Effects of an energy balance educational intervention and the COPE cognitive behavioral therapy intervention for Division I U.S. Air Force Academy female athletes

Mental Health Interventions in Middle Schools: A 10-Year Review of Research

Schools can play an important role in addressing growing concerns about adolescent mental health. Mental health of high school students has predominantly been the focus in literature with less emphasis on younger adolescents. This review identified articles published in the last decade that described evaluations of middle school-based mental health interventions and randomized participants to an intervention or control condition. Fourteen interventions met the inclusion criteria. About two-thirds of interventions were based on mindfulness or cognitive behavioral therapy. Many trials utilized racially diverse, low-income samples. All interventions were delivered to groups, and three contained a parent component. Five trials increased rigor by using an active control condition. Almost two-thirds of the interventions were effective (p < .10) in reducing at least one depression, anxiety, affect, or internalizing symptom outcome compared to a control group. This article provides information about intervention characteristics, efficacy, theoretical framework, and acceptability/feasibility.

A study protocol for the modified interactive screening program plus MINDBODYSTRONG© RCT: A mental health resiliency intervention for nurses

BACKGROUND

Nurses, the largest workforce in healthcare, are at high risk of depression, anxiety, burnout, and suicidal ideation. Suicide among nurses is higher than the general population. This randomized controlled trial pairs the MINDBODYSTRONG© cognitive-behavioral skills building program with the American Foundation for Suicide Prevention's (AFSP) Modified Interactive Screening Program (mISP) to reduce depression, suicidal ideation, post-traumatic stress, anxiety, and burnout, and improve healthy lifestyle beliefs, healthy lifestyle behaviors, and job satisfaction in nurses with moderate to high risk of suicide.

AIMS

This study aims to determine the effects of the mISP combined with the digitized MINDBODYSTRONG© program versus the mISP alone on depression, suicidal ideation, burnout, anxiety, post-traumatic stress, healthy lifestyle beliefs, healthy lifestyle behaviors, and job satisfaction in 364 U.S. nurses.

METHODS

A digitized version of MINDBODYSTRONG© combined with the mISP screening and referral platform will be compared to the AFSP mISP alone through a two-arm randomized controlled trial. Follow-up post-intervention data will be collected at week eight and months three, six, and 12.

DISCUSSION

If successful, this study's findings could assist nurses who are hesitant to use conventional mental health resources by providing them with confidential aid and learning opportunities to reduce suicidality, depression, anxiety, post-traumatic stress, and burnout and improve healthy lifestyle beliefs, healthy lifestyle behaviors, and job satisfaction.

TRIAL/STUDY REGISTRATION

The Ohio State University Protocol Record 2021B0417, Modified Interactive Screening Program Plus MINDBODYSTRONG: A Mental Health Resiliency Intervention for Nurses, is registered and posted at ClinicalTrials.gov Identifier: NCT05582343. First posted date is October 17, 2022.

Risk of low energy availability and nutrition knowledge among female team sport athletes

BACKGROUND

Nutrition knowledge influences adequate dietary intake in athletes. Inadequate dietary intakes can result in low energy availability (LEA) which can lead to relative energy deficiency in sport (RED-S). To date, there is little information on the relationship between nutrition knowledge and the risk of LEA in female team sport athletes. This study investigates if general and sports nutrition knowledge are associated with the risk of LEA in female team athletes.

METHODS

A cross-sectional design was used. Female athletes (>16 years) who participate in team sports in New Zealand were asked to complete an online questionnaire. The LEA in Females Questionnaire and the Abridged Sport Nutrition Knowledge Questionnaire were included. LEA risk and general/sports nutrition knowledge were assessed. The relationship between LEA risk and knowledge was analyzed using the Kruskal-Wallis Test of independent variables and χ2 tests.

RESULTS

Among 100 female athletes, 53% were at-risk for LEA, and 70% (N.=67) had poor nutrition knowledge. Athletes who were "at-risk" for LEA and those who were "not at-risk" for LEA did not differ statistically in terms of age (P=0.350) or BMI (P=0.576). Of those "not at risk" 54% had an A-NSK score between 50 and 60% (i.e., average knowledge), whereas 54% of the athletes who were "at risk" for LEA had poor nutrition knowledge. There was no statistical difference between the groups (P=0.273).

CONCLUSIONS

The poor nutrition knowledge and the high rates of those "at risk" of LEA among team sports athletes indicates the need for more nutrition education in this population.

