancer family history, heterogeneously dense breasts, and no prior biopsy, 5% of the population).

MAIN OUTCOMES AND MEASURES

Remaining lifetime breast cancers detected, deaths (breast cancer/other causes), false positives, and overdiagnoses for average- and higher-risk women by age and comorbidity level for screening (one or five screens) vs. no screening per 1000 women.

RESULTS

Compared to stopping, one additional screen at 75 years old resulted in six and eight more breast cancers detected (10% overdiagnoses), one and two fewer breast cancer deaths, and 52 and 59 false positives per 1000 average- and higher-risk women without comorbidities, respectively. Five additional screens over 10 years led to 23 and 31 additional breast cancer cases (29-31% overdiagnoses), four and 15 breast cancer deaths avoided, and 238 and 268 false positives per 1000 average- and higher-risk screened women without comorbidities, respectively. Screening women at older ages (80 and 85 years old) and high comorbidity levels led to fewer breast cancer deaths and a higher percentage of overdiagnoses.

CONCLUSIONS

Simulation models show that continuing screening in women ≥ 75 years old results in fewer breast cancer deaths but more false positive tests and overdiagnoses. Together, clinicians and 75 + women may use model output to weigh the benefits and harms of continued screening.

A Scoping Review of Personalized, Interactive, Web-Based Clinical Decision Tools Available for Breast Cancer Prevention and Screening in the United States

Introduction. Personalized web-based clinical decision tools for breast cancer prevention and screening could address knowledge gaps, enhance patient autonomy in shared decision-making, and promote equitable care. The purpose of this review was to present evidence on the availability, usability, feasibility, acceptability, quality, and uptake of breast cancer prevention and screening tools to support their integration into clinical care. Methods. We used the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews Checklist to conduct this review. We searched 6 databases to identify literature on the development, validation, usability, feasibility, acceptability testing, and uptake of the tools into practice settings. Quality assessment for each tool was conducted using the International Patient Decision Aid Standard instrument, with quality scores ranging from 0 to 63 (lowest-highest). Results. We identified 10 tools for breast cancer prevention and 9 tools for screening. The tools included individual (e.g., age), clinical (e.g., genomic risk factors), and health behavior (e.g., alcohol use) characteristics. Fourteen tools included race/ethnicity, but no tool incorporated contextual factors (e.g., insurance, access) associated with breast cancer. All tools were internally or externally validated. Six tools had undergone usability testing in samples including White (median, 71%; range, 9%-96%), insured (99%; 97%-100%) women, with college education or higher (60%; 27%-100%). All of the tools were developed and tested in academic settings. Seven (37%) tools showed potential evidence of uptake in clinical practice. The tools had an average quality assessment score of 21 (range, 9-39). Conclusions. There is limited evidence on testing and uptake of breast cancer prevention and screening tools in diverse clinical settings. The development, testing, and integration of tools in academic and nonacademic settings could potentially improve uptake and equitable access to these tools.

Highlights

There were 19 personalized, interactive, Web-based decision tools for breast cancer prevention and screening.Breast cancer outcomes were personalized based on individual clinical characteristics (e.g., age, medical history), genomic risk factors (e.g., BRCA1/2), race and ethnicity, and health behaviors (e.g., smoking). The tools did not include contextual factors (e.g., insurance status, access to screening facilities) that could potentially contribute to breast cancer outcomes.Validation, usability, acceptability, and feasibility testing were conducted mostly among White and/or insured patients with some college education (or higher) in academic settings. There was limited evidence on testing and uptake of the tools in nonacademic clinical settings.

Weighty words: exploring terminology about weight among samples of physicians, obesity specialists, and the general public

BACKGROUND

The words used to refer to weight and individuals with large bodies can be used to reinforce weight stigma. Given that most previous research has examined preferred terminology within homogenous groups, this research sought to examine terminology preferences across populations.

METHODS

This paper reports on data gathered with the general public, family physicians, and obesity researchers/practitioners. Participants were asked about the words they commonly: (1) used to refer to people with large bodies (general public); (2) heard in their professional contexts (physicians and obesity specialists); and (3) perceived to be the most socially or professionally acceptable (all samples).

RESULTS

Similarities and differences were evident between samples, especially related to weight-related clinical terms, the word fat, and behavioral stereotypes.

CONCLUSION

The results provide some clarity into the differences between populations and highlight the need to incorporate use of strategies that may move beyond person-first language to humanize research and clinical practice with people with large bodies.

