Understanding weight management perceptions in first-year college students using the health belief model

Exploring Rural, Black Women's Lived Experiences With Physical Activity and Nutrition: A Photo-Elicitation Study

Eastern North Carolina (ENC) residents have higher rates of type 2 diabetes, lower life expectancy, less physical activity (PA), and higher food insecurity than the rest of North Carolina. Black individuals in ENC may face health disparities due to systemic and societal barriers to PA and a nutritious diet; modifiable behaviors that may improve overall health. The purpose of this study was to explore the lived experiences of rural Black women who live in ENC and who meet the criteria for overweight and obesity in the context of PA and healthful diet promotion. Photo-elicitation was used to explore this population's specific experiences with PA and nutrition, including barriers and facilitators, through photos and focus groups. Participants (N = 14; 43.5 ± 8.7 years old; body mass index (BMI) = 34.6 ± 5.9 kg/m2) were Black women in the rural Southeastern United States. Recruitment strategies included community outreach, listservs, social media, and word of mouth. Using photos submitted, our team conducted focus groups and completed content analyses to identify themes to tailor the development of a future health promotion program for Black women. Overarching themes were (a) Reframing the Mindset, (b) Accountability, and (c) Cultural Relativity. Findings demonstrate that Black women living in rural areas desire culturally relevant PA and nutrition programming focusing on healthy lifestyles versus weight loss. Future practice and research should utilize these findings to develop and examine the health impact of a health promotion program designed for Black women by Black women on PA levels, diet quality, and quality of life.

Physical activity in university health science students: Motivations influencing behaviors

Objective: To understand how competence, self-efficacy, enjoyment and motivation relates to physical activity behavior during transition from school to university. Participants: Health science students (n = 558) studying first year biology at an Australian university. Methods: Cross-sectional correlational survey design using five self-report questionnaires to establish relationships between a physical activity index and motivational variables. Results: Self-reported physical activity index scores of satisfactory or above were achieved by 80% of students with scores significantly higher for males than females. Enjoyment, self-efficacy and competence were predictive of physical activity index scores across genders. Conclusions: The physical activity index is a useful measure of activity dimensions across a variety of physical activities. Health science students need to underpin health messages with personal practice in modeling a healthy lifestyle. Universities have a special responsibility for building and supporting physical activity for all students, but especially for future health professionals.

Logic model development for the exercise is medicine-on campus initiative

One strategy to encourage college students to meet physical activity and public health guidelines is the Exercise is Medicine on Campus Initiative (EIM-OC), whose goal is to promote physical activity as a vital health sign within universities. To develop, implement, and evaluate the EIM-OC Initiative, it is critical to understand the mechanics of the program via a logic model. Objective: The objective is to present a conceptual logic model for EIM-OC Initiative implementation. Methods: Using an activities-approach framework, a logic model was developed using inputs, activities, outputs, and outcomes. Results: This logic model serves as a guide for the conceptual relationships within the EIM-OC Initiative. It was hypothesized that the EIM-OC Initiative would have an overarching outcome of improving physical activity levels in the university setting to promote overall community wellness and health. Conclusion: The authors anticipate this logic model will serve as a framework for other universities implementing EIM-OC.

"Not me!": Optimistic bias and college students' perceived susceptibility, severity, benefits, and self-efficacy in following COVID-19 preventive guidelines

Objective The COVID-19 pandemic has created unprecedented challenges for university administrators and health professionals to keep doors open and students safe. Optimistic bias and the Health Belief Model serve as foundations for understanding students' perceived susceptibility and severity for contracting the virus and their perceived benefits and self-efficacy for following prevention recommendations. Participants: A total of 1,773 undergraduate and graduate students from a large mid-western university participated. Methods: Students were emailed an online survey examining their perceptions and knowledge of COVID-19 and their adherence to recommended preventive measures. Results: Almost one-half of students do not think they will get COVID-19 but said their friends are at risk. The majority are following most Centers for Disease Control and Prevention recommendations and understand the perceived benefits of doing so. Conclusions: Results could aid university officials in developing effective COVID-19 messages that could lead to reductions in cases numbers, deaths, and spread of the virus.

