International Journal of Behavioral Nutrition and Physical Activity最新文献

Background: Only about three percent of Latina teens are sufficiently active. As Latinas have a higher prevalence of lifestyle-related chronic health conditions, such as diabetes, compared to non-Latinas, targeted interventions that increase and maintain moderate-to-vigorous-intensity physical activity (MVPA) are needed. Chicas Fuertes is a 12-month multi-channel mHealth physical activity intervention for Latina teens shown to increase MVPA over the first six months. The purpose of this study was to test the effectiveness of Chicas Fuertes for maintaining Latina teens' initial physical activity gains over the subsequent six months.

Methods: In a randomized controlled trial, Latina teens, aged 13 -18 and underactive, participated in Chicas Fuertes or served as a control. The intervention group initially received a Fitbit, a one-on-one coaching session and two check-in calls, access to a personalized website, tailored text messages, and daily Instagram content while the control group received only a Fitbit. From six to 12-months, the intervention group received a short coaching call and continued access to the tailored digital media content. Weekly minutes of MVPA were assessed at baseline, six, and 12-months with hip-worn Actigraph GT3X+ accelerometers and the 7-Day Physical Activity Recall Interview. Mixed effects regressions were conducted to examine between-group differences in MVPA at twelve months, with models of accelerometer data adjusting for device wear-time.

Results: Of the 160 participants (Mage= 15.9 ± 1.6),137 completed the 12-month follow-up. More than half (69%) identified as second-generation and reported a household income of ≤$50,000 (62%). Weekly minutes of MVPA gained at six months were maintained at twelve months in Chicas Fuertes participants compared to control. Intervention participants had increased median changes in accelerometry-measures, 10.00 (IQR=13), compared to decreases observed in the control, -5 (IQR=21). Median changes in self-reported measures 13 (IQR=32) among intervention compared to 5 (IQR=26) among control.

Conclusions: Chicas Fuertes was able to support maintenance of objective and self-reported MVPA gains from six months to twelve months with tapered support. Digital technologies that Latina teens commonly use can be leveraged to increase dissemination and implementation of physical activity interventions at a relatively low cost, ultimately enhancing health equity among Latina teens.

Trial registration: ClinicalTrials.gov NCT04190225. Registered on November 20, 2019.

Background: Mindful eating interventions target behavioral and emotional processes involved in eating, but most structured programs have been evaluated in English-speaking settings and often compared with passive controls. This randomized controlled trial assessed the effectiveness of the Mind-Eat program, a structured mindfulness-based intervention, versus treatment as usual consisting of a therapeutic patient education (TPE) program grounded in intuitive eating principles, in adults with overweight or obesity.

Methods: In this single-center trial, 66 adults with overweight or obesity were randomized (1:1) after oral agreement. Of these, 56 completed baseline assessment, and 46 with baseline and at least one post-baseline assessment were included in the modified intention-to-treat analysis. The Mind-Eat group completed eight weekly experiential sessions plus one follow-up session, while the comparator group followed the department's usual TPE pathway. Assessments were conducted at baseline, post-intervention (week 8), and follow-up (week 12). The primary outcome was change in mindful eating, measured with the validated Mind-Eat Scale. Secondary outcomes included disordered and intuitive eating behaviors, psychological well-being, trait mindfulness, physical activity, and weight. Analyses used linear mixed-effects models.

Results: Significant Group × Time interactions favored the Mind-Eat group for mindful eating at week 8 (β = - 0.40, p = .002, d = - 1.32) and week 12 (β = - 0.31, p = .02, d = - 1.02). Compared with treatment as usual, Mind-Eat was also associated with greater reductions in emotional eating (and greater improvements in intuitive eating and trait mindfulness. Improvements were observed in both groups across several outcomes. No between-group differences were found for restrained eating, perceived stress, anxiety, depression, physical activity, or weight.

Conclusions: The Mind-Eat program was associated with greater improvements in mindful eating and key eating-related behaviors, particularly emotional and external eating, than an intuitive eating-oriented TPE program delivered as treatment as usual. These findings support the added value of structured mindfulness-based experiential training in obesity care. However, they should be interpreted in light of attrition and the absence of short-term weight effects.

