Assessing basic and higher-level psychological needs satisfied through physical activity

Background

There has been increasing interest in the extent to which the fulfillment of psychological needs is associated with physical activity engagement. However, a vast majority of studies consider only basic psychological needs such as relatedness, competence, and autonomy-with higher-level psychological needs such as challenge, creativity, and spirituality rarely being addressed. The aim of this study was to examine the preliminary reliability (i.e., internal consistency) and validity (i.e., discriminant, construct, and predictive) of a multi-dimensional scale to assess a range of basic and higher-level psychological needs satisfied through physical activity.

Methods

A sample of 75 adults (ages 19-65 years, 59% female, 46% White) completed a baseline questionnaire measuring 13 psychological needs subscales (i.e., physical comfort, safety, social connection, esteem from others, individual esteem, learning, challenge, entertainment, novelty, creativity, mindfulness, aesthetic appreciation, and morality), exercise enjoyment, and exercise vitality. Participants then completed 14 days of accelerometer monitoring of physical activity and ecological momentary assessment of affective responses during physical activity sessions in daily life.

Results

Internal consistency reliability was acceptable (>0.70) for all subscales except for mindfulness, aesthetic appreciation, and morality. Ten of the 13 subscales exhibited discriminant validity by differentiating between engagement (vs. no engagement) in at least one physical activity type (e.g., brisk walking and yoga/Pilates). All the subscales, except physical comfort and esteem from others, were associated with at least one of the construct validation criteria (e.g., exercise enjoyment, affective response during exercise). Five of the subscales were associated with at least one of the predictive validation criteria (i.e., light, moderate, vigorous intensity activity measured by accelerometer).

Conclusion

Having the capacity to assess whether one's current physical activity is failing to fulfill various psychological needs-combined with recommendations about which types of activities may satisfy those needs-may address an important gap in physical activity promotion.

Children's Daily Negative Affect Patterns and Food Consumption on Weekends: An Ecological Momentary Assessment Study

OBJECTIVE

This study evaluated the association between children's daily negative affect (NA) trajectories and unhealthy food consumption during weekends using ecological momentary assessment (EMA).

DESIGN

Children answered mobile phone-based EMA surveys 7 times a day for 2 weekend days per wave, with each survey assessing current NA and past 2-hour consumption of fried foods (chips or fries), sweets (pastries or sweets), and sugary beverages (drank soda or energy drinks).

SETTING

Los Angeles, California.

PARTICIPANTS

The sample consisted of 195 children (51% female; mean age, 9.65 years; SD, 0.93) from the Mothers and Their Children's Health cohort study.

MAIN OUTCOMES MEASURES

Negative affect trajectory (independent variable), unhealthy food consumption (dependent variable).

ANALYSIS

Latent growth mixture modeling classified NA trajectories across days and examined their association with unhealthy food consumption.

RESULTS

The latent growth mixture modeling identified 3 classes of daily NA trajectories: (1) stable low, (2) early increasing and late decreasing and (3) early decreasing and late increasing. Fried food consumption was higher on early increasing and late decreasing and early decreasing and late increasing NA trajectories than days with stable low NA.

CONCLUSIONS AND IMPLICATIONS

By better understanding day-to-day variability in children's affect and eating, we can individually tailor obesity interventions to account for the emotional contexts in which unhealthy eating occurs.

Cross-sectional and longitudinal associations of park coverage, greenness exposure and neighbourhood median household income with children's depressive and anxiety symptoms

AIM

Internalising symptoms and disorders often emerge in childhood and are associated with negative health outcomes into adulthood. Studies have shown neighbourhood characteristics (e.g. socio-economic composition, greenspace exposure) to be associated with depression and anxiety symptoms in adults; however, research that explores these relationships longitudinally in children is lacking. This study examined cross-sectional and longitudinal associations of neighbourhood characteristics with developmental trajectories of internalising symptoms in 202 children (ages 8-12) from the Mothers' and Their Children's Health (MATCH) Study.

METHODS

The MATCH Study is a Los Angeles-based longitudinal observational investigation of children's health outcomes with six semi-annual assessment waves across 3 years. Latent growth curve modelling was used to examine cross-sectional and longitudinal associations between child's self-reported anxiety or depressive symptoms and their neighbourhood's park coverage, greenness exposure and median household income. All models included the following as covariates: child's age, sex, ethnicity, family household income and mother's mental health measures.

RESULTS

Cross-sectionally, results indicated that neighbourhood median household income was negatively associated with children's depressive symptoms at baseline. Longitudinally, neighbourhood median household income was associated with steeper increases in children's depressive symptoms. Neither greenness exposure nor park coverage was associated with children's depressive or anxiety symptoms cross-sectionally or longitudinally.

