Weight gain prevention: identifying theory-based targets for health behavior change in young adults

Perceived facilitators of and barriers to healthful eating among university students

PURPOSE

Photovoice, an innovative qualitative research method in health care, has not been used to its full potential in nutrition/dietetics. We explored the use of Photovoice to determine perceived facilitators of and barriers to healthful eating among university students.

METHODS

The study included 28 students enrolled in a 2008 introductory nutrition class. The students participated in a camera orientation session to review ethics and privacy issues. They took photographs and selected two for discussion in a focus group moderated by a graduate student who used a semi-structured facilitation guide. Researchers coded the transcripts, analyzed the pictures and students' written comments about the project, and ensured data trustworthiness through credibility, dependability, confirmability, and transferability of data and methods.

RESULTS

Six major themes emerged as facilitators and/or barriers: environment, nutrition knowledge, convenience foods, time, media influence, and food cost. More than one-third of the students thought the study "stimulated their critical thinking." They felt more empowered in sharing their perceptions and "getting their voices heard."

CONCLUSIONS

Photovoice was a useful, "motivating," and "engaging" method for research on nutrition knowledge and dietary patterns of university students. Registered dietitians and other health professionals may benefit from the use of the Photovoice method when they are working with students.

Identifying clusters of college students at elevated health risk based on eating and exercise behaviors and psychosocial determinants of body weight

Weight gain and an increase in overweight and obesity in college students raise serious health concerns. Weight management interventions for college-age men and women might be more effective if they were tailored to subgroups of students with similar behavioral and psychosocial characteristics associated with body weight status. The purpose of this study was to use cluster analysis to identify homogenous subgroups of college-aged men and women enrolled in a weight gain prevention study (Project WebHealth) using baseline data collected in 2008. Project WebHealth was a 15-month nutrition and physical activity intervention designed to decrease the rate of unwanted weight gain in 1,689 college students at eight geographically diverse universities in the United States. Outcome measures included anthropometrics, fruit and vegetable intake, physical activity, cardiorespiratory fitness, and psychosocial variables associated with weight status in college students. Cluster analysis was performed separately by sex using a two-step clustering procedure using weight-related eating and exercise behaviors and psychosocial variables. Cluster groupings were validated against students' measured weight status and waist circumference as indicators of health risk. The study design was cross-sectional. Results showed that three similar clusters were identified for each sex. Validity of the cluster solution was supported by significant group differences in body mass index and waist circumference with the High Risk cluster at elevated health risk compared to the others. For men, variability in eating competence and cognitive restraint scores contributed most to the difference between clusters, whereas for women, emotional eating and uncontrolled eating scores did. These findings could be used to improve effectiveness of messages and interventions by tailoring them to subgroups of college students with similar behavioral and psychosocial characteristics associated with elevated health risk.

Preventing Weight Gain Among Coeds: The Need for Web-Based and Tailored Approaches

College students experience numerous challenges as they assume novel responsibilities and choices associated with residing on campus. Although the transition away from home and parents is associated with weight gain, sedentary behavior, and less-nutritious diets, few obesity prevention studies have targeted college adults. Because of their familiarity with the Internet, college-age adults (18-24) may be more receptive to web-based interventions as compared to traditional approaches. Furthermore, personalized interventions are likely to be more effective than generalized health and diet information if they are tailored to a student’s level of interest to make lifestyle changes. Research is needed to explore the efficacy of applying digital technologies to tailored weight loss/weight gain prevention programs among our society’s youngest adults.

Fruitful plans: adding targeted mental imagery to implementation intentions increases fruit consumption

Forming implementation intentions ('If I encounter situation X, then I will perform behaviour Y!') increases the probability of carrying out goals. This study tested the hypothesis that mental imagery targeting key elements of implementation intentions further increases goal achievement. The residents of a student residence were assigned the goal of consuming extra portions of fruit every day for 7 days and randomly assigned to one of four conditions: control (active rehearsal), implementation intentions, goal intention mental imagery or mental imagery targeted to the implementation intentions. Among low fruit consumers, but not high fruit consumers, fruit consumption at follow-up was higher in the targeted mental imagery group than in the other group, with the lowest fruit consumption in the control group. The findings suggest that it may be beneficial to use targeted mental imagery when forming implementation intentions.