Trial registration: The study protocol is recorded at Clinicaltrials.gov under the number: NCT06157411.

Introduction: Parents are a key target for interventions promoting healthy screen use in young children, but no review has evaluated the effect of such parent-focused interventions on developmental outcomes in early childhood. The objective of this study was to conduct a systematic review and meta-analyses of the effects of parent-focused interventions for screen use on young children's social-emotional, cognitive, and physical development, as well as proximal indicators of development including sleep and physical activity. A secondary objective was to assess their impact on children's screen use.

Methods: Eight databases were searched with publication dates between 2007 and March 2025. Randomised controlled trials of parent-focused interventions targeting screen use in children (birth-5.99 years) were included if they reported outcomes related to both child screen use and development. Stata was used to undertake meta-analyses using multilevel random effects models to estimate effects for outcomes with data from at least three papers.

Results: In total, 10 studies (11 papers) were eligible for inclusion, with eight studies (n = 1,776 participants) providing sufficient data to be included in meta-analyses of at least one outcome. Interventions targeted screen use duration (n = 8 studies), screen use before bed (n = 1 study) and screen content (n = 1 study; 2 papers). Interventions achieved reductions in social-emotional problems (ES=-0.32 (95%CI:-0.51,-0.12)), externalizing behaviors (ES=-0.31 (95%CI:-0.56,-0.05)) and screen time (ES=-0.92 (95%CI:-1.66,-0.18)). Few interventions (n = 2) targeted aspects of screen use other than duration (e.g. content quality and timing). Larger effects were achieved for interventions that were underpinned by a theory and incorporated a range of established behavior change techniques, compared to interventions that did not incorporate these aspects. Few studies explored intervention effects on physical activity, body mass index, cognitive development and/or motor skills, and heterogenous sleep outcomes were reported, making it difficult to draw definitive conclusions regarding these outcomes.

Conclusions: Few parent-focused interventions for screen use were identified and most targeted screen use duration. Future intervention studies may consider targeting aspects of screen use other than duration (e.g. content quality), and evaluating their feasibility and acceptability for parents, compared to interventions targeting screen use duration. The protocol was prospectively registered on PROSPERO (ID: CRD420250654905).

Background: Physical activity (PA) and mood are associated in daily life. Prior studies showed that these associations are moderated by contextual factors (e.g., weather conditions) and differ between individuals. Yet, it remains unclear to what extent associations between PA and mood reflect stable, person-specific characteristics or fluctuate over time.

Methods: We examined the temporal stability of within-person PA-mood associations derived from three one-week ambulatory assessments across three consecutive years in 65 adolescents and young adults. Mood was assessed via e-diaries, and PA was recorded with accelerometers. Multilevel models estimated the effects of preceding PA on mood. Between-person differences and within-person stability were quantified by random-effect variances and correlations across participants and weeks.

Results: As hypothesized, PA was positively associated with subsequent energetic arousal (β = 4.88, p < .001) and valence (β = 1.27, p = .042) but negatively with calmness (β = -1.86, p = .003). Intraclass Correlation Coefficients indicate that 64%, 44%, and 80% of variance of the weekly PA-mood associations of individuals are attributable to between-person differences, while 36%, 56%, and 20% of variance are accounted for by within-person fluctuations in associations of PA with energetic arousal, valence, and calmness, respectively.

Conclusions: For the first time, we show that PA-mood associations reflect a combination of both stable 'trait' components (between subjects) and 'state' variability (within subjects). Both have important implications for personalized and context-sensitive intervention approaches, such as just-in-time adaptive interventions. Future research is needed to unravel which situational components and person characteristics shape the variability of associations.

Background: Falls and physical inactivity are both linked to increased dementia risk, but their joint impact has not been well studied. It remains unclear whether physical activity can mitigate the elevated dementia risk after a fall and whether it also lowers the likelihood of future falls.

Methods: We used data from 44,488 adults aged ≥ 60 years in three cohorts. Falls and physical activity were self-reported. Incident dementia was tracked during follow-up. Cox proportional hazards models estimated the associations of falls with dementia and physical activity with dementia and falls, stratified by fall history.

