Background/Objective: Lifestyle behaviors evolve with age and are driven by biological requirements (e.g., growth and development) and environmental changes (e.g., living and working situations), and they interact bidirectionally with health. Few studies have tracked these behaviors from emerging adulthood into later adulthood. This study examines changes in lifestyle behavior patterns from precollege to adulthood and their association with weight trajectories. Methods: Between 1998 and 2007, 4783 incoming undergraduate students at a northeastern US university completed a health survey. In 2018, 970 completed a follow-up alumni survey. Latent class analysis (LCA) was used to categorize respondents into five lifestyle patterns: stable healthy, stable moderately healthy, stable minimally healthy, worsened, or improved. BMI trajectories were similarly classified into five weight status patterns. Associations between LCA lifestyle patterns and weight were examined using ANCOVA. Results: The most common lifestyle pattern was stable moderately healthy (36.7%). Over 11-20 years, 31.7% of respondents experienced a decline in lifestyle behaviors, and 18.6% improved. During this period, the prevalence of overweight more than doubled (12% to 26%), and obesity quadrupled (2% to 8%). Transitioning to a higher BMI category was noted in 34.9% of those with a stable minimally healthy lifestyle compared with 15.9% among those with a stable healthy lifestyle. Conclusions: Early lifestyle behaviors have long-term implications for weight status. Initiatives that promote the adoption and maintenance of healthy behaviors from precollege through adulthood might reduce obesity risk.

Background:Theory-informed strategies for engaging parents in children's physical activity (PA) promotion show promise. However, behavior-change interventions must become more rigorous in both their application of theory and the reporting of its use to continue to advance the field. Objective:This study aims to elucidate how 2 behavior change theories were used to develop parent communication materials in a 20-week communications campaign, nested within a multilevel (school-home) intervention to promote children's PA. The innovation described in this study is derived from the Supporting Physical Literacy at School and Home (SPLASH) feasibility study (2021-2022). Methods:A team of 7 experts, including graduate students, researchers, faculty, and child PA specialists, collaboratively designed the process used to develop the intervention content. With experience in theory-informed interventions and health-related communication campaigns, they held recurring meetings to refine the approach. Results:A four-step process was used to develop the theory-informed parent communication materials: (1) establish a theoretical foundation for communication materials (ie, social cognitive theory and self-determination theory) and conduct focus groups with the priority population; (2) identify and select PA parenting behaviors aligned with evidence and behavioral theories to form PA parenting objectives that advance children's PA; (3) identify theoretical determinants of parent behavior change and outline methods for applying determinants to address PA parenting objectives; (4) operationalize theory-informed strategy and draft, review, and finalize materials. Parent communications were delivered through print materials and electronic channels, including email, text messages, Facebook (Meta Platforms, Inc), and activity videos. Conclusions:This descriptive study advances progress in the development of school-based PA promotion efforts seeking to incorporate parent engagement strategies by detailing how behavior-change theories can be operationalized to improve PA parenting behaviors. This methodology is valuable for others seeking to translate theoretical constructs into behavior-change communication messages.

Fundamental movement skills (FMS) and behavioral self-regulation (SR) are important for lifelong physical activity (PA). While physical literacy (PL) mediates child PA, its broader developmental impact in early childhood education (ECE) remains underexplored. The Active Start feasibility study examined a 10-week PL-based intervention’s effects on FMS (stationary, locomotion, object control), total motor competency and behavioral SR, as well as sex-based differences, among 3–5-year-olds in Somerville, Massachusetts childcare centers. Children (mean age = 3.8 years, 55% boys) were randomized by childcare center (two per condition) into intervention (n = 39) or control (n = 35) groups. Outcomes were measured at baseline and final using the Peabody Developmental Motor Scales for FMS and motor competency and the Head–Toes–Knees–Shoulders task for SR. Intervention effects were assessed using linear mixed-effects and zero-inflated mixed-effects hurdle models, with interactions examining sex-based differences in program effectiveness. Stationary skills had a net average improvement of 2.3 points in the intervention group compared to the control (p < 0.01). No significant treatment effects were observed for locomotor, object control, total motor competency or behavioral SR skills (p > 0.05). The treatment effects did not significantly differ by sex. PL-based ECE interventions may enhance stability skills in motor development, but further research in larger samples is needed to determine broader impacts on early childhood development.