The apparent need for better communication between clinicians and patients regarding elevated blood pressure among United States emerging adults

Objectives: To examine the discrepancy between 'told' and screened blood pressure (BP) category, and the association between body composition and told BP category. Methods: Between 08/2019-03/2020 college students (n = 1057) were asked what category they had previously been told their BP falls into prior to having their BP and body composition (waist circumference, body mass index (BMI), and body fat percentage) objectively assessed. Results: A disproportionate number (>80%) who were told that they had normal BP were categorized as having elevated BP. Men told they had borderline/high BP had less favorable body compositions than those told they had low/normal BP. Less favorable body composition was associated with increased likelihood of men being told that they had borderline/high BP. Conclusions: Better BP screening policies and procedures would ensure healthcare providers discuss elevated BP with emerging adults regardless of body composition and avoid missing opportunities to delivery of early and cost-effective interventions.

University bicycle programming capacity for underrepresented student populations: Pedaling toward equitable opportunities

Purpose: Universities and colleges play a major role in facilitating the behaviors of students into adulthood. Active travel (AT; walking or bicycling for transportation) can provide substantial health benefits, though inequities among bicycling are shown in many underserved populations (racial/ethnic minorities, women, LGBTQ+, disabled, low-income). This study aimed to understand universities' capacity for underserved populations programming on campuses. Methods: Representatives from U.S. universities/colleges participated in an online survey which addressed basic information about university demographics/culture, common barriers and desired tools to reaching underserved students, priorities, and important outcomes. Results: University respondents (n = 51) indicated a lack of programming and implementation of strategies to reach underserved campus populations. Typically, universities ranked equity as a low priority and limited strategies for promoting bicycling reached/targeted underserved populations. Conclusion: There is a notable lack of programs and strategies to engage underserved populations on campus that should be addressed to better serve student health outcomes.

A scoping review of school-based anthropometric measurement

Though anthropometric measurement (AM) frequently occurs in school settings, it is not without risks to child wellbeing. The aim of this scoping review was to examine how AM in school settings takes place and is reported on to make recommendations on best practices. We identified and extracted data from 440 studies published since 2005 that conducted AM in school (pre-school through secondary/high school) settings. Privacy and sensitivity of AM were unclear in over 90% of studies. Thirty-one studies (7.0%) reported protecting student privacy, while nine (2.0%) reported public measurement. Only five studies reported sensitivity regarding AM (1.1%). Exactly who conducted AM was not specified in 201 studies (45.7%). Sixty-nine studies did not provide a weight status criteria citation (19.2%), and 10 used an incorrect citation (2.7%). In summary, serious shortcomings in the reporting of how AM is conducted and by whom, along with details concerning weight status classification, are evident. There is considerable room for improvement regarding the reporting of key methodological details. We propose best practices for AM in school settings, which also double as conditions that should be met before AM takes place in school settings.

Factors contributing to gender inequities in physical activity and campus recreation facility use

Examine college women's perceptions of factors contributing to gender inequities in physical activity and campus recreational facility use.

Semi-structured interviews were conducted with female undergraduate students at a large university located in the Northeast of the United States. Qualitative data were analyzed using thematic analyses using the socio-ecological model as a conceptual framework.

Women (N = 18; 6 non-Hispanic White, 5 Black, 7 Asian American; 20.6 ± 1.2 years old) cited intrapersonal, interpersonal, and environmental factors impacting their physical activity and campus recreation facility use due to their gender. Built environmental factors included facility proximity, facility layout and equipment, and crowdedness. Male peers impacted women by making them feel uncomfortable/intimidated and harassed. Intrapersonal factors included a perceived lack of skills/competence/knowledge, lack of confidence, and self-consciousness.

Findings demonstrate the need for institutions to implement and enforce policies that achieve a cultural shift in the social environment to provide equitable physical activity participation opportunities.

Inequities in the physical activity of disabled young people in Aotearoa New Zealand: a stakeholder SWOT analysis of the physical activity sector

AIMS

Disabled people, particularly children and adolescents, tend to participate in less physical activity than their non-disabled peers on average. However, disabled children and youth (i.e., young people [YP]) are typically underrepresented in physical activity (PA) research, with little data available in Aotearoa New Zealand to guide policy makers to alter societal factors that contribute to disability inequities. The purpose of this study was to conduct a Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis of the PA sector in Aotearoa New Zealand with respect to PA participation and promotion among disabled YP.

METHODS

Focus group discussions, underpinned by the SWOT framework, were facilitated with stakeholders (n=11) engaged in the Aotearoa New Zealand PA sector. Data were transcribed and analysed using content analysis. Desirable and accessible opportunities were essential enablers of PA in disabled YP.

