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Ecologic models suggest that multiple levels of influencing factors are important for determining physical activity participation and include individual, social, and environmental factors. The purpose of this qualitative study was to use an ecologic framework to gain a deeper understanding of the underlying behavioral mechanisms that influence physical activity adoption among ethnic minority women. Eighteen African American and Hispanic women completed a 1-hour in-depth interview. Verbatim interview transcripts were analyzed for emergent themes using a constant comparison approach. Women were middle-aged (age M = 43.9 ± 7.3 years), obese (body mass index M = 35.0 ± 8.9 kg/m2), and of high socioeconomic status (88.9% completed some college or more, 41.2% reported income >$82,600/year). Participants discussed individual factors, including the need for confidence, motivation and time, and emphasized the importance of environmental factors, including their physical neighborhood environments and safety of and accessibility to physical activity resources. Women talked about caretaking for others and social support and how these influenced physical activity behavior. The findings from this study highlight the multilevel, interactive complexities that influence physical activity, emphasizing the need for a more sophisticated, ecologic approach for increasing physical activity adoption and maintenance among ethnic minority women. Community insight gleaned from this study may be used to better understand determinants of physical activity and develop multilevel solutions and programs guided by an ecologic framework to increase physical activity in ethnic minority women. [ABSTRACT FROM AUTHOR]

Innovative and empirically tested strategies are needed to define and understand obesity prevention and reduction in a transcultural society. This manuscript describes the development of Science & Community, a partnership developed over a 3-year period with the end goal of implementing a community-based participatory research (CBPR) trial to reduce and prevent obesity. Outreach strategies focused on promoting the project via existing and new channels and identifying and contacting potential partners using established strategies. Science & Community developed and fostered partnerships by hosting a series of interactive meetings, including three Opportunity Receptions, four Community Open Forum Symposia, and quarterly Community Advisory Board (CAB) meetings. Opportunity Reception (N = 62) and Symposia attendees (N = 103) represented the diversity of the community, and participants reported high satisfaction with content and programming. From these events, the CAB was formed and was comprised of 13 community representatives. From these meetings, a Partnership representing 34 organizations and 614 individuals emerged that has helped to guide the development of future proposals and strategies to reduce obesity in Houston/Harris County. [ABSTRACT FROM AUTHOR]

Virtual worlds (VW) present an exciting range of possibilities for health researchers and practitioners. The value of this technology lies its ability to tap into non-traditional participant pools, to use innovative and effective forms of social interaction, and to facilitate cost-effective solutions to common challenges. The International Health Challenge (IHC) was a health intervention study done entirely in the VW of Second Life (SL) aimed at determining the feasibility and effect of obesity prevention interventions in VWs. The IHC initially started as a strategy to develop a multicultural obesity prevention project in SL as evidenced by a full service build, activities, and participating resident avatars. Using existing resources and extensive social networks, together with volunteer assistance, the IHC flourished into a full scale health intervention with the goals of improving health knowledge, attitudes and behavior among resident avatars. In the absence of clear technological and methodological precedence, our multidisciplinary team developed a novel system of in-world and Web-based interactive measurement tools, data management solutions, and participant recruitment and retention strategies. [ABSTRACT FROM AUTHOR]

Purpose: Health-related quality of life (HRQOL) among older cancer survivors can be impaired by factors such as treatment, comorbidities, and social challenges. These HRQOL impairments may be especially pronounced in rural areas, where older adults have higher cancer burden and more comorbidities and risk factors for poor health. This study aimed to assess rural–urban differences in HRQOL for older cancer survivors and controls. Methods: Data came from Surveillance, Epidemiology, and End Results-Medicare Health Outcomes Survey (SEER-MHOS), which links cancer incidence from 18 U.S. population-based cancer registries to survey data for Medicare Advantage Organization enrollees (1998–2014). HRQOL measures were 8 standardized subscales and 2 global summary measures. We matched (2:1) controls to breast, colorectal, lung, and prostate cancer survivors, creating an analytic dataset of 271,640 participants (ages 65+). HRQOL measures were analyzed with linear regression models including multiplicative interaction terms (rurality by cancer status), controlling for sociodemographics, cohort, and multimorbidities. Results: HRQOL scores were higher in urban than rural areas (e.g., global physical component summary score for breast cancer survivors: urban mean = 38.7, standard error [SE] = 0.08; rural mean = 37.9, SE = 0.32; p < 0.05), and were generally lower among cancer survivors compared to controls. Rural cancer survivors had particularly poor vitality (colorectal: p = 0.05), social functioning (lung: p = 0.05), role limitation-physical (prostate: p < 0.01), role limitation-emotional (prostate: p < 0.01), and global mental component summary (prostate: p = 0.02). Conclusion: Supportive interventions are needed to increase physical, social, and emotional HRQOL among older cancer survivors in rural areas. These interventions could target cancer-related stigma (particularly for lung and prostate cancers) and/or access to screening, treatment, and ancillary healthcare resources. [ABSTRACT FROM AUTHOR]

