Domain matters: An examination of college student physical activity participation patterns by gender and race/ethnicity.

BACKGROUND: Physical activity (PA) consists of multiple domains, including leisure-time PA (LTPA), occupational PA (OPA), and transportation PA (TPA), though limited research has examined these domains among college students. METHODS: This cross sectional, online survey asked undergraduate students to self-report demographics (gender, race/ethnicity, employment) and PA (LTPA, TPA, and OPA). Participants were categorized as meeting/not meeting current aerobic PA recommendations with only LTPA and with all domains of PA. Analyses examined differences by domain and demographics. RESULTS: For participants (n = 3732) when only considering LTPA, 79% met recommendations, while considering all forms of PA resulted in 94% of students meeting recommendations. Gender and race/ethnicity differences in the odds of meeting PA recommendations were present with only LTPA, however when considering all PA domains, some disparities were no longer present. CONCLUSIONS: These findings highlight how different domains of activity contribute to overall PA and the relationship with gender and race/ethnicity.

Gender and race/ethnicity differences in occupational activity among students.

Occupational physical activity (OPA) is related to positive health outcomes and meeting overall physical activity recommendations. OPA participation typically varies across racial/ethnic groups and by gender, though little research has examined differences in OPA among college students. A cross-sectional, online survey of college students examined demographics and OPA. Participants (n = 3739) were predominately Non-Hispanic White (77.1%) and female (57.8%) aged 20.97 ± 1.52. Employed students reported greater total PA compared with non-employed students. Males reported significantly greater vigorous OPA, overall OPA, and total PA compared with females. Among employed students, OPA contributed significantly to overall PA levels. Males reported significantly greater OPA compared with females and there were several significant differences by race/ethnicity. Academic performance was related to OPA. These findings provide some insight on the OPA levels of a population group that has not been thoroughly examined.

Physical Activity is Related to Mental Health and Sexual Orientation Among Women in College.

Non-heterosexual women tend to report lower physical activity and poorer mental health than their heterosexual counterparts. The purpose of this study was to examine differences in mental health (stress and depression) and physical activity among female college students by sexual orientation. Students self-reported socio-demographic characteristics, physical activity, perceived stress, and depressive symptoms via an online survey. Correlations, independent samples t-tests, and multiple regression analyses were used to examine relationships between perceived stress, depressive symptoms, physical activity, and sexual orientation. Most participants (n = 1072, 20.0 ± 1.5 years) identified as heterosexual (90.1%), non-Hispanic White (73%), and in their fourth semester or higher. Perceived stress and depressive symptoms differed significantly between heterosexual and non-heterosexual women, but physical activity participation did not. Higher participation in vigorous physical activity and strength training predicted both lower depressive symptoms and lower perceived stress while controlling for sexual orientation. For both heterosexual and non-heterosexual sexual women, depressive symptoms had a positive relationship with perceived stress, and a negative relationship to strength training. Depressive symptoms also had negative correlations with vigorous physical activity among heterosexual women. Findings indicate non-heterosexual women experience greater perceived stress and depressive symptoms, and these mental health issues can have multi-level implications. Greater vigorous physical activity and strength training were associated with lower perceived stress and depression regardless of sexual orientation. Administrators and health promoters should consider ways to promote these forms of physical activity among non-heterosexual women. Further research is needed on the potential barriers impacting engagement in physical activity.

The association between vaping and health behaviors among undergraduate college students in the United States.

Objective: To examine the association between vaping and health behaviors (physical activity, fruit and vegetable consumption, sleep, cigarette use, alcohol consumption) and mental health among college students. Methods: Socio-demographic characteristics, vaping, health behaviors, perceived stress, and depressive symptoms of undergraduates enrolled at a large university located in the Northeast of the United States were assessed via an online survey. Results: Of all participants (n = 1775), less than a fifth (n = 314, 17.7%) reported any vaping in the past month. More men reported vaping than women (23.2% vs. 14.5%). Those who vaped reported fewer nights of restful sleep and greater alcohol consumption. Those who smoked and binge drank were more likely to report vaping. Perceived stress was greater among women who vaped, and depressive symptoms were greater among those who vaped regardless of gender. Conclusions: Vaping was associated with smoking, alcohol consumption, and poorer mental health among young adults.