The effect of nutrition education sessions on energy availability, body composition, eating attitude and sports nutrition knowledge in young female endurance athletes

Nutrition knowledge plays a pivotal role in shaping dietary habits and food choices, particularly in the realm of sports nutrition. This study investigates the effects of a series of nutrition education sessions conducted by a registered dietitian on energy availability, various anthropometric measurements, eating attitudes, and sports nutrition knowledge in young female endurance athletes aged 15-18 years (football, basketball, volleyball) who engage in training for more than 10 h per week (n = 83). Participants were randomly divided into two groups with 45 individuals receiving six physical nutrition education lectures, and the remaining 38 participants receiving no nutrition education. Participants completed the low energy availability in females questionnaire (LEAF-Q), Eating Attitude Test (EAT-26), and Sports Nutrition Knowledge Questionnaire (SNKQ). Energy and nutrient intakes were evaluated through 3-day food records, while exercise energy expenditure was assessed using 3-day activity logs. All of the questionnaires were repeated after 6 months. At baseline, the prevalence of LEA among athletes was determined to be 63.8%. In the intervention group, energy availability (EA) and SNKQ scores increased, and LEAF-Q scores decreased significantly (p < 0.05). However, there was no significant change in EAT-26 scores between the two groups. Energy intake, weight, fat-free mass, and resting metabolic rate have been increased significantly in the intervention group (p < 0,05). These findings suggest that nutrition education proves beneficial in enhancing dietary intake, positively influencing body composition, and improving nutrition knowledge, ultimately contributing to increased energy availability in female athletes over the short term.

The evidence-based COPE program: Reducing the time between diagnosing and treating depression and anxiety in youth

ABSTRACT

The soaring prevalence of depression and anxiety in children, teenagers, and young adults is now a public health epidemic, yet access to timely evidence-based mental health treatment is often lacking due to a severe shortage of mental health providers. This article provides an overview of the current state of depression and anxiety in children and adolescents as well as first-line evidence-based treatment. The Creating Opportunities for Personal Empowerment (COPE) program, a cognitive-behavioral skills-building intervention, is highlighted as an evidence-based intervention for timely treatment that can be delivered by NPs, physicians, and physician associates/assistants in primary care settings, school-based health centers, and chronic care clinics with reimbursement as well as in schools and universities as a preventive mental health intervention.

A systematic review of interventions targeting modifiable factors that impact dietary intake in athletes

Appropriate dietary intake has been found to positively impact athletes' performance, body composition and recovery from exercise. Strategies to optimise dietary intake often involve targeting one or more of the many factors that are known to influence dietary intake. This review aims to investigate the types and effectiveness of interventions used to impact modifiable factors of dietary intake in athletes. MEDLINE, CINAHL, SPORTDiscus and Web of Science were searched from inception to May 2022 for intervention studies that measured dietary intake with a quantitative tool and explored at least one factor thought to influence the dietary intake of adult athletes. Study quality was assessed using the ADA Quality Criteria Checklist: Primary Research. Twenty-four studies were included. The most common interventions focused on nutrition education (n 10), macronutrient adjustment (n 7) and physical activity (n 5). The three most common factors thought to influence dietary intake addressed were nutrition knowledge (n 12), hunger and appetite (n 8), and body composition (n 4). Significant changes in dietary intake were found in sixteen studies, with nutrition education interventions returning significant results in the largest proportion of studies (n 8). Study quality within this review was mostly average (n 4 < 50 %, n 19 50-80 %, n 1 > 80 %). As studies included were published between 1992 and 2021, interventions and factors explored in older studies may require up-to-date research to investigate possible differences in results due to time-related confounders.

Thinking, Feeling, Behaving: Using the MINDBODYSTRONG ® Intervention to Improve Nurse Well-being Using a Virtual Format

OBJECTIVE

This study examined the impact of the MINDBODYSTRONG ® program on mental health and lifestyle behaviors among a sample of staff nurses, clinical nurse leaders, and faculty, when offered after the onset of the COVID-19 pandemic.

BACKGROUND

Previous studies have demonstrated the MINDBODYSTRONG program decreased anxiety and depressive symptoms, improved job satisfaction, and sustained healthy lifestyle behaviors in newly licensed RNs. This program has not been studied with experienced nurses. In addition, the use of a virtual format is unique.

METHODS

A pre-post design was used for this pilot study. Subjects were recruited from a large Midwestern medical center and affiliated school of nursing. Registered participants of the MINDBODYSTRONG program attended 7 weekly sessions virtually.

