Meaningful use of COMSAE Phase 1 in preparation for COMLEX-USA Level 1.

CONTEXT: The Comprehensive Osteopathic Medical Licensing Examination of the United States (COMLEX-USA) is a three level national standardized licensure examination for the practice of osteopathic medicine. The Comprehensive Medical Self Assessment Examination (COMSAE) is a three phase self assessment tool designed to gauge the base knowledge and ability of candidates preparing for COMLEX-USA. OBJECTIVES: To investigate how COMSAE Phase 1 (Phase 1) was used by candidates and how completing Phase 1 impacted their performance on the COMLEX-USA Level 1 (Level 1) examination. METHODS: Using data from the 2018-2019 administration of Level 1 and Phase 1 examinations, we counted the frequency of the unique Phase 1 forms taken by the candidates and calculated the correlation between the candidates' first attempt Phase 1 scores and the number of Phase 1 forms taken. We then calculated the correlation between the Level 1 scores and the Phase 1 scores. Next, we applied a multilevel regression model to examine the candidates' score improvement on the multiple Phase 1 forms taken. Finally, we investigated the effect of practicing through Phase 1 on the candidates' Level 1 performance using logistic regression models. RESULTS: The majority of candidates took one (2,414; 33.9%) to two (2,196; 30.8%) timed Phase 1 forms prior to the Level 1 examination. There was a significant negative correlation (r=-0.48, t(6,505)=-44.05, p<0.001) between the candidates' first attempt Phase 1 scores and the number of Phase 1 forms taken. There was a strong and positive correlation (r=0.66 to 0.74, p<0.001) between Phase 1 and Level 1 scores. With other variables controlled, on average, candidates' Phase 1 scores increased 23.2 points on one attempt from the previous attempt. Having the most recent Phase 1 score controlled, a greater number of Phase 1 forms taken was associated with an improvement on the Level 1 performance. CONCLUSIONS: The significant correlation between Phase 1 and Level 1 performance provided validity evidence for Phase 1. Moreover, our results suggested that candidates, especially those with lower performance on their initial Phase 1 attempt, might improve their Level 1 performance by taking multiple Phase 1 forms to monitor their academic improvement and gauge their readiness for Level 1.

Acceptance and Feasibility of Seated Elliptical Pedaling to Replace Sedentary Behavior in Older Adults.

The purpose of this study was to explore the feasibility and acceptability of a seated pedaling device to reduce sedentary behavior (SB) in the homes of older adults. METHODS: Each participant (N = 20) was outfitted with an activity monitor and seated pedaling device in the home for 7 days and randomly assigned to one of four light-intensity pedaling groups (15, 30, 45, and 60 min/day). RESULTS: There was 100% adherence in all groups and significant group differences in the minutes pedaled per day (p < .001), with no significant difference in the total pedaling days completed (p = .241). The 15-, 30-, 45-, and 60-min groups experienced a 4.0%, 5.4%, 10.6%, and 11.3% reduction in SB on the days pedaled, respectively. CONCLUSION: Clinically relevant reductions in SB time were achievable in this 1-week trial. Long-term adherence and the impact of replacing SB with seated light activities on geriatric-relevant health outcomes should be investigated.

Do Stand-Biased Desks in the Classroom Change School-Time Activity and Sedentary Behavior?

The purpose of this study was to determine the effect of stand-biased desks on the physical activity and sedentary behavior of third, fourth and sixth grade students across the school year. Methods: This within classroom crossover design study used teacher-determined allocation for seating within each classroom. Half of the students used a stand-biased desk and half used a sitting desk. Five-day hip-worn accelerometer assessments were completed at baseline and at the end of each nine-week intervention period. A mixed effects model was used to determine the differences in the percentage of time spent active and sedentary. Results: A total of 22, 36 and 41 students in 3rd, 4th and 6th grades, respectively, completed this study (57.1% male, 79.3% White). Regardless of the desk type, students became more sedentary (p < 0.001) and less active (p < 0.001) in the classroom as the school year progressed. After controlling for baseline activity, there was a significant interaction between the type of desk and time (p = 0.029). Students who spent a higher percentage of their classroom time sedentary engaged in less sedentary behavior when using a stand-biased desk compared to the traditional desk. Conclusion: The standing desk intervention was effective in mitigating the increase in sedentary behavior for those who started the school year more sedentary.

Efficacy of an Individually Tailored, Internet-Mediated Physical Activity Intervention in Older Adults: A Randomized Controlled Trial.

OBJECTIVE: This study determined the effectiveness of an individually tailored, Internet-mediated physical activity (PA) intervention for increasing walking behavior in inactive older adults. METHOD: This 12-week randomly controlled intervention divided participants ( N = 170) into three groups: control (CON, n = 51), pedometer only (PED, n = 62), and an individually tailored, Internet-mediated pedometer (TI-PED, n = 57) group. The PED group was instructed to increase weekly step count by 10% until 10,000 steps per day was achieved. The TI-PED group was given the same goal and received tailored feedback via an online platform. Changes in average step count pre-to-post were assessed. RESULTS: Total retention rate at postintervention was 75.3%. PED ( p < .001) and TI-PED ( p < .001) increased step count pre-to-post, which was higher than the CON group at 12 weeks (PED, p < .001; TI-PED, p < .001). The TI-PED group had a higher step count at 12 weeks than the PED group ( p < .001). DISCUSSION: Individually tailored, Internet-mediated PA interventions are an effective way to significantly increase PA in older adults.

