Does timing and sequencing of transitions to adulthood make a difference? Stress, smoking, and physical activity among young Australian women

The direct and mediating effect of social support on health-related quality of life during pregnancy among Australian women

BACKGROUND

Prenatal stress can have a negative effect on the quality of life (QoL) of pregnant women. Social support plays a vital role in improving the psychological well-being of pregnant women by enhancing their stress-coping ability. The current study assessed the association between social support and health-related quality of life (HRQoL) as well as the mediating role of social support in the linkage between perceived stress and HRQoL among pregnant Australian women.

METHODS

Secondary data was obtained from 493 women who reported being pregnant in survey six of the 1973-78 cohort of the Australian Longitudinal Study on Women's Health (ALSWH). Social support and perceived stress were assessed using the Medical Outcomes Study Social Support Index (MOS-SSS-19) and the Perceived Stress Scale, respectively. The Mental Component Scale (MCS) and Physical Component Scale (PCS) of the SF-36 were used to examine the mental and physical HRQoL. A mediation model was used to examine the mediating effect of social support in the relationship between perceived stress and HRQoL. A multivariate quantile regression (QR) model was used to assess the association between social support and HRQoL after adjusting for potential confounders.

RESULT

The mean age of the pregnant women was 35.8 years. The mediational analysis revealed that emotional/informational support (β= -1.53; 95% CI: -2.36, -0.78), tangible support (β= -0.64; 95% CI: -1.29, -0.09), and affectionate support/positive social interaction (β= -1.33; 95% CI: -2.25, -0.48), played a significant mediating role in the relationship between perceived stress and mental health-related QoL. In addition, perceived stress had a significant indirect effect on mental health-related QoL through overall social support (β = -1.38; 95% CI: -2.28, -0.56), and the mediator accounted for approximately 14.3% of the total effect. The multivariate QR analysis indicated that all the domains of social support and overall social support scores were positively associated with higher MCS scores (p < 0.05). However, social support was found to have no significant association with PCS (p > 0.05).

CONCLUSION

Social support plays a direct and mediating role in improving the HRQoL of pregnant Australian women. Maternal health professionals need to consider social support as an essential tool to improve the HRQoL of pregnant women. Further, as part of routine antenatal care activity, assessing pregnant women's level of social support is beneficial.

The mediational role of social support in the relationship between stress and antenatal anxiety and depressive symptoms among Australian women: a mediational analysis

Background

Pregnancy can be a stressful period for most women and their family members, and the mental wellbeing of pregnant women can face serious challenges. Social support can play a role in improving the psychological well-being of pregnant women by enhancing the stress coping ability and alleviating stressful conditions. The current study aimed to assess the mediating effects of social support in the relationship between perceived stress and depressive symptoms as well as anxiety symptoms during pregnancy among Australian women.

Methods

Of the 8,010 women who completed Survey 6 of the 1973–78 Australian Longitudinal Study on Women’s Health (ALSWH) cohort in 2012, those who reported being pregnant (n = 493) were included in the current analyses. Antenatal depressive and anxiety symptoms were assessed using the 10 item Center for Epidemiological Studies Depression (CES-D-10) scale, and the 9-item Goldberg Anxiety and Depression scale (GADS) respectively. The 19 item-Medical Outcomes Study Social Support index (MOSS) was used to examine social support. A parallel mediation model was used to explore the mediational role of each domain of social support between perceived stress and antenatal depressive and anxiety symptoms.

Result

The study found that emotional/informational support has a partial mediating effect on the relationship between perceived stress and antenatal depressive symptoms (β = 0.371, 95% CI: 0.067, 0.799) and on the relationship between perceived stress and antenatal anxiety symptoms (β = 0.217, 95% CI: 0.029, 0.462). Affectionate support/positive social interaction and tangible support was found to play no significant mediation role between stress and antenatal depressive and anxiety symptoms.

Conclusions

Emotional/informational support appears to play a mediating role in the relationship between stress and antenatal depressive as well as between stress and antenatal anxiety symptoms. In order to further protect pregnant women from the effects of stress, policy makers and maternal health professionals are advised to develop community-based social support programs to enhance prenatal psychosocial support and ensure pregnant women have adequate emotional/information support.

Social support is a resource or a means that an individual can use to cope with stressful events and improve psychological wellbeing. It improves emotional and physical well-being and promotes health for a successful pregnancy. However, the relationship between domains of social support and antenatal depressive and anxiety symptoms remains understudied in Australia. Therefore, our study intended to examine the mediating role of domains of social support in the linkage between stress and depressive and anxiety symptoms during pregnancy among Australian Women.