RESULTS

Communication, transport, equipment costs, awareness of activities, and social support were identified as factors that influence PA participation. Schools also have a considerable influence on PA participation among disabled YP, while greater funding for and cohesion/collaboration among PA providers is key to continued growth in PA participation.

CONCLUSIONS

Communication, accessibility, funding, and collaborative/coordinated multi-level efforts were identified as areas in need of strengthening to provide equitable opportunities for disabled YP in Aotearoa New Zealand to participate in PA.

College student aerobic and muscle-strengthening activity: Disparities between cis-gender and transgender students in the United States

Objective: To examine aerobic and muscle-strengthening activity disparities among college cis-gender and transgender students adjusting for other socio-demographic characteristics (age, race/ethnicity, sexual orientation). Methods: National Collegiate Health Assessment (NCHA) data collected between Fall 2015 and Fall 2018 were analyzed using chi-square tests for independence and odds ratios. Results: Cis-gender women were significantly less likely to meet aerobic and muscle-strengthening activity recommendations compared to cisgender men. Transgender men and transgender women were less likely to meet aerobic and muscle-strengthening activity recommendations compared to cisgender peers. Differences were also revealed among transgender individuals, with transgender women more and less likely to meet aerobic and muscle-strengthening recommendations respectively compared to transgender men. Conclusions: Considerable aerobic and muscle-strengthening activity participation disparities exist between cisgender and transgender emerging adults. The unique constraints that transgender college students experience in relation to both aerobic and muscle-strengthening activity participation require further examination to ensure the provision of equitable opportunities to be physically active.

Differences in physical activity participation among young adults in Aotearoa New Zealand

BACKGROUND

The purpose of this study was to examine socio-demographic differences in physical activity (aerobic and muscle-strengthening) among young adults (18-24 years).

METHODS

Data collected between 2017-2019 as a part of Sport New Zealand's Active NZ survey were examined using logistic regression analyses to determine the odds of participants meeting aerobic, muscle-strengthening and combined physical activity recommendations. Gender, ethnicity, employment/student status, disability status, and socio-economic deprivation were included as explanatory variables in analyses.

RESULTS

The proportion of young adults meeting recommendations varied according to physical activity type (aerobic:63.2%; strength:40.1%; combined:37.2%). Young adults not employed/studying had lower odds of meeting recommendations than those full-time employed (OR = 0.43 [0.34-0.54]). Physical activity levels differ according to gender and this intersects with ethnicity, employment/student status, and social deprivation. For example, the odds of Pasifika young adults meeting combined physical activity recommendations compared to Europeans were not different (OR = 0.95 [0.76-1.19]), but when stratified by gender the odds were significantly higher for men (OR = 1.55 [1.11-2.16]) and significantly lower for women (OR = 0.64 [0.47-0.89]. Similarly, young adults in high deprivation areas had lower odds of meeting combined physical activity recommendations than those in low deprivation areas (OR = 0.81 [0.68-0.95]), but this was mainly due to the difference among women (OR = 0.68 [0.54-0.85]) as there was no difference among men (OR = 0.97 [0.76-1.25]).

CONCLUSIONS

Intersections between socio-demographic characteristics should be considered when promoting physical activity among young adults in Aotearoa New Zealand, particularly young adults not employed/studying, and young women who live in deprived areas or identify as Asian or Pasifika. Tailored approaches according to activity type for each of these groups are required.

Learning Outcomes from Participation in Student-Run Health Clinics: A Systematic Review

Student-run clinics (SRCs) offer unique opportunities for students to engage in healthcare delivery, but the student learning outcomes of such clinics have not yet been systematically examined in a comprehensive manner. The purpose of this review was to appraise and synthesize existing literature pertaining to student learning outcomes associated with participation in SRCs. A systematic review was undertaken using PubMed, CINAHL, and Web of Science databases. The quality of articles that met inclusion criteria articles was appraised using the Mixed Methods Appraisal Tool (MMAT). Study details, such as learning outcomes, were also extracted. Ninety-two studies met inclusion criteria. Most studies were conducted in North America (n = 73, 79.3%), and related to clinics involving solely medical students (n = 35, 38.0%) or multi-professional clinics (n = 34, 37.0%). Demonstrated learning outcomes of SRC participation include clinical skills, interprofessional skills, empathy/compassion for underserved patients, and leadership. SRC participation had little apparent impact on students' future career directions. Quality appraisal via the MMAT found mixed levels of research quality amongst reviewed studies. In summary, while SRC participation appears to offer benefits for student learning, improved study design and research outside of North American contexts would further advance knowledge.