Chrononutrition behavior during the COVID-19 pandemic and its relationship with body weight among college students

Introduction

Students in colleges are exposed to unhealthy lifestyles and poor dietary choices. They are at risk of being overweight, skipping meals, and developing eating disorders. However, there is a paucity of information on their chrononutrition behavior, which is very important, especially concerning the timing of food consumption across the day. Therefore, the present study aimed to investigate chrononutrition behavior and its potential association with body weight status among college students in Malaysia.

Methods

This cross-sectional study was conducted on 409 college students aged above 18 in Malaysia. The chrononutrition behavior was assessed using the validated Chrononutrition Profile Questionnaire (CP-Q). The questionnaire was distributed using an online platform. Participants self-reported their body weight and height, and the Body Mass Index (BMI) was computed. Data were analyzed using the SPSS software.

Results

A total of 409 participants were recruited, with a mean age of 21.5 ± 2.2 years. The prevalence of underweight, normal, and overweight was 24.7, 49.4, and 25.9%, respectively. The chrononutrition behavior revealed that participants ate breakfast about four times/week (mean 4.27 ± 2.43 days), and only 135 (33.0%) consumed breakfast daily. The largest meal consumed was during lunch (75.8%), and the mean of snacking after the last meal was 3.23 ± 2.01 days. The prevalence of night eating was low, and most participants (70.9) did not wake up at night to eat. The frequency, however, was significantly higher in the underweight group compared to the normal weight group (p < 0.05). We observed a significant association between BMI and eating window, evening latency, evening eating, and night eating. It was found that the underweight had a poor eating window (p < 0.01), poor evening latency (p < 0.01), poor evening eating (p < 0.01), and poor night eating (p < 0.05) compared to those with normal and overweight BMI groups. In contrast to predictions, poor chrononutrition behavior was more likely to predict being underweight compared to normal (p < 0.05).

Conclusion

Underweight young adults are more likely to have poor chrononutrition behavior. The results of the present study suggest that future nutrition education should also focus on the chrononutrition behavior of college students.

Understanding changes in eating behavior during the transition to university from a self-determination theory perspective: a systematic review

Objective: The objective of this systematic review was to understand how and why eating behavior changes during the transition to university, and interpret findings from a self-determination theory perspective (Ryan & Deci, 2000). Methods: We searched six databases and identified 51 articles with findings involving changes in eating behavior during the transition to university. Results: During this transition, students eat less food, less healthy, and less regularly. These changes are mostly among students who move into a university residence or off-campus housing, with few changes in eating behavior among students who continue living at home. Yet, incoming students with food skills and experience living independently seem less likely to experience these changes. Conclusions: The university context offers challenges to eating healthy. Students' satisfaction of psychological needs may explain observed changes in habits, self-regulation, and motivation.

Development and Psychometric Properties of the Health Belief Scales toward COVID-19 Vaccine: A Cross-Sectional Study in North-Eastern Poland

In the study, we evaluated the psychometric properties of the Health Belief Scales Toward COVID-19 Vaccine, including the structure, reliability and validity of the scale. Psychometric properties were assessed on a general sample of 472 Polish participants aged between 19 and 69 years (M = 25.43). The procedure consisted of completing the Health Belief Scales Toward COVID-19 Vaccine, the World Health Organization’s 5-item Well-being Index (WHO-5) and demographic questions. The presented research results obtained using the measure indicate that it can be considered to be a reliable and valid research tool. A four-factor solution demonstrated a good fit to the data: χ2/df = 3.90, RMSEA = 0.079, AGFI = 0.913, GFI = 0.951, CFI = 0.960, TLI = 0.941. The reliability measures for the overall index of the Health Belief Scales Toward COVID-19 Vaccine were: Cronbach’s α = 0.88 and McDonald’s ω = 0.87. The Health Belief Scales Toward COVID-19 Vaccine total score correlated negatively and weakly with the WHO-5 score. The Health Belief Scales Toward COVID-19 Vaccine proved to be a valid and a reliable tool to assess attitudes towards vaccination in four dimensions consistent with the HBM.