Pattern Analysis of Sedentary Behavior Change after a Walking Intervention.

OBJECTIVES: We examined the pattern of change in sedentary behavior (SB) resulting from a physical activity (PA) intervention in older adults, and the influence of sex on changes in SB. METHODS: One hundred twenty (N = 120) inactive older adults from 2 12-week step/day-target interventions were included in this pooled reanalysis. Participants were randomly assigned to an intervention (STEP) or control group (CON). A Hip-worn accelerometer (Actigraph) was used to assess SB and PA. RESULTS: Significant decreases in SB (-25 minutes) were largely accounted for by the increase in moderate- to vigorous-intensity PA (MVPA; +17.3 minutes). More broadly, data showed that for every 1% increase in proportion of time spent in MVPA, SB decreased by 1.21%. Results of the pattern analysis showed significant pre-post decreases in the number of daily sedentary bouts lasting 10, 20, and 30 minutes and the number of sit-to-stand transitions in the STEP group. Males tended to decrease time spent in longer bouts and females tended to decrease the number of sit-to-stand transitions to achieve lower SB. CONCLUSIONS: Decreases in SB were accomplished through reductions in shorter bouts of SB and likely through a variety of small changes that differed between individual participants and sexes.

Development and evaluation of the Internalized Racism in Asian Americans Scale (IRAAS).

This article presents the development and psychometric evaluation of the Internalized Racism in Asian Americans Scale (IRAAS), which was designed to measure the degree to which Asian Americans internalized hostile attitudes and negative messages targeted toward their racial identity. Items were developed on basis of prior literature, vetted through expert feedback and cognitive interviews, and administered to 655 Asian American participants through Amazon Mechanical Turk. Exploratory factor analysis with a random subsample (n = 324) yielded a psychometrically robust preliminary measurement model consisting of 3 factors: Self-Negativity, Weakness Stereotypes, and Appearance Bias. Confirmatory factor analysis with a separate subsample (n = 331) indicated that the proposed correlated factors model was strongly consistent with the observed data. Factor determinacies were high and demonstrated that the specified items adequately measured their intended factors. Bifactor modeling further indicated that this multidimensionality could be univocally represented for the purpose of measurement, including the use of a mean total score representing a single continuum of internalized racism on which individuals vary. The IRAAS statistically predicted depressive symptoms, and demonstrated statistically significant correlations in theoretically expected directions with four dimensions of collective self-esteem. These results provide initial validity evidence supporting the use of the IRAAS to measure aspects of internalized racism in this population. Limitations and research implications are discussed. (PsycINFO Database Record

Increasing the Energy Expenditure of Seated Activities in Older Adults with a Portable Elliptical Device.

BACKGROUND: The ill-health effects of sedentary behavior are becoming well-documented, yet older adults spend 70-80% of waking hours sedentary. PURPOSE: To determine if a portable elliptical device increases energy expenditure (EE) while performing popular seated activities. METHODS: Twenty older adults (68.1 ± 1.4 years) participated to compare the measured EE between seated rest and three randomized seated pedaling activities: computer use, reading, TV viewing. Each pedaling activity included 5-min of self-selected paced/no resistance (SSP) and externally paced/added resistance pedaling (Paced). RESULTS: A significant increase in EE existed during SSP (+1.44 ± 0.12 kcal/min) and Paced (+2.19 ± 0.09 kcal/min) pedaling relative to Seated Rest (p < .001). EE during the Paced activities was significantly greater than all SSP activities (p <.01). CONCLUSION: Extrapolating these results, pedaling at a SSP for an hour while performing seated activities is equivalent to the net EE of walking 1.6 miles. Future home-based effectiveness and feasibility should be explored.

The Effects of a Lifetime Physical Fitness (LPF) Course on College Students' Health Behaviors.

The purpose of this study was to examine motivational constructs and the effect of physical activity engagement on health behaviors in college students who were required to take a 15-week lifetime physical fitness (LPF) course for graduation. A total of fifty-eight first and second year college students aged between 17 and 23 years (M=18.72; SD=1.09). Paper and pencil questionnaires were anonymously administered at the beginning and at the end of the 15-week long spring 2012 semester. Analysis of the differences between the beginning and the end of the semester was completed. Physical activity behaviors and Behavioral Regulations variables did not change across time (p > .05). Appearance (d = -0.34, p = .013) and fitness (d = -0.37, p = .006) reasons for participating in physical activity and all Theory of Planned Behavior variables decreased over time (d = -0.32 to - 0.41, p < .05). Changes in attitude toward physical activity negatively predicted changes in alcohol consumption (r = -.261 to -.357). This study sustains the already existing literature that supports the positive impact of LPF courses offered to college students.