College student aerobic and muscle-strengthening activity: the intersection of gender and race/ethnicity among United States students

Objective: To adopt an intersectional approach to examine differences in aerobic and muscle-strengthening participation based on the intersection of gender and race/ethnicity among college students. Methods: Data from the American College Health Association (ACHA) National College Health Assessment collected between 2015 and 2018 were analyzed. Differences in the prevalence of meeting activity recommendations based on the intersection of gender and race/ethnicity were computed and displayed graphically. Odds of meeting activity recommendations were determined by calculating odds ratios controlling for age, year of enrollment, sexual orientation, and health status. Results: Aerobic and muscle-strengthening activity differed significantly between races within genders, and between genders within races. With minor exceptions, men were more likely to meet aerobic and muscle-strengthening activity recommendations than women of the same race/ethnicity. Disparities based on race varied considerably between genders. Conclusions: The intersection of gender and race/ethnicity should be considered when examining and addressing physical activity disparities.

Gender and race/ethnicity differences in occupational activity among students

Occupational physical activity (OPA) is related to positive health outcomes and meeting overall physical activity recommendations. OPA participation typically varies across racial/ethnic groups and by gender, though little research has examined differences in OPA among college students. A cross-sectional, online survey of college students examined demographics and OPA. Participants (n = 3739) were predominately Non-Hispanic White (77.1%) and female (57.8%) aged 20.97 ± 1.52. Employed students reported greater total PA compared with non-employed students. Males reported significantly greater vigorous OPA, overall OPA, and total PA compared with females. Among employed students, OPA contributed significantly to overall PA levels. Males reported significantly greater OPA compared with females and there were several significant differences by race/ethnicity. Academic performance was related to OPA. These findings provide some insight on the OPA levels of a population group that has not been thoroughly examined.

The Value of Sport: Wellbeing Benefits of Sport Participation during Adolescence

Insight into the unique benefits of sport participation above and beyond those associated with participation in other physical activities among adolescents is limited in Aotearoa New Zealand (NZ). The purpose of this study was to examine the association between wellbeing and organised sport participation among adolescents whilst accounting for demographic characteristics and other recreational physical activity. Demographic characteristics (age, gender, ethnicity, deprivation, (dis)ability status), organized sport, recreational physical activity, and wellbeing were assessed in cohorts of NZ adolescents (11–17 years) between 2017 and 2019. After adjusting for demographics, better wellbeing was associated with participation in any recreational physical activity (OR = 2.49, 95%CI = 1.97–3.13), meeting physical activity recommendations (OR = 1.63, 95%CI = 1.47–1.81), and each additional hour of recreational physical activity (OR = 1.03, 95%CI = 1.02–1.04). After adjusting for demographics and overall recreational physical activity participation, better wellbeing was also associated with participation in any organized sport (OR = 1.66, 95%CI = 1.49–1.86), and each additional hour of organized sport (OR = 1.09, 95%CI = 1.07–1.11). Although participation in recreational physical activity appears to be beneficial for wellbeing, organized sport appears to offer unique additional wellbeing benefits. Positive experiences of organized sport participation may offer additional wellbeing value above and beyond other recreational physical activity types in young people who are active.

Differences in United States college student physical activity and exercise self-efficacy based on gender and race/ethnicity

OBJECTIVE

Disparities in physical activity (PA) and PA antecedents, such as exercise self-efficacy, based on the intersection of gender and race/ethnicity among college students are poorly understood. This study aimed to examine differences in PA and exercise self-efficacy based on the intersection of gender and race/ethnicity.

METHODS

An online survey collected data on demographics (age, gender, race/ethnicity), PA, and exercise self-efficacy from students (n = 5341) enrolled in general health and wellness at a large Northeastern U.S. University. Differences in PA and exercise self-efficacy based on gender and race/ethnicity were examined using two-way ANOVAs.

RESULTS

Analyses revealed significant differences in overall PA and exercise self-efficacy based on gender and race/ethnicity. A significant interaction between gender and race/ethnicity was found in relation to PA, but not exercise self-efficacy.

CONCLUSION

Findings demonstrate the need for universities to tailor PA promotion efforts, and to consider how gender and race/ethnicity may intersect to influence PA participation.