Results: Over a median follow-up of 5.9-7.9 years, 3,492 dementia cases were identified. Falls were associated with a 70% higher risk of dementia (pooled HR = 1.70, 95% CI: 1.57-1.84). In the no-fall group, compared with inactivity, low, moderate, and high physical activity were progressively associated with lower risks of dementia (HRs = 0.63, 0.53, 0.43) and falls (HRs = 0.77, 0.68, 0.58). These protective effects were consistent among fallers, with similar dose-response gradients.

Conclusions: Falls substantially increased dementia risk. Higher levels of physical activity were linked to lower risks of both dementia and falls, regardless of fall history.

Background: The "physical activity health paradox" posits that physical activity done during work (occupational physical activity [OPA]) may not yield the health benefits consistently observed for leisure-time physical activity (LTPA) and, in some cases, may be harmful. Given the broad implications for such a paradox, which contradicts current public health guidelines for physical activity, we conducted a narrative, non-systematic review to discuss the current epidemiological and mechanistic evidence on the topic to inform opportunities for research and practice moving forward.

Epidemiological evidence: Epidemiological evidence shows that LTPA is reliably protective against mortality and cardiovascular disease, whereas OPA has mixed or adverse associations. Several recent meta-analyses found higher all-cause mortality risk among men with high vs low OPA and found LTPA to potentially mitigate this OPA risk. Studies with device-measured OPA further highlight potential heterogeneity by OPA task and context. These conclusions remain limited by low quality evidence due to heterogeneous OPA exposure measurements, referent group selection, challenges in study design, and varied confounder adjustments.

Mechanistic evidence: Mechanistically, four interrelated pathways that may explain the observed presence of a paradox have been proposed and preliminarily tested: (1) acute cardiovascular strain catalyzed by long-duration OPA with little recovery; (2) downstream vascular changes such as greater arterial stiffness, blunted baroreflex sensitivity, and maladaptive cardiac remodeling from chronic OPA exposure; (3) systemic inflammation associated with high OPA levels; and (4) modifiers such as low cardiorespiratory fitness and high psychosocial stress amplifying strain, inflammation, and risk. Current evidence is limited by reliance on cross-sectional or between-subject designs, crude OPA classification, and limited mechanistic interventions.

Conclusions: Unlike the clear benefits from LTPA, research findings examining the health effects of OPA remain mixed. While uncertainty remains, the balance of evidence suggests that OPA is less beneficial to health than LTPA which should be considered in public health messaging. Advancing the field will require multidimensional OPA exposure assessment, rigorous study designs, and evaluation of mechanism-driven outcomes to clarify causal pathways and identify feasible intervention targets to promote health in workers with physically demanding jobs.

Background: The Implementation Leadership Scale (ILS) is widely used to measure implementation leadership for health innovations. While used often in behavioral health and other clinical settings, it remains untested in community public health contexts such as food retail. Healthy food retail strategies, including nutrition incentive programs, could benefit from measuring and subsequently strengthening leadership support to facilitate effective implementation. The objective of this study was to test the suitability of an adapted ILS to measure leadership support for a nutrition incentive program implemented in a brick-and-mortar food retail setting.

Methods: As part of a larger evaluation, a multidisciplinary team of practitioners, evaluators, and food retail representatives created a modified version of the ILS suitable for the food retail context. Food retailer staff and management from one privately-owned grocery chain who participated in implementing a nutrition incentive program for Supplemental Nutrition Assistance Program (SNAP) shoppers in Southern California completed a survey that included the adapted ILS. Of the 522 survey respondents from the larger evaluation, 473 retailers including management and staff provided complete responses for the ILS. We assessed construct validity, internal consistency reliability, and measurement invariance using differential item functioning (DIF) analyses, Cronbach's alpha, confirmatory factor analysis (CFA), and multiple-group CFA for the adapted ILS.

Results: DIF analyses indicated minimal evidence of measurement bias. The CFA supported the original four-factor ILS structure, with excellent internal consistency for the knowledgeable, supportive, and perseverant subscales and fair consistency for the proactive subscale. Further, the demonstrated measurement invariance between management and staff highlights the robustness of the ILS and its potential for assessing alignment or discrepancies in perceptions of implementation leadership between management and staff within food retail organizations.