RESULTS

The MINDBODYSTRONG intervention suggests sustained improvement in perceived stress, anxiety, depression, and use of healthy behaviors.

CONCLUSION

This pilot study supports that the MINDBODYSTRONG program may be effective in addressing mental health and healthy lifestyle beliefs for staff nurses, clinical nurse leaders, and nursing faculty.

The Impact of a 'Remotely-Delivered' Sports Nutrition Education Program on Dietary Intake and Nutrition Knowledge of Junior Elite Triathletes

Triathlon is a physically demanding sport, requiring athletes to make informed decisions regarding their daily food and fluid intake to align with daily training. With an increase in uptake for online learning, remotely delivered education programs offer an opportunity to improve nutritional knowledge and subsequent dietary intake in athletes. This single-arm observational study aimed to evaluate the effectiveness of a remotely delivered nutrition education program on sports nutrition knowledge and the dietary intake of junior elite triathletes (n = 21; female n = 9; male n = 12; 18.9 ± 1.6 y). A total of 18 participants completed dietary intake assessments (4-day food diary via Easy Diet DiaryTM) and 14 participants completed an 83-question sports nutrition knowledge assessment (Sports Nutrition Knowledge Questionnaire (SNKQ)) before and after the 8-week program. Sports nutrition knowledge scores improved by 15% (p < 0.001, ES = 0.9) following the program. Male participants reported higher energy intakes before (3348 kJ, 95% CI: 117−6579; p = 0.043) and after (3644 kJ, 95% CI: 451−6836; p = 0.028) the program compared to females. Carbohydrate intake at breakfast (p = 0.022), daily intakes of fruit (p = 0.033), dairy (p = 0.01) and calcium (p = 0.029) increased following nutrition education. Irrespective of gender, participants had higher intakes of energy (p < 0.001), carbohydrate (p = 0.001), protein (p = 0.007), and fat (p = 0.007) on heavy training days compared to lighter training days before and after the program with total nutrition knowledge scores negatively correlated with discretionary food intake (r = −0.695, p = 0.001). A remotely delivered nutrition education program by an accredited sports nutrition professional improved sports nutrition knowledge and subsequent dietary intake of junior elite triathletes, suggesting remote delivery of nutrition education may prove effective when social distancing requirements prevent face-to-face opportunities.

Back to Basics: Lifestyle Interventions for Adolescent Depression

LEARNING OBJECTIVES

After completing this activity, practitioners will be better able to:• Discuss and better understand the recently adopted screening standards for adolescents with depression and the potential advantages of using "lifestyle medicine"• Set up a process for providing effective interventions for the increased number of patients with adolescent depression• Design or update their toolbox of treatment options for adolescents with depression based on the new literature and increased demand.

ABSTRACT

Recently adopted quality standards recommend that pediatricians screen adolescents for depression and that they document follow-up plans for those who screen positive. As a result of these new recommendations, pediatricians and other pediatric providers, as well as psychiatrists and other mental health professionals, may face an increasing number of referrals and a growing need for effective interventions for adolescent depression. Given the widely acknowledged scarcity of traditional mental health resources, the current study reviewed the rapidly expanding array of evidence-based, but nontraditional, interventions applicable to outpatient pediatric and mental health care settings. Many of these interventions come from a lifestyle medicine framework. Lifestyle medicine interventions are congruent with the cultures of pediatrics and outpatient psychiatry, and offer additional evidence-based tools for providers managing adolescent depression. These interventions can be implemented individually or within group or community settings, and may be used in conjunction with more common interventions such as psychotherapy or psychotropic medications.

Body Composition of Female Air Force Personnel: A Comparative Study of Aircrew, Airplane, and Helicopter Pilots

This research aimed to analyze the body composition (BC) of different groups of women aircrew units in the Spanish Air Forces for a better understanding and improvement of their operability. Specifically, 184 female aircrew members were analyzed and classified into specialties (38 airplane pilots, age: 32.8 ± 10.8; 26 helicopter pilots, age: 32.0 ± 9.18; and 120 transport aircrew, age: 36.9 ± 8.18). The women’s BC was analyzed with an InBody720 bioimpedance device previously used in the military population. There were differences in the BC among specialties, although there were similarities between airplane and helicopter pilots. Airplane (24.0% ± 10.4%) and helicopter pilots (22.6 ± 6.32%) had a smaller percentage of body fat mass than transport aircrew (26.3 ± 7.51%), but there was uniformity among groups in skeletal muscle mass and soft lean mass. We found no differences in body water among specialties. Differences in BCs were previously reported for men in the air force, and these results in women showed similarities for different job entry requirements, different training needs, and different occupational behaviors among units in the Air Force. These results help to deepen the previous knowledge of women’s BC standards in military units. Although pilots are primarily responsible for the aircraft, healthy habits should be encouraged to keep fit and improve the performance of all aircrew members both in flight and when they are deployed.