Gender differences in college student physical activity, and campus recreational facility use, and comfort

Objective: To examine disparities in physical activity, campus recreation facility (CRF) use, and CRF comfort of college students. Methods: Students (n = 319) responded to an online survey that assessed their demographics, physical activity behaviors, CRF use, comfort using CRFs, as well as reasons for discomfort, and strategies used to feel comfortable. Results: Women reported less muscle-strengthening activity, lower frequency of weight use and informal sport participation, and higher frequency of cardio and group exercise participation. Women also reported lower comfort using CRFs, particularly weights areas. The presence of men, a perceived lack of skill (competence), and self-consciousness/judgement emerged as dominant themes explaining women's discomfort. Disassociation using music, going with friends for social support, knowledge acquisition regarding equipment, and clothing selection emerged as strategies used to increase comfort. Conclusions: Meaningful differences in physical activity behaviors, facility use, and comfort using facilities emerged. Administrators should consider changing environments and/or policies to provide equitable physical activity opportunities.

The association between vaping and health behaviors among undergraduate college students in the United States

Objective: To examine the association between vaping and health behaviors (physical activity, fruit and vegetable consumption, sleep, cigarette use, alcohol consumption) and mental health among college students. Methods: Socio-demographic characteristics, vaping, health behaviors, perceived stress, and depressive symptoms of undergraduates enrolled at a large university located in the Northeast of the United States were assessed via an online survey. Results: Of all participants (n = 1775), less than a fifth (n = 314, 17.7%) reported any vaping in the past month. More men reported vaping than women (23.2% vs. 14.5%). Those who vaped reported fewer nights of restful sleep and greater alcohol consumption. Those who smoked and binge drank were more likely to report vaping. Perceived stress was greater among women who vaped, and depressive symptoms were greater among those who vaped regardless of gender. Conclusions: Vaping was associated with smoking, alcohol consumption, and poorer mental health among young adults.

Freshman physical activity constraints are related to the current health behaviors and outcomes of college upperclassmen

ObjectiveExamine differences in physical activity (PA) constraints experienced as freshmen among college upperclassmen based on sex, race/ethnicity, adiposity, and fitness. Participants and methods: Upperclassmen (n = 524) from self-reported demographics, PA, subjective changes in PA, and freshman PA constraints via an online survey, and had adiposity and predicted aerobic fitness objectively assessed. Results: Self-reported reductions in PA since high school and freshmen year were associated with a lack of motivation as a freshman, lower current PA levels, and poorer aerobic fitness compared to those who maintained or increased PA. Women were less active than men and reported greater constraints, while non-Hispanic white students had greater vigorous PA than minority students. Multiple regression analyses revealed that motivation constraints predicted PA regardless of sex and race/ethnicity. Conclusions: Findings highlight the importance of college administrators and health promoters alleviating freshman PA constraints, particularly among women, to promote the adoption of an active lifestyle.

Participation in Higher Intensity Physical Activity Predicts Lower Depressive Symptom Incidence in College Students

The prevalence of depression and insufficient physical activity (PA) continue to rise in the United States, particularly among college students. PA is typically associated with decreased levels of depressive symptoms; however, the association between different intensities of PA and depressive symptoms is unclear among college students. The aim of this study was to examine how well weekly moderate PA (MPA), vigorous PA (VPA) and strength training (ST) volumes predicted depressive symptoms in college students. Students self-reported weekly MPA, VPA, ST, depressive symptoms (CESD-7), restful nights of sleep, grade point average (GPA) and socio-demographic characteristics. Four individual linear regression models were performed to examine how MPA, VPA, and ST predicted depressive symptoms. Covariates controlled for socio-demographic characteristics (gender, race/ethnicity, and sexual orientation) and other variables (GPA and sleep) that could influence depressive symptoms. Data suggested that higher volumes of VPA (β = -0.11; R² = 0.157) and higher days of ST (β = -0.11; R ² = 0.157) significantly predicted (p < 0.001) lower depressive symptoms. While MPA volume (β = -0.01; R ² = 0.147) did not significantly predict depressive symptoms. Higher volumes of VPA and more days of ST participation predicts lower depressive symptoms in college students. High intensity exercise programs should be promoted at universities and throughout the young adult population. Exercise prescription may be useful and successful for students at risk of depression. Emphasis placed on these intensities will attempt to decrease depressive symptoms in students.

Declines in Physical Activity among New Zealand Adults during the COVID-19 Pandemic: Longitudinal Analyses of Five Data Waves from Pre-Pandemic through April 2021

Insights specific to the impact of the COVID-19 pandemic on physical activity participation in New Zealand (NZ) is limited. The purpose of this study was to examine longitudinal changes in leisure-time physical activity from pre-pandemic through April 2021. Demographic characteristics (age, gender, ethnicity, deprivation, disability status) and numerous indicators of leisure-time physical activity participation were assessed in a cohort of NZ adults (n = 1854, 54.6% women) over five waves (pre-pandemic, April 2020, June 2020, September 2020, and April 2021). Repeat measures were completed for: proportion participating in any physical activity; proportion meeting aerobic physical activity recommendations; physical activity duration; number of physical activities. There was a significant (p < 0.05) decline in mean physical activity duration and number of activities during the initial lockdown period in April 2020, but the proportion participating in any physical activity and the proportion meeting physical activity recommendations remained stable. However, all four physical activity participation indicators were significantly (p < 0.05) below pre-pandemic levels in all subsequent waves. Considerable and sustained declines in NZ adult leisure-time physical activity participation were evident over the first year of the pandemic. As of April 2021, physical activity participation showed limited signs of recovering to pre-pandemic levels.