CONCLUSIONS

Childhood plays a key factor in setting the foundations for healthy mental, social, physical and cognitive growth. Our study suggests future mental health prevention programmes in youth should cater to a multilevel approach that integrates individual, familial and neighbourhood interventions and pay special attention to their neighbourhood SES levels.

Association of Breastfeeding Duration with 12-Month Postpartum Blood Lipids in a Predominately Lower-Income Hispanic Pregnancy Cohort in Los Angeles

Breastfeeding may protect women’s long-term cardiovascular health; however, breastfeeding-related postpartum lipid changes remain unclear. We aim to examine associations of breastfeeding duration with maternal lipids at 12 months postpartum. In a subsample (n = 79) of the Maternal and Developmental Risks from Environmental and Social Stressors (MADRES) cohort, breastfeeding status and duration at 3, 6, and 12 months postpartum were self-reported. Serum levels of lipids, including total cholesterol, triglycerides (TG), high-, low-, and very low-density lipoprotein cholesterol (HDL-C, LDL-C, VLDL-C), were measured from blood samples collected at 12 months postpartum. We used linear regression models to compare lipids by breastfeeding duration, adjusting for potential confounders. Women who were breastfeeding at 12 months had higher HDL-C (mean: 41.74 mg/dL, 95% CI: 37.27−46.74 vs. 35.11 mg/dL, 95% CI: 31.42−39.24), lower TG (80.45 mg/dL, 95% CI: 66.20−97.77 vs. 119.11 mg/dL, 95% CI: 98.36−144.25), and lower VLDL-C (16.31 mg/dL, 95% CI: 13.23, 20.12 vs. 23.09 mg/dL, 95% CI: 18.61−28.65) compared to women who breastfed for <6 months. No lipids were significantly different between women who breastfed for 6−11 months and for <6 months. Each month’s increase in breastfeeding duration was significantly, inversely associated with TG and VLDL-C and positively with HDL-C. Adjusting for fasting status, demographics, pre-pregnancy body mass index, breastfeeding frequency, and pregnancy complications did not appreciably change effect estimates. Breastfeeding at 12 months postpartum and a longer duration of breastfeeding in the first year postpartum were both associated with increased HDL-C and decreased TG and VLDL-C at 12 months postpartum.

Third trimester cortisol is positively associated with gestational weight gain in pregnant women with class one obesity

BACKGROUND/OBJECTIVE

Prevalence of pre-pregnancy obesity and excessive gestational weight gain (GWG) are higher among women of color with low SES. Dysregulation of the Hypothalamic-Pituitary-Adrenal (HPA) axis and its end-product, cortisol, during pregnancy is hypothesized to be associated with excessive GWG. However, past studies have produced inconsistent findings and often did not include health disparities populations. This study examined the association between pre-pregnancy body mass index (BMI), third trimester diurnal cortisol, and GWG in low-income, predominantly Hispanic women.

SUBJECTS/METHODS

The MADRES study is an ongoing prospective cohort study of primarily Hispanic, low-income pregnant women and their children in Los Angeles, California. Data from 176 participants were included in this study. Total cortisol secretion (area under the curve, AUC) was quantified using four salivary cortisol samples (awakening, 30 min after awakening, afternoon, and bedtime) that were collected at home on one day during the third trimester of pregnancy. Moderation of the association between total cortisol and GWG by pre-pregnancy BMI was tested using multiple linear regression with a multiplicative interaction term.

RESULTS

There was no association between total cortisol secretion and GWG overall (p = 0.82), but the association between total cortisol and GWG was stronger for women with class 1 pre-pregnancy obesity compared to women with normal pre-pregnancy BMI (interaction term p = 0.04).

CONCLUSIONS

Results suggest that obesity status before pregnancy may be exacerbating the physiological impact of cortisol on GWG.

Dyadic Effects of Pokémon GO on Physical Activity and Sedentary Behavior in Mothers and Children