Data were obtained from Survey 6 of the 1973–78 ALSWH cohort, which was conducted in 2012, and those who reported being pregnant were part of the study (n = 493, aged 34–39 years). Social support provided for a pregnant woman was the outcome variable, assessed using the 19-item Medical Outcomes Study Social Support index (MOS-SSS-19 item). A parallel mediation model was used to explore the mediational role of each domain of social support between perceived stress and antenatal depressive and anxiety symptoms.

Emotional/informational support plays a mediating role in the relationship between stress and antenatal depressive as well as between stress and antenatal anxiety symptoms. So, to further protect pregnant women from the effect of stress, policymakers and maternal health professionals are advised to develop community-based social support programs.

The association between social support and antenatal depressive and anxiety symptoms among Australian women

Background

Antenatal depression and antenatal anxiety adversely affect several obstetric and foetal outcomes, and increase the rate of postnatal mental illness. Thus, to tackle these challenges the need for social support during pregnancy is vital. However, an extensive literature search failed to show a published study on the relationship between domains of social support and antenatal depressive, as well as antenatal anxiety symptoms in Australia. This study examined the association between domains of social support and antenatal depressive and anxiety symptoms among Australian women.

Methods

The current study used data obtained from the 1973–78 cohort of the Australian Longitudinal Study on Women’s Health (ALSWH), focusing upon women who reported being pregnant (n = 493). Depression and anxiety were assessed using the 10 item Center for Epidemiological Studies Depression (CES-D-10) scale, and the 9-item Goldberg Anxiety and Depression scale (GADS) respectively. The 19 item-Medical Outcomes Study Social Support index (MOSS) was used to assess social support. A logistic regression model was used to examine the associations between domains of social support and antenatal depressive and anxiety symptoms after adjusting for potential confounders.

Result

The current study found 24.7 and 20.9% of pregnant women screened positive for depressive and anxiety symptoms respectively. After adjusting for potential confounders, our study found that the odds of antenatal depressive symptoms was about four and threefold higher among pregnant women who reported low emotional/informational support (AOR = 4.75; 95% CI: 1.45, 15.66; p = 0.010) and low social support (overall support) (AOR = 3.26; 95%CI: 1.05, 10.10, p = 0.040) respectively compared with their counterpart. In addition, the odds of antenatal anxiety symptoms was seven times higher among pregnant women who reported low affectionate support/positive social interaction (AOR = 7.43; 95%CI: 1.75, 31.55; p = 0.006).

Conclusion

A considerable proportion of pregnant Australian women had depressive symptoms and/or anxiety symptoms, which poses serious health concerns. Low emotional/informational support and low affectionate support/positive social interaction have a significant association with antenatal depressive and anxiety symptoms respectively. As such, targeted screening of expectant women for social support is essential.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12884-021-04188-4.

Prevalence and determinants of low social support during pregnancy among Australian women: a community-based cross-sectional study

Background

Pregnancy is a time for women in which the need for social support is crucial. Social support reduces stressors and improves the emotional and physical well-being of pregnant women. Women receiving low social support during pregnancy are at risk of substances use, developing mental illness, and adverse birth outcomes. The current study aims to determine the prevalence and determinants of low social support during pregnancy among Australian women.

Methods

Data were obtained from the 1973–1978 cohort of Australian Longitudinal Study on Women’s Health (ALSWH) and those who report being pregnant (n = 493) were included in the current analyses. Social support was assessed using Medical Outcomes Study Social Support index (MOSS). A logistic regression model was applied to identify determinants of low social support, separately for each MOSS domain.

Result

The study found that 7.1% (n = 35) of pregnant women reported low social support. Significant determinants of low emotional support were non-partnered (AOR = 4.4, 95% CI: 1.27, 14.99), difficulty managing on available income (AOR = 3.1, 95% CI: 1.18, 8.32), experiencing depressive symptoms (AOR = 8.5, 95% CI: 3.29, 22.27) and anxiety symptoms (AOR = 2.9, 95% CI: 1.26, 7.03). Significant determinants of low affectionate support were suffering from depressive symptoms (AOR = 5.3, 95% CI: 1.59, 17.99), having anxiety symptoms (AOR: 6.9, 95% CI: 2.21, 22.11) and being moderately/very stressed (AOR: 3, 95% CI: 1.17, 7.89). Significant determinants of low tangible support were difficulty managing available income (AOR = 3, 95% CI: 1.29, 6.95), and being depressed (AOR = 2.8, 95% CI: 1.48, 5.34).