Examine the prevalence of body weight perception discordance, and its relationship with physical activity and mental health among college women. 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. 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. 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. [ABSTRACT FROM AUTHOR]

Large denominational faith-based organizations (FBOs, e.g., conferences, dioceses) have potential to impact population health, though current activities are largely unknown. This study examined how large denominational FBOs approach health promotion programming and relevant barriers and issues related to capacity. A self-report survey via email and mail collected responses from representatives of FBOs about their health programming. The sample (n = 154) was diverse and included Catholic, Presbyterian, and Lutheran traditions. The most common activities were inclusion of health-related topics at organizational events and the provision of educational resources. Working with FBOs at a macro-level has potential implications for population-level health improvements. [ABSTRACT FROM AUTHOR]

This study tested the hypothesized stress-buffering effects of social support on physical activity, sitting time, and blood lipid profiles. 537 college students. College students volunteered to self-report stress, social support for exercise, physical activity and sitting time, and provided blood samples to assess lipid profiles in this cross-sectional study. Lower stress was associated with higher vigorous physical activity (β = −0.1, t = −2.9, p =.004). Higher social support was associated with higher moderate (β = 0.2, t = 2.0, p =.042), vigorous (β = 0.5, t = 5.4, p <.001), and total (β = 0.1, t = 3.2, p =.001) physical activity, and lower sitting time on weekdays (β = −0.1, t = −3.3, p =.001) and weekends (β = −0.2, t = −3.6, p <.001). Social support moderated the association between stress and sitting time on weekdays. Stress reduction and fostering social support may be important strategies for promoting physical activity and reducing sedentary behaviors in college students. Additional strategies are needed to buffer the deleterious effects of stress. [ABSTRACT FROM AUTHOR]

We examined the prevalence of psychological outcomes (i.e., symptoms of depression and anxiety) by age and age-varying associations between physical activity and psychological outcomes among rural cancer survivors. Participants (N = 219; ages 22–93) completed sociodemographic, psychological, and physical activity questionnaires. Time-varying effect models estimated the prevalence of psychological outcomes and assessed associations between physical activity and psychological outcomes as a flexible function of age. Depression and anxiety symptoms decreased with age among cancer survivors aged 22–40 years and were relatively stable across age among those > 40 years. Positive associations between vigorous physical activity and psychological outcomes in those aged 22–40 years were identified. In those > 70–80 years, there were negative associations between vigorous physical activity and psychological outcomes. Results suggest there is variation across age in the associations between physical activity and psychological outcomes among rural survivors. Future research should further explore these age-varying relationships to identify important intervention targets. [ABSTRACT FROM AUTHOR]

Background: This scoping review summarized research on (a) seasonal differences in physical activity and sedentary behavior, and (b) specific weather indices associated with those behaviors. Methods: PubMed, CINAHL, and SPORTDiscus were searched to identify relevant studies. After identifying and screening 1459 articles, data were extracted from 110 articles with 118,189 participants from 30 countries (almost exclusively high-income countries) on five continents. Results: Both physical activity volume and moderate-to-vigorous physical activity (MVPA) were greater in summer than winter. Sedentary behavior was greater in winter than either spring or summer, and insufficient evidence existed to draw conclusions about seasonal differences in light physical activity. Physical activity volume and MVPA duration were positively associated with both the photoperiod and temperature, and negatively associated with precipitation. Sedentary behavior was negatively associated with photoperiod and positively associated with precipitation. Insufficient evidence existed to draw conclusions about light physical activity and specific weather indices. Many weather indices have been neglected in this literature (e.g., air quality, barometric pressure, cloud coverage, humidity, snow, visibility, windchill). Conclusions: The natural environment can influence health by facilitating or inhibiting physical activity. Behavioral interventions should be sensitive to potential weather impacts. Extreme weather conditions brought about by climate change may compromise health-enhancing physical activity in the short term and, over longer periods of time, stimulate human migration in search of more suitable environmental niches. [ABSTRACT FROM AUTHOR]

Social connectedness generally buffers the effects of stressors on quality of life. Is this the case for cancer-related debt among rural cancer survivors? Drawing on a sample of 135 rural cancer survivors, we leverage family/friend informal caregiver network data to determine if informal cancer caregivers buffer or exacerbate the effect of cancer-related debt on mental-health-related quality of life (MHQOL). Using data from the Illinois Rural Cancer Assessment, a survey of cancer survivors in rural Illinois, we estimate the association between cancer-related debt and MHQOL and whether informal caregiver network size and characteristics moderate this association. Over a quarter of survivors (27%) reported cancer-related debt, and those who did reported worse MHQOL. However, this association only held for survivors who had an informal caregiver network. These findings supplement what is already known about the role of social connectedness in cancer survivors' health outcomes. We offer possible explanations for these findings. [ABSTRACT FROM AUTHOR]