Family-based mobile health applications may be an opportunity to increase children's physical activity (PA) levels. Researchers have highlighted Pokémon GO as a potential model for future PA interventions as it integrates PA with social gamification. This study provides descriptive data on Pokémon GO usage among mothers and their children and examines differences in moderate to vigorous PA (MVPA) over time among individuals playing Pokémon GO compared to non-players using a dyadic subsample from a three-year longitudinal study. After the release of Pokémon Go in July 2016, 156 mother-child dyads completed questionnaires about Pokémon Go usage and wore accelerometers continuously for seven days at baseline (Sep 2016), six months, and twelve months. Independent sample t-tests and chi-square tests were used to investigate differences in demographics and daily MVPA by player status cross-sectionally at each time point. At baseline, six mothers and 21 children reported playing Pokémon Go. Baseline demographic characteristics were not associated with player status. Across time, mothers engaged in an average of 21.12 minutes of daily MVPA (SD = 19.7) and children in 29.35 minutes (SD = 18.88). Children's daily MVPA did not differ by player status, but mothers who reported playing engaged in higher daily MVPA (M = 46.84, SD = 38.07) compared to non-players (M = 21.40, SD = 23.31). This naturalistic study lacked power to further analyze changes in MVPA after the release of the game due to lack of engagement with Pokémon GO. Understanding how to design a family-oriented game to bring together gamification, physical activity, and family-based interventions will be important for future public health efforts.

The mediating role of emotional eating in the relationship between perceived stress and dietary intake quality in Hispanic/Latino adolescents

Obesity rates have steadily increased over the past three decades, and large racial/ethnic disparities in childhood obesity rates-specifically for Hispanic/Latino youth-highlight the major need for identifying and examining key mechanisms of obesogenic behaviors for this at-risk population. This study investigates the relationship between stress and dietary quality in Hispanic/Latino adolescents and seeks to determine the mediating role of emotional eating as a behavioral mechanism. Baseline data from 169 adolescents enrolled in the Imagine HEALTH trial were used to investigate these relationships. Perceived stress and emotional eating were assessed with age-validated questionnaires, and dietary quality was measured via 24-hour recall dietary assessments (later calculated as individual Healthy Eating Index-2015 scores). Nonparametric bootstrapping was used to test the primary hypothesis that emotional eating partially or fully mediates the relationship between perceived stress and dietary quality in this sample, and to test the significance of the mediating effect. Results indicate that emotional eating partially mediates the relationship between perceived stress and dietary quality. The total effect of perceived stress scores on dietary quality scores was -0.24 (p = .006); the direct effect of perceived stress scores on dietary quality scores (controlling for emotional eating scores) was -0.16 (p = .107), and the mediating (indirect) effect of emotional eating was -0.09 (p = .001). The proportion of mediation was 0.36 (36%) (p = .008). This study identifies an important mechanism of obesogenic behavior and can be used to inform future obesity prevention and intervention strategies tailored for the Hispanic/Latino adolescent population.

Early effects of the COVID-19 pandemic on fertility preferences in the United States: an exploratory study

OBJECTIVE

To explore early disparate impacts of the COVID-19 pandemic on fertility preferences DESIGN: Cross-sectional study SETTING: Online survey questionnaire PATIENT(S): A total of 440 female participants who were trying to conceive (TTC) in the past year or currently are TTC.

INTERVENTION(S)

No interventions administered.

MAIN OUTCOME MEASURE(S)

Change in fertility preference RESULT(S): Approximately 1 in 3 participants reported changing their fertility preferences because of the COVID-19 pandemic. Of those that reported changing their fertility preferences, 23.9% reported TTC earlier and 61.6% reported TTC later. Preliminary findings show the odds of changing fertility preferences in black or African American women were 5.45 (95% confidence interval [CI], 1.50-19.90) times that of white women and in nonheterosexual women were 2.76 (95% CI, 1.41-5.42) times that of heterosexual women. Furthermore, every 1 unit increase in state anxiety and depressive symptoms was associated with a 26% (95% CI, 3%-54%) or 17% (95% CI, 5%-31%) increase in odds of pushing back TTC, respectively.

CONCLUSION(S)

This exploratory study highlights how the fertility preferences of racial and ethnic minorities, sexual minorities, and those experiencing mental health issues may be disparately influenced by the pandemic. Research is needed to examine further the disparate effect of the COVID-19 pandemic on fertility preferences.

Examining the same-day relationship between morning cortisol after awakening, perceived stress in the morning, and physical activity in youth