Conclusion

The study revealed that 7.1% of pregnant women reported low social support. Having a mental health problems, being stressed, being from low socio-economic status and being non-partnered were significant determinants of low social support during pregnancy. Maternal health professionals and policymakers can use this information to screen pregnant women at risk of receiving low social support and improve the level of support being provided.

Providing strong social support improves emotional and physical well-being, strengthens social relationships, promotes health, and enhances the stress coping ability of pregnant women. However, pregnant women receiving low social support are at risk of substances use, developing mental illness, and adverse birth outcomes. The current study aims to determine the prevalence and determinants of low social support during pregnancy among Australian women. Data were obtained from Survey 6 of the 1973–1978 cohort of the Australian Longitudinal Study on Women’s Health (ALSWH) (n = 493, pregnant women aged 34–39 years). This cohort is one of ALSWH ongoing community-based study focusing on the health of women in Australia. Social support provided for a pregnant woman was the outcome variable, assessed using the 19-item Medical Outcomes Study Social Support index (MOSS). The prevalence of low social support in each domain was calculated for each of the independent variables. A logistic regression model, using a backward stepwise elimination approach, was employed to identify determinants of low social support. In the final model, the strength of association measured by adjusted odds ratios (AOR) with 95% confidence intervals. The significance level was set at p < 0.05. From the total participant pregnant women, 7.1% of them reported low social support. Significant determinants of low social support among pregnant Australian women were, having a mental illness, being stressed and/or being from low socio-economic status and being non-partnered. Maternal health professionals can use this information to screen pregnant women at risk of receiving low social support as well as develop policy to help enhance the social support being given and the psychological wellbeing being of pregnant women.

Considering the age-graded nature of associations between socioeconomic characteristics and smoking during the transition towards adulthood

Young adulthood is a sensitive period characterized by the accumulation of resources and transitions in and out of education, employment, family, and housing arrangements. The association between these characteristics and smoking outcomes likely varies with age yet few studies address its dynamic age-graded nature. To explore this, we examined 2083 young adults ages 18-25 from the 2011-2012 cross-sectional sample of the Montreal-based Interdisciplinary Study of Inequalities in Smoking. We operationalized participants' socioeconomic characteristics using their resources (e.g., education, income, financial difficulties) and transition stages (i.e., studying, working full-time, living arrangements with parents and children, and being in a relationship). We examined differences in these characteristics' associations with occasional and daily smoking across two-year categories (18-19, 20-21, 22-23, and 24-25) using multinomial logistic regression models with age-based interaction terms. Findings highlighted four characteristics, i.e., educational attainment, personal income, student status, and relationship status, with significant differences in associations with smoking outcomes across age categories. Between the age groups of 18-19 and 24-25: 1) the negative association between low educational attainment and daily smoking increased; 2) the positive association between personal income and daily smoking decreased; 3) the negative association between student status and both outcomes decreased; 4) the negative association between relationship status and occasional smoking increased. Findings support that the associations between young adults' socioeconomic characteristics and smoking outcomes vary substantially during the second and third decades of life. Addressing this has critical implications for identifying vulnerable populations and developing appropriate age-based policies in this age group.

Impact of Religiosity on Subjective Life Satisfaction and Perceived Academic Stress in Undergraduate Pharmacy Students

Objective:

To evaluate the impact of religiosity on subjective life satisfaction and perceived academic stress in undergraduate pharmacy students.

Materials and Methods:

This 1-month descriptive study focused on pharmacy students of a public-sector university and used three survey questionnaires. The questionnaires included: the Duke University Religion Index to assess religiosity, Subjective Happiness Scale for documenting subjective happiness of life, and Perceived Stress Scale for evaluation of perceived stress due to academic load. The data were analyzed through Statistical Package for Social Services software, version 22. Chi-square test, Pearson’s correlation, and logistic regression were used. Study was exempted from ethical review.

Result:

Subjective happiness was positively (+) correlated with non-organized religious activity and intrinsic religiosity (P < 0.01). Perceived stress score reported negative (–) correlation with organized religious activity (P < 0.05). Female students appeared more stressed (P < 0.05).

Conclusion:

Religiosity may enhance life satisfaction and may relieve academic stress in pharmacy students.

Methodological systematic review of studies on social inequalities in smoking among young adults: A field coming of age?

OBJECTIVE

Socioeconomic circumstances are critically important to addressing smoking. In young adulthood (ages 18-25), dynamic transitions in education, employment, family and housing complicate the measurement of socioeconomic circumstances. To better understand approaches to capturing these circumstances, this methodological systematic review examined how socioeconomic characteristics used to identify social inequalities in smoking among young adults are measured.