Strategies to Promote Healthy Eating Among University Students: A Qualitative Study Using the Nominal Group Technique

Introduction

The years spent at university are critical in terms of altering people's dietary patterns. This study aimed to: (1) understand the main dietary changes that students experience after starting university; (2) determine the personal and objective factors that hinder healthy eating, and (3) define possible strategies to facilitate healthier diets among university students.

Methods

The nominal group technique (NGT) was used to elicit ideas from 39 students from the University of Parma, Italy. The sample comprised 16 freshmen and 23 non-freshmen. Participants prioritized and weighed their top five ideas regarding dietary changes, barriers to healthy eating, and possible strategies to maintain a healthy diet. A thematic analysis was conducted to compare the priorities across groups.

Results

Forty-three themes were elected as the most significant changes related to diet, 39 themes related to personal barriers, 43 themes related to objective barriers, and 55 themes related to strategies. A lack of time for cooking, low financial availability, consumption of unvaried food or junk food, and gaining knowledge about food were identified as the main changes. Personal barriers to eating healthy were intrinsic (i.e., lack of willpower, personal gluttony, and little effort in cooking preparation), poor dietary information, and a busy lifestyle. Market and financial factors (i.e., the high price of healthy products and low financial availability), as well as social factors (i.e., the negative influence of social networks, childhood food education, and origin/tradition), emerged as objective barriers. Possible strategies that could encourage students to adopt a healthy diet include varying the food products offered in university canteens, including organizing spaces where students who prepare meals from home can warm up and eat their food. Student discounts at supermarkets and information on nutrition and a healthy diet were also identified as important ways of supporting students.

Conclusion and Implication for Practice

In order to make students part of the solution, the NGT provided them with the opportunity to equally contribute their ideas and opinions about having a healthy diet in a university context. This could potentially lead to tailor-made solutions for policymakers, educators, and foodservice providers in promoting healthy eating habits.

Measuring university students' beliefs toward healthy snack selection

Objectives: Understanding university students' beliefs toward selecting healthy snacks is important in developing effective programs targeting healthy eating behaviors. The purpose of this research was to assess students' beliefs toward healthy snack selection and consumption. Participants: In November 2017, a convenience sample of 779 undergraduate students living on campus completed an online survey. Methods: A survey was developed to measure students' beliefs about eating healthy snacks. Paired t-tests were used to compare differences in beliefs and their importance. Independent t-tests were used to compare differences in belief responses by gender. Results: Students believed that healthy snacks were good for health and assisting with weight management. However, time management, motivation, preparation needs, and poor taste were reported as barriers to selection and consumption of healthy snacks. Conclusions: Increasing students' awareness of available food preparation facilities, developing food preparation skills, and motivation for consumption of healthy-good tasting snacks may increase healthier snacking.

The use of the health belief model to assess U.S. college students' perceptions of COVID-19 and adherence to preventive measures

Background: This study utilized the Health Belief Model to examine college students’ perceptions of the COVID-19 pandemic. It examined the extent to which the Health Belief Model and perceived threat are associated with the adoption of COVID-19 preventive measures among college students.

Design and Methods: An online questionnaire was utilized and sent to a simple random sample of college students at a large Midwestern university in the United States between May and July of 2020. The number of undergraduate and graduate students who participated in this study was 1,723.

Results: The study found that the Health Belief Model and perceived threat are significantly associated with COVID-19 preventive measures. College students with higher Health Belief Model scores were more likely to adhere to COVID-19 preventive measures than those with lower scores. College students also reported high cues to action and low perceived barriers to most of the COVID-19 preventive measures.

Conclusion: Applying the Health Belief Model is crucial for health professionals and university administrators for developing effective communication messages for COVID-19 prevention and future health outbreaks.