Patient Outcomes from Student-Run Health Services: An Integrative Review

Background

Methods

Results

Conclusion

Using Exercise as a Stress Management Technique During the COVID-19 Pandemic: The Differences Between Men and Women in College

Psychological stress is a major concern in college students and can lead to negative mental and physical health outcomes. The COVID-19 pandemic has increased psychological stress. Using exercise as a stress management technique has been shown to have a large effect in preventing and treating psychological stress. This study attempts to understand the gender differences between how using exercise as a stress management technique predicts perceived stress levels during the COVID-19 pandemic. Students completed an online survey to self-report their stress management techniques, perceived stress (PSS-10), grade point average (GPA) and demographics (age, race/ethnicity, sexual orientation, gender identity). Independent samples t-tests compared each PSS-10 item for those who did/not use exercise as a stress management technique for each gender. Separate linear regression models compared perceived stress levels in those who did/not use exercise as a stress management tool for each gender. GPA, sexual orientation, and race/ethnicity were included as covariates. Data from 384 students were analyzed. Four PSS-10 items showed significant differences in women who did/not use exercise as a stress management technique. Women who used exercise as a stress management technique reported significantly lower levels of perceived stress compared to those women who did not (p < 0.05); while men showed no significant differences whether or not they used exercise as a stress management technique. University officials should recognize gender differences in stress among their students when creating programs/interventions to prevent and treat student psychological stress.

What happens when the party moves home? The effect of the COVID-19 pandemic on U.S. college student alcohol consumption as a function of legal drinking status using longitudinal data

Many young adults in the United States (U.S.) moved from college accommodations to live with their parents/family during the Spring 2020 semester due to the COVID-19 pandemic. While alcohol consumption fluctuates during a typical semester among students, the impact of the sudden changes stemming from the pandemic on students' alcohol consumption patterns is unclear. To examine the impact of the COVID-19 pandemic on college student alcohol consumption while accounting for legal drinking age and living situation. Data were collected from students (n = 302) at a large, northeastern U.S. university at the beginning and end of the of the 2019 and 2020 Spring semesters via an online survey that assessed socio-demographic characteristics (age, gender, race/ethnicity, living situation) and alcohol consumption using the daily drinking questionnaire. Data were analyzed using a 2 (cohort group: COVID-19 vs. normal) × 2 (age group: above 21 vs. under 21) × 2 (time: beginning vs. end of the semester) mixed model ANOVA. There was a significant three-way interaction. Students over the legal drinking age impacted by the pandemic demonstrated a drastic decrease in alcohol consumption by the end of the semester compared to those under normal circumstances. Change in living situation as a result of the pandemic drastically impacted the alcohol consumption patterns of students over the legal drinking age. Suggestions for future research on the continuing effects of the pandemic on students are discussed.

Freshmen weight and body composition change determinants: A scoping review

Scoping review of freshmen weight and body composition change determinants in order to inform practice, policymaking, and research that improve health and well-being. Methods: A systematic search of the literature identified potential sources. Duplicates were removed before a title and abstract review. A full-text review was then conducted on the remaining sources. Retained sources were then reviewed systematically before synthesis. Results: Eighty-five sources were synthesized. Variation in study design, measurement, reporting, and analyses of determinants, in particular dietary characteristics and physical activity, complicate comparisons. Dietary characteristics and physical activity appear to influence freshmen weight and body composition changes, while evidence indicates alcohol consumption is associated with deleterious weight and body composition changes. Conclusions: Design, measurement, analyses, and reporting can be improved considerably to better examine relationship between body composition changes and determinants in order to provide insight into, and inform, interventions and policies to benefit students' health and well-being.