Objective: To evaluate implementation of nutrition/physical activity-related policies/practices at colleges participating in a healthy campus initiative and campus health leaders' perceptions of policies/practices' support for student health and ease of/barriers to implementation. Participants: Health leaders at colleges participating in the Healthier Campus Initiative (HCI), with completed or ongoing three-year HCI commitments. Methods: Surveys asked which of 41 guidelines were implemented and perceptions around support for student health and ease of/barriers to implementation. Qualitative interviews explored similar domains. Results: Campuses with completed HCI commitments (n = 17) averaged 27.6 guidelines implemented, versus 21.1 on campuses with commitments ongoing (n = 13; p = 0.003). Perceived support for student health and implementation ease varied by guideline. Common implementation barriers included financial costs and time. Interviews largely reinforced these findings. Conclusions: Completion of a campus environmental change initiative may be associated with more health-supporting practices. Campuses may benefit from implementing coordinated policy/practice changes supporting healthy eating and physical activity.

ObjectivesWe piloted GamerFit-ASD, a theory- and evidence-based exergaming and telehealth coaching intervention, specifically adapted for autistic youth, for feasibility, acceptability, accessibility, and preliminary efficacy.MethodsThis 12-week single-arm demonstration pilot recruited youth ages 10-15 years; the intervention included wearing a Fitbit, following a 3-times/week exergaming program, and meeting weekly with a health coach. Accelerometry data were collected at baseline and week 12; paired t-tests were used to assess physical activity (PA) changes. Feasibility and engagement were assessed with process measures.Results23 participants with a parental report of autism spectrum disorder were enrolled (average age 11.6 years; 78% male-identified; 83% white; 17% with parent-reported intellectual disability). Coaching session attendance was 92%; on average, participants completed 67% of exergaming sessions/week, 78.5 min/week of exergaming, and 6645 steps/day. Most youth reported enjoying the exergames (72%) and intending to continue playing them (67%); 94% reported it was easy to learn the games; and 79% of parents reported it was easy to participate. Total PA increased on average by approximately one hour per week, but this change was not statistically significant (p = 0.35).ConclusionsGamerFit-ASD was feasible, acceptable, and accessible among these participants. Effectiveness should be evaluated via randomized controlled trial (RCT) with a larger, more diverse sample.

Abstract Objective Social media are promising channels for health communication promoting positive weight‐related behaviors, but no prior studies have synthesized evidence on the independent effects of social media campaigns focused on promoting healthy eating, physical activity (PA), and healthy weight. This study aimed to fill that gap and inform future social media‐based obesity‐prevention research and practice by reviewing findings from studies testing the effects of such campaigns on individual‐level cognitive, behavioral, and anthropometric outcomes. Method The Web of Science and PubMed databases were searched for peer‐reviewed articles published between 2012 and 2023 that explored the independent effects of social media campaigns related to healthy eating, PA, or weight management. Study characteristics and outcomes were extracted and summarized. Results Eleven studies were included in this review describing campaigns targeting healthy eating‐related outcomes (e.g., fruit and vegetable consumption, meal preparation, nutrition label reading), PA, or weight management. Most campaigns (n = 7) were developed by universities or research centers. Priority audiences included parents, adult females, adolescents, college students, and adult government employees. The majority (n = 8) of the campaigns used single platforms, with the most common being Facebook, Instagram, blogs, and YouTube. Campaigns had mixed effects on cognitive outcomes (e.g., intention, attitude, knowledge), behavioral outcomes (e.g., food choices, PA), and anthropometric outcomes (e.g., weight, waist circumference). Conclusion Social media campaigns focused on promoting healthy eating, PA, and healthy weight had mixed effects on individual‐level cognitive, behavioral, and anthropometric outcomes. Various limitations of the included studies make it difficult to ascertain which factors influence campaign effectiveness. Advancing knowledge in this area is important, particularly given social media's widespread use and potential for broad reach. New research with features such as rigorous study designs, larger and more diverse samples, and strong theoretical foundations may provide important insights into what types of interventions are effective or not and under what conditions.