Power 5 conference institutions' summer transition program physical activity promotion efforts: A review.

Objective: To review the physical activity promotion efforts of Power 5 conference institutions' summer transition programs. Methods: The websites of Power 5 Conference and affiliate member institutions (N = 78) were systematically reviewed and information on summer transition programs pertaining to health were extracted. Results: Most (n = 45, 57.7%) institutions had a summer transition program of some kind. Among those who had summer transition programs, 14 (31.1%) had a nonphysical activity health course (i.e. health and/or nutrition), while courses that incorporated a physical activity component were uncommon (n = 6, 13.3%). Only two institutions covered physical activity, nutrition, and health in at least one offered course. Conclusions: There is an opportunity for tertiary institution-level summer transitional programs to expand coverage to address a currently unmet need for physical activity promotion while avoiding perpetuation of existing inequities.

Freshman physical activity constraints are related to the current health behaviors and outcomes of college upperclassmen.

ObjectiveExamine differences in physical activity (PA) constraints experienced as freshmen among college upperclassmen based on sex, race/ethnicity, adiposity, and fitness. Participants and methods: Upperclassmen (n = 524) from self-reported demographics, PA, subjective changes in PA, and freshman PA constraints via an online survey, and had adiposity and predicted aerobic fitness objectively assessed. Results: Self-reported reductions in PA since high school and freshmen year were associated with a lack of motivation as a freshman, lower current PA levels, and poorer aerobic fitness compared to those who maintained or increased PA. Women were less active than men and reported greater constraints, while non-Hispanic white students had greater vigorous PA than minority students. Multiple regression analyses revealed that motivation constraints predicted PA regardless of sex and race/ethnicity. Conclusions: Findings highlight the importance of college administrators and health promoters alleviating freshman PA constraints, particularly among women, to promote the adoption of an active lifestyle.

The Impact of the COVID-19 Pandemic on US College Students' Physical Activity and Mental Health.

BACKGROUND: Investigating the impact of the COVID-19 pandemic on both physical activity (PA) and mental health is important to demonstrate the need for interventions. This study examined the apparent impact of the pandemic on college students' PA, perceived stress, and depressive symptoms. METHODS: From 2015 through 2020, data were collected at the beginning and end of the spring semester at a large Northeastern US university via an online survey assessing student demographics, PA, perceived stress, and depressive symptoms. Mixed ANOVA examined differences in PA and mental health changes over the spring semester between "normal" and COVID-19 circumstances. Two-way ANOVA examined the interaction between circumstance and changes in PA in relation to changes in mental health. RESULTS: Participants (n = 1019) were predominately women and non-Hispanic white. There was a significant decline in PA and an increase in perceived stress under COVID-19, but not normal, circumstances and a significant increase in depressive symptoms under COVID-19, but not normal, circumstances among women. CONCLUSIONS: A significant decline in PA and mental health among college students occurred under COVID-19 circumstances, and PA did not appear to protect against deterioration in mental health. Proactive and innovative policies, programs, and practices to promote student health and well-being must be explored immediately.

Female college student weight perception discordance.

OBJECTIVES: Examine the prevalence of body weight perception discordance, and its relationship with physical activity and mental health among college women. PARTICIPANTS AND METHODS: Data were collected from a convenience sample of female undergraduates enrolled in general education health and wellness courses at a large, northeastern United States university (n = 1607) via direct email using previously validated measures that assessed: demographics; physical activity; weight goals and perceptions; mental health and sleep; and, physical activity enjoyment, self-efficacy, and goal setting. Analyses included one-way analysis of variance analyses and chi-square tests for independence. RESULTS: Though most women had accurate weight status perceptions (n = 987, 62.6%), there was a tendency to overestimate weight status (n = 482, 31.2%) that was associated with greater depressive symptoms. CONCLUSION: A relatively large minority of women demonstrated discordant weight status perceptions, which were associated with adverse mental health outcomes. Colleges should consider improving healthy weight status perception education among women to improve mental health.