Most children in the United States currently do not meet physical activity (PA) guidelines, and perceived stress is a known barrier against PA. However, most studies have solely focused on the between-subject (BS) association of stress and PA, whereas the within-subject (WS) relationship remains under-studied in children. This limits our understanding of day-level psychosocial factors that influence children's PA engagement. This study assessed the same-day associations of the Morning Cortisol after Awakening (MCA) and morning perceived stress with moderate-to-vigorous physical activity (MVPA) in children using Ecological Momentary Assessment (EMA) methodologies. The analytic sample consisted of 143 children from Los Angeles in the Mothers and Their Children's Health (MATCH) study. Children collected four saliva samples and wore accelerometers to assess MVPA minutes across four days (two weekdays and two weekend days) during each data collection wave. On weekend days, they also answered a mobile phone EMA survey on perceived stress within 1 h of awakening. Data from four assessment waves, each approximately six months apart, were combined and analyzed cross-sectionally. Multilevel modeling, which adjusts for the nested data structure, was used to test the same-day associations of MCA and weekend morning perceived stress with MVPA. On weekend days when morning perceived stress was higher than usual, participants engaged in more MVPA on the same day (β = 0.79, SE = 0.32, p = 0.02), but no association was found between MCA and MVPA. These findings elucidate same-day factors that predict MVPA in children and inform future WS studies on stress and PA.HighlightIt is unknown how stress influences children's daily activity levels. We tested if two types of stress (self-reported and saliva-measured) are related to children's daily activity. We found that self-reported stress is associated with physical activity, but saliva-measured stress is not.

Associations of Mothers' and Children's Stress With Children's Device-Measured Physical Activity and Sedentary Behavior Trajectories Across 3 Years

BACKGROUND

Psychological stress has adverse effects on health-related behaviors, yet longitudinal research is lacking. Research examined how children's and mothers' perceived stress are associated with children's physical activity and sedentary behavior trajectories across 3 years.

METHODS

Mothers and their children (N = 186 dyads; 8-12 y at baseline, 57% Hispanic) completed 6 assessments across 3 years. Children and mothers self-reported perceived stress using the Stress in Children Scale and Perceived Stress Scale, respectively. Children's moderate to vigorous physical activity (MVPA) and sedentary behavior were assessed using accelerometers. Mixed models examined interactions of mothers' and children's perceived stress by time elapsed in the study on children's MVPA and sedentary behavior.

RESULTS

The perceived stress × time elapsed interactions were significant for children's MVPA and sedentary behavior (Ps < .05). Higher average perceived stress in mothers was associated with greater decreases in children's MVPA and increases in children's sedentary behavior. The child stress × time elapsed interactions was significant for children's MVPA (P < .05) but not sedentary behavior. Higher average perceived stress in children was associated with smaller decreases in children's MVPA.

CONCLUSION

Interventions to promote physical activity and reduce screen time in children should mitigate the effects of psychological stress, especially among mothers, on these behaviors.

Longitudinal associations of maternal stress and child stress with child body mass index trajectory

BACKGROUND

Although exposure to stress is common among children and their parents, longitudinal research on the effects of perceived stress on child obesity risk is lacking. This study examined the 3-year longitudinal associations of children and mothers' perceived stress with children's body mass index (BMI).

METHODS

A sample of 199 mothers and their children (8-12 years at baseline, 56% Hispanic) completed six semi-annual assessments across 3 years with questionnaire-based self-report measures of perceived stress and measured height/weight. Parallel process latent growth curve modelling specified regressions of latent intercept and slope of children's BMI on latent intercepts and slopes for mothers' and children's perceived stress.

RESULTS

Greater child self-reported perceived stress at baseline predicted greater increase in children's BMI across the six assessments whereas mother self-reported perceived stress at baseline was unrelated to change in child BMI. Baseline child BMI was unrelated to change in children or mothers' perceived stress across the six assessment waves.

CONCLUSION

Children's own perceptions of stress may play a larger contributing role in BMI progression during middle childhood than their mother's perceived stress levels. These findings underscore the importance of focusing on children's stress-coping strategies for promoting a healthy weight.

Momentary and personal characteristics predicting maternal fruit and vegetable preparation for children using ecological momentary assessment

A large body of literature on child-focused research regarding healthy eating within the family context has focused on behavioral management strategies, such as reinforcement, or parental modeling through personal intake or encouragement. However, food preparation behaviors among mothers have been understudied. Also unknown is how maternal food preparation behaviors vary across population subgroups and contexts. The study objective was to elucidate momentary characteristics (i.e., time of day, weekday, and family meals) and personal characteristics (i.e., ethnicity, working status, household characteristics, body mass index, income, and child's age) associated with maternal fruit and vegetable (F/V) preparation through ecological momentary assessment (EMA). 186 mothers (M_age = 40.81) of children (M_age = 9.61, 49.5% female) completed six semi-annual waves, each lasting seven days. Mothers completed up to eight EMA surveys a day, which assessed family meals and F/V preparation, and reported personal characteristics through paper questionnaires. Multilevel generalized estimating equations examined the likelihood of F/V preparation. Momentary, within-day characteristics (i.e., occurrence of family meals, weekdays, afternoons) were associated with greater likelihood of mothers' fresh F/V preparation (ps < 0.05). Additionally, personal characteristics such as non-Hispanic ethnicity, not working full-time, having a child aged six months to five years in the household, and lower child BMI-z were associated with greater fresh F/V preparation among mothers (ps < 0.05). Findings may inform family-based obesity and nutrition intervention programs by understanding which families and in what contexts mothers are more likely to prepare F/Vs.