BackgroundHealth disparities faced by autistic youth are exacerbated by inadequate physical activity (PA) and sleep, whereas healthy PA and sleep may improve mood and function. Adaptive Game Squad (AGS) is an evidence-based telehealth coaching and exergaming intervention to improve PA and sleep for adolescents with diverse neurodevelopmental and psychiatric conditions. This study aimed to adapt AGS for autistic youth ages 10–15 years; beta-test the modified intervention for feasibility, accessibility, and engagement; and further refine the intervention for a larger planned demonstration pilot.MethodsInterdisciplinary experts adapted AGS to create GamerFit-ASD, a 12-week intervention that included a progressive exergame schedule, Fitbit step-tracking, weekly health coaching, and health tip/exercise videos. For beta testing, the intervention was shortened to a 4-week trial with 5 parent/child dyads. Children completed exit surveys and parents and children were interviewed about intervention feasibility, accessibility, and engagement. Exit survey data were summarized with descriptive statistics. Qualitative data were analyzed using a modified grounded-theory approach.ResultsAll participants (n = 5; ages 10–14 years) attended all 4 planned coaching sessions and completed an average of 9 of 12 planned exergame challenges for a weekly average of 50 min. All participants reported enjoying coaching sessions, 4 of 5 reported enjoying exergames, and 3 of 5 reported enjoying on-demand exercise videos. In interviews, children generally reported finding participation feasible, exergaming challenges active and fun, and coaches friendly and helpful. Parents reported high feasibility of supporting their children's involvement and valued child goal-setting and intervention flexibility; however, some found telehealth sessions overly scripted. Several adaptations to coaching scripts, coach training, and parent materials were made for the larger demonstration pilot, including changes to reduce scriptedness of coaching sessions, to provide parents with more information specific to autism, and to make video content more appropriate to children's needs/preferences.DiscussionA telehealth coaching and exergaming intervention appears feasible, accessible, and engaging for autistic youth aged 10–15. Future studies with larger, more diverse samples, longer study durations and/or follow-up periods, and more rigorous study designs are needed to advance understanding of the appropriateness and effectiveness of this type of intervention for this population.

Evidence links parent-offspring weight status, but few studies have evaluated whether markers of socioeconomic status moderate this relation. The 2014 Family Life, Activity, Sun, Health, and Eating study was used to assess intergenerational weight status in a national sample of parent-teen dyads. Multivariable logistic regression models assessed the relation between parent-teen weight status, controlling for teen and parent dietary factors, physical activity, demographic factors, and socioeconomic factors. Models with interaction assessed moderation by household food security status and participation in federal assistance programs. In fully adjusted models, sons were 2.66 (95% CI: 1.56, 4.55) times more likely to have overweight/obesity if their mother had overweight/obesity, and daughters were 3.35 (95% CI: 1.91, 5.86) times more likely. This relation was stronger in mother-son pairs in households with lower food security. These findings provide important new information that can be used to inform nutritional counseling efforts and educational programs that support families with socioeconomic disadvantage.

Summary Research indicates that most college students are not meeting dietary and physical activity guidelines, and the average student gains an estimated 1.6–3.0 kg during 4 years of study. College administrations are well‐positioned to influence student weight‐related health behaviours by ensuring that campus environments/policies promote health. However, to date, campus health interventions have largely addressed individual and interpersonal factors rather than environmental/policy‐level changes. Using an ecological perspective, this narrative review synthesizes the literature on campus environmental/policy‐level factors (e.g., food availability, physical activity requirements) associated with student diet, physical activity and weight, as well as campus interventions to address these factors. Web of Science and PubMed databases were searched between December 2018 and November 2019. Results indicate that campus food environments may contribute to overconsumption and weight gain, and the number of campuses requiring students to participate in physical activity courses is in decline. Eight examples of environmental/policy‐level campus interventions are presented: nutrition labels in dining halls, campus‐wide healthy choice marketing campaigns, restricted payment methods for à la cart dining, trayless dining, health‐themed residence halls, peer health education programmes, active classroom spaces and physical activity course requirements. Implications for research and health promotion programmes/policies in the field of college health are discussed.

ABSTRACTBACKGROUNDWhole school, whole community, whole child (WSCC) approaches to education address contexts beyond school that influence young people's academic and life outcomes. These recommended approaches demand mobilization of an array of actors, but such mobilization is challenging. Little research has explored strategies for convening national experts to support local communities.METHODSThis paper presents a case narrative of Every School Healthy (ESH), a grant‐funded effort to support organizations/school districts in 6 communities building WSCC initiatives by engaging national youth development organizations as expert advisors to ESH and communities. A thematic analysis of the narrative yielded 3 key learnings.RESULTSThree themes emerged as key learnings regarding implementation of national‐local initiatives: (1) baseline assessment of local communities should be conducted to identify opportunities for maximizing strengths; (2) national organizations must be flexible with the expertise they bring to the initiative; (3) national organizations should prioritize community‐cultivated solutions and meet communities where they are.CONCLUSIONSThe 3 themes presented in this case narrative offer insights for effectively mobilizing national organizations to support healthy, equitable school environments at the local level.