DATA SOURCES

We searched PubMed/MEDLINE, Scopus, EMBASE, ERIC and Sociological Abstracts, and used three prior reviews. We updated the search in March 2018.

STUDY SELECTION

Two reviewers independently screened peer-reviewed records from OECD countries published in English, French, German or Spanish after 1995 whose samples covered at least 1 year between the ages of 18 and 25. We included 89 of 1320 records.

DATA EXTRACTION

One reviewer extracted study characteristics, indicators used to operationalise socioeconomic circumstances and each indicator's relation to results on smoking (ie, significance and direction). We found 39 indicators of socioeconomic circumstances related to six broad domains. These indicators were used in 425 results.

DATA SYNTHESIS

We descriptively analysed the extracted data using evidence tables. Educational attainment was most common. Evidence of inequalities varied by indicator used. For example, there was inconsistent evidence regarding the role of parental characteristics and transition stages and insufficient evidence regarding personal income on smoking.

CONCLUSION

Despite its importance, studies have disproportionally examined inequalities among young adults using traditional indicators. The mismatch between young adults' life transitions and measurement strategies may attenuate evidence of inequalities. We suggest strategies to improve future measurement.

Stay active for life: physical activity across life stages

Purpose

This paper concerns participation of Poles aged 15+ years in leisure time and transport-related physical activity (PA) with a special focus on the life stages. The purpose of the paper was to analyze types of exercises, current and future behavior concerning PA, availability of sport and recreation facilities, and factors having the strongest relation with undertaking PA at a sufficient level according to pro-health recommendations of World Health Organization (WHO).

Patients and methods

A survey was carried out on the representative sample (n=2,000). Respondents were classified in accordance to their life stages with a two-step cluster analysis. Relationships between meeting the dose of PA required for health recommendations and a membership in groups of life stages were evaluated using log-linear analysis. The strength of this relationship was expressed by the odds ratio. In order to capture relationships between meeting WHO recommendations and a set of explanatory variables, a predictive model was built.

Results

Life stages and various related events have a significant relation with a decrease of PA. Among groups of a particular risk, there are professionally active and unemployed people aged 50–64 years without children as well as retirees aged 65+ years who do not meet WHO recommendations (45.3; 50.4% and 47.6%). The unemployed and retirees more frequently (p<0.0001) do not or cannot practice sport and do not think that a change of their situation is expected soon. However, 35% of professionally active people aged 50–64 years without children and 18.2% of unemployed people declare that they are currently not active but if they had the possibility, they would start practicing sport.

Conclusion

Campaigns promoting PA should be targeted at groups of a particular risk. Any attempts of increasing PA or changing tendencies of its decrease should consider life conditions of these persons, as well as their needs, motivations, and barriers.

Coping with stressful events: A pre-post-test of a psycho-educational intervention for undergraduate nursing and midwifery students

BACKGROUND

Knowledge of coping mechanisms is important for nursing and midwifery students to cope with stressful events during undergraduate education.

OBJECTIVES

To evaluate the impact of a psycho-educational intervention "Coping with Stressful Events" with first year undergraduate nursing and midwifery students.

DESIGN

A quasi-experimental, one-group pre-post-test.

SETTINGS

One school of nursing/midwifery in one university in Ireland.

PARTICIPANTS

A convenience sample of all first year undergraduate nursing and midwifery students (n=197). Of these 166 completed the pretest and 138 students completed the post test.

METHODS

Using the COPE Inventory questionnaire (Carver et al., 1989) data was collected pre and post-delivery of the psycho-educational intervention "Coping with Stressful Events" by two research assistants. Data were analysed using the IBM SPSS Statistics version 22 (NY, USA).

RESULTS

Results demonstrated improved coping skills by students. There were statistically significant differences between pre and post intervention for some coping subscales. For example, the mean subscale scores were lower post-intervention for restraint and mental disengagement, and higher for use of emotional and instrumental social support indicating improved coping strategies.

CONCLUSIONS

This intervention has the potential to influence undergraduate nursing and midwifery students coping skills during their first year of an undergraduate programme.

