First-year undergraduate students: depressed, distressed, and drained? Influence of depressive symptoms on markers of psychological well-being, sleep, and physical activity.

Objective: This study examined depressive symptomatology (DS) across the academic year in first-year undergraduate students and the influence of DS on anxiety, stress, body esteem, physical activity, and sleep. Participants: Participants were first-year undergraduate students (N= 164). Methods: Participants completed validated self-report measures each quarter. A repeated measures ANCOVA was conducted to examine changes in DS over time. Students were categorized as reporting subclinical (SCD) or clinical (CD) depressive symptoms. A repeated measures MANCOVA was conducted to examine the effect of time and DS groups on primary outcomes. Results: No significant main effects of time were observed for outcomes. Significant between-subjects effects were observed with CD participants reporting significantly higher anxiety and stress and lower sleep than SCD participants. Conclusions: First-year undergraduates with CD may have increased risk for negative markers of psychological and physical health outcomes. Universities should prioritize the psychological and physical health of their first-year students.

Physical activity motives and self-efficacy to overcome physical activity barriers in first-year undergraduates: Do they differ based on physical activity levels?

Objective: Physical activity (PA) declines during the transition to university. Identifying contributing factors is imperative. Participants: Participants were first-year undergraduate students (N = 283). Methods: Participants completed validated surveys. Participants were categorized as meeting PA guidelines or not meeting PA guidelines. MANCOVA's with Bonferroni correction and Kruskal Wallis tests examined differences in PA motives and self-efficacy to overcome PA barriers across PA groups. Results: Significant multivariate effects were observed across PA groups for PA motives and self-efficacy. Univariate analyses revealed students meeting PA guidelines reported significantly higher PA motives of fitness/health management, appearance/weight management, and stress/mood management compared to students not meeting PA guidelines. Students meeting PA guidelines reported significantly higher self-efficacy for all PA barriers compared to students not meeting PA guidelines. Conclusions: Universities should prioritize education about the physical and psychological benefits of PA and teach first-year students behavioral skills to increase PA motivation, self-efficacy, and PA behavior.

Replacing Sedentary Time with Physically Active Behaviour Predicts Improved Body Composition and Metabolic Health Outcomes.

BACKGROUND: Discretionary leisure time for health-promoting physical activity (PA) is limited. This study aimed to predict body composition and metabolic health marker changes from PA reallocation using isotemporal substitution analysis. METHODS: Healthy New Zealand women (n = 175; 16-45 y) with high BMI (≥25 kg/m2) and high body fat percentage (≥30%) were divided into three groups by ethnicity (Maori n = 37, Pacific n = 54, and New Zealand European n = 84). PA, fat mass, lean mass, and metabolic health were assessed. Isotemporal substitution paradigms reallocated 30 min/day of sedentary behaviour to varying PA intensities. RESULTS: Reallocating sedentary behaviour with moderate intensity, PA predicted Maori women would have improved body fat% (14.83%), android fat% (10.74%), and insulin levels (55.27%) while the model predicted Pacific women would have improved waist-to-hip (6.40%) and android-to-gynoid (19.48%) ratios. Replacing sedentary time with moderate-vigorous PA predicted Maori women to have improved BMI (15.33%), waist circumference (9.98%), body fat% (16.16%), android fat% (12.54%), gynoid fat% (10.04%), insulin (55.58%), and leptin (43.86%) levels; for Pacific women, improvement of waist-to-hip-ratio (5.30%) was predicted. CONCLUSIONS: Sedentary behaviour must be substituted with PA of at least moderate intensity to reap benefits. Maori women received the greatest benefits when reallocating PA. PA recommendations to improve health should reflect the needs and current activity levels of specific populations.

Compendium of Health and Wellness Coaching: 2019 Addendum.