Internalizing symptoms modulate real-world affective response to sweet food and drinks in children

The purpose of the current study was to examine affective response to sweet foods and drinks as a function of children's internalizing symptoms using ecological momentary assessment (EMA). A sample of 192 8-12-year-old children completed a self-report measure of internalizing symptoms and EMA prompts of affect and food intake for eight days, excluding time at school. There was an interaction between sweet food intake and internalizing symptoms for positive affect and for sweet drink intake and internalizing symptoms for negative affect. Those low in internalizing symptoms had significantly lower positive affect after consumption of sweet foods compared to when they did not consume sweet foods whereas those higher in internalizing symptoms had slightly, but not significantly, higher positive affect after consumption of sweet foods. Those low in internalizing symptoms had significantly higher negtive affect after consumption of sweet drinks compared to when they did not consume sweet drinks whereas those higher in internalizing symptoms had slightly, but not significantly, lower negative affect after consumption of sweet drinks. Findings highlight the ways in which internalizing symptoms may modulate affective response to sweet foods and drinks.

Prenatal Maternal Cortisol Levels and Infant Birth Weight in a Predominately Low-Income Hispanic Cohort

Infant birth weight influences numerous health outcomes throughout the life course including childhood obesity and metabolic morbidities. Maternal experience of stress, both before and during pregnancy, has been hypothesized to influence fetal growth and birth outcomes. However, these associations currently are not fully understood, due to conflicting results in the published literature. Salivary cortisol is often used as a biological biomarker to assess the diurnal pattern of the hypothalamic-pituitary-adrenal axis (HPA-axis) functioning. Cortisol metrics include both the total cortisol concentration secreted during waking hours, reflected by the area under the curve (AUC), and cortisol dynamics, which include the diurnal cortisol slope (DCS) and the cortisol awakening response (CAR). This study examined the association of these cortisol metrics measured during the third trimester of pregnancy and infant birth weight among 240 mother-infant dyads participating in the Maternal and Developmental Risks from Environmental and Social Stressors (MADRES) pregnancy cohort study, which is predominately comprised of Hispanic low-income women. There were no significant associations with the maternal biological stress response and infant birth weight in this study. More research is needed in larger studies to better understand how the biological stress response influences birth weight in populations facing health disparities.

Within-subject effects of environmental and social stressors on pre- and post-partum obesity-related biobehavioral responses in low-income Hispanic women: protocol of an intensive longitudinal study

Background

Disproportionately high rates of maternal overweight and obesity among the Hispanic population before, during, and after pregnancy pose serious health concerns for both mothers (e.g., preeclampsia, gestational diabetes, weight retention) and children (e.g., elevated lifelong obesity risk). A growing body of evidence implicates environmental exposures (e.g., air pollution, metals) and social stressors (e.g., poverty, violence) in contributing to obesity-related biobehavioral processes, such as physical activity, dietary intake, perceived stress, and cortisol regulation. However, current understanding of the role of environmental exposures and social stressors on obesity-related biobehavioral processes is limited by infrequent, inter-individual measurement, and lack of personal exposure monitoring.

Methods

The “Maternal and Developmental Risks from Environmental and Social Stressors” (MADRES) real-time and personal sampling study examines the within-subject day-level effects of environmental and social stressors on maternal pre- and post-partum obesity-related biobehavioral responses. Among a cohort of 65 low-income, Hispanic women in urban Los Angeles, this study uses innovative personal, real-time data capture strategies (e.g., ecological momentary assessment [EMA], personal exposure monitoring, geolocation monitoring, accelerometry) to repeatedly assess obesity-related processes during the 1st and 3rd trimester, and at 4–6 months postpartum. Day-level effects of environmental exposures and social stressors on women’s physical activity, diet, perceived stress and salivary cortisol measured across repeated days will be tested using multilevel modeling.

Discussion

Hispanic women of childbearing age bear a disproportionately high burden of obesity, and this population is also unduly exposed to numerous obesogenic settings. By using innovative real-time data capture strategies, the current study will uncover the daily impacts of environmental and social stressor exposures on women’s obesity-related biobehavioral responses, which over time can lead to excessive gestational weight gain, postpartum weight retention and can pose serious consequences for both mother and child. Findings from the real-time and personal sampling study will identify key mechanistic targets for policy, clinical, and programmatic interventions, with the potential for broad-reaching public health impacts.