Relationships of cognitive load on eating and weight-related behaviors of young adults

Little is known about the relationship between weight-related behaviors and cognitive load (working memory available to complete mental activities like those required for planning meals, selecting foods, and other health-related decisions). Thus, the purpose of this study was to explore associations between cognitive load and eating behaviors, physical activity, body mass index (BMI), and waist circumference of college students. College students (n=1018) from 13 institutions completed an online survey assessing eating behaviors (e.g., routine and compensatory restraint, emotional eating, and fruit/vegetable intake), stress level, and physical activity level. BMI and waist circumference were measured by trained researchers. A cognitive load score was derived from stress level, time pressure/income needs, race and nationality. High cognitive load participants (n=425) were significantly (P<0.05) more likely to be female, older, and further along in school than those with low cognitive loads (n=593). Compared to low cognitive load participants, high cognitive load participants were significantly more likely to eat <5 cups of fruits/vegetables/day, have greater routine and compensatory restraint, and greater susceptibility to eating in response to external cues and emotional eating. Both males and females with high cognitive load scores had a non-significant trend toward higher BMIs, waist circumferences, and drinking more alcohol than low cognitive load counterparts. In conclusion, cognitive load may be an important contributor to health behaviors. Understanding how cognitive load may affect eating and other weight-related behaviors could potentially lead to improvements in the effectiveness of obesity prevention and intervention programs.

Physical Health of Young, Australian Women: A Comparison of Two National Cohorts Surveyed 17 Years Apart

INTRODUCTION

Very little is known about the extent of physical health issues among young women in early adulthood and whether this is changing over time.

METHODS

We used data from two national samples of young women aged 18-23 years, surveyed 17 years apart, who participated in the Australian Longitudinal Study on Women's Health. We used multinomial logistic regression to compare the women's physical health (i.e., self-rated health, common symptoms and conditions) and identify whether sociodemographic factors, health behaviours and stress explained any physical health differences between the samples.

RESULTS

Women aged 18-23 years in 2013 (N = 17,069) were more likely to report poor self-rated health and physical symptoms (particularly urogenital and bowel symptoms) than women aged 18-23 years in 1996 (N = 14,247). Stress accounted for a large proportion of the physical health differences between the cohorts, particularly for allergies, headaches, self-rated health, severe tiredness, skin problems, severe period pain and hypertension.

CONCLUSIONS

Women's health appears to be changing, with young women born in more recent decades reporting greater physical symptom levels. Changing socio-cultural and economic conditions may place pressure on young adults, negatively affecting their health and wellbeing. Assessing the extent to which social structures and health care policies are offering adequate support to young women may offer avenues for promoting positive health and wellbeing.

Socioeconomic position during childhood and physical activity during adulthood: a systematic review

OBJECTIVES

A growing body of evidence links socioeconomic position early in life and physical activity during adulthood. This systematic review aimed to summarize this evidence.

METHODS

Medline and EMBASE were searched for studies that assessed socioeconomic position before age 18 years and physical activity at age ≥18 years. Studies were rated according to three key methodological quality criteria: (1) was childhood socioeconomic position assessed prospectively? (2) Was socioeconomic position during adulthood included in the statistical analysis? (3) Was a validated instrument used to measure of physical activity?

RESULTS

Forty-two publications were included. Twenty-six (61.9 %) found a significant association between socioeconomic position early in life and physical activity during adulthood. Twenty-one studies met at least two methodological quality criteria. Among those, the proportion was higher: 15/21 (71.4 %). Associations were of weak to moderate strength, positive for physical activity during leisure time, and negative for transports and work.

CONCLUSIONS

The bulk of the evidence supports the notion that there is a life course association between socioeconomic position early in life and physical activity during adulthood. Studies using more rigorous methodology supported this conclusion more consistently.

Recruitment lessons learned from a tailored web-based health intervention Project Y.E.A.H. (Young Adults Eating and Active for Health)

Purpose

– Recruiting college students for research studies can be challenging. The purpose of this paper is to describe the lessons learned in the various recruitment strategies used for enrolling college students in a theory-based, tailored, and web-delivered health intervention at 13 US universities.

Design/methodology/approach

– The community-based participatory research (CBPR) model was used to develop a staged-tailored, web-based, randomized control trial, focussing on eating behavior, physical activity, and stress management. Participant feedback during baseline assessments was used to evaluate recruitment strategies.

Findings

– Findings from this feedback suggest that traditional recruitment strategies, such as newspaper ads and flyers, may not be the best approach for recruiting college students; instead, web-based efforts proved to be a better recruitment strategy.

Research limitations/implications

– This project included results from 13 US universities and thus may not be generalizable: more research is needed to determine successful recruitment methods for 18-24 years old college students.

Originality/value

– This paper lessens the gap regarding successful recruitment strategies for 18-24 years old college students.