The 2019 Addendum, in conjunction with the original health and wellness coaching (HWC) Compendium, organizes HWC literature with the aim of assisting researchers while providing a resource for practitioners. The 2019 Addendum to the HWC Compendium extends the initial work by adding HWC-related literature published in the past 2 years. The 2019 Addendum divides articles retrieved into 8 categories, including a new miscellaneous section complementing categories examining HWC effects on cancer, cholesterol, diabetes, heart disease, hypertension, obesity, and wellness. The 2019 Addendum again provides in-depth information about the nature, quality, and results from each article in a detailed spreadsheet provided as an electronic appendix. The 2019 Addendum contributes another 104 peer-reviewed coaching-related articles to the HWC Compendium. This most recent research again describes HWC as a favorable intervention with treatment potential in all categories, though only 3 new cancer articles were included in the 2019 Addendum. Trends in HWC (ie, e-coaching and group coaching) are identified, and there is also discussion of future research needs. In conclusion, the field of HWC continues to grow, as does the research describing this clinical practice; the 2019 Addendum to the Compendium of HWC organizes and assists understanding of this literature.

Are all Sedentary Behaviors Equal? An Examination of Sedentary Behavior and Associations with Indicators of Disease Risk Factors in Women.

Sedentary behavior increases risk for non-communicable diseases; associations may differ within different contexts (e.g., leisure time, occupational). This study examined associations between different types of sedentary behavior and disease risk factors in women, using objectively measured accelerometer-derived sedentary data. A validation study (n = 20 women) classified sedentary behavior into four categories: lying down; sitting (non-active); sitting (active); standing. A cross-sectional study (n = 348 women) examined associations between these classifications and disease risk factors (body composition, metabolic, inflammatory, blood lipid variables). Participants spent an average of 7 h 42 min per day in sedentary behavior; 58% of that time was classified as non-active sitting and 26% as active sitting. Non-active sitting showed significant (p ≤ 0.001) positive correlations with BMI (r = 0.244), body fat percent (r = 0.216), body mass (r = 0.236), fat mass (r = 0.241), leptin (r = 0.237), and negative correlations with HDL-cholesterol (r = -0.117, p = 0.031). Conversely, active sitting was significantly (p ≤ 0.001) negatively correlated with BMI (r = -0.300), body fat percent (r = -0.249), body mass (r = -0.305), fat mass (r = -0.320), leptin (r = -0.259), and positively correlated with HDL-cholesterol (r = 0.115, p = 0.035). In summary, sedentary behavior can be stratified using objectively measured accelerometer-derived activity data. Subsequently, different types of sedentary behaviors may differentially influence disease risk factors. Public health initiatives should account for sedentary classifications when developing sedentary behavior recommendations.

Mobile Health Technology in Prenatal Care: Understanding OBGYN Providers' Beliefs about Using Technology to Manage Gestational Weight Gain.

OBJECTIVES: High gestational weight gain (GWG) is linked to adverse maternal/infant outcomes. Scant research has examined OB/GYN providers': 1) beliefs and barriers to using mobile health (mHealth) technology and 2) their perceptions of patient beliefs/barriers for using mHealth technology for managing GWG. METHODS: Semi-structured interviews and focus groups with OB/GYN providers (N = 25) were conducted in person and via telephone. Principles of thematic analysis were used to content analyze the interviews; sample size was determined via data saturation. RESULTS: Most providers didn't use technology when providing prenatal care (94%), recommended public websites for patients to obtain health information (72%), and reported a smartphone/tablet as the ideal tool for clinical care (83%). Providers also believed mHealth tools would be beneficial for high risk patients (e.g., overweight/obese; 67%). For the use of mHealth tools in clinical care, the most salient provider barriers were lack of time (78%), costs (61%), facility/technology issues (56%), and lack of provider willingness to adapt to change (44%). The most important provider-perceived patient barriers were access (72%) and lack of interest (67%). CONCLUSIONS FOR PRACTICE: These findings suggest some OB/GYN providers may be open to using mHealth technology in prenatal clinics to help their patients manage GWG if the technology is time efficient and both providers and patients can overcome barriers. The success of incorporating mHealth technology for diet/exercise counseling in prenatal clinics will lie in making it time efficient and interesting for the patient. Novel strategies to overcome provider and patient barriers are essential.