Conclusions: Findings suggest that the adapted ILS is a valid and reliable tool for measuring implementation leadership support for nutrition incentive programs in a food retail setting in the US. Future research should examine the adapted ILS across diverse food retail environments and healthy food retail strategies to improve its generalizability and applicability.

Background: Social factors shape health behaviors and contribute to persistent inequalities, especially in the Global South. However, few studies have examined how intersecting social identities influence physical activity in low- and middle-income countries. This study explored social inequalities in leisure-time (LTPA) and transport physical activity (TRPA) through the lens of intersectionality among individuals living in São Paulo, Brazil.

Methods: Longitudinal data from 978 participants of the Health Survey of São Paulo: Physical Activity and Environment cohort were analyzed from three waves: 2014/2015, 2020/2021, and 2023/2024. Physical activity was measured using the long-form International Physical Activity Questionnaire (IPAQ). To capture intersectional social disadvantage, a Multiple Jeopardy Index was constructed by combining sex, race/skin color, and educational level, with scores ranging from 0 (lower vulnerability) to 4 (higher vulnerability). Associations between Jeopardy Index and physical activity in both domains were assessed using multilevel Poisson regression models, considering repeated measures nested within three hierarchical levels: observations, individuals, and census tracts.

Results: Individuals in the highest vulnerability groups (female, belonging to racial or ethnic minority groups, and with low educational attainment) consistently reported lower levels of LTPA over time. In fully adjusted models, participants in higher vulnerability Jeopardy categories 3 and 4 showed significantly lower prevalence of LTPA compared to the lower vulnerability reference group (category 0: male, White, and highly educated), with prevalence ratios of 0.72 (95% CI: 0.57-0.91) and 0.62 (95% CI: 0.49-0.80), respectively. A clear inverse gradient and significant dose-response trend was observed (p < 0.001). Regarding TRPA, prevalence was higher among males and younger participants, and also more frequent among individuals from racialized or minority groups and those with a high school education. However, no significant associations were found between the Jeopardy Index and TRPA in any model.

Conclusions: Persistent and widening inequalities in LTPA were observed among Brazilians over a 10-year period, with intersections of sex, race/skin color, and education disproportionately affecting the most vulnerable groups, particularly women from racialized or minority groups with lower educational attainment. Public policies and programs should prioritize socially disadvantaged groups by promoting inclusive and sustained opportunities for leisure-time activity.

Background: Food parenting practices play a vital role in shaping children's food intake, yet evidence linking fathers' earlier diet patterns to later parenting is limited. This study examined the association between fathers' diet quality patterns during their adolescence and food parenting practices during fatherhood.

Methods: Data were drawn from Fathers & Families (F&F), a father-based cohort that recruited participants from an ongoing cohort in the United States that has followed participants since adolescence. Participants (n = 584) reported their dietary intake during adolescence (ages 10-18) using a Youth/Adolescent Food Frequency Questionnaire across multiple survey waves (1996-2011), and reported their food parenting practices using an online survey completed in 2021-2022. Fathers' diet quality patterns during their adolescence were derived from Healthy Eating Index-2020 (HEI-2020) scores using sequence analysis and hierarchical clustering. Associations between these adolescent diet quality patterns and food parenting practices (coercive control, structure, autonomy support) were estimated with ordinal logistic regression, adjusting for sociodemographic covariates and family meal frequency measured during adolescence.

Results: Three diet quality patterns were identified in adolescence: Low HEI-2020 (50.0%), Declining HEI-2020 (36.5%), and Increasing HEI-2020 (13.5%). Compared to those with Low HEI-2020, fathers demonstrating Increasing HEI-2020 had higher odds of using supportive food parenting practices with their preschool-aged children including higher use of structure-based food parenting practices (OR = 1.93, 95%CI [1.18-3.18]) and lower use of coercive control-based food parenting practices (OR = 0.57, 95%CI [0.36-0.91]).

Conclusions: Improving men's diet quality during adolescence may have enduring benefits, promoting not only healthier adult eating patterns but also more supportive food parenting practices as fathers.