Background: Previous reviews of rural physical activity interventions were focused on intervention effectiveness and had reported overall mixed findings. The purpose of this systematic review was to apply the Reach, Efficacy, Adoption, Implementation and Maintenance (RE-AIM) framework to evaluate the extent to which rural physical activity interventions in the U.S. have reported on dimensions of internal and external validity and to offer suggestions for future physical activity interventions for rural U.S. populations. Methods: Pubmed, PsychINFO, CINAHL, PAIS, and Web of Science were searched through February 2019 to identify physical activity intervention studies conducted in rural regions in the U.S. with adult populations. Titles, abstracts, and full texts of articles were reviewed against inclusion and exclusion criteria. Data extraction from included articles included a summary of study details, rural classification system used, and the presence or absence of a total 61 RE-AIM indicators, including reach (n = 13), efficacy/effectiveness (n = 10), adoption (n = 21), implementation (n = 9), and maintenance (n = 8). Results: A total of 40 full-text articles representing 29 unique studies were included. Classifications of rurality included self-statements by authors (n = 19, 65.5%), population/census-based definitions (n = 3, 10.3%), Rural Urban Continuum Codes (n = 3, 10.3%), Rural Urban Commuting Area codes (n = 2, 6.9%), the 2014 Alabama Rural Health Association classification system (n = 1, 3.4%) and the U.S. Office of Management and Budget classification system (n = 1, 3.4%). Individual studies reported between 14.8 to 52.5% of total RE-AIM indicators. Studies reported 15.4 to 84.6% indicators for reach; 20.0 to 70.0% indicators for efficacy/effectiveness; 4.8 to 47.6% indicators for adoption; 11.1 to 88.9% indicators for implementation; and 0 to 25.0% indicators for maintenance. Conclusions: We found an overall poor reporting of components related to external validity, which hinders the generalizability of intervention findings, and a lack of consistency in the definition of rurality. Future research should focus on balancing factors of internal and external validity, and should aim to develop a greater understanding of how rurality influences health and behavior to provide contextual knowledge needed to advance the translation of physical activity interventions into practice in rural communities and reduce rural health disparities. Trial registration: The review protocol was registered with PROSPERO: CRD42019116308. [ABSTRACT FROM AUTHOR]

BACKGROUND We describe the development of sustainability via active garden education (SAGE), an early care and education (ECE) garden‐based curriculum developed from a 5‐year community partnership to link national health policy guidelines with ECE accreditation standards. METHODS: National health guidelines and ECE accreditation standards were reviewed, and community advisory board members, ECE staff, and parents provided feedback and support throughout the development of the curriculum. The SAGE curriculum components were guided by the Ecologic Model of Physical Activity and Social Cognitive Theory. Strengths‐weaknesses‐opportunities‐threat analyses were used to refine and revise the curriculum to overcome challenges to implementation. RESULTS: Twelve 1‐hour, developmentally appropriate, modularized lessons were created using the garden as a metaphor for human development. Lessons featured songs, simple games, pretend play, modeling, and garden activities. Parents were engaged via weekly newsletters with information about activities in the classroom, strategies to improve health habits at home, and free community resources. CONCLUSION: SAGE partnered scientific theory and rigor with community ingenuity and innovation to create a clear translation of policy guidelines to easily implementable practice in a fun and engaging manner. [ABSTRACT FROM AUTHOR]

Objective: Physical activity is important for health, yet most young adults are insufficiently active. Physical activity is regulated in part, by habit, typically operationalised as automaticity. Little is known about the characteristics of automaticity, or whether broad bandwidth unidimensional measures of automaticity for physical activity are superior to narrower bandwidth multi- dimensional measures. Design: This secondary analysis ( N  = 238) investigated the nature of automaticity, and relations between the dimensions of automaticity, global automaticity, and physical activity. Main Outcome Measures: The structure of the Generic Multifaceted Automaticity Scale (GMAS) was examined by confirmatory factor analyses. Structural equation models were estimated to evaluate relations between automaticity (measured on the GMAS and the Self- Report Behavioral Automaticity Index, SRBAI) and device- measured activity. Results: The hypothesised 3- factor structure of the GMAS was rejected, in favour of a 2- factor solution. Lack of intention/control and efficiency were associated with global automaticity, but not physical activity. Global automaticity was associated with moderate to vigorous physical activity and daily steps, but not light physical activity. Conclusion: Multi- dimensional measures of automaticity may not provide a more nuanced understanding of automaticity when predicting overall physical activity.