Frequent restful sleep is associated with the absence of depressive symptoms and higher grade point average among college students.

OBJECTIVES: To examine how health behaviors and outcomes differ based on restful nights of sleep among college students. DESIGN: This is a cross-sectional study. SETTING: The study was conducted in a large, northeastern United States university. PARTICIPANTS: The participants include college students (n = 4376), the majority of whom were women (59.2%) and non-Hispanic white (76.1%). MEASUREMENTS: Students completed an online survey, self-reporting sex, height, weight, cumulative grade point average (GPA), physical activity (PA), fruit and vegetable consumption (FVC), substance use, and depressive symptoms, along with nights of restful sleep. Participants were grouped into those who had frequent (≥4 nights/week) or infrequent (<4 nights/week) nights of restful sleep. Analyses included independent sample t-tests, chi-square tests for independence, and logistic regression analyses to compute odds ratios. RESULTS: Parametric analyses indicated a significant, although unmeaningful, association between frequent restful sleep and PA and GPA, but not body mass index or FVC. Nonparametric analyses indicated a positive association between frequent restful sleep and the absence of depressive symptoms. Odds ratios revealed a positive association between the absence of depressive symptoms and GPA with frequent restful sleep. CONCLUSIONS: Findings indicate that restful sleep is associated with the absence of depressive symptoms and higher GPA among college students. Further research is required to examine the relationship, particularly directionality, between the amount of sleep and health behaviors and outcomes. Future researchers should consider using better measures of mental health, dietary quality, and objective measures of sleep and PA were possible. College administrators and health professionals should consider ways in which they can educate students about the benefits of sleep to mental health and academic performance.

Changes in Health Behaviors and Outcomes following Graduation from Higher Education.

The purpose of this study was to examine changes in health behaviors and outcomes of higher education (college) students following graduation. Undergraduate students (n = 206) enrolled at a large, northeastern United States university in general education health and wellness courses were assessed pre and post-graduation. Participants self-reported their demographics, physical activity behaviors, dietary behaviors, sleep, and stress pre and post-graduation via an online survey. Paired sample t-tests examined changes health behaviors pre and post-graduation. Following graduation, fruit and vegetable consumption increased significantly, moderate physical activity declined significantly, and both vigorous physical activity and energy expenditure, as well as weight remained stable. There was a significant reduction in stress, for men but not women, and, an increase in restful nights of sleep among women but not men. College students tended to maintain the seemingly healthy lifestyles they had as students during the period immediately following graduation. Findings highlight the value of general health and wellness courses within college given vigorous physical activity and energy expenditure did not decline following graduation.

Differences in college students' aerobic physical activity and muscle-strengthening activities based on gender, race, and sexual orientation.

Aerobic physical activity and muscle-strengthening activities are beneficial to both physical and mental health, though disparities in these behaviors exist based on social determinants. The purpose of this study was to examine differences in college students' aerobic physical activity and muscle-strengthening activities based on gender, race, and sexual orientation. Undergraduates enrolled in general education health and wellness courses at a large northeastern University in the United States responded to an online survey in August 2018 that assessed their demographics and physical activity behaviors. Differences in physical activity behaviors based on social determinants were examined using independent-samples t-tests and chi-square tests for independence. Less than half (40.3%) of participants (n = 606) met both aerobic physical activity and muscle-strengthening recommendations. No differences were found in physical activity based on sexual orientation. However, significantly more non-Hispanic white participants met aerobic physical activity (74.4% vs. 63.8%) and muscle-strengthening recommendations (47.2% vs. 37.6%); and, men reported significantly greater vigorous physical activity (p = .034, η2 = 0.01) and participation in muscle-strengthening activities (p < .001, η2 = 0.06), and were more likely to meet muscle-strengthening recommendations compared to women (50.8% vs. 41.4%). Findings demonstrate disparities in physical activity based on race and sex, particularly with respect to muscle-strengthening activities. Findings are of concern given the importance of muscle-strengthening activities to both physical and mental health. Colleges should consider ways in which they can facilitate increased participation of racial/ethnic minorities and women in muscle-strengthening activities.