Comparison of mobile health education messages verses face-to-face consultation for weight reduction among overweight female adolescents in Thailand

Background: Obesity is considered a significant public health problem in Thailand. This study was conducted to compare the impact of mobile health education messages verses face-to-face consultation on weight reduction among overweight female university students. Methods: This comparative cross-sectional study comprised three groups: a control group, a group receiving mobile health education, and a group receiving face-to-face consultation. Each group contained 26 participants taking part over a period of 12 weeks, with a 12-week follow-up thereafter. The data analysis used two-way repeated measures ANOVA with least significant difference testing. The study was ethically approved at Chulalongkorn University, Thailand. Results: The results revealed that the group receiving mobile health education had the lowest average body mass index and waist-hip ratio after intervention ( p < 0.05). In addition, both intervention groups significantly improved their health belief, social support, and health behavior scores in comparison to the control group ( p < 0.001). The results show that the average scores for social support for eating and exercise at baseline were significantly lower than at post-intervention or follow-up ( p < 0.001). In addition, the results of both aspects of social support showed that the average social support score at post-intervention was significantly higher than at follow-up. Furthermore, the health behavior score measured post-intervention was higher than at follow-up. There was a statistically significant difference in average metabolism during physical activity ( p < 0.001) but no statistical difference in average eating behavior score. Conclusion: The study found that the use of mobile health education to deliver health programs facilitates communication between the healthcare provider and individual, and can empower adolescent females in their pursuit of weight loss by improving their attitudes and knowledge, leading to better health behavior.

Comparison of mobile health education messages verses face-to-face consultation for weight reduction among overweight female adolescents in Thailand

Background: Obesity is considered a significant public health problem in Thailand. This study was conducted to compare the impact of mobile health education messages verses face-to-face consultation on weight reduction among overweight female university students. Methods: This Quasi-experimental study comprised three groups: a control group, a group receiving mobile health education, and a group receiving face-to-face consultation. Each group contained 26 participants taking part over a period of 12 weeks, with a 12-week follow-up thereafter. The data analysis used two-way repeated measures ANOVA with least significant difference testing. The study was ethically approved at Chulalongkorn University, Thailand. Results: The results revealed that the intervention found significant results in weight reduction among the respondents ( p < 0.05). In addition, both intervention groups significantly improved their health belief, social support, and health behavior scores in comparison to the control group ( p < 0.001). The results show that the average scores for social support for eating and exercise at baseline were significantly lower than at post-intervention or follow-up ( p < 0.001). In addition, the results of both aspects of social support showed that the average social support score at post-intervention was significantly higher than at follow-up. Furthermore, the health behavior score measured post-intervention was higher than at follow-up. There was a statistically significant difference in average metabolism during physical activity ( p < 0.001) but no statistical difference in average eating behavior score. Conclusion: The study found that the use of mobile health education to deliver health programs facilitates communication between the healthcare provider and individual, and can empower adolescent females in their pursuit of weight loss by improving their attitudes and knowledge, leading to better health behavior. Keywords Electronic health education, Facebook, health education, health belief model, social support, obesity, Thailand, health behaviors.

Dietary Practices and Barriers to Adherence to Healthy Eating among King Faisal University Students

Proper dietary practices should be developed during the student years that will continue into the future. This study aimed to identify the eating habits and dietary practices among King Faisal University (KFU) students, explore the barriers to adherence to healthy eating, associate the understanding of healthy diets with students’ characteristics, and determine the association between body mass index (BMI) and awareness of the concept of healthy diets, academic discipline, and enrollment in a nutrition course. In this cross-sectional study, students were selected randomly and a questionnaire was distributed using an electronic platform through KFU email. Out of 564 students, nearly half (45.7%) reported eating snacks as their main food, and some (38.3%) reported eating with their family twice daily. The students rarely reported eating with friends (73%) or eating dates (48.8%). Furthermore, many reported that they were not consuming a balanced diet (42.6%). Some students (46.3%) reported taking breakfast daily, and 49.1% reported eating meals regularly. There was low consumption of vegetables (29.3%) and fruits (26.2%) among the students. The barriers to adherence to healthy eating were the availability of fast food (73.2%), high cost of healthy food (72.7%), limited time (59%), and laziness (57.1%). Statistically significant data indicated that the students with a normal BMI were more aware of the concept of healthy diets, studied medical and applied sciences, and were enrolled in KFU nutrition courses.

