Obesity is a problem of vast social concern in the United States. One factor that has been linked to reduction in body fat and the health problems associated with obesity is increasing physical activity. Although in-person behavioral interventions have been shown effective at increasing physical activity, attention is now being placed on disseminating these interventions through the use of technology. Several internet-based interventions have been developed and are readily available. The purpose of this study was to evaluate "Fitbit," a web-based behavioral intervention for increasing physical activity and losing weight. Additionally, this study examined if the addition of contact from a behavioral coach through videoconference and email enhanced the effectiveness of this program. Through a multiple-baseline design across seven participants this research project evaluated the effectiveness of the "Fitbit" program with and without a behavioral coach. Step counts were recorded by a Fitbit sensor as a measure of physical activity. The Fitbit program alone increased physical activity for some of the participants, and the addition of the behavioral coach resulted in further increases in mean step counts.

Physical activity is important for children as many children are considered overweight or obese. The benefits of exercise have been demonstrated in empirical studies across all age ranges (Horne, Hardman, Lowe, & Rowlands, 2009; Kelly et al., 2004; Louie & Chan, 2003; Southard & Southard, 2006). In the current study, a multiple baseline design across participants was used to assess the effectiveness of goal setting, reinforcement contingencies, and pedometers that provide feedback to increase step count of 5 participants. During baseline each participant wore a sealed pedometer to assess the average steps the participants took per day. After baseline, each participant, researcher, and parent set a reasonable goal of steps to achieve per day in order to receive a specific reinforcer chosen by the parent and participant. A behavioral contract stated the specific goal number of steps for the day and the specific reinforcer they would receive. At the end of each day before the child went to bed, the parent recorded the number of steps and provided the child with feedback about whether reinforcement was earned. Data collection for four of the five participants showed a mean increase in steps taken per day during intervention 1 in comparison to baseline levels. Participants met their goal step counts during intervention 1 on 12%, 35%, 50%, 71% and 76% of days. All three participants that participated in intervention 2 increased their mean count from both baseline and intervention 1 levels. Participants met their goal step counts during intervention 2 on 62%, 100%, and 100% of days. Two participants participated in the follow up phase of the study; both participants maintained their goals from intervention 2 and completed their goal step count on 100% of days.

Background: Physical activity (PA) is an important component of a healthy pregnancy and has consistently been associated with improved weight management and a reduced risk of pregnancy complications. While the percentage of pregnant women meeting PA guidelines internationally is alarmingly low, no such data exists for the Canadian population. PA in pregnancy may also be a useful intervention for preventing and managing cardiometabolic dysfunction, but research in pregnancy is limited. Objectives: 1) To describe the PA and exercise habits of women in early pregnancy and assess the percentage of women meeting SOGC/CSEP guidelines for exercise in pregnancy; 2) To determine the association of PA with maternal cardiometabolic health in early pregnancy. Study Design: Maternal blood samples, and PA, dietary, and adiposity measures were collected from a subset of women in early pregnancy (12 – 17 wk gestation) upon enrollment in the Be Healthy in Pregnancy RCT. Fasted blood samples were analyzed for glucose, triglycerides, insulin, leptin, adiponectin and C-reactive protein (CRP). Self-reported and objectively measured PA were assessed using the PARmed-X for Pregnancy and an accelerometer. PA was quantified by three parameters: daily step count, energy expenditure (kcal/day) and meeting the SOGC/CSEP recommendations. Results: For the 198 participants of age 31 ± 4 years; BMI 25.4 ± 4.7kg/m2; at 13 ± 2 wk gestation (mean ± SD), 19.2% reported not exercising in early pregnancy. Approximately half of participants met the minimum SOGC/CSEP recommendation (15 min, 3x/wk), but only 14.2% met the preferred SOGC/CSEP recommendation (30 min, 4x/wk). Meeting the preferred recommendation was associated with lower CRP. Daily step count and energy expenditure (kcal/day) were not significantly associated with glucose, triglycerides, insulin, leptin, adiponectin or CRP. Percent body fat and a higher diet quality were associated with some of the cardiometabolic biomarkers. Conclusion: In a healthy pregnant cohort, while the majority had PA below recommendations, measured PA was not associated with most cardiometabolic biomarkers thus cardiometabolic risk in early pregnancy was low. / Thesis / Master of Science (MSc)