Technology-Based Physical Activity Self-Monitoring Among College Students.

Understanding the relationship between college students' physical activity (PA) self-monitoring and PA levels has the potential to inform initiatives to promote PA. This study's purpose was to examine the prevalence of technology-based self-monitoring among college students the potential relationship between device usage, goal setting behaviors, PA enjoyment, and PA levels. An online survey assessed students' demographics, current PA level, technology-based PA self-monitoring, and psychosocial outcomes. Independent t-tests examined differences in PA level and psychosocial outcomes by device use. 55.5% of the final sample (N=1,154) reported technology-based self-monitoring. Mobile phone app-based PA tracking was the most commonly reported (29.9%), followed by heart rate monitors (23.1%). Device use was significantly related to vigorous PA and psychosocial outcomes. Findings have the potential to inform development of technology-based interventions that promote student PA.

Implementation and evaluation of an Exercise is Medicine™ on campus week.

UNLABELLED: Exercise is Medicine™ (EiM) on campus targets physical activity (PA) participation on college campuses. Limited research has addressed how PA initiatives can be operationalized on college campuses. PURPOSE: To describe the implementation of EiM on a large U.S. university campus and present preliminary outcomes on participation and awareness. METHODS: EiM week was implemented on a large university campus. Exercise stations were set-up at campus locations to encourage brief bouts of PA and educate about the benefits of PA. Evaluation included observations of participation, surveys, and intercept surveys to assess awareness and reach. RESULTS: EiM week was implemented during Fall 2013. Exercise stations elicited 1771 exercise bouts from participants. Surveys indicated widespread reach across the university (13 of 17 colleges); most students (50.8%) became aware of the EiM campaign by passing by the exercise stations. Campus intercept surveys 1-week post-event indicated 54% students had heard about EiM, of which 39% had heard/seen the event through messages encouraging exercise. CONCLUSION: The current study was successful in engaging a large, diverse population on a college campus. Lessons learned from the development, implementation, and evaluation of EiM on campus activities provide insight for university campuses looking to target student health and PA participation.

Military movement training program improves jump-landing mechanics associated with anterior cruciate ligament injury risk.

As part of the physical education program at the United States Military Academy, all cadets complete a movement training course designed to develop skills and improve performance in military-related physical tasks as well as obstacle navigation. The purpose of this study was to determine if completion of this course would also result in changes in jump-landing technique that reduce the risk of anterior cruciate ligament (ACL) injury. Analysis of landing mechanics on a two-footed jump landing from a height of 30 cm with a three-dimensional motion capture system synchronized with two force plates revealed both positive and negative changes. Video assessment using the Landing Error Scoring System (LESS) revealed an overall improved landing technique (p=.001) when compared to baseline assessments. The studied military movement course appears to elicit mixed but overall improved lower extremity jump-landing mechanics associated with risk for ACL injury.

History of shoulder instability and subsequent injury during four years of follow-up: a survival analysis.

BACKGROUND: Little is known about the risk factors for glenohumeral joint instability. We hypothesized that a prior history of instability would be a significant risk factor for subsequent injury. METHODS: We conducted a prospective cohort study over a four-year period within a high-risk group of young athletes to address the research hypothesis. Subjects were freshmen entering the U.S. Military Academy in June of 2006. Part of the baseline assessment included documenting a prior history of glenohumeral instability on entry into the study. All subjects were followed for subsequent glenohumeral joint instability events until graduation in May of 2010. The primary outcome of interest in this study was time to glenohumeral instability event during the follow-up period. We examined injury outcomes, looking for any instability, anterior instability, and posterior instability events. Cox proportional-hazards regression models were used to analyze the data. RESULTS: Among the 714 subjects, eight shoulders were excluded from the analyses due to prior surgical stabilization, leaving 1420 shoulders, of which 126 had a self-reported prior history of instability. There were forty-six (thirty-nine anterior and seven posterior) acute instability events documented in the cohort during the follow-up period. Subjects with a prior history of instability were over five times (p < 0.001) more likely to sustain an acute (anterior or posterior) instability event during the follow-up period. Subjects with a history of instability were also 5.6 times (p < 0.001) more likely to experience a subsequent anterior instability event and 4.6 times (p = 0.068) more likely to experience a posterior instability event during follow-up. Similar results were observed in multivariable models after controlling for the influence of demographic and baseline physical examination findings. CONCLUSIONS: Despite meeting the rigorous physical induction standards for military service, subjects with a prior history of glenohumeral joint instability were approximately five times more likely to experience a subsequent instability event, regardless of direction, within this high-risk athletic population.