Exercise and Alcohol Consumption: What We Know, What We Need to Know, and Why it is Important

Exercise provides a wealth of benefits to brain and body, and is regarded as a protective factor against disease. Protective factors tend to cluster together - that is, people who engage in one healthy behavior, such as exercise, also engage in other healthy behaviors, such as maintaining a nutritious diet and getting sufficient sleep. In contrast to exercise, alcohol consumption is not typically regarded as a health-promoting behavior, although moderate intake has been associated with a lower risk of cardiovascular disease. Surprisingly, several large, population-based studies have shown a positive association between physical activity and alcohol intake. The present review focuses on what is known about this relationship, including potential neural bases as well as moderating factors, and discusses important directions for further study, such as a more thorough characterization of people who both drink and exercise. We focus on ramifications for intervening with people who have alcohol use disorders, as exercise has been assessed as both a treatment and preventive measure, with mixed results. We believe that, in order for such interventions to be effective, clinical trials must distinguish treatment-seeking populations from non-treatment-seeking ones, as well as ensure that the use of exercise as a tool to decrease alcohol consumption is made explicit. We posit that a better understanding of the relationship between physical activity and alcohol intake will maximize intervention efforts by informing the design of clinical trials and research-driven prevention strategies, as well as enable individuals to make educated decisions about their health behaviors.

The effects of Young Adults Eating and Active for Health (YEAH): a theory-based Web-delivered intervention

OBJECTIVE

To assess the effectiveness of a tailored theory-based, Web-delivered intervention (Young Adults Eating and Active for Health) developed using community-based participatory research process.

DESIGN

A 15-month (10-week intensive intervention with a 12-month follow-up) randomized, controlled trial delivered via Internet and e-mail.

SETTING

Thirteen college campuses.

PARTICIPANTS

A total of 1,639 college students.

INTERVENTION

Twenty-one mini-educational lessons and e-mail messages (called nudges) developed with the non-diet approach and focusing on eating behavior, physical activity, stress management, and healthy weight management. Nudges were short, frequent, entertaining, and stage-tailored to each behavior, and reinforced lesson content.

MAIN OUTCOME MEASURE

All participants were assessed at baseline, postintervention (3 months from baseline), and follow-up (15 months from baseline) for primary outcomes of weight, body mass index (BMI), fruit and vegetable intake (FVI), physical activity (PA), and perceived stress; and secondary outcomes of waist circumference, percent dietary fat, energy from sugar-sweetened beverages, servings of whole grains, self-instruction and regulation for mealtime behavior, hours of sleep, and stage of readiness for change for consuming 5 cups of FVI, completing 150 minutes of PA/wk, and managing stress on most days of the week. Demographics were collected at baseline.

ANALYSIS

Chi-square analysis and mixed-models repeated measures analysis were performed to determine differences between experimental and control outcomes.

RESULTS

There were no differences between experimental and control participants in BMI, weight, and waist circumference. There were small improvements in FVI (P = .001), vigorous PA in females (P = .05), fat intake (P = .002), self-instruction (P = .001), and regulation (P = .004) for mealtime behavior, and hours of sleep (P = .05) at postintervention, but improvements were not maintained at follow-up. At postintervention, a greater proportion of experimental participants were in the action/maintenance stages for FVI (P = .019) and PA (P = .002) than control.

CONCLUSIONS AND IMPLICATIONS

Young Adults Eating and Active for Health is one of the first studies to use the community-based participatory research process of PRECEDE-PROCEED to develop a non-diet approach intervention. Although there were no differences between experimental and control participants in weight change or BMI, the intervention supported positive change in behaviors that may mediate excessive weight gain, such as increasing FVI and more healthful self-regulation mealtime behaviors immediately postintervention. Additional strategies to maintain the behavior changes need to be explored.

Nine year changes in sitting time in young and mid-aged Australian women: findings from the Australian Longitudinal Study for Women's Health

OBJECTIVE

To examine changes in sitting time (ST) in women over nine years and to identify associations between life events and these changes.

METHODS

Young (born 1973-78, n=5215) and mid-aged (born 1946-51, n=6973) women reported life events and ST in four surveys of the Australian Longitudinal Study on Women's Health between 2000 and 2010. Associations between life events and changes in ST between surveys (decreasers ≥2 h/day less, increasers ≥2 h/day more) were estimated using generalized estimating equations.