No one-size-fits-all strategy works to increase physical activity (PA) at schools. To realize success, practitioners need flexible PA programs to support the multi-component comprehensive school physical activity program (CSPAP) approach. Walk/run programs have the potential to provide this flexibility, and some have demonstrated increased physical activity at school. Walk/run clubs may be particularly amenable to widespread adoption given that they require limited equipment, facilities or training among adult leaders; their implementation can occur at diverse times before, during or after school; and they demonstrate high levels of acceptability among children, parents and administrators. This article shares both the challenges and best practices of 85 schools participating in a district-level walk/run club initiative. These actionable findings can inform practice at the thousands of schools nationwide already providing walking and running programs or other schools looking to implement such a program. Incorporating the suggested tactics, such as setting moderate goals, using incentives judiciously, emphasizing fun, and fostering a supportive PA environment, may help other practitioners lead effective walk/run programs.

Programs that increase children’s physical literacy (PL), defined as the ability, confidence, and motivation to be physically active for life, hold promise for helping children achieve physical activity recommendations, yet few studies have tested PL interventions. PURPOSE: To fill this gap, we conducted a pilot evaluation of a PL-based intervention in the school setting. METHODS: Three New York City elementary schools were recruited. The intervention included twice-weekly lessons during regularly scheduled 3rd/4th grade PE classes over 10 weeks between Feb-Jun 2017. Twenty lessons were selected from a bank of 400 activities designed to build running, locomotion, and balance skills through age-appropriate play and games. Lessons were linked to SHAPE America PE standards and involved a warm up activity, skill-based activity, games focused on the skill, and a cool down activity. Ability was measured by direct observation (eight tasks from the PL Assessment for Youth (PLAYfun) tools). Each task was graded on a four-point rubric (0-100), categorized as: Initial (0-25), Emerging (26-50), Competent (51-75) and Proficient (76-100). Confidence and motivation were measured by child-reported surveys; demographics were collected via parent-reported surveys. Height/weight were measured; body-mass index z-scores computed. Paired sample t-tests tested change in PLAYfun scores, reported as mean (SD). RESULTS: Baseline (T1) and post-intervention (T2) data were collected on n=45 children. Most children were 9.4 (0.5) years old (n=28), female (n=24), either Non-Hispanic Black or Hispanic (n=40), and of a healthy weight (n=30). Children improved in two running tasks: run there/back (T2: 50.4, T1: 45.2, [INCREMENT]5.1 (11.7, p lt 0.01) and run/jump/land (T2: 42.8, T1:37.5, [INCREMENT]5.3 (16.3), p=0.03); one locomotor task: crossovers (T2:27.0 T1:22.3 [INCREMENT]4.8 (13.4), p=0.02); and the balance task: backward balance walk (T2:32.9 T1:29.2, [INCREMENT]3.7 (10.8), p=0.02). Self-reported confidence and motivation were high (>4 on 5-point scales) at baseline with no change observed at post. CONCLUSION: Children participating in a PL-based program focused on running, locomotion, and balance may demonstrate improvements in PL domains, particularly motor skills. This study was funded by NYRR.

Let's Move! Active Schools (LMAS), now Active Schools, is a national initiative in the United States (US) that aims to engage schools to increase students' opportunities to be physically active. This evaluation describes changes in school-level practices related to physical education (PE) and physical activity (PA) among schools that received an LMAS-partner grant from ChildObesity180 or Fuel Up to Play 60 (FUTP60). ChildObesity180 and FUTP60 asked grantee schools to complete nine common questions, between October 2013 and August 2014, before and after receiving the grants to assess progress in implementing practices for PE and PA. "Yes" responses indicated presence of PE/PA-supportive practices. For schools with complete pre and post data (n=972), frequencies of "yes" responses were calculated for each practice at pre/post. Schools receiving a FUTP60 partner grant reported statistically significant improvements from pre to post across five practices for PE and PA, and ChildObesity180 grantees reported significant increases on all practices except daily recess, which was already in place at 95% of schools at pre-survey. Schools across both grant programs reported the largest increases for promoting PA via messaging, implementing classroom PA breaks, and providing PA before and after school. Schools in both programs reported smaller, but statistically significant, increases in requiring the recommended minutes of PE. This study illustrates the feasibility of offering small grants, at a national scale, for schools to make changes that support PA throughout the day. Results suggest that schools can shift PA policies and practices over the course of a school year.