Isometric shoulder strength reference values for physically active collegiate males and females.

BACKGROUND: It is common clinical practice to assess muscle strength during examination of patients following shoulder injury or surgery. Strength comparisons are often made between the patient's injured and uninjured shoulders, with the uninjured side used as a reference without regard to upper extremity dominance. Despite the importance of strength measurements, little is known about expected normal baselines of the uninjured shoulder. The purpose of this study was to report normative values for isometric shoulder strength for physically active college-age men and women without history of shoulder injury. METHODS: University students-546 males (18.8 ± 1.0 years, 75.3 ± 12.2 kg) and 73 females (18.7 ± 0.9 years, 62.6 ± 7.0 kg)-underwent thorough shoulder evaluations by an orthopaedic surgeon and completed bilateral isometric strength measurements with a handheld dynamometer. Variables measured included internal rotation, external rotation, abduction, supine internal rotation and external rotation at 45°, and lower trapezius in prone flexion. RESULTS: Significant differences were found between the dominant and nondominant shoulder for internal rotation, internal rotation at 45°, abduction, and prone flexion in males and in internal rotation at 45° and prone flexion for females (P ≤ 0.01).

Clinical descriptive measures of shoulder range of motion for a healthy, young and physically active cohort.

BACKGROUND: The objective of this innovative research study was to describe clinical shoulder complex range of motion (ROM) measures for a young, healthy, and physically active population. This investigation represents a cross-sectional experiment conducted at a military academy-based sports medicine center. Military cadets with no history of shoulder complex injury were assessed within two months of enrollment in the academy; 548 men (18.8 ± 1.0 yr, 75.2 ± 12.2 kg, 178.3 ± 7.4 cm) and 74 women (18.7 ± 0.9 yr, 63.2 ± 8.9 kg, 165.2 ± 6.9 cm) participated. Descriptive measures included cross-body adduction (CAD), flexion (FLX), external rotation (ER0) with the shoulder complex in adduction and elbow flexed to 90°, internal and external rotation (IR, ER) with the shoulder complex at 90° of abduction and elbow flexed to 90° as well as arc (ARC) of IR-ER using standardized clinical quantification techniques. Bilateral and sex differences were evaluated using dependent and independent t-tests, respectively. Percentiles by arm dominance and sex were also calculated for all ROM measures. RESULTS: Data were normally distributed. Active and passive ROM measures indicated significant bilateral differences (P < 0.05) except for ARC. Sex differences (P < 0.05) were noted for active and passive CAD, FLX and ER0 for the dominant arm as well as active and passive CAD, FLX and ARC for the non-dominant arm. CONCLUSIONS: These original data provide descriptive measures for shoulder complex ROM excursions, assisting sports medicine practitioners in potentially identifying clinical deficiencies and functional outcomes following shoulder injury.

Physical examination findings in young athletes correlate with history of shoulder instability.

The goal of this study was to evaluate physical examination findings in a healthy cohort and determine potential correlations with a history of shoulder instability. A cross-sectional analysis was performed using the baseline data for an ongoing prospective cohort study to examine the risk factors for shoulder instability. A complete history of shoulder instability events was obtained, and a blinded physical examination was performed. The cohort comprised 711 patients (627 men, 84 women) with a mean age of 18.8 years. A total of 100 patients had a history of shoulder instability. Patients with a history of instability were more likely to have increased posterior translation (P=.010), positive apprehension sign (P=.003), positive relocation sign (P=.007), and sulcus sign (P=.017).