A Prospective Examination of Physical Activity Predictors in Pregnant Women with Normal Weight and Overweight/Obesity.

BACKGROUND: Scant research has examined the relationship between exercise behavior and weight status in pregnant women. METHODS: A prospective study was conducted in which pregnant women (N = 332) completed self-report measures at each trimester. Repeated measures multivariate analysis of covariance (controlling for race, education, and parity) examined changes in the motivational determinants of exercise over time and by weight status. Regression analyses were conducted to understand how the motivational determinants predicted exercise behavior and to examine the impact of prepregnancy weight status. RESULTS: A significant main effect for time was observed, with an increase in early pregnancy followed by a decrease in late pregnancy for the motivational determinants of exercise and exercise behavior. A significant main effect for weight status was observed such that normal weight pregnant women had significantly greater attitude and intention for exercise when compared with pregnant women with overweight/obesity. The primary predictors of intention were perceived behavioral control (first to second trimester) and attitude (second to third trimester). The primary predictor of exercise behavior was intention. Prepregnancy weight status provided no unique contributions. CONCLUSIONS: Findings from this study suggest that interventions designed to promote exercise in pregnancy should consider targeting perceived behavioral control in early pregnancy and attitude in later pregnancy. Improving exercise attitude in women with overweight or obesity may further strengthen their motivation to be active in pregnancy. Customized interventions may need to be designed to address the unique needs of women because their motivational determinants change over the course of pregnancy.

Falling Short of Guidelines? Nutrition and Weight Gain Knowledge in Pregnancy.

OBJECTIVES: The objective of this study was to characterize pregnant women's gestational weight gain (GWG) knowledge and awareness of healthy eating behaviors known to impact GWG. METHODS: Formative research was conducted including semi-structured individual interviews and focus group interviews. The participants were mostly Caucasian pregnant women (N = 30; Mage = 28 years old) residing in a suburban/rural region of Central Pennsylvania. Descriptive and thematic analyses were used to examine the primary outcomes of GWG and healthy eating knowledge and informational sources. RESULTS: Many women had no knowledge of how much GWG they should gain in pregnancy (42%). Women appeared to have adequate knowledge on foods they should avoid eating during pregnancy. However, one-fourth of women indicated that they did not feel as though they received adequate information from their healthcare provider about the foods they should be eating and how to meet the healthy eating recommendations. Therefore, one-fourth of women reported using non-healthcare provider resources (e.g., magazines, internet) with questionable reliability to obtain healthy eating guidance. CONCLUSION: These exploratory findings show that pregnant women have some knowledge of the GWG and healthy eating guidelines; however, most women received this information from a non-healthcare provider resource. Focused efforts are needed to educate pregnant women about GWG and healthy eating using accurate and reliable sources andencourage strategies to meet guidelines in an effort to promote healthy GWG.

Mediating effects of body image satisfaction on exercise behavior, depressive symptoms, and gestational weight gain in pregnancy.

BACKGROUND: Body image satisfaction in pregnancy may have an important influence on maternal biopsychosocial outcomes. PURPOSE: This study aims to examine the mediating influence of trimesters 2 and 3 body image satisfaction on trimesters 2 and 3 depressive symptoms, exercise behavior, and gestational weight gain. METHODS: Pregnant women (N = 151; mean age = 30) prospectively completed study measures via mail during their 1st, 2nd, and 3rd trimesters. RESULTS: As predicted, trimesters 2 and 3 body image satisfaction mediated the relationship between trimester 1 body image satisfaction and trimester 2 depressive symptoms and the relationship between trimester 2 body image satisfaction and trimester 3 depressive symptoms. In contrast to the hypothesis, no mediation was observed for the relationship between body image satisfaction and exercise behavior or gestational weight gain. CONCLUSIONS: These preliminary findings demonstrate that body image satisfaction is an important psychological determinant of depressive symptoms in pregnancy. Promoting healthy body image may be a non-pharmacological strategy that offers protective effects against depressive symptoms during pregnancy.