Objective: Multilevel interventions to prevent underage drinking are more effective than individual-level strategies, and messaging campaigns are key to such approaches. Recognizing the benefits of translating best practices across public health domains, this paper details the communications campaign from Shape Up Somerville (SUS), an exemplar for multilevel community-based approaches to address pediatric obesity, highlighting lessons learned for alcohol educators.Methods: All elements of SUS, including the communications strategy, were developed collaboratively with local partners. Communication initiatives included community-engaged brand development to unify diverse intervention components; school-based communications to promote new opportunities for healthy eating and physical activity; and media partnerships to promote healthy behaviors communitywide.Results: The overall SUS intervention was effective in reducing prevalence of overweight/obesity among first-to third-graders in Somerville relative to control communities. Process evaluation showed that communications successfully reached diverse community segments and raised awareness of and receptivity to changes.Conclusions and practice implications: Communications campaigns are essential components of multilevel interventions addressing public health challenges including obesity and underage drinking. Such communications should be developed collaboratively with the target audience and stakeholders, designed to engage community members at multiple levels through multiple channels within a systems framework, and sustained through local partnerships. (C) 2016 Elsevier Ireland Ltd. All rights reserved.

This study tested whether overweight/obese children’s attendance in a community-based physical activity (PA) program was associated with changes in cardiorespiratory fitness (CRF) and adiposity and whether in-program activity levels influenced those associations. Program sessions (offered twice/week, 2 hours/session, over 9 months) included structured exercise/sports. At baseline and follow-up, CRF was measured as Progressive Aerobic Cardiorespiratory Endurance Run (PACER) laps, height/weight were measured, and body mass index (BMI) was calculated. Attendance was recorded as sessions attended. Children wore pedometers in 10 representative sessions; in-program activity was calculated as mean steps/minute across sessions. Linear mixed models tested associations between attendance and changes in PACER score and BMI and the influence of in-program activity on those associations. A total of 101 participants (56% male, 93% Hispanic) completed baseline and one or two follow-up fitness/adiposity measurements. Attendance was associated with PACER change (β = .093, p = .01) but not BMI change (β = .00026, p = .97). There were significant interactions between attendance and in-program activity: Attendance more favorably affected PACER (p < .0001) and BMI (p = .03) as in-program activity levels increased. Attending community-based PA programs may improve CRF among overweight/obese children, particularly when participants are highly active during program time. Community practitioners should not only enroll overweight/obese children in PA programs but also promote adequate attendance/in-program activity levels.

Crowdsourcing has been used in business contexts to identify ready-for-market innovations, but its application in public health has been limited. This article proposes a framework for crowdsourcing public health intervention models, using as a case example a national effort to surface, select, disseminate, and scale up school-based physical activity (PA) programs. In 2012, a national innovation competition was held to identify PA programs being implemented in US schools. Cash prizes were offered as incentives, and the competition was promoted nationwide. Submissions were scored by multiple evaluators against a priori criteria and then ranked. Nine total winners were selected, and three were chosen for national dissemination on the basis of cost-effectiveness and readiness for scale. In 2013, an application-based microgrant program was promoted nationwide to support dissemination of the three programs. Grantee schools were chosen on the basis of the level of readiness. In 2013–2014, winners adopted one of the three programs and completed surveys regarding their implementation experience. From the three programs, a running/walking program emerged as best suited to a broader scale. In 2015, a national campaign was launched to promote school-based running/walking. In the innovation competition, 427 applications were submitted from applicants spanning all 50 US states. During the dissemination phase, most grant applicants (67%) requested funding to deploy the running/walking program. Surveys suggested that the running/walking program added PA minutes to the school day and was well received by students, staff, and parents. To date, more than 4000 schools have registered with the national running/walking campaign. In conclusion, crowdsourcing is a promising strategy for identifying and scaling innovative, real-world–tested approaches to address public health challenges. Further research should explore crowdsourcing in a wider range of public health domains.