RESULTS

Against a background of complex changes there was an overall decrease in ST in young women (median change -0.48 h/day, interquartile range [IQR]=-2.54, 1.50) and an increase in ST in mid-aged women (median change 0.43 h/day; IQR=-1.29, 2.0) over nine years. In young women, returning to study and job loss were associated with increased ST, while having a baby, beginning work and decreased income were associated with decreased ST. In mid-aged women, changes at work were associated with increased ST, while retiring and decreased income were associated with decreased ST.

CONCLUSIONS

ST changed over nine years in young and mid-aged Australian women. The life events they experienced, particularly events related to work and family, were associated with these changes.

Development of Young Adults Eating and Active for Health (YEAH) internet-based intervention via a community-based participatory research model

OBJECTIVE

To develop a tailored, theory-based, Web-delivered intervention to prevent excessive weight gain in young adults using a Community-Based Participatory Research model.

DESIGN

Investigators from 14 universities developed the intervention and supporting administrative portal using the 4 phases of the PRECEDE model. Steering committees were composed of the target audience (aged 19-24 years) and key health/wellness personnel were formed at each institution and provided information during each phase that was used to guide development of the intervention, Project YEAH (Young Adults Eating and Active for Health). Piloting results were used to refine the curriculum and identify and avoid barriers to delivery.

RESULTS

Qualitative and quantitative data collected at each phase informed Project YEAH development. In Phase 1, factors of highest priority to young adults were identified. In Phase 2, environmental supports for healthful lifestyles were elucidated. In Phase 3, behavior and environmental changes considered important and changeable were identified. In Phase 4, the 10-week, theory-based, stage-tailored, interactive-learning intervention with a 10-month reinforcement period was developed.

CONCLUSIONS AND IMPLICATIONS

Applying the PRECEDE model with fidelity during development of Project YEAH resulted in an intervention that pilot participants found relevant and useful, gained attention, instilled confidence in the ability to apply the information, and provided a sense of satisfaction.

The effects of stress on physical activity and exercise

BACKGROUND

Psychological stress and physical activity (PA) are believed to be reciprocally related; however, most research examining the relationship between these constructs is devoted to the study of exercise and/or PA as an instrument to mitigate distress.

OBJECTIVE

The aim of this paper was to review the literature investigating the influence of stress on indicators of PA and exercise.

METHODS

A systematic search of Web of Science, PubMed, and SPORTDiscus was employed to find all relevant studies focusing on human participants. Search terms included "stress", "exercise", and "physical activity". A rating scale (0-9) modified for this study was utilized to assess the quality of all studies with multiple time points.

RESULTS

The literature search found 168 studies that examined the influence of stress on PA. Studies varied widely in their theoretical orientation and included perceived stress, distress, life events, job strain, role strain, and work-family conflict but not lifetime cumulative adversity. To more clearly address the question, prospective studies (n = 55) were considered for further review, the majority of which indicated that psychological stress predicts less PA (behavioral inhibition) and/or exercise or more sedentary behavior (76.4 %). Both objective (i.e., life events) and subjective (i.e., distress) measures of stress related to reduced PA. Prospective studies investigating the effects of objective markers of stress nearly all agreed (six of seven studies) that stress has a negative effect on PA. This was true for research examining (a) PA at periods of objectively varying levels of stress (i.e., final examinations vs. a control time point) and (b) chronically stressed populations (e.g., caregivers, parents of children with a cancer diagnosis) that were less likely to be active than controls over time. Studies examining older adults (>50 years), cohorts with both men and women, and larger sample sizes (n > 100) were more likely to show an inverse association. 85.7 % of higher-quality prospective research (≥ 7 on a 9-point scale) showed the same trend. Interestingly, some prospective studies (18.2 %) report evidence that PA was positively impacted by stress (behavioral activation). This should not be surprising as some individuals utilize exercise to cope with stress. Several other factors may moderate stress and PA relationships, such as stages of change for exercise. Habitually active individuals exercise more in the face of stress, and those in beginning stages exercise less. Consequently, stress may have a differential impact on exercise adoption, maintenance, and relapse. Preliminary evidence suggests that combining stress management programming with exercise interventions may allay stress-related reductions in PA, though rigorous testing of these techniques has yet to be produced.

CONCLUSIONS

Overall, the majority of the literature finds that the experience of stress impairs efforts to be physically active. Future work should center on the development of a theory explaining the mechanisms underlying the multifarious influences of stress on PA behaviors.