Effects of the MINDSTRONG© CBT-based program on depression, anxiety and healthy lifestyle behaviors in graduate health sciences students

ObjectiveTo evaluate effects of the MINDSTRONG^© cognitive-behavioral skills building program versus an attention control program on mental health outcomes and lifestyle behaviors of graduate health professional students. Participants: 201 entering graduate students from seven health sciences colleges at a public land grant University in the U.S. Midwest. Methods: A randomized controlled trial was conducted with three-month follow-up. Valid and reliable instruments measured depression, anxiety, stress, healthy lifestyle beliefs and healthy lifestyle behaviors. Results: Students receiving MINDSTRONG^© reported less depression/anxiety and healthier lifestyle behaviors than those receiving the control program. Students with elevated levels of depression/anxiety at baseline demonstrated greater benefits from the program. Conclusions: MINDSTRONG^© can be used as a preventive and early intervention for improving mental health outcomes and lifestyle behaviors in graduate students. Because the program can be delivered by trained non-mental health professionals, it has the potential to be widely scaled on campuses throughout the U.S.

Effectiveness of nutrition interventions on improving diet quality and nutrition knowledge in military populations: a systematic review

CONTEXT

Optimizing nutrition in military groups through improved diet quality and nutrition knowledge is key in supporting the high physical and cognitive demands.

OBJECTIVE

The objective of this investigation was to systematically review the effectiveness of nutrition interventions among military personnel in improving diet quality and/or nutrition knowledge.

DATA SOURCES

Medline, Embase, CINAHL, and Scopus were searched from the earliest records to May 2020.

DATA EXTRACTION

Data were extracted by 2 reviewers. The primary outcomes were diet quality and/or nutrition knowledge.

DATA ANALYSIS

Twenty studies were included. The main intervention approaches identified were nutrition education of individuals (i.e., education-based studies; EB) (n = 12), and manipulation of the food service environment (i.e., dining facility studies; DFACs) (n = 8). The most common strategies were face-to-face lectures (n = 8) for EB, and healthier menus (n = 7) and education of catering staff (n = 6) for DFAC interventions. Most studies (18/20) demonstrated favorable within-group effects; however, dietary changes were inconsistent. Five of 10 studies using a comparator group demonstrated positive between-group differences.

CONCLUSION

Although potential exists for improving diet quality and nutrition knowledge in military populations, the heterogeneity of the studies to date limits conclusions on the most efficacious strategies.

The state of mental health and healthy lifestyle behaviors in nursing, medicine and health sciences faculty and students at Big 10 Universities with implications for action

BACKGROUND

High rates of mental health conditions and poor healthy lifestyle behaviors are reported in nurses, other clinicians, and health science students but have not been compared across different professions.

PURPOSE

The purpose of this study was threefold: (1) describe rates of mental health problems and healthy lifestyle behaviors across the Big 10 health professional faculty and students, (2) compare the health and healthy lifestyle behaviors of the Big 10 health sciences faculty and students across health sciences' professions, and (3) identify factors predictive of depression, stress, and anxiety.

METHODS

Faculty and students from eight health science colleges at the Big 10 Universities responded to the study survey, which included: demographics, healthy lifestyle behavior questions, and three valid/reliable mental health scales. Descriptive statistics described the findings and multiple linear regression identified factors associated with mental health conditions.

RESULTS

Eight-hundred and sixty-nine faculty and 1087 students responded. Approximately 50% of faculty and students reported 7 h of sleep/night, a third achieved 150 min of physical activity/week; 5.5%-9.9% screened positive for depression; and 11.5%-25.5% had anxiety. Age, sleep, and physical activity were associated with lower depression and anxiety.

CONCLUSIONS

University leadership must build wellness cultures that make healthy lifestyle behaviors easy to engage in and enhance mental well-being.