College Student Aerobic and Muscle-Strengthening Activity: The Intersection of Gender and Sexual Orientation Among United States Students

The purpose of the study was to examine differences in aerobic and muscle-strengthening activity participation based on the intersection of gender and sexual orientation among cisgender college students. Data from the American College Health Association National College Health Assessment collected between Fall 2015 and Fall 2018 were analyzed. Differences from the population average for meeting aerobic and muscle-strengthening activity (separately) recommendations were computed for each gender and sexual orientation intersection. The likelihood of meeting aerobic and muscle-strengthening activity (separately) recommendations were calculated using a series of logistic regression analyses to determine odds ratios controlling for age, year of enrollment, race/ethnicity, and health status. Overall, more men and those identifying as straight met activity (aerobic and muscle-strengthening) recommendations. Asexual and straight women were less likely to meet activity recommendations compared to men, and bisexual and questioning women were less likely to meet muscle-strengthening recommendations compared to men. Bisexual, pansexual, and questioning individuals were less likely to meet activity recommendations compared to straight individuals among both genders, as were queer and gay men and women who identified as pansexual or another identity. Men who identified as pansexual or another identity, as well as lesbian and queer women were less likely to meet muscle-strengthening recommendations compared to straight individuals. In summary, findings demonstrate that aerobic and muscle-strengthening activity participation disparities are evident based on the intersection of gender and sexual orientation. The intersection of socio-demographic characteristics should be considered by researchers and physical activity promoters in order to better understand and address disparities.

Female college student weight perception discordance

OBJECTIVES

Examine the prevalence of body weight perception discordance, and its relationship with physical activity and mental health among college women.

PARTICIPANTS AND METHODS

Data were collected from a convenience sample of female undergraduates enrolled in general education health and wellness courses at a large, northeastern United States university (n = 1607) via direct email using previously validated measures that assessed: demographics; physical activity; weight goals and perceptions; mental health and sleep; and, physical activity enjoyment, self-efficacy, and goal setting. Analyses included one-way analysis of variance analyses and chi-square tests for independence.

RESULTS

Though most women had accurate weight status perceptions (n = 987, 62.6%), there was a tendency to overestimate weight status (n = 482, 31.2%) that was associated with greater depressive symptoms.

CONCLUSION

A relatively large minority of women demonstrated discordant weight status perceptions, which were associated with adverse mental health outcomes. Colleges should consider improving healthy weight status perception education among women to improve mental health.

Changes in Health Behaviors and Outcomes following Graduation from Higher Education

The purpose of this study was to examine changes in health behaviors and outcomes of higher education (college) students following graduation. Undergraduate students (n = 206) enrolled at a large, northeastern United States university in general education health and wellness courses were assessed pre and post-graduation. Participants self-reported their demographics, physical activity behaviors, dietary behaviors, sleep, and stress pre and post-graduation via an online survey. Paired sample t-tests examined changes health behaviors pre and post-graduation. Following graduation, fruit and vegetable consumption increased significantly, moderate physical activity declined significantly, and both vigorous physical activity and energy expenditure, as well as weight remained stable. There was a significant reduction in stress, for men but not women, and, an increase in restful nights of sleep among women but not men. College students tended to maintain the seemingly healthy lifestyles they had as students during the period immediately following graduation. Findings highlight the value of general health and wellness courses within college given vigorous physical activity and energy expenditure did not decline following graduation.

Comparison of obesity classification methods among college students

The purpose of this study was to compare obesity classification methods (body mass index (BMI)), abdominal girth (AG), and body fat percentage (BF%)), among college students. College students (n=5943) completed an objective fitness assessment, where height and weight (used to calculate BMI), AG, and BF% (using Bioelectrical Impedance Analysis) were assessed. Correlation and chi-square tests for independence analyses examined relationships between variables and obesity classification methods; and, the sensitivity and specify of BMI using AG and BF% were calculated. Significant correlations were found between BMI and BF% for men (r=0.775, p<0.001) and women (r=0.849, p<0.001); BMI and AG for men (r=0.868, p<0.001) and women (r=0.858, p<0.001); and, BF% and AG for men (r=0.749, p<0.001) and women (r=0.767, p<0.001). There were significant associations between BMI, AG, and BF% for both sexes. Obesity categorization differed significantly between methods. In men and women, respectively, 47.6% and 44.1% classified as normal weight based on BF% were classified as overweight or obese based on BMI (Men: χ2=1547, p<0.001; Women: χ2=1127, p<0.001). In men and women, respectively, 48.3% and 24.0% classified as normal based on AG were classified as overweight or obese using BMI (Men: χ2=1274, p<0.001; Women: χ2=996, p<0.001). Comparing AG and BF%, 25.1% of men and 18.6% of women classified as normal based on AG were classified as overweight or obese using BF% (Men: χ2=1412, p<0.001; Women: χ2=421, p<0.001). Obesity classification differed significantly between methods, and BMI demonstrated relatively poor predictive value with respect to obesity classification. Thus, caution should be applied when using BMI to diagnose obesity among college students.