Pathoanatomy of first-time, traumatic, anterior glenohumeral subluxation events.

BACKGROUND: Relative to dislocations, glenohumeral subluxation events have received little attention in the literature, despite a high incidence in young athletes. The pathoanatomy of first-time, traumatic, anterior subluxation events has not been defined, to our knowledge. METHODS: As part of a prospective evaluation of all cases of shoulder instability sustained during one academic year in a closed cohort of military academy cadets, a total of thirty-eight first-time, traumatic, anterior glenohumeral subluxation events were documented. Clinical subluxation events were defined as incomplete instability events that did not require a manual reduction maneuver. Twenty-seven of those events were evaluated with plain radiographs and magnetic resonance imaging within two weeks after the injury and constitute the cohort studied. Magnetic resonance imaging studies were independently evaluated by a musculoskeletal radiologist blinded to the clinical history. Arthroscopic findings were available for the fourteen patients who underwent arthroscopic surgery. RESULTS: Of the twenty-seven patients who sustained a first-time, traumatic, anterior subluxation, twenty-two were male and five were female, and their mean age was twenty years. Plain radiographs revealed three osseous Bankart lesions and two Hill-Sachs lesions. Magnetic resonance imaging revealed a Bankart lesion in twenty-six of the twenty-seven patients and a Hill-Sachs lesion in twenty-five of the twenty-seven patients. Of the fourteen patients who underwent surgery, thirteen had a Bankart lesion noted during the procedure. Of the thirteen patients who chose nonoperative management, four experienced recurrent instability. Two of the thirteen patients left the academy for nonmedical reasons and were lost to follow-up. The remaining seven patients continued on active-duty service and had not sought care for a recurrent instability event at the time of writing. CONCLUSIONS: First-time, traumatic, anterior subluxation events result in a high rate of labral and Hill-Sachs lesions. These findings suggest that clinical subluxation events encompass a broad spectrum of incomplete events, including complete separations of the articular surfaces with spontaneous reduction. A high index of suspicion for this injury in young athletes is warranted, and magnetic resonance imaging may reveal a high rate of pathologic changes, suggesting that a complete, transient luxation of the glenohumeral joint has occurred.

Association of generalized joint hypermobility with a history of glenohumeral joint instability.

CONTEXT: Little is known about the relationship among sex, generalized joint hypermobility, and glenohumeral joint instability. OBJECTIVE: To examine the relationship among sex, generalized joint hypermobility scores, and a history of glenohumeral joint instability within a young, physically active cohort and to describe the incidence of generalized joint hypermobility within this population. DESIGN: Cross-sectional cohort study. SETTING: United States Military Academy at West Point, New York. PATIENTS OR OTHER PARTICIPANTS: Of the 1311 members of the entering freshman class of 2010, 1050 (80%) agreed to participate. MAIN OUTCOME MEASURE(S): Generalized joint hypermobility was assessed using the Beighton Scale. A history of glenohumeral joint instability was identified via a baseline questionnaire. RESULTS: Most participants (78%) had no signs of generalized joint hypermobility. Only 11 volunteers (1.5%) had Beighton Scale scores of 4 or greater. Logistic regression analysis revealed a relationship between generalized joint hypermobility and a history of glenohumeral joint instability (P = .023). When sex and race were controlled, those with a total Beighton Scale score of >or=2 were nearly 2.5 times as likely (odds ratio = 2.48, 95% confidence interval = 1.19, 5.20, P = .016) to have reported a history of glenohumeral joint instability. A relationship was observed between sex and nearly all individual Beighton Scale items. Although women had higher total Beighton Scale scores than men, sex (P = .658) and race (P = .410) were not related to a history of glenohumeral joint instability when other variables in the model were controlled. CONCLUSIONS: In these participants, generalized joint hypermobility and a history of glenohumeral joint instability were associated.