The Platform to Evaluate Athlete Knowledge of Sports Nutrition Questionnaire: a reliable and valid electronic sports nutrition knowledge questionnaire for athletes

Reliable and valid assessment of sports nutrition knowledge can inform athlete nutrition education to address knowledge gaps. This study aimed to test the reliability and validity of an electronically administered sports nutrition knowledge tool – Platform to Evaluate Athlete Knowledge of Sports Nutrition Questionnaire (PEAKS-NQ). A 94-item PEAKS-NQ was piloted to 149 developmental athletes (DA) in New Zealand, with a subset invited to complete the PEAKS-NQ again to assess reliability. Reliability was evaluated using sign test, intraclass correlation and Cronbach’s α. Accredited sports dietitians (ASD; n 255) completed the PEAKS-NQ to establish construct validity via known-groups methodology and provided relevance scores to determine the scale content validity index (S-CVI). Rasch analysis was conducted to identify potentially problematic items and test reliability. Score differences between DA and ASD were analysed using independent t or non-parametric tests. DA (n 88) were 17·8 (sd 1·4) years, 61·4 % female and mostly in high school (94·3 %). ASD (n 45) were 37·8 (sd 7·6) years, 82·2 % female, with >5 years of dietetic experience (59·1 %). ASD scored higher than DA in all sections and overall (91·5 (sd 3·4) v. 67·1 (sd 10·5) %) (P < 0·001). There were no differences between retests (n 18; P = 0·14). Cronbach’s α was 0·86. S-CVI indicated good content validity (0·88). Rasch analysis resulted in a fifty-item PEAKS-NQ with high item (0·91) and person (0·92) reliability. The PEAKS-NQ is reliable and valid for assessing sports nutrition knowledge which could assist practitioners effectively tailor and evaluate nutrition education.

The effectiveness of nutrition education programmes on improving dietary intake in athletes: a systematic review

Nutrition education programmes for athletes aim to enhance nutrition knowledge and more importantly support positive dietary change to enhance performance, health and well-being. This systematic review assessed changes in the dietary intakes of athletes in response to nutrition education programmes. A search was conducted which included studies providing quantitative dietary intake assessment of athletes of any calibre aged between 12 and 65 years in response to a nutrition education programme. Standardised differences (effect sizes) were calculated (when possible) for each dietary parameter. The search yielded 6285 papers with twenty-two studies (974 participants (71·9 % female)) eligible for inclusion. Studies described athletes competing at high school (n 3) through to college level or higher (n 19). Study designs were either single arm with an intervention-only group (twelve studies; n 241) or double arm including an intervention and control group (ten studies; n 689). No control groups received an alternative or ‘sham’ intervention. Face-to-face lectures (9/22) and individual nutrition counselling (6/22) were the most common education interventions. Non-weighed, 3-d diet records (10/22) were the most frequently utilised dietary assessment method. Although 14/22 studies (n 5 single and n 9 double) reported significant change in at least one nutrition parameter, dietary changes were inconsistent. Poor study quality and heterogeneity of methods prohibit firm conclusions regarding overall intervention success or superior types of educational modalities. Of note, carbohydrate intakes ‘post-intervention’ when assessed often failed to meet recommended guidelines (12/17 studies). Given the substantial investment made in nutrition education interventions with athletes, there is a need for well-designed and rigorous research to inform future best practice.

Effectiveness of Education Interventions Designed to Improve Nutrition Knowledge in Athletes: A Systematic Review

BACKGROUND

A range of nutrition education strategies are used to assist athletes to improve nutrition knowledge. Evaluation of nutrition education interventions guides the delivery of efficacious nutrition education for athletes.

AIM

Our aim was to systematically review sport/general nutrition education interventions delivered to athletes, and to evaluate their effectiveness.

METHODS

A search was conducted using terms related to nutrition knowledge, athletes, education, and intervention. Included studies had to be conducted in athletes (all calibres), use a scored nutrition knowledge assessment tool, and measure knowledge before and after a nutrition education intervention. Peer-reviewed and unpublished theses were included.

RESULTS

Thirty-two manuscripts (randomised controlled trial, n = 13; single-arm pre/post design, n = 19) met the inclusion criteria. Participants (n = 2180; mean age 17.4 ± 1.7 years) were mostly female (66.1%), university-level (56.3%) athletes based in the US (75%). Comparison of different education methods was limited since the majority of interventions (n = 28/36, 77.8%) used face-to-face education. Most intervention conditions (n = 19) had a total contact time of < 300 min (5 h). The majority of interventions (n = 30, 85.7%) reported significant knowledge improvement, with a mean increase of 16.1 ± 0.7% (mean effect size 1.72; range 0.4-17.1). Only 15.6% of studies used well-validated knowledge assessment tools (more than three types of validity or reliability testing).