EFFECTS OF LISTENING TO PREFERENTIAL MUSIC ON SEX DIFFERENCES IN ENDURANCE RUNNING PERFORMANCE.

Music is a common accompaniment to exercise, but some running environments do not allow for personalized control over the music stimulus. The purpose of this study was to explore the effects of listening to preferred versus non-preferred music on sex differences in running performance. The sample consisted of 20 women and 15 men (M = 20.7 yr., SD = 2.3) who reported running at least once per week over the previous year. The participants completed three 12-min. Cooper Tests (i.e., aerobic fitness test) accompanied by preferred, non-preferred, or no music in randomized order. A 2 × 2 repeated-measures analysis of covariance (ANCOVA) was used to test the effect of music preference and sex on endurance running performance while controlling for the distance run with no music. Women ran further in the preferred music condition. However, music selection did not significantly change running performance for men. Listening to preferred instead of non-preferred music had a larger effect on the endurance running performance of women than men.

Prompts to disrupt sitting time and increase physical activity at work, 2011-2012.

INTRODUCTION: The objective of this study was to assess change in sitting and physical activity behavior in response to a workplace intervention to disrupt prolonged sitting time. METHODS: Sixty office workers were randomized to either a Stand group (n = 29), which received hourly prompts (computer-based and wrist-worn) to stand up, or a Step group (n = 31), which received the same hourly prompts and an additional prompt to walk 100 steps or more upon standing. An ActivPAL monitor was used to assess sitting and physical activity behavior on the same 3 consecutive workdays during baseline and intervention periods. Mixed-effect models with random intercepts and random slopes for time were performed to assess change between groups and across time. RESULTS: Both groups significantly reduced duration of average sitting bouts (Stand group, by 16%; Step group, by 19%) and the number of sitting bouts of 60 minutes or more (Step group, by 36%; Stand group, by 54%). The Stand group significantly reduced total sitting time (by 6.6%), duration of the longest sitting bout (by 29%), and number of sitting bouts of 30 minutes or more (by 13%) and increased the number of sit-to-stand transitions (by 15%) and standing time (by 23%). Stepping time significantly increased in the Stand (by 14%) and Step (by 29%) groups, but only the Step group significantly increased (by 35%) the number of steps per workday. Differences in changes from baseline to intervention between groups were not significant for any outcome. CONCLUSION: Interventions that focus on disrupting sitting time only in the workplace may result in less sitting. When sitting time disruptions are paired with a physical activity prompt, people may be more likely to increase their workday physical activity, but the effect on sitting time may be attenuated.

Feasibility of retrofitting a university library with active workstations to reduce sedentary behavior.

BACKGROUND: Libraries are an inherently sedentary environment, but are an understudied setting for sedentary behavior interventions. PURPOSE: To investigate the feasibility of incorporating portable pedal machines in a university library to reduce sedentary behaviors. METHODS: The 11-week intervention targeted students at a university library. Thirteen portable pedal machines were placed in the library. Four forms of prompts (e-mail, library website, advertisement monitors, and poster) encouraging pedal machine use were employed during the first 4 weeks. Pedal machine use was measured via automatic timers on each machine and momentary time sampling. Daily library visits were measured using a gate counter. Individualized data were measured by survey. Data were collected in fall 2012 and analyzed in 2013. RESULTS: Mean (SD) cumulative pedal time per day was 95.5 (66.1) minutes. One or more pedal machines were observed being used 15% of the time (N=589). Pedal machines were used at least once by 7% of students (n=527). Controlled for gate count, no linear change of pedal machine use across days was found (b=-0.1 minutes, p=0.75) and the presence of the prompts did not change daily pedal time (p=0.63). Seven of eight items that assessed attitudes toward the intervention supported intervention feasibility (p<0.05). CONCLUSIONS: The unique non-individualized approach of retrofitting a library with pedal machines to reduce sedentary behavior seems feasible, but improvement of its effectiveness is needed. This study could inform future studies aimed at reshaping traditionally sedentary settings to improve public health.

Self-determined Engagement in Physical Activity and Sedentary Behaviors of US College Students.

Although the importance of promoting physical activity is well established, researchers have recently considered "sedentary behaviors" as another key risk factor for chronic disease. However, little is known about the motivational processes regulating sedentary behavior on a daily basis. A substantial amount of research has been based on the self-determination theory to examine the motivational processes regulating physical activity behaviors. However, only limited attention has been paid to sedentary behaviors from this theoretical perspective. This study aims to identify and understand motivational aspects related to sedentary behavior from a self-determination perspective. A convenience sample of undergraduate students (N=875) enrolled in a university required Lifetime Physical Activity and Fitness class completed an online survey which inquired about physical activity and sedentary behaviors as well as about motivational variables related to these behaviors. Physical activity variables were inversely and only slightly related to sedentary behavior (ρ = -.084 to -.146, p < .05). Psychological needs and behavioral regulations together explained 14.3% of the variance in moderate-to-vigorous physical-activity (p < .001), but only 2.8% of the variance in sedentary behavior (p = .002). These findings suggest physical activity and sedentary behaviors are explained by unique motivational factors.