Anthropometric and behavioral measures related to mindfulness in college students

OBJECTIVE

To determine whether mindfulness is associated with physical and behavioral measures in first semester college students.

PARTICIPANTS

Male and female first year college students (n = 75) from the University of Rhode Island.

METHODS

Height, weight, waist circumference (WC), and blood pressure were assessed and online questionnaires were completed. Independent t tests and Pearson correlations were utilized for analysis.

RESULTS

The less mindful group had a higher WC than the more mindful group. Correlations were seen between mindfulness and weight-related behaviors.

CONCLUSIONS

Mindfulness can impact health status of first year college students, particularly with behavioral measures that have been found to effect weight status. However, additional research is needed focusing on mindfulness as a potential weight gain prevention technique for first year college students in order to decrease chronic disease prevalence.

Web-based nutrition education intervention improves self-efficacy and self-regulation related to increased dairy intake in college students

Dairy consumption declines substantially during young adulthood. Interventions that incorporate theory-based nutrition education can provide insight into factors associated with dietary choices. The aim of this experimental study was to improve outcome expectations, self-efficacy, self-regulation, and behavior related to dairy intake in college students using social cognitive theory. Students (n=294) enrolled in a personal health class were randomized to intervention (n=148) or comparison group (n=146). The 5-week intervention (March 2006 to April 2006) was conducted using an online course system; components included e-mail messages, posted information, and behavior checklists with tailored feedback. Multivariate analysis of covariance with age and sex as covariates (P<0.05) was conducted to measure change related to dairy intake and social cognitive theory variables. Ninety-two percent of participants (n=135 intervention, n=136 control) completed the study. Dairy intake from food records did not differ between groups at baseline; baseline intake for all participants (mean ± standard error) was 0.45 ± 0.05 servings/day for low-fat dairy products and 1.44 ± 0.06 servings/day for total dairy products. Participants in the intervention group made greater increases in use of self-regulatory strategies (P=0.038) and self-efficacy for consuming three servings/day of dairy products (P=0.049), but not in outcome expectations or consumption of dairy products. A Web-based intervention designed to change dairy intake in college students was effective in modifying some social cognitive theory constructs; strategies that positively impact outcome expectations and social support through online interventions require further development.

Healthy Habit Changes in Pre-Professional College Students: Adherence, Supports, and Barriers

This study examined the impact of participation in a wellness assignment on healthy habit changes in pre-professional undergraduate students. Participants consisted of 58 students enrolled in an undergraduate occupational science health and wellness course. Students were given an assignment to alter three to five habits that would improve their wellness over the semester, and follow-up surveys tracked their adherence to the changes. The assignment and outcomes were retrospectively analyzed using social cognitive and self-determination theories. Students believed that participation in the assignment increased (1) their own wellness status, (2) their understanding of how to impact their own wellness, and (3) their ability to understand client and therapist perspectives on making habit changes. The outcomes suggest that using the principles of social cognitive and self-determination theories appears to support the success of and adherence to healthy habit changes. Implications for occupational therapy educators and practitioners in the use of these theoretical models to support behavior changes are discussed.

College freshmen perceptions of effective and ineffective aspects of nutrition education

OBJECTIVE

Identify college freshmen perceptions of the effectiveness of a nutrition module taught by graduate nutrition students.

PARTICIPANTS

Thirty-four college freshmen, 18 and older.

METHODS

Three graduate nutrition students conducted 5 focus groups during spring semester, 2004. Audio recordings were transcribed and data analysis was based on the long-table approach.

RESULTS

Students reported increased knowledge of food portions and healthier breakfast and snack food choices. Peer instructors were preferred because of their enthusiasm and healthy image. Effective aspects of the module were the food models and visuals; less effective aspects included the game and computer activity.

CONCLUSIONS

Students desired information that could be integrated into a college student's lifestyle. Many students gained new nutrition information and found the module worthwhile. Findings can be used to build on best practices, to improve nutrition education initiatives, and to further advance the health of college students.