CONCLUSIONS

Most interventions reported a significant improvement in nutrition knowledge. Unfortunately, the wide range of knowledge assessment tools with limited validation, and the predominant use of face-to-face interventions, prohibits identification of the most effective modality and dose for nutrition education in athletes.

Dietary Assessment Methods in Military and Veteran Populations: A Scoping Review

Optimal dietary intake is important for the health and physical performance of military personnel. For military veterans, the complex nature of transition into civilian life and sub-optimal dietary intake is a leading contributor to the increased burden of disease. A scoping review was undertaken to determine what is known about the assessment and reporting of dietary intakes within both military and veteran populations. In addition, this review determines if studies reporting on the dietary intake of military personnel or veterans include comparisons with dietary guidelines. Six databases were searched to identify papers published from the database inception to April 2019. Observational and intervention studies were searched to identify if they assessed and reported whole dietary intake data, reported data exclusively for a military or veteran population, and included only healthy populations. A total of 89 studies were included. The majority of studies used one dietary assessment method (n = 76, 85%) with fewer using multiple methods (n = 13, 15%). The most frequent methodology used was food frequency questionnaires (FFQ) (n = 40, 45%) followed by 24-hour recalls (n = 8, 9%) and food records (n = 8, 9%). The main dietary outcomes reported were macronutrients: carbohydrate, protein, fat, and alcohol (n = 66, 74%) with total energy intake reported in n = 59 (66%). Fifty four (61%) studies reported a comparison with country-specific dietary guidelines and 14 (16%) reported a comparison with the country-specific military guidelines. In conclusion, dietary intake in military settings is most commonly assessed via FFQs and 24-hour recalls. Dietary intake reporting is mainly focused around intakes of energy and macronutrients. Most studies compare against dietary guidelines, however, comparison to specific military dietary guidelines is minimal.

Reducing Healthcare Costs for Mental Health Hospitalizations With the Evidence-based COPE Program for Child and Adolescent Depression and Anxiety: A Cost Analysis

INTRODUCTION

Although depression and anxiety affect approximately 20% of children and adolescents, many of those affected do not receive treatment because, in large part to the shortage of mental health providers across the United States. As an alternative to traditional mental health counseling, the Creating Opportunities for Personal Empowerment (COPE) program is an evidence-based manualized 7-session cognitive behavioral therapy-based program that is being effectively delivered to children and teens with depression and anxiety by pediatric and family healthcare providers in primary care practices with reimbursement from insurers.

METHODS

The purpose of this study was to perform a cost analysis of delivering COPE and compare it to the cost of hospitalization for primary mental health diagnosis.

RESULTS

Findings indicated a cost savings of $14,262 for every hospitalization that is prevented.

DISCUSSION

Implementation of COPE can improve outcomes for children and teens with depression and anxiety, and could potentially result in millions of dollars of cost savings for the U.S. healthcare system.

Sports nutrition interventions: A systematic review of behavioural strategies used to promote dietary behaviour change in athletes

Designing and implementing successful dietary interventions is integral to the role of sports nutrition professionals. Despite this, no review has evaluated sports nutrition interventions and consequently their active ingredients are not defined. This systematic review aimed to identify the behavioural strategies used in sports nutrition interventions and to explore any relationship between the strategies employed and intervention effects. SPORTDiscus, MEDLINE, CINAHL, PubMed, and SCOPUS were searched for behavioural interventions that aimed to change athletes' dietary behaviour. Behavioural interventions were eligible for inclusion provided pre and post-measures of dietary intake were reported. The protocol adheres to Preferred Reporting Items for Systematic reviews and Meta-Analyses Protocols (PRISMA-P). Each study was coded against the "Template for Intervention Description and Replication" (TIDieR) checklist and the Behaviour change technique (BCT) taxonomy v1. Only 19 BCTs are currently employed within sports nutrition interventions suggesting that 80% of the available BCTs are not being used. Only three studies were theory informed and the standard of reporting across all studies requires substantial improvement. However, the majority of studies reported changes in athletes' dietary behaviour post-intervention. This review highlights an absence of evidence-informed approaches defining the professional practice of sports nutrition and illuminates a limited application of BCTs within the sports nutrition field. Consequently, the authors provide a framework and guide for intervention development to increase rigour and effectiveness of future sports nutrition interventions. PROSPERO registration number: CRD42018072283.