Development of a logic model for a service learning, dog walking course for college students

Despite overwhelming evidence of the importance of physical activity, only 20% of US adults meet physical activity recommendations. A subsector of the population vulnerable to inactivity is college students. There is a disconnect between evidence-based physical activity programming and dissemination into college communities, which may be overcome through logic model development and evaluation. The purpose of this paper is to discuss logic model development for a service-learning, dog walking program for undergraduates. Participants were undergraduates (18-25 years). Process evaluations and observational data were used in a content analysis to determine major themes to create the logic model. A set of resources were needed to complete program activities, which led to short- and long-term outcomes. The overarching goal of the program is to improve the overall health status of college students and companion animals. This logic model may have significant public health impact as it can serve as a framework for universities wanting to develop, implement, and evaluate a service-learning, dog walking program for students.

Setting Kids Up for Success (SKUFS): Outcomes of an Innovation Project for Promoting Healthy Lifestyles in a Pediatric Patient-Centered Medical Home

INTRODUCTION

The greatest increase in childhood obesity prevalence occurs from preschool to school-age (SA). Evidence supports a family-centered approach to promote healthy lifestyle behaviors and weight management among SA children. The purpose of this study was to establish a healthy weight management support group in a pediatric patient-centered medical home.

METHODS

Overweight or obese SA children and their parent participated in four biweekly support meetings consisting of an educational presentation, group exercise, and a healthy snack. Sessions included education about nutrition, exercise, emotions, and health. Anthropometrics, the Healthy Habits screening tool, and Daily Logs, including step counts, were utilized to track outcomes.

RESULTS

There was a significant improvement in fruit and vegetable intake and dining out (p = <.05), and a clinical improvement in physical activity and sugar sweetened beverage intake.

DISCUSSION

Setting Kids Up For Success provides a framework for patient-centered medical home's to provide a healthy lifestyle support group for SA children and their families.

The Effect of Expressive Writing on Symptoms of Depression in College Students: Randomized Controlled Trial

Introduction: The first year of college can be particularly difficult for students, as they typically face a number of emotional, developmental, social, and financial challenges. Expressive writing (EW) is a writing intervention that requires participants to write about their thoughts and feelings related to a particular event over several days.

Methods: Participants in this study included 90 first-year undergraduate students. Participants were assigned to the EW condition (writing about their thoughts and feelings related to their transition to college) or a control condition (writing about any object or event of their choosing). Participants completed 3 consecutive days of writing, and then completed two follow-up visits that occurred one month and six months post-intervention. Participants were divided into two groups based on their initial depression scores (one group with minimal symptoms, and a second group with mild/moderate/severe symptoms).

Results: Among participants in the mild/moderate/severe group, those in the EW condition demonstrated significant decreases in depression symptoms over the six-month study period, while participants in the control condition did not. Among this same subset of participants, those in the EW condition also demonstrated significantly fewer physician visits due to physical illness when compared to the control group. Changes in depression and physical illness visits were not found for participants with minimal symptoms of depression.

Discussion: EW is a low-cost procedure that has been empirically demonstrated to alleviate symptoms of depression six months post-intervention. However, this finding only held for participants who were initially categorized in the group of participants with mild/moderate/severe symptoms of depression (as opposed to those participants initially categorized with minimal symptoms of depression). Clinical implications and future directions are discussed.

