The transition to college has been identified as a critical period for increases in overweight status. Overweight college students are at-risk of becoming obese adults, thus prevention efforts targeting college age individuals might be one key to reducing adult obesity rates. The current study developed and implemented an intensive, 6-session, internet intervention. This intervention was evaluated with first year college students assigned randomly to one of four treatment conditions: 1) no treatment, 2) 6-week weight and caloric feedback only, 3) 6-week internet intervention, and 4) 6-week combined feedback and internet intervention. As expected, the combined intervention group had lower BMI at post-testing than the internet, feedback, and control groups. The combined intervention showed reduced snacking behaviors after dinner; however, other measures of eating and exercise behaviors and beliefs were not observed. Ethnic and gender differences were observed. African American participants had lower body dissatisfaction than White participants. Further, within the White subsample, the combined intervention group manifested reductions in binge eating symptoms and increased fiber intake compared to controls. Males reported more physical activity across all intervention arms than females. This study demonstrates the effectiveness and feasibility of an internet based intervention to prevent weight gain among college students. Future studies are needed to understand the mechanisms involved in preventing weight gain in this age group and to develop more culturally targeted interventions for diverse students.

Background: Disparities exist in mortality rates in African American breast cancer survivors (AABCS), partly due to modifiable lifestyle behaviors. Gaps remain in developing effective tools to assess AABCS' motivations to prevent weight gain. Conceptual Framework: This research study used the Theory of Planned Behavior (TPB) to guide development of the elicitation study and the AABCS-Weight Gain Prevention Intention Questionnaire (AABCS-WGPIQ). Purpose: Aim One was to use the elicitation approach of the TPB to identify, define and describe AABCS' salient behavioral (advantages/disadvantages), normative (social influence) and control (facilitators/barriers) beliefs related to the prevention of post diagnosis weight gain. Aim Two was to develop and pilot test a questionnaire based on qualitative data to quantify the magnitude of influences of attitudes, subjective norms and perceived behavioral controls related to intentions to prevent weight gain in AABCS. Methods: Guided by the TPB, this cross-sectional, descriptive study used an internet based qualitative elicitation questionnaire to identify salient beliefs of 27 AABCS regarding their motivations to prevent weight gain and inform development of the quantitative AABCS-WGPIQ. Initial psychometric testing of the questionnaire included content and face validity and temporal stability assessment of belief constructs, using the test-retest approach. Findings: Aim One: Motivators to preventing weight gain among AABCS included improving health and well-being (advantages), social support from family and friends (approvals), external support systems, and personal accountability (facilitators). Time and effort required preventing weight gain (disadvantages), lack of social support (disapprovals), and time constraints, lack of accountability, unhealthy eating and health issues (barriers) negatively influenced AABCS' decisions to prevent weight gain. Future interventions aiming to increase motivation to prevent weight gain in AABCS should emphasize positive benefits of preventing weight gain, include social support systems, focus on skill building for time management, planning and goal setting, managing health issues and incorporate weight loss management strategies. Aim Two: The AABCS-WGPIQ has acceptable content validity, face validity and temporal stability of belief constructs. The AABCS-WGPIQ has the potential to be a valid instrument for assessing correlates of weight gain prevention in AABCS. Future research with larger groups of AABCS should include assessing internal consistency and construct validity.

Background Excessive gestational weight gain (GWG) poses significant risk for maternal and neonatal health. Various guidelines have recommended healthy diets and enhancing physical activity during pregnancy to prevent excessive GWG. However, results of intervention studies are inconsistent in the developed countries, and there are no official guidelines and few interventions for GWG in China. This paper aims to review and synthesize relevant studies on diet and physical activity interventions to prevent excessive GWG so that practical suggestions can be provided to public health authorities in China. Methods This systematic review was performed using PubMed, Google and Google Scholar to search all relevant studies in English and randomised controlled trials (RCTs) that investigated diet and physical activity interventions to limit excessive GWG up to May 2014. The quality of included studies was assessed using CONSORT statement and JADAD scale. Results Nine studies describing diet and physical activity interventions to prevent excessive GWG were incorporated in the systematic review. Overall, the contents of interventions were diverse, which consisted of one-to-one counselling, and community-based physical activity interventions. Weekly mailed newsletters and supportive telephone calls were used as assistive tools to remind pregnant women of limiting excessive GWG. Seven studies showed less weight gain in pregnant women receiving the intervention, of which four studies demonstrated a reduction in excessive GWG in women with varying body mass index (BMI) spanning the normal, overweight and obese categories, while three studies reported a reduction of excessive GWG only in normal weight women and obese women need to be paid attention in the future. Conclusions The effectiveness of diet and physical interventions to limit excessive GWG may not be confirmed because of limited quality or sample size of intervention studies. However, studies have demonstrated reduction of excessive GWG during pregnancy, in addition to persistent healthy behaviours following such interventions during pregnancy. Further meta-analyses of RCTs studies should be done to confirm the effectiveness of such interventions among Chinese women. / published_or_final_version / Public Health / Master / Master of Public Health

The increasing prevalence of overweight and obesity suggests that current policies and interventions have been inadequate to counteract the driving forces. Young adults attending college gain weight at a faster rate than the general population, without evidence of compensatory weight loss. Therefore, college may be an important stage for the primary prevention of obesity. We sought to identify weight gain mediators in college underclassmen using the social cognitive model for health behavior change. Eligible students living on-campus to underwent assessments of height, weight, waist circumference, blood pressure, body composition, cardiorespiratory fitness, habitual physical activity and dietary intake, and psychosocial determinants of health behavior change. We conducted elicitation interviews and focus group discussions to identify themes related to the diet and physical activity habits, attitudes, social norms, and experiences of the target population. Results found that students were generally physically fit and enjoyed a variety of physical activities, yet spent considerable amounts of time in sedentary activity and had difficulty exercising regularly. Healthy eating perceptions were instilled by parents; however, families are much less influential in college, and students almost always eat with friends. Healthy eating and exercise habits were secondary to several other responsibilities. Skills in planning, goal setting, and self-monitoring are necessary to overcome the social and environmental forces contributing to weight gain. These results will be used to develop a social cognitive theory-based intervention to improve health behaviors, and consequently prevent weight gain in young adults attending college. / Master of Science