Prevalence and Correlates of Depression, Anxiety, Stress, Healthy Beliefs, and Lifestyle Behaviors in First-Year Graduate Health Sciences Students

BACKGROUND

Graduate and professional students are reported to have higher than average rates of depression compared to age- and gender-matched populations. Further, more than half of student health visits are due to anxiety, yet little is known about the relationships among depression, anxiety, and healthy lifestyle behaviors in this population as well as what factors predict depression and anxiety.

AIMS

The purposes of this study were as follows: (a) to examine the prevalence of depression, anxiety, stress, physical health, healthy beliefs, and lifestyle behaviors in incoming first-year health sciences professional students; (b) to describe the relationships among these variables; and (c) to determine predictors of depression and anxiety.

METHODS

A descriptive correlational study design was used with baseline data collected from first-year graduate health sciences students from seven health professions colleges who were participating in a wellness onboarding intervention program, including Dentistry, Medicine, Nursing, Optometry, Pharmacy, Social Work, and Veterinary Medicine.

RESULTS

Seventeen percent of incoming students reported moderate-to-severe depressive symptoms with 6% reporting suicidal ideation. In addition, 14% of the participating students reported moderate-to-severe anxiety. Factors that predicted depression and anxiety included having less than 7 hr of sleep per night, worse general health, lower healthy lifestyle beliefs, lower healthy lifestyle behaviors, higher stress, and a perceived lack of control.

LINKING EVIDENCE TO ACTION

These findings highlight the need to routinely screen incoming health sciences students for depression and anxiety upon entrance into their academic programs so that evidence-based interventions can be delivered and students who report severe depression or suicidal ideation can be immediately triaged for further evaluation and treatment. Providing cultures of well-being and emphasizing self-care throughout academic programs also are essential for students to engage in healthy lifestyles.

Making a Case for Integrating Evidence-Based Sexual Risk Reduction and Mental Health Interventions for Adolescent Girls

Recently identified as the top concern of teens, mental health issues now compete with sexual health risks as major threats to the well-being of adolescent females. Depression and anxiety can lead to or compound the negative repercussions of sexual behavior choices that result in disproportionately high rates of sexually-transmitted infections (STIs), hetero-sexually acquired HIV, and unplanned pregnancy rates in girls ages 15-19. There are a limited number of CDC- and DHHS-recognized HIV/STI and teen pregnancy evidence-based interventions (EBIs) targeted to adolescent girls of diverse races/ethnicities and none that simultaneously address common mental health disorders. The Health Improvement Project for Teens (HIPTeens), a manualized gender-specific sexual risk reduction intervention, and the Creating Opportunities for Personal Empowerment (COPE) Program, a manualized cognitive-behavioral skills intervention that reduces depression and anxiety, are recognized by national agencies as strong EBIs that have successfully improved their targeted outcomes. Baseline data from the HIPTeens clinical trial revealed that a substantial portion of the more than 700 girls enrolled had moderate to high levels of depressive symptoms as well as other mental health challenges (e.g., binge drinking and eating, cannabis use). Thus, there is an urgent need to combine EBIs, such as HIPTeens and COPE, to curtail these leading public health problems confronting today's adolescents.

Intervention Effects of the MINDBODYSTRONG Cognitive Behavioral Skills Building Program on Newly Licensed Registered Nurses' Mental Health, Healthy Lifestyle Behaviors, and Job Satisfaction

OBJECTIVE

The purpose of this study was to evaluate the effects of the MINDBODYSTRONG for Healthcare Professionals Program on stress, anxiety, depressive symptoms, healthy lifestyle behaviors, and job satisfaction on newly licensed RNs (NLRNs) participating in a nurse residency program.

BACKGROUND

The constellation of burnout, depression, and suicide in clinicians is a public health epidemic that affects the quality and safety of healthcare. The National Academy of Medicine's Action Collaborative on Clinician Well-being and Resilience has called for an increase in evidence-based interventions to combat this alarming problem. The MINDBODYSTRONG Program is a novel adaptation of an evidence-based cognitive behavioral skills-building intervention that provides a theory-based approach to improve the mental health, healthy lifestyle beliefs and behaviors, and job satisfaction of NLRNs.