Baseline Body Mass Predicts Average Depressive Symptoms over the Next Two Decades for White but Not Black Older Adults

Background: Although obesity and depression have a bidirectional association, this link may vary based on race. The current study tested racial variation in bidirectional links between depressive symptoms and body mass index (BMI) over 24 years of follow-up in older adults over the age of 50 in the United States. We hypothesized weaker bidirectional links in Blacks compared to Whites. Methods: Data came from waves 1 to 12 (1990 to 2014) of the Health and Retirement Study (HRS), an ongoing state-of-the-art national cohort. The study followed a representative sample of Americans (n = 15,194; 2,200 Blacks and 12,994 Whites) over the age of 50. Dependent variables were average depressive symptoms and BMI over 24 years, based on measurements every other year, from 1990 to 2014. Independent variables included baseline depressive symptoms and BMI. Covariates included age, gender, marital status, veteran status, and activities of daily living. Structural equation models were fitted to the data for data analysis. Results: In the pooled sample, bidirectional associations were found between BMI and depressive symptoms as baseline BMI predicted average depressive symptoms over time and baseline depressive symptoms predicted average BMI over 24 years. Racial differences were found in the bidirectional association between BMI and depressive symptoms, with both directions of the associations being absent for Blacks. For Whites, baseline BMI predicted average depressive symptoms over the next 24 years. Conclusion: Reciprocal associations between BMI and depressive symptoms over a 24-year period among individuals over the age of 50 vary for Blacks and Whites. As these associations are stronger for Whites than Blacks, clinical and public health programs that simultaneously target comorbid obesity and depression may be more appropriate for Whites than Blacks.

Health promoting lifestyle of university students in Saudi Arabia: a cross-sectional assessment

Background

College is a critical time where students are more prone to engage in risky health behaviors known to negatively affect well-being, such as physical inactivity, stress, and poor dietary habits. A health promoting lifestyle is an important determinant of health status and is recognized as a major factor for the maintenance and improvement of health. This study was designed to assess the health-promoting lifestyle of students in health colleges and non-health colleges in Saudi Arabia.

Methods

A total of 1656 students participated in this descriptive cross-sectional study. Data gathering was conducted from November 2016 to February 2017 at King Saud University. Participating students completed a self-reported questionnaire that included questions regarding their demographic characteristics and their health-promoting behaviors.

Results

The majority of participants were females (70.4%), 20% of the participants were overweight and 11.3%, were obese. The analysis showed that there was a significant difference between health colleges and non-health colleges with regards to the factor of health responsibility. Students at both schools were found to have an inadequate level of adherence to recommendations regarding physical activity and healthy eating habits. The analysis also found that majority of the students in both colleges do not attend educational programs on health care. The model shows that gender, type of college, year in school, and family structure were significant predictors of the health lifestyle of students in Saudi Arabia.

Conclusion

The results of the current study indicate that university students are leading unhealthy lives, where the majority of them have unhealthy eating habits and poor physical activity level. Universities are ideal settings for implementing health promotion programs. Therefore, planning and implementing programs to motivate students to be more responsible for their own health, to engage more in physical activity, and to practice healthy eating habits and other forms of wellness are of paramount importance.

Understanding barriers to healthy behaviors in black college men

OBJECTIVE

Due to the short life expectancy of black men, it is important to understand what impacts health behaviors in this group so that interventions and programs can be developed to improve their health behaviors which may help in increasing the life expectancy of black men. The purpose of this study was to understand what perceived barriers exist for black college men that prevent them from engaging in healthy behaviors.

PARTICIPANTS AND METHODS

Thirty-five black male students at a southern Historically Black College and University participated in five focus groups and four interviews. A qualitative analysis was used to analyze data for similar themes and codes.

RESULTS

Perceived barriers to engaging in healthy behaviors appear to be influenced by image, food cost, and education. Cues to action for not engaging in healthy behaviors appear to be related to role models.

CONCLUSIONS

Black college men are not adequately informed or educated about elements that can impact their health and how they can improve it. College administrators and researchers should develop interventions that include elements of increasing health knowledge and age-appropriate role models to improve health behavior change among this group.