Timing of Adult Transitions

Regarding the differences in timing of adult transitions (i.e., completion of education, full-time employment, having an intimate relationship, having a child) and their relation to childhood antecedents and adulthood psychological functioning, 282 participants were examined. The study was based on the ongoing Finnish Jyväskylä Longitudinal Study of Personality and Social Development in which the same individuals have been followed from age 8 to mid-adulthood. Three groups were formed: On-Time Transitions (all transitions by age 27), Late Transitions (at least one transition after age 27), and Partial Transitions (not all transitions at age 42). Participants with all transitions (On-Time or Late) were socially more active in childhood than participants with partial transitions. Furthermore, participants with on-time transitions were more likely females, and participants with late transitions came more likely from high SES families than participants with partial transitions. Regarding psychological functioning, the participants with all transitions reported higher psychological well-being and self-esteem at ages 36 and 42, and higher life satisfaction at age 42 than participants with partial transitions. Furthermore, participants with on-time transitions showed higher life satisfaction at ages 27 and 36 than participants with late transitions, but by age 42 the difference leveled off.

Influence of marriage and parenthood on physical activity: a 2-year prospective analysis

BACKGROUND

Physical activity (PA) tends to decrease from adolescence to young adulthood, and factors that have been proposed to contribute to this decrease are life transitions. The focus of this study is to examine life transitions, such as marriage and parenthood, and the impact they may have on the physical activity levels of young adults.

METHODS

This 2-year prospective analysis assessed physical activity (hrs/wk) and sociodemographics in young adults (n = 638, 48% male, 15% nonwhite, 24 ± 1.1 years old) via questionnaire. PA data were normalized through log transformations and examined using ANCOVAs, controlling for appropriate covariates.

RESULTS

ANCOVA results showed that becoming married did not significantly change PA compared with individuals who stayed single [F(1,338) = 0.38, P = .54, d = 0.06]. Conversely, PA was significantly lower [F(1,517) = 6.7, P = .01, d = 0.41] after having a child, compared with individuals who stayed childless.

CONCLUSIONS

These results suggest that marriage does not impact PA in young adults, but having a child significantly decreases PA in parents, and may offer an optimal period of intervention.

Purposeful exercise and lifestyle physical activity in the lives of young adult women: findings from a diary study

It is important to know how physical activity is incorporated in women's lives to assess ways they can feasibly attain and maintain lifelong healthy practices. This study aimed to determine whether patterns of activity differed among young women whose physical activity met nationally recommended levels from those who did not. The sample was 42 women (aged 18-30 years) who had completed an exercise intervention (22 from the exercise group, 20 from the control group). Participants recorded pedometer steps and physical activities in diaries including form, duration and perceived exertion during 12 randomly assigned weeks over 26 weeks. We divided the sample into quartiles of moderate to vigorous physical activity to examine the composition of physical activities per quartile. Walking and shopping comprised the majority of physical activity in the lowest quartile of moderate to vigorous physical activity. In the second and third quartiles, walking and household/childcare together comprised more than two-thirds of all activities. Only in the highest quartile was cardio activity (not including walking, shopping and household/childcare) the largest proportion of activity; this category stood alone as varying significantly across quartiles of moderate to vigorous physical activity (p < 0.005). Among these young adult women, self-reported "lifestyle" physical activity was not sufficient to meet recommended levels of moderate to vigorous physical activity. The one-quarter who met recommended levels of moderate to vigorous physical activity did so largely through purposeful physical activities directly associated with exercise. Further research is needed to refine means of more fully measuring physical activities that women frequently perform, with particular attention to household work, childcare and shopping and to differing combinations of activities and levels of exertion by which diverse women can meet the recommended levels. The findings of this small scale study reinforce the ongoing benefit of recommending structured, planned physical activity at moderate and vigorous levels of intensity to young, healthy women to ensure they obtain the health benefits.

Life events and changing physical activity patterns in women at different life stages

BACKGROUND

The impact of life events on physical activity (PA) is little understood.

PURPOSE

The purpose of this study is to examine relationships between specific life events and changes in PA in three cohorts of Australian women.

METHODS

Young (N = 7,173; age 22-27 years), mid-age (N = 8,762; 51-56 years), and older (N = 6,660; 73-78 years) participants in the Australian Longitudinal Study on Women's Health completed surveys on two occasions, 3 years apart.

RESULTS

About one third of the young and mid-age women and one quarter of the older women were "active" at both times. Decreasing PA was associated with marriage and childbirth in young women and with declining health in older women. Increasing PA was associated with retirement and death of spouse in the mid-age women. Stressful events such as divorce, harassment at work, and violence were also associated with changing PA.

CONCLUSIONS

There were significant associations between age-specific life events and PA changes. Understanding these relationships could inform interventions for preventing declines in activity at specific life stages.