METHODS

A 2-group, cluster randomized controlled trial was used with 89 new nurses participating in a new-graduate nurse residency program. The experimental intervention, MINDBODYSTRONG, consisted of 8 manualized weekly 45-minute sessions. Data were collected at baseline, immediately following, and 3 months after intervention that measured stress, depressive symptoms, anxiety, healthy lifestyle beliefs and behaviors, and job satisfaction. Repeated-measures analysis of variance was used for data analysis.

RESULTS

The intervention group scored significantly better with moderate to large positive effects on the mental health variables as well as healthy lifestyle beliefs and healthy lifestyle behaviors at both follow-up time points compared with the attention control group. Moderate to large positive effects also were found for job satisfaction.

CONCLUSIONS

The MINDBODYSTRONG Program has excellent potential as an evidence-based intervention for improving the mental health, healthy lifestyle beliefs and behaviors, and job satisfaction, in NLRNs.

The Impact of Nutrition Education Intervention with and Without a Mobile Phone Application on Nutrition Knowledge Among Young Endurance Athletes

Athletes often have significant gaps in their nutrition knowledge. Thus, the aim of this study was to investigate whether young Finnish endurance athletes' nutrition knowledge and dietary intake can be improved through an education intervention with or without a mobile food application. Seventy-nine endurance athletes, 18.0 years (SD: 1.4), participated in this randomized, controlled intervention. We compared the effects of participatory nutrition education sessions alone (group EDU) to those including the use of a mobile food application (group EDU + APP) for four days after each session. Both groups attended three 90-min education sessions fortnightly. The participants completed a validated nutrition knowledge questionnaire in Weeks 0, 5, and 17, and a three-day food diary in Weeks 0 and 17. The education plan was based on the Self-Determination Theory and the concept of meaningful learning process. The EDU group's nutrition knowledge scores were: 78 (week 0), 85 (week 5), and 84 (week 17) and the EDU + APP group's 78, 86, and 85, respectively. Nutrition knowledge increased significantly (main effect of time (p < 0.001)), but we observed no significant group × time interaction (p = 0.309). The changes in dietary intakes were minor (p > 0.05). The amount of carbohydrates was below endurance athletes' recommendations throughout the intervention. The reported energy intakes were also below the estimated energy expenditures. In conclusion, nutrition knowledge improved significantly after only three education sessions and food diary feedback, but the mobile app did not improve learning further. However, the nutrition education intervention alone was not enough to change dietary intake.

Dietary, physical activity, and weight management interventions among active-duty military personnel: a systematic review

BACKGROUND

Research has been conducted to assess the effectiveness of weight management, dietary and physical activity interventions in military settings. However, a recent and comprehensive overview is lacking. The aim of this systematic review is to examine the evidence and describe key components of effective interventions in terms of improving body composition, dietary behaviors, and physical activity among active-duty military personnel.

METHODS

PubMed, PsycInfo, and CINAHL were searched on the 17th of November 2017 to identify interventions that promoted diet and/or physical activity among active-duty military personnel. Studies were included if they assessed outcomes related to anthropometric measurements, dietary behaviors, or fitness/physical activity levels. There were no restrictions regarding publication date, follow-up duration, and sex. After screening, a total of 136 studies were eligible. Of these studies, 38 included an educational and/or behavioral change component, and 98 had only physical or fitness training as part of basic military training. Only studies that included an educational and/or behavioral change component were assessed for quality using the Effective Public Health Practice Project tool and included in the qualitative synthesis of the results.

RESULTS

Based on consistent evidence from studies that were rated as moderate or strong, there is good evidence that military weight management interventions are effective in improving body composition for durations of up to 12 months. Effective interventions are more likely to be high intensity (have a greater number of sessions), are more often delivered by specialists, and use theoretical base/behavioral change techniques and a standardized guideline. Dietary interventions can potentially reduce total fat and saturated fat intake. Dietary interventions that target the kitchen staff and/or increase the availability of healthy food are more likely to be effective in the short term. The results regarding military physical fitness interventions were inconclusive.

CONCLUSION

Despite limitations such as the diversity and heterogeneity of the included interventions, outcome measurements, and follow-up duration, this systematic review found good evidence that weight management interventions are effective, especially in terms of weight loss. More studies are needed to acquire solid evidence for effectiveness for durations longer than 12 months and to identify key components of the effective dietary and physical activity educational and/or behavioral change interventions, especially in countries outside Europe and the US.