College Freshmen Students' Perspectives on Weight Gain Prevention in the Digital Age: Web-Based Survey

BACKGROUND

College freshmen are highly vulnerable to experiencing weight gain, and this phenomenon is associated with an increased risk of chronic diseases and mortality in older adulthood. Technology offers an attractive and scalable way to deliver behavioral weight gain prevention interventions for this population. Weight gain prevention programs that harness the appeal and widespread reach of Web-based technologies (electronic health or eHealth) are increasingly being evaluated in college students. Yet, few of these interventions are informed by college students' perspectives on weight gain prevention and related lifestyle behaviors.

OBJECTIVE

The objective of this study was to assess college freshmen students' concern about weight gain and associated topics, as well as their interest in and delivery medium preferences for eHealth programs focused on these topics.

METHODS

Web-based surveys that addressed college freshmen students' (convenience sample of N=50) perspectives on weight gain prevention were administered at the beginning and end of the fall 2015 semester as part of a longitudinal investigation of health-related issues and experiences in first semester college freshmen. Data on weight gain prevention-related concerns and corresponding interest in eHealth programs targeting topics of potential concern, as well as preferred program delivery medium and current technology use were gathered and analyzed using descriptive statistics.

RESULTS

A considerable proportion of the freshmen sample expressed concern about weight gain (74%, 37/50) and both traditional (healthy diet: 86%, 43/50; physical activity: 64%, 32/50) and less frequently addressed (stress: 82%, 41/50; sleep: 74%, 37/50; anxiety and depression: 60%, 30/50) associated topics within the context of behavioral weight gain prevention. The proportion of students who reported interest in eHealth promotion programs targeting these topics was also generally high (ranging from 52% [26/50] for stress management to 70% [35/50] for eating a healthy diet and staying physically active). Email was the most frequently used electronic platform, with 96% (48/50) of students reporting current use of it. Email was also the most frequently cited preferred eHealth delivery platform, with 86% (43/50) of students selecting it. Facebook was preferred by the second greatest proportion of students (40%, 20/50).

CONCLUSIONS

Most college freshmen have concerns about an array of weight gain prevention topics and are generally open to the possibility of receiving eHealth interventions designed to address their concerns, preferably via email compared with popular social media platforms. These preliminary findings offer a foundation to build upon when it comes to future descriptive investigations focused on behavioral weight gain prevention among college freshmen in the digital age.

Sustained Obesity and Depressive Symptoms over 6 Years: Race by Gender Differences in the Health and Retirement Study

Background: Although obesity and physical activity influence psychosocial well-being, these effects may vary based on race, gender, and their intersection. Using 6-year follow-up data of a nationally representative sample of adults over age of 50 in the United States, this study aimed to explore race by gender differences in additive effects of sustained high body mass index (BMI) and physical activity on sustained depressive symptoms (CES-D) and self-rated health (SRH).

Methods: Data came from waves 7, 8, and 10 (2004–2010) of the Health and Retirement Study (HRS), an ongoing national cohort started in 1992. The study enrolled a representative sample of Americans (n = 19,280) over the age of 50. Latent factors were used to calculate sustained high BMI and physical activity (predictors) and sustained poor SRH and high depressive symptoms (outcomes) based on measurements in 2004, 2006, and 2010. Age, education, and income were confounders. Multi-group structural equation modeling (SEM) was used to test the additive effects of BMI and physical activity on depressive symptoms and SRH, where the groups were defined based on race by gender.

Results: Group differences were apparent in the direction and significance of the association between sustained high BMI and depressive symptoms. The association between sustained high BMI and depressive symptoms was positive and significant for White women (B = 0.03, p = 0.007) and non-significant for White men (B = −0.03, p = 0.062), Black men (B = −0.02, p = 0.564) and Black women (B = 0.03, p = 0.110). No group differences were found in the paths from sustained physical activity to depressive symptoms, or from physical activity or BMI to SRH.

Conclusion: Sustained high BMI and high depressive symptoms after age 50 are positively associated only for White women. As the association between sustained health problems such as depression and obesity are not universal across race and gender groups, clinical and public health interventions and programs that simultaneously target multiple health problems may have differential effects across race by gender groups.