Objective vs self-report assessment of height, weight and body mass index: Relationships with adiposity, aerobic fitness and physical activity

Researchers, policymakers and clinicians commonly use height and weight to determine body mass index (BMI) and classify weight status. Self-report measures are widely used but often result in misreported height and weight and, consequentially, underestimation of BMI and-potentially-weight status misclassification. The purpose of this study was to examine differences in objective and self-reported height, weight and BMI values and to find whether discordance is associated with other anthropometric measures, fitness and physical activity. Data were collected from college students through: (a) a pre-consultation online questionnaire where participants self-reported gender, height and weight; (b) an objective fitness assessment that assessed height, weight, body fat percentage, abdominal girth and predicted aerobic fitness; and (c) a post-assessment electronic survey that assessed physical activity. Parametric and non-parametric analyses examined differences between groups. Objective and self-reported height and weight data were collected from 1061 participants, 224 of whom also provided physical activity data. Women significantly under-reported weight (P = .003, η² = 0.02), and both genders over-reported height (P < .001, η² ≥ 0.07), resulting in a significant difference between BMIs calculated using the different measures (P < .001, η² ≥ 0.07) and the weight status misclassification of ~15% of participants. Significant differences were found in anthropometrics, fitness and physical activity based on reporting differences for weight (P ≤ .015) and BMI (P ≤ .015). Students demonstrated a tendency to under-report weight and over-report height, resulting in weight status misclassification. Those who under-reported weight tended to be in poorer health as indicated by lower aerobic fitness and higher abdominal girth and body fat percentage in particular. Further research is required to establish the link between under-reporting weight and over-reporting physical activity.

Behavioral and Physiological Health-Related Risk Factors in College Students

The purpose of this study was to assess the behavioral and physiological health-related risk factors in college students. A cross-sectional study was conducted in 1620 college students (21.3 ± 1.7 years, 897 males, and 723 females). Physical activity (PA), sitting time, body composition, cardiorespiratory fitness (CRF), muscular endurance (ME), and blood test were assessed. In the total sample, 15.2% were not meeting PA guidelines, 33% were sedentary, 13.3% were obese, 10.7% had low CRF, 36.8% had poor ME, 33.7% had dyslipidemia and 5.9% presented with prediabetes. Obesity and poor CRF were more prevalent in male students, whereas inactivity was more prevalent in female students. Individuals with poor CRF were more likely to be obese (odds ratio = 5.2, 95% CI = 3.5-7.8, P = .007 for male students, and 9.4, 95% CI = 1.5-57.8, P = .021 for female students). Sitting time positively correlated with fat percentage (fat%) and inversely with lean body mass (LBM) in male students, whereas ME inversely correlated with fat% and positively with LBM in female students. Although most students were active, significant prevalence of health-related risk factors were observed. Sedentary behavior and poor fitness were associated with a compromised body composition in both sexes. Improving fitness and reducing sedentary behavior in college students could be a public health strategy for health promotion and chronic diseases prevention.

Comparison of College Student Hypertension Prevalence between the JNC7 and ACC/AHA Diagnostic Criteria

Hypertension is highly prevalent and associated with non-communicable diseases and increased premature mortality risk. However, the impact of the new hypertension diagnostic criteria on the prevalence of hypertension diagnoses has yet to be examined among college students. The purpose of this study was to compare the prevalence of hypertension between the JNC7 and the ACC/AHA hypertension diagnostic criteria among college students. The blood pressure of 5,945 college students was assessed, and chi-square tests for independence examined differences between JNC7 and ACC/AHA criteria. The mean age of participants was 21.30 ± 1.05 years, and the majority identified as men (60.5%). Men were found to have significantly higher systolic (p < .001, η 2 = .10) and diastolic (p < .001, η 2 = .04) blood pressure, so all analyses were separated by sex. Hypertension guideline changes resulted in significant changes in hypertension categorization of both men, χ 2 = 7,178, p < .001, Φ c = .816 and women, χ 2 = 4,670, p < .001, Φ c = .816. Under the JNC7 guidelines, 292 (8.2%) men and 67 (2.8%) women were hypertensive. Using the ACC/AHA guidelines, 1455 (40.5%) men and 521 (22.3%) women were hypertensive. Hypertension guideline changes resulted in a significant increase in the prevalence of hypertension among college students, highlighting the potential demand for targeted prevention programs focused on fostering healthy lifestyle behaviors, i.e. physical activity and healthy eating, among students.